You’ve seen the data. You’ve read the reports. And you know where we stand. Over 100,000 Americans dead of drug overdoses in a single 12 month period. People are shocked. Quite shocked. And a lot of them are willing to lend their arms to the effort. Could a fentanyl vaccine be the jab we need to win the war?
That’s a question folks like Scripps Research problem-solver Dr. Kim Janda are seeking to answer. And that’s an idea forward-thinkers such as Baylor College of Medicine’s Dr. Thomas R. Kosten seem fully inclined to advocate. Both esteemed professionals are determined to help solve one of the most pressing problems of our time. Neither is afraid to go to the great lengths it might take to do so either. In fact, they pretty much insist upon it.
But would there be great risk in having a fentanyl vaccine? Yes, opioid addiction is something we wish to completely eradicate, just like we eradicated smallpox. Addiction isn’t a virus though. Neither, of course, are opioids. And blocking their effects doesn’t block the effects of other addictive substances. So if a drug user knew they were safe from fentanyl-laced drugs, might they just be even more inclined to do those drugs?
Think about it.
Fentanyl Vaccine
Scripps Research’s Dr. Janda looked at the opioid epidemic from a chemist’s point of view. Then again, he does hold the Ely R. Callaway, Jr. Chair in Chemistry and work out of the Department of Immunology and Microbial Science.
The vaccines Janda envisioned would work in partnership with the immune system by training it to recognize heroin and fentanyl as “invaders” and thus put up a strong defense before these drugs could reach pleasure centers in the brain.
As you probably suspect, Janda didn’t develop a solution overnight. In fact, “creating these first-of-their-kind vaccines took more than eight years of research,” says the Scripps page, “of testing and re-testing, of refining vaccine cocktails and testing them again.”
But the effort paid off.
Janda’s vaccines have already proven effective in non-human primates. They’ve not produced any negative side effect either. The next step will be human clinical trials.
“I know the costs when a family has a member with a substance-use disorder,” says Janda. “Current therapies, while useful, are not solving the problem.”
Indeed.
However….
But again, therein lies the rub. Will a fentanyl vaccine also save a person from heroin or oxycodone or morphine? Will one be required to take a vaccine for each drug? And what about cocaine or methamphetamine? Both drugs are currently almost always heavily cut with fentanyl. In fact, one would be hard-pressed to find an uncut batch. Will a fentanyl vaccine make it safe(r) for crack smokers and speed freaks to again freely imbibe? And what about those weekend cocaine warriors?
Don’t get us wrong, please. We firmly believe that anything that can help stave off this rampant fentanyl attack on our nation is a welcome and laudable development. We also believe the Good Professor has directed his sights and his talents toward a noble cause. At the same time, we know the insidious way addiction works on a person. And given even a vague carte blanche to have at it could undermine much of the vaccine’s inherent good.
Opioid Vaccines
Dr. Thomas R. Kosten, writing in the Psychiatric Times, is also on the pro-vaccine track. And his piece, Anti-Fentanyl Vaccines as Medical Solutions to Overdose Deaths, provides more than enough ammo to back his position.
Dr. Kosten is particularly concerned “about substances adulterated with illicitly manufactured fentanyl, which has spread from being the major cause of not only overdoses from opioids, but also from nonopioids.”
Fake opioids (Percocet), benzodiazepines (Valium), and even stimulants (Adderall) are showing up in illicit U.S. drug markets, the Good Doctor warns, and they often contain toxic or lethal doses of fentanyl. Like us, he’s particularly concerned with the amount of fentanyl-laced methamphetamine, which currently is at 89%. In fact, Dr. Kosten calls it a Fourth Wave in the Opioid Epidemic. And he’s not wrong.
Dr. Kosten then backtracks a bit through our nation’s history with opioid-based vaccines, from late ’60s efforts to fight heroin to the early ’90s onslaught of oxycodone, most notoriously known as OxyContin. He then charts the three previous stages of our collective grief — prescription pill overdoses, heroin overdoses, and fentanyl overdoses — culminating in today’s lacing of the entire medicine chest.
“An ideal vaccine would induce antibodies specific to the misused opioids (eg, fentanyl),” writes Dr. Kosten, “while allowing for medical interventions with other classes of opioids when necessary.” That would make it safe for say surgery patients to be administered morphine and recovery patients to continue undergoing Medication-Assisted Treatment (MAT).
“Anti-fentanyl vaccines will be life-saving adjuncts to opiate agonist treatments and provide complete overdose protection from fentanyl and its derivatives, against which current treatments cannot protect.”
In other words, let’s keep at it!
To Vax or Not to Vax?
Even when we do finally develop a fentanyl vaccine, we’ll still be faced with a divided populace. In this case however the decision to vaccinate oneself won’t affect anyone other than the person themselves. It could still impact the public health sector, especially first responders and emergency room personnel. After all, they won’t know who is or isn’t vaccinated, let alone how it affected their behavior. Then again, those public heroes are constantly attending to folks who make unwise decisions. That’s not to be shrugged off, mind you, let alone forgiven. It’s just a sad part of the current world.
Healing Properties has no fentanyl vaccine hesitancy whatsoever. If you’re doing street drugs, you’re at risk. So if there’s a life-saving vaccine available, why wouldn’t you take it? That’s how we view all life-saving vaccines, in fact. With some good old-fashioned common sense.
We still have concerns about how it might impact the user who’ll see the vaccine as a green light to imbibe even more. But there our concerns end. That bridge can be crossed at another time. Meanwhile let’s thank good folks like Kim Janda and Thomas Kosten for spear-heading the charge. And by all means let’s keep cheering them along.
What about you? Are you having drug issues? Fentanyl? Heroin? Cocaine? Speed? Give us a ring. Please. We’ll get you sorted. No matter what your D.O.C. Really.
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(Image: Courtesy Ariel Javellana Flickr)