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posted by takyon on Wednesday June 28 2017, @04:03PM   Printer-friendly
from the permanent-fix dept.

Dr. Lowe, from In The Pipeline, writes about the development of a vaccine for heroin:

At first thought, that might seem like a weird idea. Drugs of abuse, such as heroin, cocaine, methamphetamine et al. are small molecules, and as such are too small to set off immune responses on their own. But a strategy could be to attach them to some larger protein that can raise antibodies – if those antibodies recognize the drug-labeled part of the protein conjugate, they may well retain activity against the drug molecule in its free state.

[...] It's been a long road. The first morphine immunoconjugate was described in 1970, and a morphine vaccine was tested in rabbits in 1975. But very little progress in the field occurred over the next twenty years or so, partly because methadone treatment for heroin addiction had become widely used. It's interesting to note, though, that vaccine development work against amphetamine seems to have followed a roughly similar path

[...] It would seem that we really are getting close to human clinical trials for some of these, which will be quite interesting. A drug-abuse vaccine is not going to be magic, though. Because of the specificity of the immune response, someone who's been vaccinated against heroin would almost certainly still respond to morphine, and most definitely would to compounds like fentanyl or oxycodone [...] But vaccines could, at the same time, provide the extra help needed for people to finally break free of a particular drug, and addicts who are really trying to quit need all the help that they can get.

I'd say that last part is the key. One of the big issues in drug addiction is (in the end) a philosophical argument about free will (which would explain why it never gets resolved!) Is drug addiction a disease, a choice, a behavior, a biochemical problem. . .the arguments go on forever, complicated by the way that different people attach different meanings to those terms.

http://blogs.sciencemag.org/pipeline/archives/2017/06/26/a-heroin-vaccine
http://pubs.acs.org/doi/abs/10.1021/jacs.7b03334


Original Submission

Related Stories

Chicago Jail Handing Out Naloxone to Inmates Upon Release 41 comments

The Cook County Jail in Chicago, IL has trained hundreds of inmates on how to use the opioid overdose-reversing drug naloxone, and has given doses out to inmates upon release:

Cook County now gives at-risk inmates the overdose-reversing drug naloxone upon their release from jail and Los Angeles is poised to follow suit, putting the antidote in as many hands as possible as part of a multifaceted approach to combatting the nation's opioid epidemic.

Cook County Jail, the largest single-site jail in the country, has trained about 900 inmates how to use naloxone nasal spray devices since last summer and has distributed 400 of them to at-risk men and women as they got out. The devices can undo the effects of an opiate overdose almost immediately and are identical to those used by officers in many of the country's law enforcement agencies.

[...] It is too soon to gauge the effectiveness of Cook County's program, but Dart said anecdotal evidence suggests that the kits have saved lives, including a man who was arrested again, returned to jail, and told of how a friend he had trained to use the kit had done so when he overdosed. In New York City, more than 4,000 kits have been distributed to friends and relatives of inmates at the city's jail at Rikers Island since the program there was launched in 2014.

Related: Kroger Supermarkets to Carry Naloxone Without a Prescription
Obama Administration Expands Access to Suboxone Treatment
One Upside to Opioid Overdoses: More Organ Donors
Development of a Heroin Vaccine


Original Submission

Opioid Crisis Official; Insys Therapeutics Billionaire Founder Charged; Walgreens Stocks Narcan 98 comments

"The best way to prevent drug addiction and overdose is to prevent people from abusing drugs in the first place. If they don't start, they won't have a problem." – President Donald J. Trump

President Trump has declared the "Opioid Crisis" a nationwide public health emergency. This action will allow for "expanded access to telemedicine services" to remotely prescribe medicines for substance abuse, allow the Department of Health and Human Services to "more quickly make temporary appointments of specialists with the tools and talent needed to respond effectively to our Nation's ongoing public health emergency", allow the Department of Labor to issue dislocated worker grants for those "displaced from the workforce" due to the Opioid Crisis, and will help people with HIV/AIDS to receive substance abuse treatment. The press release lists several actions that the Trump Administration has taken to respond to the Opioid Crisis, including the July 2017 law enforcement action against AlphaBay.

The declaration has been criticized for not requesting any funds to respond to the Crisis. The "nationwide public health emergency" declaration is also distinct from a promised "national emergency declaration", which would have freed up money from the Disaster Relief Fund to be spent on the Crisis. 14 Senate Democrats have introduced a bill that would authorize $45 billion to address the Opioid Crisis. The Obama Administration called on Congress last year to pass just over $1 billion in funding for opioid treatment programs nationwide. This funding was included in the 21st Century Cures Act.

The Department of Justice has arrested and charged the founder and majority owner of Insys Therapeutics Inc., John Kapoor, along with other executives from his company. Kapoor is accused with leading a nationwide conspiracy to bribe doctors and illegally distribute the company's fentanyl spray, intended for cancer patients, so that it could be prescribed for non-cancer patients. Kapoor stepped down as CEO of Insys in January. Acting U.S. Attorney William D. Weinreb said, "Mr. Kapoor and his company stand accused of bribing doctors to overprescribe a potent opioid and committing fraud on insurance companies solely for profit. Today's arrest and charges reflect our ongoing efforts to attack the opioid crisis from all angles. We must hold the industry and its leadership accountable - just as we would the cartels or a street-level drug dealer." Six former Insys executives and managers were charged in December.

[takyon: a262 would like you to know that Insys Therapeutics donated $500,000 to help defeat Arizona's 2016 ballot initiative that would have legalized recreational use of cannabis.]

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  • (Score: 0) by Anonymous Coward on Wednesday June 28 2017, @04:07PM (4 children)

    by Anonymous Coward on Wednesday June 28 2017, @04:07PM (#532507)

    Just legalize cannabis and let the free market take care of it. Simple, easy, and effective.

    Yeah, yeah, you'll have to forego the billion dollar contracts with the criminal injustice system to sell millions of batches of this "vaccine" made at great profit to a number of stakeholders, even though as TFS points out it won't be effective against many opioids, while putting the victim of the addiction, caused by doctors selling highly addictive pain pills, on the line for funding the whole shebang, at least until he's bankrupt and back in jail because he can't pay the late fee on the late fee on the vaccine fee that was mandated by the court.

    • (Score: -1, Troll) by Anonymous Coward on Wednesday June 28 2017, @08:18PM (1 child)

      by Anonymous Coward on Wednesday June 28 2017, @08:18PM (#532609)

      The levels of stupid in your post. Legalizing a way for stupid people to get dumber is definitely not what I would want. Most of addicts are already marginal use to society. How they got that way was not my doing and should not be my fucking problem, yet that's where my tax money goes. If there were no drugs and any other vices, maybe these ass-hats could find something productive to do with their time. Too bad the supply of people with low morals doesn't perfectly overlap supply of idiots, because all it takes is one smart scumbag to come up with the next vice.

      Stupidity vaccine would be one thing I can get behind.

      • (Score: 1, Interesting) by Anonymous Coward on Thursday June 29 2017, @07:12AM

        by Anonymous Coward on Thursday June 29 2017, @07:12AM (#532851)

        By the time its gone this far, I know this sounds terribly inhumane, but the individual wants his fix so bad he is in pure misery.

        Let him have all he wants. The stuff is cheap enough to make. I hate to have this guy making everyone else's life miserable by being forced to rob and pillage everyone else's stuff to pay for a whole army of warlord-type drug dealers in his supply chain.

        Yes, it will drastically cut his life-span. But the shorter life lived will be a happier one for everyone involved.

        Funding a chain of drug-lords will not happen.... they will have to find something else to do if heroin is as cheap as salt. And no-one gives a damn if he has all he wants.

        If the addict wants to knock himself out overdosing - its his right to do so. He does not have the right to involve me in it though. I find it much less burdensome to provide him directly with a cheap legal fix than to be burdened with supporting many opposing factions fighting to both supply and keep him from getting the supply of that which he craves so much.

        He does not live my lifestyle, but I do not want to deny him his. All I ask is keep ME out of it. My life is mine. His life is his. Don't tax the hell out of me to fund enforcement against someone else mandating his obedience to things that concern no one else but him. If he wants to knock himself off, who am I to sentence him to a life of hell wanting something he is not allowed to have? If someone wants to live, the old, the sick, the handicapped, whatever, I am all for helping them, but if someone wants to burn a bright short life and go like a flash of gunpowder, I also support that. Trying to fight this just drains our resources and prolongs misery.

        We are NOT an endangered species, and I, for one, would like to see the tendency to use drugs eliminated from our gene pool.

        ( Submitted AC for obvious reasons. )

    • (Score: 0) by Anonymous Coward on Wednesday June 28 2017, @08:33PM (1 child)

      by Anonymous Coward on Wednesday June 28 2017, @08:33PM (#532620)

      Not just cannabis, everything. The most harmful aspect of drugs is the black market. It leads to more violence, higher costs, and this more crime. Putting people in jail prevents them from adding to the labor market, etc.

      Legalize all the things, use taxes to help deal with remaining problems.

      • (Score: 2) by JoeMerchant on Wednesday June 28 2017, @09:39PM

        by JoeMerchant (3937) on Wednesday June 28 2017, @09:39PM (#532655)

        But, but, but... if it's illegal, if it's banned, then there would be no reason to have any problems with it, it just goes away. Like teen pregnancy, and STDs, and every crime on the books.

        Yeah, seriously, any "banned" substance should be legalized, regulated, taxed, and studied to determine what programs need to be put in place to fix any social problems that result from access to the substance. The taxes can't be so high that they make black market smuggling profitable (after accounting for risks of death, imprisonment, etc. for smuggling.) But, in a world where we can charge $671 for a pair of epi-pens... it would seem like the "really bad" drugs could be taxed into a price bracket that would effectively keep them off the streets.

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  • (Score: 1, Interesting) by Anonymous Coward on Wednesday June 28 2017, @04:28PM (2 children)

    by Anonymous Coward on Wednesday June 28 2017, @04:28PM (#532514)

    Or you could stop waging pointless wars around the globe and putting Our Troops into dangerous situations where they get badly wounded enough to need morphine to deal with the pain. Give peace a change.

    • (Score: 0) by Anonymous Coward on Wednesday June 28 2017, @04:38PM

      by Anonymous Coward on Wednesday June 28 2017, @04:38PM (#532515)

      They've been changing peace for thousands of years, why stop now ;)

    • (Score: 2) by JoeMerchant on Wednesday June 28 2017, @09:58PM

      by JoeMerchant (3937) on Wednesday June 28 2017, @09:58PM (#532660)

      Morphine is widely used in civilian hospitals for things that have nothing to do with traumatic injuries (unless you count surgery as a traumatic injury...)

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  • (Score: 5, Interesting) by VLM on Wednesday June 28 2017, @04:46PM

    by VLM (445) on Wednesday June 28 2017, @04:46PM (#532518)

    How does this work when you need legit surgery or have a legit orthopedic failure? My guess is rather poorly.

    You know for a fact this will start being injected voluntarily into addicts with a history of relapse and will end with it being mandatory for all participants in high school sports, everyone who puts up with a pee test for a job (aka virtually everyone), anyone who wants to attend uni, etc. And probably 5 years later they'll learn it gives fatal ass cancer to everyone who takes it.

  • (Score: 0) by Anonymous Coward on Wednesday June 28 2017, @04:59PM (9 children)

    by Anonymous Coward on Wednesday June 28 2017, @04:59PM (#532523)

    someone who's been vaccinated against heroin would almost certainly still respond to morphine, and most definitely would to compounds like fentanyl or oxycodone

    Suppose we had a vaccine which makes our immune system annihilate heroin upon entry. Effect could be, with mass vaccination of the vulnerable social groups and children, eradication of heroin abuse, and hence production of it.
    Don't you think that illegal industry wouldn't just employ chemists to invent another opioid derivative of opium, and then continue business as usual?

    I am not any kind of expert in medicine, psychiatry, pharmacology, or helping, so take the following for random ramblings:

    Treatment of drug addiction needs to check two crucial key points: withdrawal effects and dopamine deficiency, and euphoric effects of the drug. Perhaps drug addiction is just a very hard, chemically induced, case of bipolar disorder. Perhaps it could be as well treated as one.

    • (Score: 2) by takyon on Wednesday June 28 2017, @06:02PM

      by takyon (881) <reversethis-{gro ... s} {ta} {noykat}> on Wednesday June 28 2017, @06:02PM (#532545) Journal

      Don't you think that illegal industry wouldn't just employ chemists to invent another opioid derivative of opium, and then continue business as usual?

      Yes, according to the summary:

      Because of the specificity of the immune response, someone who's been vaccinated against heroin would almost certainly still respond to morphine, and most definitely would to compounds like fentanyl or oxycodone

      This is just speculation, but maybe a "vaccine" could be made for an entire class of drugs, such as opioids. In which case substituting one molecule for a very similar one wouldn't cut it. Since the person addicted to heroin wants the effects of heroin, maybe they would not seek out something dissimilar, like barbiturates or ketamine or whatever.

      Even more speculation: how about "molecular cages" that float around in your body, and release Narcan when opioids are present.

      I didn't know this bit of info [wikipedia.org]:

      Opiate is a term classically used in pharmacology to mean a drug derived from opium. Opioid, a more modern term, is used to designate all substances, both natural and synthetic, that bind to opioid receptors (including antagonists).

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    • (Score: 0) by Anonymous Coward on Wednesday June 28 2017, @06:08PM (6 children)

      by Anonymous Coward on Wednesday June 28 2017, @06:08PM (#532548)

      Prevention.

      The vaccine would induce antibody production, which would prevent heroin from being processed into its active form; thereby, increasing the threshold level of heroin required to reach a "high". The antibodies may or may not have sustained production without further "boosting".

      This is not meant to treat addiction, but it could be used to prevent relapse.

      • (Score: 2) by bob_super on Wednesday June 28 2017, @06:24PM (3 children)

        by bob_super (1357) on Wednesday June 28 2017, @06:24PM (#532558)

        I haven't found the answer to my question: does it prevent withdrawal symptoms?
        From the description, it doesn't look like it. So the addicts will just go looking for another high which still works. Recent market offerings (listed as not affected by the "vaccine") are more dangerous.

        I'm failing to see the positive side.

        • (Score: 0) by Anonymous Coward on Wednesday June 28 2017, @06:50PM (2 children)

          by Anonymous Coward on Wednesday June 28 2017, @06:50PM (#532574)

          No, it would only prevent heroin from being converted into its active form.

          The vaccine could be used to help willing patients break their addition. This specific vaccine is not meant to be a perfect solution for drug abuse, so it failing to meet that standard would not mean that there are no positive sides to its use.

          • (Score: 2) by bob_super on Wednesday June 28 2017, @06:58PM (1 child)

            by bob_super (1357) on Wednesday June 28 2017, @06:58PM (#532577)

            Genuine question: What's the worst part of breaking the addiction? Wanting the highs, or living with the withdrawal?

            • (Score: 0) by Anonymous Coward on Wednesday June 28 2017, @07:18PM

              by Anonymous Coward on Wednesday June 28 2017, @07:18PM (#532582)

              Withdrawal is usually temporary, while the desire to get high and the addiction to the drug lasts much longer. People can get past withdrawal, but many often fail to remain "clean" despite wanting to break the addiction.

      • (Score: 0) by Anonymous Coward on Wednesday June 28 2017, @08:21PM (1 child)

        by Anonymous Coward on Wednesday June 28 2017, @08:21PM (#532613)

        Yeah but it sounds like the person would just try to take much more, leading to overdose. Not saying that's not a good outcome, for us, but probably shitty outcome for the druggie.

        >In before "He wuz a gud boi"

        • (Score: 0) by Anonymous Coward on Wednesday June 28 2017, @08:36PM

          by Anonymous Coward on Wednesday June 28 2017, @08:36PM (#532623)

          the person would just try to take much more, leading to overdose

          Possibly.
          It would depend on how much the threshold is increased. If the person has to increase the dose 10-fold, then they may not have a reasonable opportunity to get access to that much heroin.

    • (Score: 2) by JoeMerchant on Thursday June 29 2017, @12:06AM

      by JoeMerchant (3937) on Thursday June 29 2017, @12:06AM (#532702)

      Sounds like a big business opportunity... hence: probable.

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  • (Score: 3, Informative) by butthurt on Wednesday June 28 2017, @05:09PM (3 children)

    by butthurt (6141) on Wednesday June 28 2017, @05:09PM (#532524) Journal

    There's an effective antidote for heroin, which is off-patent but is subject to the Epipen effect in the U.S.:

    Naloxone, sold under the brandname Narcan among others, is a medication used to block the effects of opioids, especially in overdose. [...] Naloxone was patented in 1961 and approved for opioid overdose by the Food and Drug Administration in 1971. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. Naloxone is available as a generic medication. Its wholesale price in the developing world is between US$0.50 and 5.30 per dose. The vials of medication are not very expensive (less than 25 USD) in the United States. The price for a package of two auto-injectors in the US, however, has increased from $690 in 2014 to $4,500 in 2016.

    -- https://en.wikipedia.org/wiki/Naloxone [wikipedia.org]

    The Philadelphia Inquirer ran an editorial (semi-paywalled) advocating its use:
    http://www.philly.com/philly/opinion/20170102_Commentary__More_Narcan_in_cops__hands_will_prevent_OD_deaths.html [philly.com]

    and a series of articles about its use in Philadelphia:

    http://www.philly.com/philly/columnists/mike_newall/HEROIN-NEEDLE-PARK-OVERDOSE-LIBRARIANS-NEWALL.html [philly.com]

    • (Score: 2) by takyon on Wednesday June 28 2017, @05:53PM (2 children)

      by takyon (881) <reversethis-{gro ... s} {ta} {noykat}> on Wednesday June 28 2017, @05:53PM (#532541) Journal

      If I'm reading this right, the vaccine would prevent heroin from affecting and/or killing you. It's the first responders or people/family on the scene that are administering Narcan, not the person who has had their mind blown. It can also take multiple doses of Narcan to bring the person out of the danger zone, which could be a problem (if you don't have enough or fail to administer the right doses at the right times).

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      • (Score: 1, Interesting) by Anonymous Coward on Wednesday June 28 2017, @06:22PM (1 child)

        by Anonymous Coward on Wednesday June 28 2017, @06:22PM (#532556)

        I know an EMT. She says they won't administer narcan unless the cops are there to hold the addict down. The first thing the addict does after the shot is get so mad at the EMT for taking away their high that they generally attack them.

  • (Score: 0) by Anonymous Coward on Wednesday June 28 2017, @07:34PM (2 children)

    by Anonymous Coward on Wednesday June 28 2017, @07:34PM (#532591)

    Maybe instead invest in curing the social and mental problems that lead to addictions.

    • (Score: 0) by Anonymous Coward on Wednesday June 28 2017, @07:45PM

      by Anonymous Coward on Wednesday June 28 2017, @07:45PM (#532598)

      Good idea, but it would probably be best to approach the problem from multiple angles.

    • (Score: 2) by t-3 on Wednesday June 28 2017, @08:17PM

      by t-3 (4907) on Wednesday June 28 2017, @08:17PM (#532608) Journal

      Agreed, treating the vast majority of addiction cases as diseases rather than as a symptom of various societal ills is just as misguided as the approach the legal system takes. Address the social and economic forces that trap people in drug lifestyles, reform the legal system that brands offenders as unemployable, and you might be getting somewhere. Of course, the social/economic side is nearly impossible to address in a predominantly capitalist system so I see the problem continuing for quite a while.

  • (Score: 2) by butthurt on Wednesday June 28 2017, @07:52PM

    by butthurt (6141) on Wednesday June 28 2017, @07:52PM (#532600) Journal

    In case I'm not the only one who had trouble opening the abstract:

    https://www.webcitation.org/6rZ5Mo0BW [webcitation.org]

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