The War on Drugs: Time for a Medical Intervention
Up until now, the international ‘War on Drugs‘ can be thought of as near enough a complete failure. Despite tough government policies and over $1 trillion of wasted tax-payers’ money, drug use remains a huge problem, with an estimated 272 million people aged 15-64 using drugs each year. In addition to the obvious damage to their personal health and the resulting burden on our healthcare services, drug users and drug-related gangs pose a significant and costly problem for law enforcement, local communities and families. On an international scale, inconsistent government policy surrounding this issue has resulted in political tension between countries such as Mexico and the United States: as California talks about relaxing its laws surrounding the use of cannabis, an estimated 47,000 are killed on the streets just over the Mexican border.
Cocaine: flickr.com/photos/adeepbreath/4047798889/in/photostream/
Anti-Addiction Vaccines on the Horizon
Part of the reason why international policy seems to fail continuously is down to the simple concept of supply and demand. Amphetamines, cocaine and opiates are some of the most common drugs in circulation and are all highly addictive, creating a large and dependent client base from which dealers and gangs can profit. Unfortunately, in most places the source of the problem, drug abuse, is treated as a crime before it is considered a health problem, which leads to overworked police, overstretched budgets and overflowing prisons.
Maybe it’s time we started viewing addiction for what it is; a complex illness and healthcare issue that should be treated, not fought.
Since drug abuse and addiction has so many different aspects to each individual case, it is near impossible for psychologists and clinicians to employ a standard ‘one-size fits all’ therapeutic approach. Because drug addiction can be considered a chronic disease, treatment is often ‘long term’ and needs to help the patient to initially cease using drugs, maintain abstinence and to restore their productive functioning in the family, at work and in society. This approach can be very costly and time intensive, and months of hard work can be negated by the simple and all-too-easy relapse into drug use.
In our efforts to counter this problem, could vaccines against the effects of cocaine, opiates, methamphetamines and even nicotine be the answer we’re looking for?
The idea has been around for nearly 40 years and, in principle, is rather simple – create vaccines that will enable the body to produce ‘anti-drug’ antibodies in high enough concentrations to negate the effects of the drug in question, much in the same way that a vaccine for a disease would work.
Currently, there are vaccines in development for all the major addictive drug groups; however, only cocaine and nicotine vaccines have, so far, reached the clinical-trial (human testing) stage. (See Addiction Vaccine, Tantalizingly Close – NYT)
Some persons injecting heroin. flickr.com/photos/phase3/359966492
The cocaine vaccine (TA-CD), which has been in development since 1994, is undergoing evaluation in a multi-centre clinical trial involving 300 treatment seeking, cocaine-dependent patients, after showing very promising results in previous studies . The treatment consists of 5 injections over a period of 12 weeks, producing effective levels of anti-cocaine antibodies in the body at around 7 weeks, reducing cocaine use. From the results of the previous studies on this vaccine, TA-CD looks likely to become the first anti-addiction vaccine approved by the Food and Drug Administration (FDA).
This could potentially be a breakthrough in the treatment of cocaine-addicted individuals, bolstering current therapeutic approaches, such as counseling, and reducing relapse rates. In theory this would lead to more patients finishing therapy and, over time, could dramatically reduce the overall number of regular cocaine users.
Unfortunately, at this moment in time there are no vaccines currently at the human-testing stage for methamphetamine or opiate addiction due to difficulties in maintaining high enough concentrations of antibodies. Also, the sheer variety of these types of drugs makes development of vaccines particularly difficult. That is not to say that these vaccines will definitely not appear in the next few years, however.
Vaccine Syringe: http://www.flickr.com/photos/8499561
The news of all these potential ‘cures’ to drug addiction may be very welcome to some, however we should definitely step forwards with caution.
Using any type of anti-addiction vaccine to help a patient who has voluntarily entered treatment is all very well and good, but any vaccine used to ‘treat’ addicts under legal coercion raises serious ethical concerns. For example, using vaccination as an ‘alternative’ to imprisonment in individuals who have been charged or convicted with an offense linked to their drug abuse.
It may seem a little far-fetched that addicts could be forced into receiving vaccinations that they don’t want with the threat of prison as their alternative. However, in view of the current prison overcrowding situation of many countries, this option would probably look very attractive to those in charge of keeping inmate numbers down…
The future development and use of vaccines and anti-addiction therapy in general depends on government policy surrounding addiction. As long as success in the ‘War on Drugs’ continues to be measured in the number of arrests and drug seizures, we will continue to fight a long and costly losing battle. Drug addiction is a medical issue and, consequently, policy should focus on health care, families and society – not just law enforcement.
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