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I tend to be a civil libertarian. But when it comes to semi-coercive use of medication to stop addiction, I have trouble getting worked up. If you're already hooked on coke or heroin, it's hard to see an anti-addiction vaccine as undermining your freedom. You aren't free as it is.

So I could go along with sentence reductions for taking the vaccine. But my rationale wouldn't extend to preemptive vaccination, since you're free to say no to any drug up front.

Thoughts?

If there were vaccines that were capable of stopping various addictions, then I would recommend a world-wide party commemorating the event. Hopefully, the efforts of those researching them will be successful.

Treating a specific addiction - say, to cocaine - will only break one habit. Addicts are prone to switch their substance of choice rather than cease to be addicted. If the new substance is less immediately harmful, then great, but quitting heroin to become an alcoholic is a bit counterproductive. It's also worth noting that a lot of recovering addicts smoke, for example.

"If you're already hooked on coke or heroin, it's hard to see an anti-addiction vaccine as undermining your freedom. You aren't free as it is."

This isn't really true. What if you freely chose to become addicted to heroin? Then your addiction is a direct result of and in accord with your choices, whereas taking the vaccine may not be. It's at least arguable that anyone who does a drug as addictive or cocaine or heroin and who knows about it's addictive properties has implicitly claimed that they are OK with the possibility of becoming an addict. Therefore, forcing a vaccine on them they have explicity said they don't want would be more restrictive than their addiction. To say otherwise would, i think, be to claim that everyone who has ever done a highly addictive drug is woefully irrational, and I just don't see how that could be the case.

MessyONE:

If there were vaccines that were capable of stopping various addictions, then I would recommend a world-wide party commemorating the event. Hopefully, the efforts of those researching them will be successful.

Treating a specific addiction - say, to cocaine - will only break one habit. Addicts are prone to switch their substance of choice rather than cease to be addicted. If the new substance is less immediately harmful, then great, but quitting heroin to become an alcoholic is a bit counterproductive. It's also worth noting that a lot of recovering addicts smoke, for example.

Even if we can cure only cocaine addiction and addicts promptly seek out alternate addictive drugs, it's still worth doing -- if only to help stabilize Central American nations such as Columbia. Even if the addicts themselves don't benefit, there's a value in putting any one group of narco-terrorists out of business. Another drug crop might not grow so well in their location.

The same is true of heroin addiction. Even if heroin addicts promptly become alcoholics, at least it will be one less drug to worry about interdicting.

If all our addicts switch to alcoholism, it will have the political effect of an end to the War on Drugs, with all its threat to our Civil Liberties and all the business it creates for street gangs.

You may "freely choose to become addicted", but if you do, you are a slave. You have no volition any more. The drug is your God, your Saviour, your family, your life.

You will do things that before the drug you would have thought yourself incapable of. You will steal, you will lie, you will sell yourself, in short, you will do whatever it takes to get the dose you need to function. You will betray friendships, destroy your family, lose your home, and in the end, your life, all because you have to have your drug of choice.

It's clear from your comment that you haven't had a lot of experience with addicts. They all chose to take their drug of choice, but they had no idea what they were getting into when they tried it for the first time. Don't kid yourself by pretending that they did.

They are physically impossible. An antibody (size > 100,000) binds one or a few molecules of something (size 300). Assuming the binding is terrific, assuming that the binding means the drug just is spirited away without doing anything else after binding (and we all know what you do when you ASS-U-ME), then you still have the issue of getting enough antibody to equal the amount of drug you put in. Since milligram quantities of cocaine or heroin are used MULTIPLE TIMES a DAY, this is a lot of antibody to be made since on a weight per molecule basis you'd need 50 times more weight of antibody to equal it. It would have to be a more than visible quantity of the specific antibody made daily.

An antibody against where the drug goes would need far far fewer molecules. But immunization against the nervous system is called 'auto-immune disease'. Well.... let us say, that the drug habit would no longer be a major concern in those particular, unfortunate individuals........

MessyONE:

(Addicts) all chose to take their drug of choice, but they had no idea what they were getting into when they tried it for the first time. Don't kid yourself by pretending that they did.

It puzzles me as to why it's like this. Even if addicts don't read Readers' Digest, didn't their elementary school teachers tell them what they'd be getting into? Didn't the television public service announcements tell them?

Where, exactly, is the communication breaking down?

The antibodies don't bind the drug, but the drug receptors. With the receptors bound, the drug can't.

According to this article, the heroin vaccine was derailed because almost all the demand was for preemptive vaccination.

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I have a number of questions about the vaccine before I would want to see it used:

What effects does it have while the immune system is fighting the drug? This seems like more of an artificial allergy than a vaccine and allergic reactions can be unpredictable.

What other things would be affected besides the intended drug? I would be surprised if a heroin vaccine didn't make the person allergic to morphine and codine, but I don't know if there would be other drugs affected.

How would preemptive vaccines be prevented? I can easily see employers or schools requiring it.

Would this start an "arms race" between drug dealers and vaccine makers? Jack Shafer wrote a piece (http://www.slate.com/id/21238­38/) crediting federal attempts to control amphetamines for creating demand for meth. While using this vaccine may help someone who is trying to quit, I doubt requiring it will help much.

If all these anti-bodies do is block access to the receptor, then how are they different from existing receptor antagonists?

For instance, for heroin addicts, wouldn't this be the same as implanting some sort of device that released a steady stream of a very strong opiate antagonist like naloxone into the body? These treatments exist, I believe, but I'm not sure how well they work in practice. I can't imagine a heroin addict voluntarily signing up for such an approach, which would basically amount to starting an irreversible process of withdrawal, with its attendant and various miseries. I suppose you could coerce people or give them this sort of option over jail-time, but it seems pretty cruel to force somebody to go through withdrawal of this sort, especially with alternatives like methadone and buprenorphine available.

In the case of cocaine, where there is not the same sort of withdrawal problem but the receptors targeted are those for dopamine, other problems seem like they would present themselves. For instance, I would imagine that antagonism of dopamine receptors leads to all sorts of unpleasant side effects... I'd guess severe depression, but also possibly very serious muscular side effects like those associated with Parkinson's disease. To do this with the immune system (which could presumably go haywire and do permanent damage that administering the drug with a pill or even an implant could not) seems pretty dangerous. How do you know that a couple years down the road after you've administered this thing that makes the body antagonize its dopamine receptors that people will still be able to walk and have voluntary control of their muscles.

The general idea (of antagonizing the receptor site for drugs of abuse) is not new but it has not been particularly successful. I know there is, for instance, an alcohol inhibitor <link> that was never developed and marketed because of problems with half-life, but also with serious problems of side-effects of its use. With all of these receptor antagonists it seems that (especially in addicts) you get effects paradoxical to the drug of abuse. Taking a drug addict and not just blocking the effect of their drug of choice but also blasting them into a realm where they are feeling displeasure relatively equal and opposite to the pleasure of their drug of choice does not seem like a viable long term strategy in getting people to stop using drugs. Sure, you could mandate the use of such treatments, but then again you could just lock people up in solitary confinement; in either case the result will be that they are not getting high anymore. The problem arises when you want that person to rejoin society and be able to make the choice to remain drug free.

In addition to this fundamental problem with receptor antagonist strategies, as articulated above, I would worry a great deal about serious, permanent side effects of using the immune system to modulate the nervous system. It sounds like a great way to induce a serious, irreversible, massively unpleasant cascade of side effects.

The Kosten vaccine produces antibodies which recognize the cocaine molecule itself, preventing it from crossing the blood-brain barrier, and not the receptors to which cocaine binds.

It should be possible to achieve levels of circulating antibodies high enough to bind any cocaine an addict has on board—vaccines are frequently observed to result in specific antibody concentrations between 2 and 5 micrograms per mL. A British company previously tested a similar vaccine, which was found to prevent the ‘high’ addicts experience when using the drug.

In any event Kosten’s team has applied to conduct a clinical trial with their vaccine, which should settle whether or not the approach works.

The antibodies raised with this vaccine recognize the cocaine molecule itself, not cocaine receptors.

If it were true that an addict has "no volition," it would be impossible to quit. Ergo, it's not true.

Addicts change substances because the problem isn't the drug. It's the underlying psychological issues that drive people to seek drugs or gambling or whatever. I think anything that would help an addict stop long enough to recieve some therapy and have a clear head to understand it would be a plus though. Jail is not a helpful alternative.

what about non-addicts?