Cocaine vaccine
January 5, 2008 6:04 AM   Subscribe

Ignoring the ethics, this may just guide the user to other drugs in the same class. And cocaine seems somewhat of a special case, along with nicotine, in terms of targeting ability.
posted by daksya at 6:19 AM on January 5

I would be very interested to see how the tobacco lobby reacts should a nicotine vaccine be considered for FDA approval. On one side, you'd have pharmaceutical firms who stand to make shit-tons of money on such a product, and on the other, cigarette salesman who stand to lose just as much. It'd be an Improper Oversight Influence battle royale!

As for the cocaine vaccine, it's an attractive notion for folks who decide on their own to clean up. And quite a creepy one if we start discussing compulsory doses.
posted by EatTheWeak at 6:32 AM on January 5

Cocaine vaccine is a helluva drug.
posted by Arch_Stanton at 6:48 AM on January 5

Are they working a pork vaccine?
posted by b1tr0t at 6:57 AM on January 5 [1 favorite]

This doesn't really seem like a boon for coke addicts as I would think the last thing someone heavily addicted to cocaine would want is for it to stop working.

I also wonder how this would affect a person given the medical applications of cocaine derivatives... genetic siblings of cocaine's active chemicals are used as medicines and painkillers in hospitals... would the vaccine render those ineffective?

I'm guessing if the nicotine vaccine ever became effective the tobacco lobby would just advertise and demand to sell more cigarettes to more people than ever, now that they're "no longer addictive."
posted by XQUZYPHYR at 7:05 AM on January 5

Won't work, because addiction is not only a metabolic issue.
posted by Henry C. Mabuse at 7:05 AM on January 5 [1 favorite]

Are they working a pork vaccine?

The Torah?
posted by XQUZYPHYR at 7:06 AM on January 5 [2 favorites]

Torahzine.
posted by hermitosis at 7:09 AM on January 5 [5 favorites]

Henry C. Mabuse, the vaccine isn't meant to treat addiction as a metabolic issue. It's supposed to break the stimulus-effect pairing within the addict's psyche. The vaccine is the result of trying a metabolic approach.
posted by daksya at 7:14 AM on January 5

The addict's psyche? A thing that can't be measured and is not understood? How can a vaccine be anything but metabolic? A psychic vaccine? A vaccine of the mind? A mental vaccine is a good idea for a science fiction story (in fact I may use it) but it won't work in the real world. (yet)

The article describes the stimulation of the immune system to combat the neurological products of cocaine. Have I misinterpreted the meaning of the word metabolic, or is that description not of a metabolic process?

Something other than a vaccine, such as a 12 step-type program, would target the addict's 'psyche', if such a thing even exists. Chemical compounds designed to inhibit or short-circuit the stimulus-response in the patient's body to other types of intoxicants (alcohol, opiates) have shown to be not very effective.
posted by Henry C. Mabuse at 7:28 AM on January 5

I suppose administering a vaccine is easier than replacing a pancreas.
posted by emmastory at 7:31 AM on January 5

I've tried cocaine; I snorted a little (a few times) and injected (once). While snorting it did nothing but destroy my alcohol buzzes, injecting it is so extremely pleasurable (at least the first time), that I can see now just how dangerous it is. I consider myself fortunate that at the time when I injected it, I had no access to additional money to buy more, and I am too honest of a person to resort to crime. But for around 24-36 hours, I could literally think of nothing else but how much pleasure that had been, and man, it sure would be nice to do that again, and again, and again.

So, anything that eradicates that overwhelming desire for more -- that's a good thing. I don't think it'd need to be compulsory to have a reasonably decent effect. I don't think people *want* to be addicted, to anything, and I think at least a goodly number of people would choose this vaccine if it would help them beat their addiction. Forcibly injecting someone though, mmm, not sure I like the sound of that much.
posted by jamstigator at 8:13 AM on January 5 [2 favorites]

Henry C. Mabuse: the approach is metabolic, and the target is the psyche.

The model assumed, in broad strokes, is simple:
if one takes the drug, 'effect' is produced. Repeated observation imprints this as an instrumental belief within the subject. The subject then uses this belief, when they wish to induce 'effect', i.e. take drug. Since drugs have to reach the brain to do their magic, the vaccine aims to stop drug from reaching brain, hence prevent 'effect'. The belief is undermined, and in theory, subject no longer employs it to induce 'effect' since effect is no longer expected. The vaccine ultimately seeks to influence the psychology of the subject hence target is the psyche.

Chemical compounds designed to inhibit or short-circuit the stimulus-response in the patient's body to other types of intoxicants (alcohol, opiates) have shown to be not very effective.

I'm not disputing your judgement on the lack of efficacy.
posted by daksya at 8:15 AM on January 5

Well, the scientific method calls for testing. Irrespective of the fact that no one knows what a psyche is or if it really exists, rather than being, say, a subjective facade of consciousness (see bereitschaftspotential vs volition), let's see if this vaccine model produces results. I have dealt with many addicts who have been prescribed Naltrexone only to continue their abuse, so let's see how it goes.
posted by Henry C. Mabuse at 8:29 AM on January 5

Its such a fine line; I hate to see it go.
posted by breezeway at 8:33 AM on January 5 [1 favorite]

OK, since nobody else has done this: eponysterical.
posted by GrammarMoses at 8:58 AM on January 5 [1 favorite]

I heard Dr. Kosten talking about this on CBC. It's a clever trick. Because cocaine molecules are too small to be recognized by antibodies, the researchers have hooked some cocaine molecules onto deactivated cholera proteins to fool the body into attacking both. Future cocaine is then broken down by antibodies before it reaches the brain, so there is no high. They may be able to perform this trick with many other drugs as well. It's a voluntary thing--the addict must want to get off the drug, and must update the vaccine every few weeks. Lots more info out there if you Google "cocaine vaccine cholera".
posted by weapons-grade pandemonium at 9:09 AM on January 5 [1 favorite]

I really hope the vaccine doesn't stimulate an immune response against naturally produced neurotransmitters, or these guys are going to lose all ability to feel pleasure.
posted by topynate at 9:10 AM on January 5

Now if we could just get an orgasm vaccine, and vaccines against alcohol and all the other recreational drugs, and against tasty food, we could all be so much more focused and productive. Enough fun, get the fuck back to work.
posted by Meatbomb at 9:33 AM on January 5 [7 favorites]

I will support any vaccine that will prevent me from finding myself at a bathroom stall at a party, surrounded on either side by two strangers, both coked to the gills, simultaneously yammering excitably in my ear about what a good sales year they had and how, every time they make a sale, it's as good as having an orgasm, and how selling is a contest of wills and the reason they make so many sales is because their will is unbreakable, and how, later tonight, their going to take the Jag out and pick up some chicks and hop bars, because they're celebrating, and this celebration needs to go on all night, and do I want to join them?

Fuck no. I'd rather tear off my own ears and throw them in the urinal.
posted by Astro Zombie at 9:34 AM on January 5 [1 favorite]

topynate, most neurotransmitters, especially the one oversimplistically reputed as pleasure-mediating, such as dopamine, are synthesized in the brain. The vaccine itself doesn't make it there.

Irrespective of the fact that no one knows what a psyche is or if it really exists, rather than being, say, a subjective facade of consciousness

The vaccine targets the 'psyche' as much as 12-step programs do. Modern science takes physicalism i.e. a monistic thesis as its basis, so these disputes are all pedantic at some point. Basic idea is that the vaccine model implicitly assumes a folk metaphysics of human agency and seeks to manipulate something thought of as within volition. Whether it's true or false or not even wrong is irrelevant.
posted by daksya at 9:45 AM on January 5

I'm not sure how this fixes anything. If cocaine stops working, they'll just start using crystal meth, or ritalin or whatever.
posted by empath at 9:49 AM on January 5

Uh... ok, biology not my strong suit, daksya. But the vaccine works by causing the production of anti-cocaine antibodies, right? Well, do the antibodies make it into the brain?
posted by topynate at 9:51 AM on January 5

I really hope the vaccine doesn't stimulate an immune response against naturally produced neurotransmitters, or these guys are going to lose all ability to feel pleasure.

But that's exactly how Naltrexone works, and the vast majority of people using it don't have this problem.

Though there is a very small proportion of people who report depression/anhedonia and it's quite possible that the inability to produce endorphins might be a cause. Alternatively, it might be related to the fact that you've spent the last ten years screwing your career, selling your arse or letting down your family and friends?
posted by PeterMcDermott at 10:30 AM on January 5

If cocaine stops working, they'll just start using crystal meth, or ritalin or whatever.

Depends on whether you're using it on people who have a genuine desire to quit. There are lots of people out there who desperately want to stop using their drug of choice, but a combination of environment and craving makes them relapse over and over again.

If you've got something that can remove the craving, then large numbers of people who would otherwise relapse might not do so.

I know what you're saying though. Talking to people who have relapsed while on naltrexone, they tend to make the decision to use a couple of days in advance of actually scoring. Then they stop taking the drug, to give its protective effect time to wear off and ensure that they'll get high. But for people who are prone to spur of the moment decisions, and are genuinely committed to their recovery, I think it's another helpful tool in the toolbox. And if you're going to succeed, you need as many as possible.
posted by PeterMcDermott at 10:37 AM on January 5

Well, it's mostly that my experience with people that use drugs is that getting fucked up is the point, not getting fucked up on any particularly drug.
posted by empath at 10:42 AM on January 5

"Vaccine" seems like a misnomer to me; doesn't that imply that it is administered as a preventative measure? This is for people already addictive, so I think "treatment" might be a better choice of words. I don't want to be pedantic but this seems misleading.

I agree though, this could be a helpful tool for those who genuinely want to quit.
posted by mayfly wake at 11:11 AM on January 5

Oh I missed that it causes the production of antibodies. I guess that makes sense then.
posted by mayfly wake at 11:11 AM on January 5

I cannot be the only one who is having a visceral dystopian reaction. Thank God Vonnegut isn't around to laugh at this. I can't believe that the article talks about "prevention" in such a way, that it seems downright eager to bring up the questions as to who we could give this vaccine.

Let me allude to Meatbomb above and note, that no matter whether or not you approve of recreational drug use, there is one thing in a modern society you should not approve of: changing the body in order to prevent it from enjoying the disapproved.
posted by cotterpin at 11:28 AM on January 5 [3 favorites]

The study found that users did not seek alternative drugs to abuse. Where the vaccine was effective, they simply stopped using cocaine. Remember, this is a voluntary study: the participants wanted to clean up, so why would they seek a different drug that acted on a different metabolic pathway? It wouldn't actually give them a cocaine fix, so they had no particular urge to try meth or heroin or whatever.
posted by jedicus at 11:47 AM on January 5

The first time I tried coke I stayed up until eight or nine in the morning doing lines, and at some point decided I was going to build a boat. I NEEDED a boat.

Man, people on coke are annoying.
posted by Roman Graves at 12:57 PM on January 5 [2 favorites]

Cocaine use stops being about getting high pretty rapidly in the game. It's a fun party drug, until you start worrying about getting enough to last you through the next day's work so that you won't crash and burn and get fired. Cocaine rapidly becomes a treadmill that accelerates so quickly that you have no idea you can't get off until you try.

It actually increases impulsive behavior, and that makes it really hard to quit. You'll find yourself calling the dealer before it even becomes a conscious thought. Anything that can derail that train is a wonderful thing. This vaccine could save a lot of lives.
posted by The Light Fantastic at 2:10 PM on January 5

If you've got something that can remove the craving, then large numbers of people who would otherwise relapse might not do so.

Does this remove the craving? The article seems to say that what is removed is the effect.
posted by telstar at 3:20 PM on January 5

"Basic idea is that the vaccine model implicitly assumes a folk metaphysics of human agency and seeks to manipulate something thought of as within volition."

Word-soup bullshit. Try getting peer review on that.
posted by Henry C. Mabuse at 4:28 PM on January 5

"Does this remove the craving? "

What do you mean by craving? Mental obsession or physical withdrawal?
posted by Henry C. Mabuse at 4:30 PM on January 5

i see all this as a slippery slope to mandatory. just think of the power.
posted by brandz at 4:31 PM on January 5

i see all this as a slippery slope to mandatory. just think of the power.

Yeah, cause it's just soooo much easier to control sober people than it is crackheads. The power! bwah ha ha!! There are people who've spent 20 years trying to get off this crap. If one of them is helped by this vaccine...I'm completely for it.
posted by The Light Fantastic at 7:12 PM on January 5 [1 favorite]

people have a problem with cocaine because it's not readily available. just legalize the dang frigging thing and just get over it.

it's not like the incas, quechuas or aymaras were all coked out when Balboa, Cabeza de Vaca, Magallanes and all those other greedy spaniards invaded their lands.
posted by liza at 8:23 PM on January 5

people have a problem with cocaine because it's not readily available. just legalize the dang frigging thing and just get over it.

It's readily available where I live. And there are plenty of people who have problems with it, not because of the cost, but because of the pharmacological properties of the drug itself. These people, for example.

The incas, quechuas and aymaras weren't injecting hydrochloride or smoking freebase. If you take a look at any social history of cocaine use -- Marek Kohn's Dope Girls is a pretty good example of the genre -- you'll find that the sort of compulsive, self-destructive use patterns that exist for some people today also existed prior to criminalization. In fact, it was concerns about such behaviours, in part, that led to criminalization in the first place.

(NOT PROHIBITIONIST.)
posted by PeterMcDermott at 8:36 PM on January 5

It sounds like Anabuse in that it will be most helpful to people who want it, but for addicts who are forced to take it then it will likely have a mixed effect at best. I know alcoholics who drank while taking Anabuse even though it made them violently ill. They just drank through the explosive vomiting and viola! they eventually got drunk. An addict who was bound and determined to get high would probably just find a way around it. Addicts are smart like that.
However, it could be a useful tool in a recovering addicts arsenal, along with 12-Step programs, and treatment.
I appreciate the compassion some have expressed for the addicts situation, speaking as a recovering crackhead (seriously) myself.
posted by slickvaguely at 10:38 PM on January 5

Here's a podcast from a mindstates conference a couple of years back that covers some possible implications of anti drug vaccines from a rather concerned (as not to say slightly paranoid) point of view. Although, as stated there, considering how the war on drugs has been handled by the US so far it's probably not even too far off to expect a new weapon like this to be used in compulsory ways.
posted by morizky at 8:52 AM on January 6

I think slickvaguely nails it; something like this is only useful for people who *want* to quit. Forcing it on people won't be effective, since undoubtedly they'll either find other ways to get high or ways to avoid its effects (if you just take more and more, will you eventually get high, I wonder?).

But it sounds like a great tool for people trying to clean up. Hopefully it won't be outrageously priced.
posted by Kadin2048 at 1:53 PM on January 6

I'm reminded of the Alzheimer's vaccine against beta-amyloid, that gave most of the experimental recipients a multiple sclerosis-like illness. In hindsight how obvious is that: make an antibody to attack the brain, the brain will then be attacked by antibodies. Doesn't take a brain surgeon to figure that one out.

Coke addicts take coke. They then get sick because of an immune reaction. Do they stop taking coke? No, because they are addicts. They give themselves enough coke, possibly IV if the transmucosal route is immunized, to get it across the blood-brain barrier before it's all neutralized by antibody. Now suddenly you've got a guy who's totally coked to the gills and would be dead except for the neutralizing antibody. Are there going to be antigen-antibody complexes precipitating out in the small vessels, causing a type III immune reaction (serum sickness)? Is there going to be a tipping point where one more line will overcome the circulating antibody's ability to neutralize, and suddenly there'll be a giant cardiotoxic or neurotoxic dose of cocaine running around?

This seems like a splendidly bad idea, unless the goal is to kill off a few hundred coke addicts during the clinical trial. I see a lot of ways it could go wrong and do a lot of harm, which is supposedly something that Hippocrates warned us about.

What the hell - same approach got rid of a few hundred of those old Alzheimer geezers. Why not go for it.