Until recently, attempts to treat addiction with drugs have proven ineffective at best, crude at worst. Methadone is mellower than heroin, but users often trade one addiction for another. The drug Anabuse keeps alcoholics in line by triggering nausea when they drink. And users have yet to report dramatic results from drugs that promise to temper cravings for cigarettes.
But the pharmaceutical industry is closing in on a new approach that, in effect, takes the fun out of using so-called recreational drugs. At least five drug companies and several university scientists are testing ‘vaccines’ for cocaine, phencyclidine (PCP), meth-amphetamine, and nicotine, according to Philip Cohen, writing in New Scientist (June 10, 2000.) Like standard vaccines, these drugs program the body to produce immune-system proteins called antibodies. But instead of fighting off disease, these antibodies chemically disarm specific drugs in the bloodstream. Some keep the naughty drugs from reaching the brain, while others break them up into nonintoxicating chemical bits.
On an individual level, these new drugs offer hope to people who are struggling to quit smoking or snorting. But as potential new weapons in the war against drugs, Cohen argues, the vaccines come with a load of ethical questions. ‘Should people be vaccinated simply because they belong to a group thought to be particularly at risk of becoming addicted?’ he writes. ‘Should parents be allowed to make that decision for their children? Might companies screen job applicants for traces of anti-drug antibodies, in the belief that this would finger former users?’
When the scientist Barbara Fox first asked the National Institute on Drug Abuse (NIDA) for money to research a cocaine vaccine, the agency turned her down flat. Reviewers at NIDA, a division of the federal government’s National Institutes of Health, expressed nervousness about the ethical implication of the drugs. But three years later, in 1997, the agency had warmed to the idea. Fox, who is now with a Boston area pharmaceutical company called Addiction Therapies Inc., won a $700,000 NIDA award to test her approach.
Fox and other researchers have already had some success with animal studies. Rats and monkeys with intravenous access to cocaine partied away until they got the vaccine and then seemed to lose their enthusiasm for cocaine. In human tests, one of the vaccines has passed its first hurdle, Cohen notes. A group of recovering cocaine addicts who took the vaccine reported no serious side effects, and antibodies could be detected in some of them a year later.
Researchers working on this latest generation of vaccines seem to have worked out some of the bugs that plagued earlier approaches to anti-drug medications, Cohen writes. ‘Antibodies don’t mess with the brain chemistry . . . so there should be fewer side effects,’ he wrote. ‘And antibodies are expected to be long-lived–from weeks to years–compared with a single day for a dose [of blocking drugs like] naltrexone.’
Of course, every addict knows that all drugs come with a price. For example, writes Carla Spartos in The Village Voice (July 21, 2000), vaccines often last forever. ‘There’s no turning back,’ Spartos argues. ‘And if the choice of a child [is] in the hands of a parent, or that of a prisoner in the hands of the government, then involuntary vaccinations become the result.’
She also points out some other shortfalls: If you take enough of a drug, you can overpower the antibodies. Or you can switch poisons, which is one reason drug counselor Peter Kerr thinks it is unlikely that the vaccines will completely replace other treatments. ‘We’re not going to run out of new and inventive things that are going to make people high, but that doesn’t mean the vaccine won’t help some people,’ Kerr says.
Just who those people might be is another issue. Selective use of the vaccine raises one set of issues; universal inoculations raise another. ‘There would be pressure to get an anti-drug vaccine, especially when it comes to insurance companies (who might offer special premiums to the vaccinated) or employers (who in the age of mandatory drug testing have obvious motives),’ Spartos writes. ‘Though mass forced vaccinations may be unlikely, a scenario in which individuals feel pressure to get the vaccine is no less chilling in its implications.’
There are no drug vaccines on the market yet, and there may never be. The leap from lab animals to humans is a big one, and many drugs don’t make it. Still, as Frank Vocci, NIDA’s director of drug dependence research, tells New Scientist, the debate over the legal and ethical issues has already begun. ‘I don’t think it’s too early to start thinking about these things.
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