A Vaccine for Addiction: For the 1.

A Vaccine for Addiction: For the 1.9 million cocaine users in the US alone, addiction is a problem for which no FDA-approved therapy exists. Now, a vaccine effective on primates is ready for human trials.

● Cocaine blocks the recycling of dopamine so that it accumulates in the brain, prolonging and amplifying signaling in reward centers to generate that pleasurable “high”. Over time, dopamine receptors (pink buckets in image) decrease, requiring higher doses of cocaine and causing a vicious cycle of dependence. There are drugs that interfere with cocaine’s action but they alter these important signaling pathways and have side effects.

The Cocaine Vaccine  triggers an immune response to the drug, that “eats up the cocaine in the blood like a little Pac-Man before it can reach the brain,” says Dr. Ronald G. Crystal, of Weill Cornell Medical College.  The trick is to chemically link a cocaine analog to the common cold virus so that the body is tricked into making antibodies. The virus is crippled and cannot cause an infection. To feel the drug high that cocaine users seek to achieve, at least 47 percent of the dopamine transporter needs to be occupied by cocaine. The vaccine reduces this occupancy to 20% so the user fails to achieve the cocaine high.

Story: http://rt.com/usa/cocaine-vaccine-drug-pacman-219/

Free PubMedCentral Read: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3048190/

Image: Left, Mechanism of Cocaine at the Synapse (http://goo.gl/ZCk4K), Right, Effect of anti-cocaine vaccine on non-human primate brain, taken from Maoz et al., Neuropsychopharmacology. 2013 May 10. doi: 10.1038/npp.2013.114. Epub ahead of print)


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109 Responses to A Vaccine for Addiction: For the 1.

  1. E.E. Giorgi says:

    I read about this and it’s extremely interesting, the only question I have is whether it would be effective on people who’ve been using cocaine already. If you want to prevent a new addiction, then it works because the person does not get high, hence presumably they won’t get addicted, but people who’ve experienced it before will be induced to use more of the drug to achieve the same effect and they will likely get lethal doses… I would assume, no?

  2. Rajini Rao says:

    E.E. Giorgi , if the antibodies do a good enough job of clearing the drug from the blood stream, they would not only prevent cocaine levels from hitting pleasure highs, but also keep it from reaching lethal levels. I think the strategy is to get the blood titer of antibody to be high enough (with booster shots), so that cocaine levels stay low. The trials should tell us if an addict can still manage to overdose- you raise a good point!

  3. Brad Esau says:

    Interesting. I suspect that this is not “there” yet but seems headed in the right direction. 

  4. Rajini Rao says:

    Brad Esau , that’s correct. The preclinical work is done and they expect to start human trials by this fall.

  5. Brad Esau says:

    Rajini Rao  – the thing with animal based trials is that they fail to account for more complex human psychological and environmental factors. Nonetheless, it certainly looks promising. One possible difficulty I foresee is that the person will simply attempt to ingest more cocaine. Cocaine (or other drugs) acquisition is often one of the biggest problems with drug addiction and I’m not sure that this addresses that part of the issue. 

  6. Amit Algotar says:

    Grt work….. It will surely save life and future of Millions of Youngsters 

  7. This should prove an interesting test protocol.  Users (well, potential ex- users, anyway) will have to be persuaded (say, by a judge in sentencing) to be administered this vaccine, knowing/believing it will “kill the buzz”.  Presumably, a few will try cocaine even after the vaccine’s application, not fully believing in its “curative” properties.  If the results so far are to be believed, they’ll feel nothing for it.  Speaking psychologically, it will then require a bit of rational economics for them to realize their wasted assets in pursuit of another high.  In short, then, the vaccine is not the only step in cessation — some psychological intervention (personal or professional) will likely be part of the process.

  8. Rajini Rao says:

    Brad Esau , indeed many promising therapies that work on mouse models fail to work on humans. The pubmed central article that I linked to summarizes some of these studies. This one has been validated in primates, so it has a better chance of being effective in humans. 

    Regarding the possibility of ingesting more cocaine, E.E. Giorgi also brought that up. It remains to be seen if the antibodies clear cocaine away quickly enough that levels fail to reach threshold. Treatments can include other options: counseling and psychiatric help for one. Also, there are drugs that evoke unpleasant effects when taken along with addictive substances. Something like that could be a deterrent. I think of this as one more tool in the tool kit! 

  9. Rajini Rao says:

    Exactly, well said William McGarvey . The first step is to be committed to becoming drug free. I wonder though if the vaccine can be used as a preventative measure for a high risk subject (say, an adolescent growing up in a family of cocaine users)?

  10. Brad Esau says:

    William McGarvey  speaks for my concerns vis-a-vis real world conditions. But I like what you say, Rajini Rao , about it being another tool in the tool kit. 

    Mani Saint Victor  knows that I’m a real PITA when it comes to real world applications of clinical trial discoveries. 🙂

  11. One problem I see is that if the drug of their choice(cocaine) does not give a high then they will just seek something else that does.

  12. Brad Esau says:

    Celeste Sanders  yes, possibly. Sometimes though, if the person is willing, all it takes is breaking the cycle of highs to get them off of it. Being willing is always a key in breaking any addiction.  But yes, this is the psychological factor that doesn’t show up in clinical animal trials. I think this vaccine concept would be best applied along with psychological counselling. The vaccine would control the physical addiction, the counselling would address the life problems associated with it.

  13. Rajini Rao says:

    Yes, very true Celeste Sanders . One cannot expect a miracle cure that saves us from everything. It’s like asking an anti-polio vaccine to prevent us from getting all infectious diseases. 

  14. Giving hope to the addicted may work in this case, not so a miracle, but a tool. 

  15. Rajini Rao says:

    I couldn’t have said it better, thanks J. DeRon Walker .

  16. I also see a possible interference with needed pain medicines that use the same mechanisms 

  17. If this works, perhaps it could be added to the list of childhood vaccines. Possibility of wiping out the world of cocaine addiction. Will it work on crack, all forms of cocaine ingestion?  The possibility of never seeing a cocaine/crack addicted baby again thrills me. 

  18. Mark Herndon says:

    ?Welll ok as long as it does not turn them into zombies ; )

  19. Rajini Rao says:

    Tom Lee ‘s post on another approach to reduce addiction is here: http://goo.gl/1hkzt Actually, it was the inspiration for this post, thanks Tom. The study shows that an antibiotic used to treat meningitis unexpectedly has the effect of increasing levels of another neurotransmitter transporter, thereby clearing it away from the synapse and reducing the effect of cocaine.

  20. Rajini Rao says:

    Mark Herndon , hehe…it merely removes the drug from the bloodstream instead of adding anything so it may well reverse the zombie statehood 🙂

  21. Rajini Rao says:

    Celeste Sanders , would there be ethical issues involved with using such a vaccine in prevention of addiction, do you think? It should not be used with some sort of illegal or unscientific “profiling” of ethnic or economically disadvantaged populations.

  22. Tom Lee says:

    Thanks for the very informative post Rajini Rao . They must have used the PET scan technology to produce the images on the right which show the ROI in red.

  23. Brad Esau says:

    I just want to say that this has been an excellent discussion with lots of interesting points raised. G+ can be very high noise to signal ratio but threads like this make it worthwhile. Thanks for your gracious hosting, Rajini Rao .

  24. Rajini Rao says:

    It is comments such as yours that add value to a topic, Brad Esau , and makes me learn and think some more. Thanks!

  25. Rajini Rao says:

    Tom Lee , yes that’s right, thanks for pointing it out. The brain scan on the right is a PET scan and I forgot to paste in the intensity bar: red is highest.

  26. Tom Lee says:

    The term FDA approved vaccine can be questionable. Look at it this way, so a person can get vaccinated to prepare for him to use drug? Drug use is not a disease, but a lifestyle choice. This vaccine, if successfully tested and approved, should not replace public drug education programs, teachings and sanctions to control drugs trafficking. Hollywood celebrities will be happy to get vaccinated. :)

  27. Rajini Rao  No racial profiling, just give to all preteens like the HPV vaccine

  28. Rajini Rao says:

    Agree with you on the importance of all the other education programs and law enforcement, Tom Lee. The vaccine will take away the pleasure, hence the motivation, of drug use. I assume these drugs cost quite a lot, so it wouldn’t make sense for someone to spend money on a fix that does not make them high. So in that sense, it may be effective. But as you say, all other options should be on the table as well.

  29. Rajini Rao says:

    Interesting suggestion, Celeste Sanders ! What do other people think?

  30. G Money says:

    Actually, dealing with the “arrested development” phenomenon caused by significant emotional trauma in the formative years leading to limbic hyper-activation (aka a continual state of fight or flight) which subsequently causes decreased dopamine, serotonin and nor-epinephrine production could truly strike at the root of the addiction feature before it develops.

  31. Brad Esau says:

    Tom Lee  

    Drug use is not a disease, but a lifestyle choice. 

    Uuuhhmm, sorry, not so. For some, sure it’s a lifestyle choice. Addiction is a different animal, however. You should probably read up a little more before making statements like this. 

  32. Rajini Rao says:

    G Money , that was a complex statement that I’m trying to parse 🙂 Do you mean that childhood stresses predispose one to use addictive drugs like cocaine and we should deal with the causative factors? Hope I got that right, if so, I agree.

  33. Brad Esau says:

    I disagree with forced vaccinations for this. Vaccination politics is already a huge issue even for widespread arbitrary illnesses such as various flus. It’d never fly with the public. Alcoholism is a far more common illness. Why not vaccinations for that? Or any other of dozens of other possible addictions? The possibilities are endless. A slippery slope best avoided. 

    Besides, it’d be Big Pharma’s wet dream. Their profits are already huge enough and their tentacles too deep into our minds.

  34. Rajini Rao says:

    Brad Esau , I think Tom Lee  was extrapolating on my use of the term vaccine, which is typically used to treat diseases (I take the blame for that!). Treating drug abuse is a lot more complicated than vaccinating against an infectious disease, I didn’t mean to imply otherwise. Perhaps it starts off as a choice but then that quickly changes. I’m thinking of dependency on medication, for example.

  35. Jean Liss says:

    I have questions about the real effectiveness of the HPV vaccine, but that aside, I would start with people who have a problem first. After it has many years in service, then I would consider allowing some high risk youth to be vaccinated.

  36. Brad Esau says:

    Rajini Rao  – oh for sure. I just take exception to the claim that it’s a “choice”. It’s a little more complex than that. 

    Addictions to prescription medicines and pain killers is a good example. Many people can use the same substance at similar rates and only some become addicted. It’s not completely understood why this is but it roughly has to do with genetics, environmental conditions and the individual’s brain development. I’d have to revisit the science on it that I’ve read to go into more detail. That it is not a choice is pretty well established though.

  37. If it vaccine works with no side effect, then I support Celeste Sanders suggestion

  38. Rajini Rao says:

    Jean Liss , my personal preference is similar to yours. qasim okuneye , good point, but in reality, everything has side effects..all vaccines have some sort of adverse reaction in rare cases and one has to consider if the benefits outweigh the risks.

  39. Rajini Rao says:

    Brad Esau , right on. There are genetic predispositions to addiction and  population based studies are uncovering these (Genome Wide Association Studies or GWAS). One of the genes we study in my lab, known as NHE9 (or SLC9A9) is linked to addiction..we still don’t know what the gene variants do exactly, but it is something we are interested in understanding at a very basic cellular level.

  40. Is this something that parents would be giving their children via pediatricians? While I don’t like the idea of government mandated injections, I could see an argument made where a parent can make choices for their children. This is a very interesting topic, btw.

  41. Tom Lee says:

    Brad Esau you ‘re right. We all need to learn more as life progress. I assume , and I hope, you know your subjects perfectly well. No argument here on my part. This make our scientific discussion more productive and mor civilized.:-)

  42. Rajini Rao says:

    We’ve been grappling with that possibility, Matt Kevins . It could be a vaccine that is misused or perhaps used unnecessarily. I think it is being developed as a therapy to treat cocaine users who are in rehabilitation, and we are just speculating as an intellectual exercise!

  43. This subject is very interesting to me. I think some people who are “functional addicts” would resist using the vaccine. I could even envision misuse of such a vaccine wherein someone “spikes” someones drink so that they can’t get high anymore.

    There is often a lot of dishonesty around drug use (not only from users). There is a very big question here regarding free will.. and I could see this being used by someone in secret who desperately wants to “cure” a loved one. If and when a drug like this becomes available, it will be interesting to see if such cases arise. I am curious what the reactions will be (since there are so many ethical dilemmas going on).

  44. Rajini Rao says:

    Drug spiking of alcoholic drinks is horrible, used for date rapes, for example: http://casapalmera.com/effects-of-drugs-used-in-drink-spiking/

    This vaccine is not so much as a drug, but a pretreatment that removes the drug once it gets into the body..sort of anti-drug. I suppose it could be administered orally (like the polio vaccine), good point Matt Kevins .

  45. Brad Esau says:

    Rajini Rao  – David Eagleman writes in his book Incognito that genetic predisposition for a given condition (and he used depression as an example) needs environmental conditions to activate the gene, something that twin studies help establish. While I’m somewhat well read on the basics, I’m a bit out of my depth here though. 🙂

    Environmental factors growing up are known to establish an individual’s “wiring” as well. This wiring establishes “locked in” behavioural loops in the brain which can be a factor in addiction as well. This is why psychological therapy is important (the right kind) as it can help “rewire” the brain to better behaviours (which somewhat addresses Tom’s point about choice). Jeffery Swartz is a well established expert in this field although he deals mainly in other issues. The same principles he uses can be applied to addictions however.

    Tom Lee  – yes, quite so. I’ve quite enjoyed this discussion and again thank Rajini Rao  for her excellent hosting. (“perfectly well” would be a stretch … see above 🙂 )

  46. Belinda Blok says:

    This  needs way more research and studies.  As E.E. Giorgi points out, its usage is obvious to prevent a new would-be-addiction.  However, even in that basis, think of usage and adoption:  are you going to inoculate your children just in case they ever try to use cocaine?  And what about addicts, will they be willing to take a medication for a condition they don’t necessarily want to correct?   Then there is the aspect of not enough research…what happens when you need a medication such as codeine?  I don’t know…The concept of vaccination is to prevent diseases…cocaine is a choice not a disease.

  47. Rajini Rao says:

    Belinda Blok , yes..we’ve covered all the issues you raise in the comments above. To be fair, as I mentioned, we are speculating well beyond the scope of the research, although it is both fun and informative to do so. 

  48. Brad Esau says:

    Belinda Blok – see above about “choice”. Sorry, not a choice. Read the science before making such statements, please. 

  49. Tom Lee says:

    Brad Esau , is your bro Gregory Esau ? He’s on G+ forever, posting some good stuff.

  50. Brad Esau says:

    Tom Lee – indeed he is! Twin as a matter of fact. He and I are good examples of how twins, despite being genetically identical, change and become different due to different environmental conditions. We’re quite different in a lot of our views. 😉

  51. G Money says:

    The work of Dr. Paul Hegstrom has produced a 98% addiction cure rate because his methods address the arrested development syndrome….do we really need a vaccine or do we need to correct the root cause?

  52. Brad Esau says:

    G Money  – I’ll have to look him up, thanks. Offhand though, I’d say that 98% sounds suspiciously high. Relapses can occur years later and these would likely fall outside his efficacy data. 

    Personally, I don’t think we “need” a vaccine but as Rajini Rao  has pointed out, it is another tool in the tool box. If used wisely it could be very useful in my opinion (and if it works as conceived). It’s that using it “wisely” that’s a problem. 

  53. Rajini Rao says:

    Brothers, yes, but I didn’t know that Greg was your twin Brad Esau 🙂

  54. Brad Esau says:

    Rajini Rao  – I sometimes find it hard to believe myself! Some days I swear we’re from different planets, let alone from the same womb at the same time. 😉

  55. Belinda Blok says:

    Rajini Rao Sorry…started the post way earlier…mine would have been the second comment had I not been distracted by other things…Just saw it open and figured I’d finish it.  But thanks for your comment, it alerted me to go go back and actually read all discussions.

  56. Rajini Rao says:

    It is a long thread, Belinda Blok . Would love your perspective on some the discussion.

  57. Rajini Rao says:

    Brad Esau , I do believe that Gregory Esau is even more positive and optimistic than I am, and I’ve been told that I am (annoyingly) cheerful! 😀

  58. Jean Liss says:

    As for the date rape drugs, a few years back I saw a show on tv that had an inventor who made drinking glasses that would change color when they were exposed to a few of the commonly used drugs…. But I just digressed….

  59. Brad Esau says:

    Rajini Rao  – yes! Whereas I tend to the more …uuhhmm, “skeptical” side of things shall we say. 😉 

  60. Rajini Rao says:

    How interesting, do you have a link Jean Liss ? I’m curious about the chemistry.

  61. j boogie says:

    This is great, i hope that it will work i am a recovering addict myself and it took me countless years to become free from my drug of choice,cocaine was one of my drugs so this vaccine would be great for people that use it,we need more therepys for addicts and funding from the goverment to explore more options of treating addiction!!!!

  62. Belinda Blok says:

    Brad Esau lol!  Wish I had read all the comments before finishing my original post–then I would have seen choice is a hot button of yours, thus the patronizing comment directed at me.  I can’t even keep up with my email inbox and you suggest I go read more science…sorry.  

    Many studies and research publications are cataloged and easily accepted as facts when in reality its all theories.  The day you can produce, repeatable, consistent and measurable results, and have the statistics to back it up, then I’ll consider moving it from the theory column to the fact column.

  63. Kalua J.K says:

    In my opinion, it sounds like a really great potential breakthrough for hopefully helping cocaine addicted people out of their addiction, if it is used in rehab centers for people who are willing to try out a new method to help them have a more successful recovery I say fantastic go for it. In regards to making it a vaccine to give to kids, um are you freaking kidding me? No one knows who will become an addict and who won’t one cannot just say well since for example 5% of the future population of kids could become addicts we’ll vaccinate all of them. As far as I know we still live in a semi-free state that allows freedom of choice right, or did I just wake up in 1984?

  64. Jean Liss says:

    Rajini Rao I Shared link for drinksavvy with with you in a separate post…. Phone has limited cut and paste. Feel free to share.

  65. Brad Esau says:

    Belinda Blok – sorry, the science is pretty well established. It’s not a “hot button” for me at all. I just don’t like ignorant statements (I don’t use ignorant as an insult, just the pure meaning of the word).  One could well ask for your science to back up the “choice” theory. You’ve just admitted that you can’t keep up with the reading on it so I’m a little puzzled as to how you know enough to dismiss it. 

  66. Brad Esau says:

    Just to be clear, yes, drug and alcohol use are a choice. Addiction is not. Many people choose, only some are addicted. This is true in both recreational drugs and pharmaceutical drugs. (though pharmaceutical drugs are not always a choice)

  67. Surely this would just cause people to overdose as they take more and more of the chemical to try and get the high they yearn even though they are now incapable of getting high from it

  68. Brad Esau says:

    Anthony Lawrence  – that was my concern as well. If I understand it correctly, however, the vaccine will interrupt the pleasure cycle making it easier to break the habit. I don’t think anyone is claiming that the vaccine alone will necessarily work (though it could, depending on the individual). For those willing to break their addiction, it would give them a powerful tool to first break the cycle and then alter the behaviour (which might require further therapy or coaching). 

    I believe the term “vaccine” might be a bit misleading here as it implies prevention (which it could do, I suppose). It sounds from the paper that it is intended to function more as an antidote. Rajini Rao ?

  69. The only problem is that as we’re all aware the brain is an amazingly complex thing and although the pleasure receptors maybe be blocked and stop the user gaining an enjoyable buzz from the chemical. The user would still be aware of previous enjoyment and the memory of that would give the user an expectation of what to expect. Like you say though, it’s early days and counselling would probably also play a large part as would the users own desire to rid themselves of the addiction.

  70. Brad Esau says:

    Anthony Lawrence  – yes, the psychological component. 

    The brain is an amazingly complex organ – the one thing all neuroscientists agree on. 🙂

  71. Jeff G says:

    Ibogaine works now…

  72. Rajini Rao says:

    Just got back, sorry for the delay in responding. To clarify, this is a vaccine in the real sense of the word. The body generates antibodies to an inactive (decoy) virus linked to cocaine, just as it would to the flu virus. When the drug enters the blood, antibodies bind to it and inactivate it or tag it for destruction. It could be considered an antidote in that it clears away the drug from the body.

    Chelsey Thomas the compounds in chocolate are different from cocaine. Chocolate comes from the cacao plant, cocaine comes from the coca plant. As explained in this link, there’s a world of difference that one letter makes 🙂 http://valsgalore.blogspot.com/2010/06/cocoa-versus-cocaine-or-what-difference.html

  73. Brad Esau says:

    Rajini Rao  – thank you!

  74. Brad Esau says:

    Brief aside. I love the new format at NCBI. Much easier to read (or I find it so anyway). 

  75. is it just me or does it look like that after the vaccine, it is necessary to consume cocaine to be normal?

  76. Brad Esau says:

    Brian Prewett  – I’m not sure how you’re arriving at that conclusion. Could you be more specific?

  77. Rajini Rao says:

    Not sure how you got that, Brian Prewett ? Are you talking about the brain scans in the image? The original paper showed scans from a bunch of animals, followed by statistical analysis. I just picked one. There is no statistical difference in Dopamine receptors before and after vaccine in the animals who do not have cocaine. After cocaine, there is less of a drop in the receptors in vaccinated animals (which is a good thing).

  78. Just looks like the Before Vaccine+Before Cocaine is nearly the same as the After Vaccine+After Cocaine one.

  79. gtwqm ftwak says:

    High life 😀 give me some!

  80. Rajini Rao says:

    Chelsey Thomas , certainly a few nitrogen atoms make all the difference between compounds. Chocolate compound (theobromine, caffeine, phenethylamine) are pleasurable but not addictive as cocaine is.

    This vaccine would be like a other flu vaccine. The adenoviral vector is the one used in gene therapy trials. One should make a benefit vs. risk analysis for any treatment, whether vaccine or drug or physical therapy.

  81. After the Vaccine and Before the cocaine, there are way to many receptors active… I am not smart enough to be a doctor, I just look at the pictures.  😉

  82. Rajini Rao says:

    Brian Prewett , yes that is correct. That’s a good thing. It means that the vaccine kept the receptor levels looking like it did before cocaine. The critical samples are the two on the right: bottom has stronger signal than top (sorry, I should have included the intensity chart..red is highest , yellow is low intensity).

  83. Rajini Rao says:

    Cocaine addiction is a very serious, life threatening condition and not at all in the same league as chocolate or coffee. This study is a serious attempt to deal with a million+ drug abusers in this country alone whose lives have been destroyed by addiction. Cocaine binds to the DAT protein, dopamine transporter. Caffeine does not. Therein lies the difference.

    Also, Chelsey Thomas , the vaccine is not a chemical drug! It is a pre-treatment with a modified virus that generates antibodies to destroy cocaine as it comes in, so I’m really not sure what the basis of your argument is to compare it to chocolate? After vaccination, there will be less cocaine in one’s blood to interact with anything, that includes coffee or chocolate.

  84. Belinda Blok says:

    The “keeping up” comment was meant in jest, Brad Esau.  The word ignorance does not offend me–the statement “go read on it” might; you are basically telling I cannot share my opinion or views lest I’m an authoritative figure in the subject.

    Glad you clarified your objection is with the word choice in the context of addiction; and that usage by anyone else not chemically, genetically, and/or environmentally predisposed, is a choice.  My post reference to addicts was:  “…will they be willing to take a medication for a condition they don’t necessarily want to correct?”  The closing statement on the post was ” vaccination is to prevent diseases…cocaine is a choice not a disease.”  I does not infer cocaine addiction is a choice.  

    We could split more hairs or delve into semantics…I think it’s a dead  horse.  Thanks for attempting to clarify your views and remaining civil (albeit condescending)  🙂

  85. Rajini Rao says:

    P.S. Chelsey Thomas , I looked up the structures. Caffeine and theobromine (ingredients of chocolate) do not resemble cocaine at all. Cocaine is C17H21NO4 and caffeine is C8H10N4O2.

  86. Rajini Rao says:

    Belinda Blok , it’s the medium that is to blame ..hard to convey tone and intent (that’s why I use those silly emoticons even though my formal upbringing rebels against it) 🙂

  87. Brad Esau says:

    Belinda Blok – you are basically telling I (sic) cannot share my opinion or views lest I’m an authoritative figure in the subject.

    Guilty as charged. I have almost zero patience for what I see as ignorant drive by statements (in general). I see it all too often and am not one to let them slide. If one is not well read on a subject I do not believe they have the “right” to express opinion couched as a factual statement. Without qualifiers such as “in my opinion, ….” such statements are easily taken the wrong way. I’d still probably pounce on that, though. It’s my belief that if one is not at least somewhat well versed in a subject, the correct way to approach it may be something like, “that’s not my understanding of it but that is interesting information” or “I didn’t know that”, etc. I deal with a number of “brain issues”, mental health issues mainly but addictions tie into those so in researching those and dealing with mental health people I’ve gotten to know quite a bit about both issues. I see and hear far too many insensitive and ignorant comments all over the web and in person about people with mental health issues and/or addiction issues. So yeah, I take it seriously and I will always  choose to speak up.

     One cannot detect jest in online statements. I’m not sure how one is not supposed to take things at face value. It’s one of the pitfalls of online discourse. 

    I too am glad you came back to clarify. Few people take the time. 

  88. Brad Esau says:

    Rajini Rao – thank you, I’m glad you addressed that. 

  89. Rajini Rao says:

    Chelsey Thomas  One can overdose on table salt. I think you understand the point of this research. It is designed to treat addicts who have little or no options available to them. Neither I nor the scientists who published this paper said anything about forcing someone to do what they don’t want to do.Please let’s stick to the scientific merits of this approach. If you are an anti-vaxxer, so be it. This post is not about the general merits of vaccination, but about a unique and promising medical approach to deal with addiction.

  90. Brad Esau says:

    Rajini Rao  – did you mean “misunderstand”?

  91. Brad Esau says:

    Chelsey Thomas  – Only individuals can think for themselves and choose for themselves.

    Yes, I believe that is the point Rajini is trying to make, that this will be a choice. I do agree with your views regarding larger philosophical underpinnings but clinical research should not be restricted by such. As long as a given treatment is not forced and an individual understands what’s at stake, science just provides choices. If we had public philosophical debates before every bit of science went forward, we’d still be in the Dark Ages. Science first, philosophical and ethical debates second. Once some preliminary human trial data is available,then it should be opened up more for broader discussion among those who are qualified. 

    As for the statement at the end of your first paragraph, I think you too are making the error that breaking addiction is a “choice”. Many people do try to deal with it themselves but are unable to because of the addictive properties of the substance. This is what addiction means – cannot stop even if one wants to. It’s not simply a matter of will if that’s what you’re implying. 

  92. Brad Esau says:

    Chelsey Thomas – yes, I thought so (same wavelength). Different paths but some same basic thoughts. 

    Just to parse things a bit though, it’s that some can and some can’t part. It’s an awfully gray line. Many, because of the changes drugs/alcohol/ect have on the brain itself, can’t recognize they even have a problem. It’s evident to others but not to themselves. There’s a term for this but I can’t come up with it just now. 

    Anyway, once again, a very good discussion and I’ll thank Rajini Rao  once more. Very few people moderate a discussion on their posts like she’s done. ::tip of the hat::

  93. Yeah, we need a cure for alcoholics. Why are people even born when they throw it away and drag everyone down with them.

  94. Rajini Rao says:

    There ought to be an emoticon for sarcasm, Angie Walters 😉

  95. Brad Esau says:

    Chelsey Thomas  – this is the thing. Just as there are many different people and personal circumstances, there are many different paths to overcoming addiction. I tend to look at things from a philosophical/ethical standpoint so yeah, I tend to raise questions. I do not at all disagree  with the vaccine model under study here though.

  96. Brad Esau says:

    Chelsey Thomas  – yes, thank you, too. I’ve really enjoyed this whole thread. Some widely varying views but I think on the whole it turned out well. 

  97. Marking this on for a later read Rajini Rao I have one quick question, (maybe I should read the whole post first). Does this also work for heroin, morpheine based addictions (oxycontin etc) If so, the federal courts will probably vaccinate millions.

  98. Rajini Rao says:

    Cheryl Ann MacDonald , the strategy could well work on other drugs. This one is specifically targeted to cocaine. We’ve been having a discussion on whether it would be ethical to mandate vaccinations. 

  99. In terms of using this in the court system they can apply this “tool” as a part of a plea bargain. And follow ups via the parole system.

    However, as a treatment choice the same ethical discussion centers around using Antabuse and subloxone (alcohol deterrent/opiate withdrawal).  The client is given the choice. 

    The vaccine might assist in decreasing the stigma related to the whole area of addiction. (Which IMO decreasing stigma is good!)

    Is there any way to follow the field trials? (I did my post doc at the courthouse in SD. And worked with Kleber in Connecticut, so following this info is interesting indeed)

    Edit. We had this discussion a while back, but you might not remember http://www.pbs.org/wgbh/pages/frontline/shows/drugs/interviews/kleber.html

  100. Would this have the same effect on the other ‘caines, novacaine, lidocaine…?

  101. Rajini Rao says:

    Thanks for the link, Cheryl Ann MacDonald . It was an excellent read. Other than contacting the lead author, I’m not sure how one can follow the trial…assuming they get funding and are set to start soon. I hope it works, since it could be adapted to other drugs.

     Stephen Stillwell , from what I read the antibodies were specific to cocaine. Depending on the chemical similarity there could be some cross reactivity to other compounds, which would make them less effective as medication.

  102. Chuck Dudley says:

    Hope this is something that really works

  103. It’s also worth reading up on the nicotine vaccines like those being done by BIND.

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