As you might imagine, some recovering addicts and alcoholics take issue with the belief that addiction is incurable. Many prefer to think of themselves as fully recovered. Even the Big Book uses this word on its title page. Nevertheless, many of those same individuals who see themselves as cured often find themselves dealing with relapse further down the line. This does not invalidate their beliefs, but it certainly doesn’t do much to alleviate the controversy. Nonetheless, wouldn’t it be great if we could put some sort of final hush on the debate? If we could just take an addiction vaccine and call the whole thing a done deal?
Unfortunately, no such vaccine yet exists, although many still wish to believe in it. A great number of us, upon first entering treatment, felt betrayed when we discovered that sobriety would require lifelong practice. That’s because, quite frankly, many enter treatment expecting to learn how to control their substance use. Abstinence wasn’t on the table for most of us at all. We thought that treatment and therapy would somehow lobotomize the mental obsession, anesthetize the physical cravings, and allow us to drink like normal people.
It took a lot of soul searching to accept that we could never use safely again. For some, the extent of our affliction necessitated anti-craving medications. Still others found ourselves “white-knuckling” our way through the first few weeks until the cravings naturally diminished and only the obsession required maintenance. And even upon reaching this point, some of us continued to resist treatment. We still longed for that addiction vaccine, that antidote that would make recovery a million times easier.
Then, in early August, Health and Human Services Secretary Tom Price told the press:
“One of the things they’re actually working on is a vaccine for addiction, which is an incredibly exciting prospect.”
An exciting prospect indeed. Naturally, however, many met the idea of a real addiction vaccine with skepticism. We don’t just mean the press, either. According to many experts in drug abuse and medical science, a lot would go into making an addiction vaccine feasible. And in the end, we might have no guarantee that it would actually yield the desired results.
How Vaccinating Addiction Would Work
First of all, we should note that despite making headlines, Price’s assertion didn’t actually reveal anything new. Various forms of an addiction vaccine have been in the works for many years. Close to twenty years, in fact. Health researchers currently seek methods of vaccinating addiction to a number of substances, ranging from common chemicals such as nicotine to more illicit fare such as heroin and cocaine.
After Price made his declaration, NPR spoke to Dr. Ivan Montoya, who currently works for the National Institute on Drug Abuse under the Therapeutics and Medical Consequences division. As acting director of his division, Montoya knows quite a bit about the ongoing search for an addiction vaccine. He told NPR that it would work similarly to medical cures for other diseases.
“Like any other vaccine, you inject the vaccine and you use your immune system to produce antibodies. In this case, the antibodies are against the drugs of abuse.”
Breaking this down further, an addiction vaccine aimed at heroin would seek to create antibodies that keep the drug from affecting the brain’s reward centers. Since the brain produces its own natural painkillers, the addiction vaccine would need to work without inadvertently blocking these as well.
Easier said than done, but at least researchers can identify a relatively firm goal. Unfortunately, the brain’s endogenous opioids only mark one obstacle standing between us and an addiction vaccine. Numerous other roadblocks may stand in the way, some more difficult to overcome than others.
Why the Vaccine Might Not Happen
The addiction vaccine sounds like a great idea, but with a few notable caveats. First of all, doctors would not vaccinate addiction in the same sense that they vaccinate polio and other preventable diseases. When we think of a vaccine, we think of a single shot followed by a lifetime of immunity. Even when shots require upkeep, we only require boosters every so often. In the case of the addiction vaccine, we could expect to receive additional shots a few times per year.
While this may not sound too bad, the underlying implication is that those who would benefit most from an addiction vaccine are those who are willing to continue receiving regular shots. In other words, it only works on those who maintain dedication to their recovery. If a person wishes to continue using, they can easily just stop showing up for their boosters.
Furthermore, current research on various forms of the addiction vaccine do not hint toward the possibility of a true panacea. Rather than a cure-all, the addiction vaccine would only focus on specific drugs. A person may not be able to get high by using heroin, but they can still seek chemical escape elsewhere. This would include substances such as fentanyl and carfentanil, which yield greater potency and risk of death.
These issues focus on the merits of the vaccine, but cost may prevent us from even getting that far. According to NPR:
“Human trials will cost tens of millions of dollars. The NIH generally doesn’t fund that kind of study and hasn’t made an exception for the opioid crisis.”
Professor Kim Janda of the Scripps Research Institute does hope to overcome these roadblocks. Not only does he wish to create an addiction vaccine that blocks the effects of both heroin and fentanyl, but he plans to seek funding from a pharmaceutical company if he cannot acquire the necessary subsidies from the NIH. Even then, however, he expects it to take time. Human trials wouldn’t begin for a year and a half after he acquires backing, and the testing period will need to last a while in order to ensure that his addiction vaccine works.
He also does not believe that an addiction vaccine would replace current forms of treatment, but rather act as a mere supplement. From a business standpoint, this makes it slightly less marketable to the pharmaceutical companies—which in turn could hurt his search for funding.
An Addiction Vaccine is Still Possible
Despite the roadblocks, we may still see some form of an addiction vaccine a few years down the road. Although the effects described mimic those of currently existing drugs such as Vivitrol, the promise of blocking opioid effects without inhibiting natural endorphins will appeal to many. And as the opioid crisis continues largely unabated, there exists a great desire in this nation to add more tools to our fight against substance abuse.
Additionally, Trump’s recent promise to declare the opioid crisis a state of emergency will free up funding. Researchers such as Janda will not have to jump through as many hoops to raise the necessary capital for their trials. Once Trump files the paperwork on the SOE, we may see more experts such as Janda attempting similar vaccines. More teams working on this type of treatment just may serve to raise the chances that one of them could achieve success.
Most importantly, these scientists appear dedicated to their work. Janda is far from the only one attempting an addiction vaccine that attempts to block opioids on a broader spectrum. While all researchers currently searching for a cure will inevitably face the same obstacles, they haven’t strayed from the course just yet. Perhaps human trials are still a long way off, but research on rodents, monkeys and even fish continues. By the time they acquire necessary funding for human testing, these researchers will have made great progress in fine-tuning their approach to fighting the drug menace.
Current Alternatives to Vaccination
As of now, there exists no cure for addiction. And as noted above, even the so-called addiction vaccine may not prevent addicts from using. Fortunately, we still have many tools at our disposal. For instance, those who require extra effort may seek anti-craving medications to quell their urges to use. There exists a difference between physical craving and simple desire, so these medications do not constitute a full-proof solution. But they do help many people.
Traditional methods also continue to yield results for many. The spiritual remedy outlined by 12-step programs such as AA and NA helps thousands upon thousands of people every day. All over the world, people overcome addiction on a day-by-day basis by working on the internal symptoms of their malady. By building a support network, taking responsibility for the past and performing service work to instill more purpose in their present lives, these individuals learn to live in contentment without turning to drugs and alcohol for escape.
Other initiatives prove beneficial as well. For instance, some prisons now house entire wings dedicated to the treatment of incarcerated addicts and alcoholics. The propagation of such programs throughout the nation could reduce recidivism rates, improving addicts’ chances of staying out of the system upon release.
We also see great success from take-back initiatives. According to The Recorder, the daily newspaper for Greenfield, Massachusetts:
“In six years, the Northwestern District Attorney’s Office has collected more than 32,000 pounds, or 16 tons, of unwanted or out-of-date drugs through 25 secure medication-return boxes located at police stations.”
This year so far, their DA’s program director of drug diversion and treatment reported 3,900 pounds of drugs emptied from drop boxes in just two counties alone. Given the success of this program, started for the express purpose of keeping drugs out of addicted hands, one can only wonder at the success we’d achieve by installing such drop boxes nationwide. Similar programs such as Operation HOPE in Scarborough, Maine, allow addicts to hand over unwanted drugs in return for amnesty and access to treatment.
With no addiction vaccine in clear sight, these initiatives remain vital. We unfortunately may never see a true cure for alcoholism and addiction. In the meantime, those who struggle can still seek treatment. For more information on addiction treatment and recovery, contact us today. As this disease continues to take more lives every day, time is simply too precious to wait for a cure.