Why Big Pharma (and the Public) Doesn't Want an Addiction Vaccine

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The initial problem confronting Janda was that these drugs, once in the bloodstream, make terrible targets because they are way too small for the immune system to even detect them. Zoom—they fly straight to the brain. But Janda figured out a way to bulk up these minute molecules by attaching them to a big, fat, harmless protein, like a small plane flying a giant banner at the beach. In addition, Janda had to find the right mix of chemicals to create an adjuvant, which is an additional lure to get the immune system jumping. “It’s not like some magical premise,” the sweetly humble Janda told the Times. “And the beauty of it is you’re not messing with brain chemistry.”

(Alcohol and marijuana have so far baffled vaccinologists: ethanol is too miniscule to be manipulated, while pot’s active ingredient, THC, hides inside cells, invisible to antibodies.)

In July, Janda made news when he announced that an anti-heroin vax seemed to work in rat experiments, meaning it could move into safety trials for humans. Yet as the Times reported, “as has often been the case in Dr. Janda’s career, that breakthrough came on the heels of a setback: A Phase 2 clinical trial for a nicotine vaccine that was based largely on his work was declared a failure this summer.”

And so it goes for Janda, who estimates he has five to ten years left to realize his vision, his dream, of an effective anti-addiction vaccine. Yet a number of his experimental vaccines have worked well in small numbers of people—for example, an anti-coke vax helped some addicts in clinical trials either stay off the drug longer or, when they did use, feel like the high was too low to be worth the money.

And every day, Janda, like other leading researchers toiling on science’s margins to develop a vaccine for addictions, gets calls, emails, even visits from alcoholics or drug addicts (or their parents or doctors) who are desperate—even dying—to stick out their arm for a shot of an experimental vax and a shot at recovery. But unless you are already enrolled in one of the (small) clinical trials, tough luck.

But desperation day after day seems insufficient to squeeze a drop of compassion from the article’s readers’ hard hearts. Perhaps the reason is that “a shot a recovery” is not supposed to be as simple as “a shot in the arm.” For veterans of recovery, men and women with five, ten, twenty years of sobriety, who work the program faithfully, who know rock bottom in all its lurid detail, the prospect of a “magic bullet” is absurd. Yet no one expects an effective vaccine to be a magic bullet—it would probably offer partial protection against the effects of a drug and therefore remain but one of many weapons against what can otherwise be a terminal disease.

Scratch “one of many weapons” because there are actually only a few.Which is why the knee-jerk negativity of this addiction vaccine anti-claque is so unworthy of anyone in the so-called recovery community.

Here’s a sample of three comments coming from distinctly different areas of expertise: 

"These studies betray a startling lack of understanding of the learned neurobiology of addiction. It does not take many exposures before the habits associated with drug consumption themselves acquire rewarding properties. It is not surprising that simply blocking the actions of nicotine would not substantially affect the habits of people who have been addicted to cigarettes for many years. Sorry, guys, but the brain had got to be messed with since it calls the shots."