Cocaine Vaccine? Shots Offer Cure for Shooting Up

A drug abuse scenario from the future: after inhaling crack from a smokeless carbon-neutral pipe, our hero finds himself naked in public ranting that he invented the Internet. Whisked away in a flying police car, he’s taken before a judge who notes multiple convictions for drug-related thefts and failed drug rehabilitation. Our hero is dragged to the Vaccine Clinic, where he is injected against his will and set loose, never to offend again.

Some of this could soon come true, and unfortunately, it’s not the flying cars. Researchers just published a study of a new anti-cocaine vaccine, which shows promise that future addicts might be immunized against drugs of abuse.

The researchers gave about 50 cocaine abusers a vaccine against the drug. About half had a strong immune response, while the remainder only responded weakly to the vaccine. Those with a strong immune response continued to use cocaine, but at a decreased rate when compared to the weak responders and the placebo group. Certainly this initial version of the vaccine is no cure for cocaine addiction, but the study is proof of concept that a vaccine can limit drug abuse.

The vaccine itself is a molecule of a cocaine derivative, called succinylnorcocaine, linked to a piece of the bacteria that causes cholera. The patient’s immune system recognizes the cholera component, and develops antibodies to the cocaine-cholera complex. The next time the patient uses cocaine, the antibodies recognize the cocaine and neutralize it. No drug reaches the brain, and the user doesn’t get high.

The concept behind the anti-cocaine vaccine can be applied to other drugs of abuse such as nicotine, meth and heroin. However, such vaccines will not work against alcohol, which is too simple a molecule. NicVAX, an investigational anti-nicotine vaccine, shows some promise in reducing smoking rates. While the anti-nicotine and anti-cocaine vaccines are exciting advances, no anti-drug vaccine will be ready for several years. Still, it is realistic to expect that vaccines will be a legitimate future treatment option for drug abuse, likely in combination with behavioral counseling.

What will happen once we do have effective vaccines against drugs of abuse? The implications are fascinating. People convicted of drug-related crimes might be ordered to go to vaccine clinics instead of prison. Parents of teenagers abusing drugs might force their children to get the vaccine. Health care agencies, recognizing that drug abuse burdens society as much as measles, mumps, and rubella, might recommend that you take your two-year old to get an anti-cocaine shot along with those routine immunizations. Universities seeking to curb recreational drug use might require the vaccine for incoming freshmen. Insurance companies could lower premiums for those who receive the vaccine. The airline industry or health care industry, recognizing the potential dramatic impact of a coke-snorting pilot or physician, might mandate that their employees get vaccinated.

Once an effective vaccine against drug abuse is here, who should and should not be required to get it? Share your thoughts below.

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