Vaccines against drugs of abuse: a viable treatment option?
Kantak KM.
Laboratory of Behavioral Neuroscience, Department of Psychology, Boston
University, Boston, Massachusetts, USA.
Drug addiction is a chronically relapsing brain disorder. There is an urgent
need for new treatment options for this disease because the relapse rate among
drug abusers seeking treatment is quite high. During the past decade, many
groups have explored the feasibility of using vaccines directed against drugs
of abuse as a means of eliminating illicit drug use as well as drug overdose
and neurotoxicity. Vaccines work by inducing drug-specific antibodies in the
bloodstream that bind to the drug of abuse and prevent its entry into the
brain. The majority of work in this area has been conducted with vaccines and
antibodies directed against cocaine and nicotine. On the basis of preclinical
work, vaccines for cocaine and nicotine are now in clinical trials because
they can offer long-term protection with minimal treatment compliance. In
addition, vaccines and antibodies for phencyclidine, methamphetamine and
heroin abuse are currently under development. An underlying theme in this
research is the need for high concentrations of circulating drug-specific
antibodies to reduce drug-seeking and drug-taking behaviour when the drug is
repeatedly available, especially in high doses. Although vaccines against
drugs of abuse may become a viable treatment option, there are several
drawbacks that need to be considered. These include: a lack of protection
against a structurally dissimilar drug that produces the same effects as the
drug of choice;a lack of an effect on drug craving that predisposes an addict
to relapse; andtremendous individual variability in antibody formation. Forced
or coerced vaccination is not likely to work from a scientific perspective,
and also carries serious legal and ethical concerns. All things considered,
vaccination against a drug of abuse is likely to work best with individuals
who are highly motivated to quit using drugs altogether and as part of a
comprehensive treatment programme. As such, the medical treatment of drug
abuse will not be radically different from treatment of other chronic
diseases.
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OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR
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