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Meningitis B jab callFile photo dated 5/10/2009 of a nurse preparing a syringe. Government health advisers have rejected calls for all children to be given the meningitis B jab. PRESS ASSOCIATION Photo. Issue date: Wednesday July 13, 2016. The Joint Committee on Vaccination and Immunisation (JCVI) said extending the meningitis B programme to all children under two would put current stocks of the vaccine at risk. See PA story HEALTH Meningitis. Photo credit should read: David Cheskin/PA Wire
Swapping one type of syringe for another could be a potent weapon against drug addiction. But there could be consequences. Photograph: David Cheskin/PA
Swapping one type of syringe for another could be a potent weapon against drug addiction. But there could be consequences. Photograph: David Cheskin/PA

Needle vs needle: a vaccine for drug addiction?

This article is more than 7 years old

Research suggests that we could soon see vaccines for addiction. How can we vaccinate against behaviours? And if it is effective, what are the ethical issues?

I was recently a guest at a recording of the Wellcome Trust’s brilliant Level Up Human, a comedy/science podcast about improving humanity, hosted by Simon Watt. One of the first things guests have to do is talk about some interesting science news, focusing on human biology/medicine. To be honest, it was refreshing to read news that wasn’t about the EU referendum for a change.

One of the particularly intriguing things I found was that they’re apparently working on a vaccine for drug addiction (specifically, opiate addiction). Now there’s something to make a neuroscientist sit up and pay attention. A new weapon in the war on drugs? How can you even do that? How do you vaccinate against a type of behaviour? You don’t catch debilitating behaviour from a rusty nail, it doesn’t do the rounds of nursery classes like colds and chickenpox.

However, facetiousness aside, the logic behind this type of vaccine is impressive, and actually quite straightforward. The problem with drug addiction is that it does have a physical basis, where foreign elements introduced into the body disrupt the function of certain organs, in this case the brain. The brain is a very plastic organ which adapts to deal with whatever we throw at it (within reason). So, if you constantly dose it with potent narcotics, it will change to compensate for this. That’s largely why addiction is such a problem; it’s not just a matter of having the willpower to give up a bad habit, the brain itself has changed, to the point where it needs the drug to function normally.

It makes sense. Opiates activate the receptors that govern things like analgesia and pleasure, hence the intense “high” from heroin. But from a neurological perspective, this isn’t sustainable. So the brain adapts by increasing the amount of receptor activity required to trigger the same reaction. And so we get drug tolerance. So more drug is needed to achieve the same effects as before, and the brain adapts to this, and it increases ever upwards.

So imagine, then, that you suddenly stop taking your opiate of choice. You’ve now got a brain that has adapted to a constant level of powerful analgesics, and it suddenly doesn’t have that. What it ends up with, is an incredibly enhanced pain-perception system. And so going cold turkey can be agonising.

This isn’t even counting the other brain changes, such as how connections with the frontal cortex and other cognitive processes actually scramble conscious control and motivation, so people are constantly craving and seeking out the drug, despite copious evidence for the terrible damage it’s wreaking.

At the simplest level, all of this is the end result of a foreign substance entering the body and causing unpleasant consequences. So, what if you could train the immune system to recognise this substance in advance, and quickly neutralise it before it can have any harmful effects? That’s the mechanism by which standard vaccines against diseases work. And the aforementioned research is looking into whether the same approach could work on narcotics.

The brain is many things, but a target for vaccines is not one of them. At least, not yet... Photograph: Alamy Stock Photo

It looks promising thus far. Studies which inject specially designed shots into test subjects showed the subjects were incredibly resistant to the effects of opiates, for long periods. While the chemicals in drugs tend to be much smaller and simpler than actual viruses and pathogens, immune cells can be trained to recognise them and bind to them, which prevents the drug from crossing the blood-brain barrier, so it’s effectively denied entry to the place where it needs to be to have any effect. If this happens, then none of the effects leading to addiction can occur, so the individual is “safe”.

There are still issues to overcome, of course. For example, a drug dose isn’t the same as in infection. A virus usually invades your body in a very small dose and quietly builds up in infected tissue, while something like an injection of heroin is more like a tidal wave hitting your bloodstream. But the results are encouraging, and these aren’t insurmountable obstacles.

It does make you wonder what the long term ramifications of this approach would be, though. There are already studies into vaccinating against cocaine use, so maybe we could end up with a suite of anti-drug vaccines. Assuming they’re successful, the coverage of the vaccine linked to above focuses solely on its use for existing drug users, to stop them becoming dangerously addicted and helping them quit. But who’s to say it will be limited to them? If the vaccines become widespread, what’s to stop well-meaning parents from paying for their children to be vaccinated against a future or drug dependence, “just in case”? Would it be ethical to do this? To alter someone’s body chemistry to prevent them from experiencing things you don’t approve of?

Would it even be wise? Without the threat of crippling addiction, maybe drug use could increase, not decrease, because they’re “not so dangerous” now.

Playing with the brain’s processes via vaccines seems to be more viable every day, especially with recent news about a possible Alzheimer’s vaccine. Who knows where this could lead us. The temptation to interfere with the brain’s development for seemingly altruistic reasons could be too great for some. Can anyone realistically say that, if there were a vaccine that blocked hormones linked to homosexuality, that doting but less-enlightened parents would wouldn’t eagerly line up to have their children “inoculated” against a life of sinful behaviour? Regardless of how simplistic and questionable this approach would be? Nothing you see in the modern news suggests such an optimistic prediction is likely.

But ethical concerns aside, we could soon see vaccines for brain-based concerns become a part of life, with all that that would entail. Who knows, maybe one day they’ll develop a vaccine that’s proven to prevent autism. That would be worth it purely to see how the anti-vaccination campaigners deal with the logical paradox this would present.

Dean Burnett discusses, among other things, the brain and addiction in his book The Idiot Brain, soon to be released in the USA on July 26th as “Idiot Brain: what your head is really up to”.

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