The scientific basis behind the idea for anti-drug vaccines and the potential advantages and disadvantages of such vaccines with a discussion the social and ethical implications of this kind of therapy.
Research is being done to develop anti-drug vaccines for the disease of addiction much like that of other pathologies in infectious disease. The same biological mechanisms that produce antibodies that bind to cellular target will do the same for a drug target rendering it inactive or interfering with its ability to enter the brain. The resulting drug reaction would be nullified giving little utility to the offending drug to the user. The “Drug Vaccinated Patients or DVPs” would get no reward or would have a total loss of craving after taking the drug in question. Researchers note that the main challenge to anti-drug vaccines is complex at the immunological level where B lymphocytes, which make antibodies, do not normally detect or respond to the offending drugs. A challenge to say the least, but as the frontier of immunomodulating drug research expands from those already developed, the scientific understanding and ultimate utility will inevitably expand as well. Case in point, as immunopathologist have already developed drugs to fight inflammatory diseases like rheumatoid arthritis (RA), it is only a matter of time before they are able to raise a monoclonal antibody against a foreign compound like alcohol or cocaine. For the purposes of this discussion, I will use cocaine to illustrate the mechanistic approaches to a drug vaccine as well as speak to possible advantages and disadvantages of implementing a drug vaccine.
An example of this methodology is seen with in the chemical make-up of cocaine. Although this approach with cocaine or other stimulants like amphetamine, methamphetamine has not yet been effective work is being done at the cellular level. The most important mechanism of action of cocaine is inhibition of presynaptic dopamine transporters. The goal for treatment might be to prevent cocaine's binding to the transporter without affecting the transporter's normal functioning. A “cocaine vaccine,” which would block cocaine's entry into the brain through immunologic approaches is a complex and challenging. Researchers have tested immunizing with cocaine coupled to a carrier amd it has been possible to generate immunity in animals. When the animals are subsequently challenged with cocaine three positive results have been found. 1- the drug's clearance is increased, 2-its penetration into the brain is decreased, and 3-its behavioral effects are attenuated. Very exciting and promising results in my opinion but currently, despite intense effort, suitable molecules have not yet been developed and validated for mass production and delivery.
Cocaine vaccines are now in clinical development and could prove useful, but there are several potential drawbacks. First, cocaine already has a very short half-life and it is not yet clear whether increased clearance is actually made possible by active immunological processes and whether it would have a functionally meaningful effect in humans. Second, a cocaine vaccine would not be active against other stimulants like methamphetamine. Additionally, the user's preference could rapidly switch to another drug.
The use of a cocaine vaccine also raises important ethical considerations like whether it should be voluntary or involuntary. Notwithstanding, many legal and privacy issues could arise. In one such scenario, the potential loss of privacy by the presence of such antibodies could “mark” a person with addiction in the clinical setting and prejudice or bias could occur. An alternative to these issues might be to have an active vaccine with passive immunity or where a user would be injected at set intervals with anticocaine antibodies that would be cleared by the body's natural defenses. Either way, researchers will find the answers to these neurobiological questions which will one day improve the quality of life in those with addiction.
Using this as just one of many possible examples it is my belief and personal ideology that society is in need of Drug Vaccines. A challenging and daring approach but worth it if one looks at the numbers of cocaine addicts and the damage it causes in society at all levels personal and professional. There is no downside to developing a vaccine for those in need whether it be an at-risk unborn child or developing adolescent. Moreover, an adult in the throes of active addiction or relapse in terminal addiction.
There will be much controversy and debate with this issue but is all in part of the final common goal with the providing a greater good. There a just too many disadvantages for society for not having vaccines. I believe the prevailing theory that most parents allow their new born children to have vaccines against deadly viruses and other infectious diseases so their children will have the highest chances of long-term health and survival. I truly believe the same to be true for the disease of addiction. No parent would wish their child to struggle with addiction and maybe may ultimately die from a disease that one day might be prevented.
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