
Vaccines against addictive drugs push forward despite past failures - fern12
https://cen.acs.org/articles/96/i8/Vaccines-against-addictive-drugs-push.html
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RcouF1uZ4gsC
What is going to be an issue, is that opiods (like heroin, Fentanyl, morphine,
oxycodone) actually have a clinical use apart from the abuse. So either the
vaccine is very specific and just changing from say fentanyl to another of the
many available opiods defeats the vaccine, or else it renders a whole class of
drugs that may be legitimately used for pain management or anesthesia during
surgery no longer able to be used for potentially the rest of the person's
life.

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freedomben
My thoughts exactly. So somebody gets this vaccine and then breaks their arm
or goes into surgery, and suddenly there is no pain treatment available to
them because of the vaccine.

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danieltillett
I was under the impression that past heavy (ab)users of opioids no longer get
any analgesic benefit from them?

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Blindedwino
Yes, I had a friend who was an ex heroin addict, she needed huge quantities of
any sort of painkillers to get any effect.

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epmaybe
It goes back to basically any medication that acts on G Protein Coupled
Receptors (of which opioid Receptors fall under). If given the same dose for
over 10 days, by day 3 you are seeing a significant loss of analgesic effect.

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baxtr
Wait, so we we invent some great drugs for very specific use cases, prescribe
them to the masses, just to find out that we created an epidemic and, then,
instead of going back to prescribing it only rarely, invent a new drug against
the abuse!? I don’t get it

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adventured
I've had a few friends that became addicted to opioids over the last ~20
years. It's terrifying to see what it can do to a person, how the addiction
takes over. The only product I've seen work consistently to stop relapse and
interrupt the craving, is Suboxone and the equivalent. It worked extremely
well, returned them to a fully normal functioning state, but they couldn't
stop taking it.

The vaccination approach, even if it's unlikely to succeed, I certainly hope
that it does, as every opioid addict I've known has ended up in a battle that
never actually stops. It becomes a life-long struggle.

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CodeWriter23
There must be a dose where the volume of heroin outstrips the body’s ability
to generate antibodies, resulting in opiates passing into the brain. Addicts
who have taken the vaccine will increase their chance of overdose when they
relapse because they know just one balloon isn’t going to do the trick. And
slam 5 balloons instead.

Also, opiate receptors serve a purpose in pain relief and feeling pleasure
when the brain secretes endorphins. The article doesn’t cover whether
endorphins will trigger the immune response in people who have been modified
by the vaccine.

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Animats
There have been previous attempts. There was "NicVax", which blocks nicotine
somewhat. That made it to Phase III trials, but it wasn't very effective.

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tcj_phx
> Rather than activate the receptor, another drug called naltrexone blocks the
> receptor and can decrease cravings over time.

Naltrexone is essentially a vaccine against both opioids and and alcohol. My
recovered-alcoholic friend found that Naltrexone eliminated her ability to
consume large amounts of alcohol. But she drank "to make it all go away", and
Naltrexone didn't provide any relief for her emotional problems. She took
herself off Naltrexone and drank herself into a 2-year prison sentence for her
3rd DUI. She tried to stay sober after getting released, but was unsuccessful
because of her anger at her ex-husband (which I somewhat helped her release).

Gabor Maté [0] says that virtually 100% of his most-hopeless drug addict
patients had experienced "adverse childhood experiences".

[0]
[https://news.ycombinator.com/item?id=16023802](https://news.ycombinator.com/item?id=16023802)

Last month I met "Henry" \- our mutual friend said he was trying to get off
"Black" (black tar heroin). A while later Henry tagged along with us... Mutual
friend disappeared for a bit. Henry told me how scared he was of Black... That
he'd once gone to Mexico with his family, thought he took enough to get him
through the week, but started to go into withdrawal at the end of the trip.

He also said how much he loves G (meth amphetamine), and that he'd tried to
find some that day, but was unsuccessful. He then said, "A junky like me _has_
to shoot something...", and said he'd used Black in the Taco Bell bathroom
that afternoon, shortly before getting in my car.

I told him I thought my friend (whom I've mentioned here before) was
predisposed to addiction on account of her being adopted. Henry immediately
said that he was adopted -- that he was found in a dumpster at 4 months old,
screaming his little heart out.

> But people struggling with addiction to cocaine or stimulants such as
> methamphetamine don’t have treatment options like these. They don’t exist.

I've read some studies that found that Naltrexone is also helpful for reducing
people's stimulant use, and that the anti-psychotics (anti-dopamine drugs)
cause people to use more cocaine/amphetamine.

Really there's no need for developing "vaccines" for "addictive drugs" \- we
have tools (naltrexone, the MAOIs, etc) that work well enough to address the
reasons that people self-medicate with substances that cause long-term harm.
Doctors just need to consider the full conditions of the person who can't
limit their use of addictive substances to "recreation".

It would also help to stop teaching addicts to be helpless in jail.

This week I finally found the rest of a quote about 'feeling safe' that I've
referenced for years [1]. Someone had asked about "ego" \- the response was,
"It's very important to develop an ego. When a person feels safe, the false-
ego goes away."

[1]
[https://news.ycombinator.com/item?id=15024780](https://news.ycombinator.com/item?id=15024780)

~~~
hookdump
Interesting points.

Something else I'd point out is that science often goes through the trouble of
finding paliative solutions rather than developing a fundamental understanding
of the root causes.

If you don't tackle the root causes of addiction, they'll respawn identically
or in the form of other addictions, in my opinion.

Re. your quote about the ego, I didn't quite get its meaning. Can you
elaborate on it?

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fake-name
I don't think any of the people involved in the science here _want_ to be
doing paliative solutions, but rather it's the best they can get funding for.

It's much harder to fund "we have to completely rework our public health
infrastructure" (in the US, at least), then "We can help save these lives in
<insert relatively short timeframe>".

~~~
tcj_phx
> I don't think any of the people involved in the science here want to be
> doing paliative solutions, but rather it's the best they can get funding
> for.

Elisabeth Rosenthal wrote _An American Sickness_ about this phenomenon. This
essay is a good preview: _How Economic Incentives have Created our
Dysfunctional US Medical Market_ \- [https://medium.com/@RosenthalHealth/how-
economic-incentives-...](https://medium.com/@RosenthalHealth/how-economic-
incentives-have-created-our-dysfunctional-us-medical-market-b681c51d6436)

~~~
mattkrause
The claim in that article--"a lifetime of treatment is preferable to a
cure"\--is bonkers.

It _might_ be true if there was only one pharma company, but surely most
companies would prefer that you buy their one-time cure than become a lifetime
customer of their competitors. Diabetes is a particularly bad example because
an ungodly amount of time and money has been spent trying to protect, repair,
or regrow beta cells. Despite this, we have made very little progress.
However, Accu-Chek is not bribing researchers to tank their experiments in the
hopes of selling more test strips. The problem is that biology is absurdly
complex and messy.

Plus, we have a nice counter-example. Until recently, patients with Hepatitis
C were treated with a long course of interferon (6 months to a year), with
relatively mixed results and fairly nasty side effects. About 50% of patients
did not clear the virus, and needed liver transplants.

In 2013-4, Gilead got approval for sofosbuvir, which needs to be taken for
only 12 weeks, has a much higher cure rate, and more mild side effects. To be
fair, it _is_ eye-wateringly expensive, especially in the US, but that's one
way to make 'cures' work.

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teslabox
Type-2 diabetes is a sham diagnosis. A key factor in the development of
"insulin resistance" is the overconsumption of vegetable oils. These thin oils
go rancid in the production process, and have to be "refined" to remove the
rancid smell.

Before the middle of the 20th century, linseed oil and soybean oil were drying
oils that were used to make stain and paint. When the paint producers figured
out how to make paint from petroleum, the seed oil industry rebranded their
product as "vegetable oil".

~~~
hookdump
And there are lots of other key factors within our eating habits.

Why this isn't the focus, and instead people receive insulin, escapes my
grasp.

