A vaccine for heroin addiction

Since reading this book, and listening to certain episodes of this podcast, I’ve been thinking about addiction now and then. Today, this came across my desk:

I’ve not read the original article, but it certainly looks interesting.

On the other hand it also brings up several difficult questions. Which, I’m sure, you immediately see.

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16 thoughts on “A vaccine for heroin addiction

  1. Given a vaccine would be sold at markup, it could work. Given it cuts the legs out of the opiod painkiller market, it might be killed.

    But what won’t happen for some years yet, if ever, is the use of weed smoking as a painkiller between asprin and opium.

    What will also not happen for a bit after this vaccine is introduced is the cutting of the opioid epidemic, since the doctors will still be rewarded with proscribing too many opium pain remedies and that reward won’t go away, it anything it will be done worse since there’s a way out of the downside of addiction. And that is another revenue stream. And one that could be continued if you just ramp up the over-prescription of the opium drugs even more.

  2. I find it a little odd that this was published in a chemical society journal. I’m also a little skeptical that it would work in people. There have been clinical trials for vaccines for alcohol, nicotine, cocaine (and meth? My memory may be off here). None of them showed any meaningful usefulness despite working well on animal trials. Similarities between humans and certain lab animals in terms of chemistry and physiology are limited, and that doesn’t begin to address the additional pressures and issues people have regarding addiction.

  3. This reminds me of a product called Anergex that appeared in the ’60’s. It was an extract of poison oak. Given intramuscularly, it suppressed most forms of allergy. I had a monster attack of something and got the shots. Three days later, I was symptom free. It cost like $20 for a vial and required 6-8 shots a year. It was successful. It was cheap. It is gone.

  4. I found a couple of summaries of early studies of anergex. They said the same thing: there was no demonstrable improvement for study participants using it compared to those on a placebo.

    It seems you can still get it — from some shady sources in India, ones specializing in all sorts of worthless remedies.

  5. Amid a surging opiate crisis, the maker of the anti-addiction drug Vivitrol skirted the usual sales channels. It found a captive market for its once-a-month injection in the criminal justice system…

    The judges say they don’t force anyone to take a particular medicine. But in effect, they give addicts a choice: the shot, or jail…

    “In what other medical situation do judges prescribe specific treatments from the bench?” asked Mark Willenbring, an addiction psychiatrist in St. Paul, Minnesota. “If you get in a car crash because you’re diabetic, do they prescribe a specific medication from the bench? This is the only area in medicine or health care where judges think they know more than doctors.” …

    “Nobody was really interested in getting involved in some weird ‘Clockwork Orange’ thing where the government is making you take medication when you’re a criminal. That’s really how it came off to me originally.”

    https://www.propublica.org/article/vivitrol-opiate-crisis-and-criminal-justice

    What really grinds my gears is the attempted schedual oneing for the herb kratom in conjunction with all the get tough on opiods talk. Kratom has traditionally been used to ween off opiods and, indeed, the first banning of it was because it was cutting into the opium tax. Also, there are several promising studies of two alkoloids (Mitragynine and 7-Hydroxymitragynine) of kratom; MGM-9, MGM-15, MGM-16, PZM21. Scheduling halts this research in safer pain relief (there is no respiratory depression — the leading cause of death with an overdose — with kratom.

    “In Thailand, kratom was first scheduled for control in 1943 under the Kratom Act. At the time, the government was levying taxes from users and shops involved in the opium trade. Because of the increasing opium costs, many users were switching to kratom to manage their withdrawal symptoms. However, the launch of the Greater East Asia War in 1942 and declining revenues from the opium trade pushed the Thai government into action to curb and suppress competition in the opium market by making kratom illegal.”

    https://en.wikipedia.org/w/index.php?title=Mitragyna_speciosa&oldid=732653479

    So, here we are again. Only this time, the windfall profits to be protected are the pharma solutions to clean up pharma-induced addiction; Suboxone, buprenorphin, and methadone.

    There have been far too many medicinals blocked and lives irreperably harmed over the immutable wrongness that is cannabis prohibition; So why not do it with kratom to:

    Kratom was banned in Alabama on May 10, 2016. From that month to the next, overdoses on opiates both FDA approved and illicit doubled:

    “Birmingham Fire and Rescue Service responded to 101 overdoses last month alone, said Capt. Bryan Harrell. That was up significantly from 56 in May and 47 in April.”

    http://www.al.com/news/birmingham/index.ssf/2016/07/jeffco_sees_25_heroin_fentanyl.html

  6. Addiction is a mental health issue and this focus on the molecule is misplaced. Screening patients can dramatically reduce addiction risk and the overwhelming majority of people presenting at hospitals for overdose treatment are not chronic pain patients.
    Prohibiting alcohol did nothing to solve the social and psychological conditions that promulgated alcohol abuse. Replace alcohol with any other drug you choose in the sentence.

  7. So kratom was allowed in Thailand (a bastion of science and good research, snark) in the 1940s? Hardly evidence for use as you suggest.

    There is nothing nefarious with the plan to put it through real tests, especially since there is nothing past anecdotes (read, stories and/or rumors) of its efficacy. This notion that “natural” items have been proved to work because they’ve been used for a long time is foolish, and dangerous — as foolish as the “big pharma” conspiracy crap.

  8. Some addiction is mental health issue, but there’s a lot of physical addiction. And Opium is one of those things that comes with real physical addiction.

    Marijuana is almost all mental addiction.

    Tobacco is a physical addiction. It’s nearly as addictive as heroin. The problems much less because smokes are fairly cheap and available just about everywhere.

    And you know what a big reason for alcohol (and other substance) abuse is? Poverty and a crappy job. Escape the shithole your life is in by getting blasted. That and shagging.

  9. JDK, there is no version of modern medical science that says that addiction is a mental health issue to the exclusion of chemistry, or the reverse.

    Opiates are truly physically addictive. How one gets to using an opium derivative (including heroin), how one deals with any ensuing addiction, probably how likely one is to become addicted or the speed of that process, may be related to the psychology or psychiatry of the situation.

    As Wow points out, one can not make a simple sentence then substitute all the different drugs and things and have the sentence remain accurate or true (if it was to begin with).

  10. I would recommend reading Gabor Mate’s book In the Realm of the Hungry Ghosts. In the Viet Nam war, opiate use was rampant in soldiers but most of them (>95%) dropped it on return stateside. How is that possible under the molecule-has-power model?

  11. Dean, those *anecdotes* are gospel amongst the users who did not die because they switched to kratom. Of course, there are no *studies to show*. It is just known like the effects of stab wounds on longevity:

  12. “How is that possible under the molecule-has-power model?”

    Uh, you ever heard of nicotine patches, JDK?

    Tell me what, while I look for that book, you pick up a medical textbook on addiction physiology (pick opium if you like) and ask yourself how all these people who studied this for a century could have got it all wrong. Especially after all those trials and cases.

    Because it’s either that or you have it wrong.

  13. “It is just known like the effects of stab wounds on longevity:”

    I stabbed my finger once. Actually nearly tut the tip of the finger off. I stuck it back on and it reattached but it;s a bit misshapen.

    And I didn’t die.

    Odd that.

  14. It rather boggles the mind to imagine say, Martin Shkreli, cornering the market in both opioids AND a vaccine for same….

    Pretty indicative of Western Culture to look for a short cut cure to what is , IMHO, a deeper angst than either psychology OR chemistry can “fix” [see what I did there?] The present ‘crisis’ re opioids feels a bit like “OMG its white folks dying!” and rather ignores A] the crack epidemic amongst non whites for a few decades there B] the toll that booze takes [ more than all other illicit drugs combined last I looked] and C] we just might be seeing “a whimper, not a bang” response to all those living quiet, desperate lives….

    In my 12 step group I call addiction a “rational response to an irrational universe” So. The past Week: A video of the POTUS from his days in Wrestlemania II. Best Korea pummeling the Pacific Ocean with another missile , the Phillipines enacting a law demanding enthusiastic singing of the national anthem and the NJ gov sitting his Bloaty McBloatface on a deserted beach as their govt shuts down…. ‘splain to me exactly WHY I should quit ingesting insanity producing chemicals?
    [and yeah- I’m 20 yrs clean now . BFD]

  15. So kratom was allowed in Thailand (a bastion of science and good research, snark) in the 1940s?

    Dean, I think you misread. Kratom was banned in the ’40s because it was cutting into the opium tax.

    *danderous*?? It does not depress breathing like any other opiate/opiod. Dangerous? How? Can one overdose on it? I’ve heard tell that nausea kicks in way before any toxic dose is attained. I was trying to point out that scheduling the herb would halt research around it to provide a safer pain killer.

    I guess you think *cannabis* is dangerous also.

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