

Researcher Develops Cocaine Vaccine - jamesbritt
http://singularityhub.com/2011/07/24/researcher-makes-a-career-developing-cocaine-vaccine-but-pharmaceutical-companies-won%e2%80%99t-produce-it/

======
skue
This is an opinion piece that doesn't even look at the science. The
ClinicalTrials.gov entry they link to as their source only lists one peer-
reviewed study, and its conclusion is this
(<http://www.ncbi.nlm.nih.gov/pubmed/19805702>):

    
    
      Attaining high (>or=43 microg/mL) IgG anticocaine antibody
      levels was associated with significantly reduced cocaine
      use, but only 38% of the vaccinated subjects attained
      these IgG levels and they had only 2 months of adequate
      cocaine blockade
    

That's not a stellar success. More importantly, if the Phase I trial revealed
that some addicts had up to 5x the level of cocaine in their systems _that's a
big deal!_

Cocaine doesn't just do damage to your brain. It can trigger heart attacks and
death by causing the blood vessels that feed your heart to spasm and reduce
blood flow. If a person under 40 walks into the ER and complains of chest
pain, one of the first questions any competent doc will ask is whether they
have recently used cocaine.

Apparently, they didn't see increased mortality in the small sample of people
they studied -- but that doesn't mean it wouldn't kill significant numbers of
people when deployed across a sizeable population.

So in summary, we have a vaccine that's immunologically ineffective on the
majority of recipients, which doesn't eliminate their cocaine use (just
reduces it, p=0.048), and which can cause some users to boost their cocaine
ingestion to very dangerous levels, and thereby quite possibly increasing
cardiac morbidity and mortality (which the vaccine producer may be found
liable for).

Why aren't pharma companies lining up to produce this remarkable invention? It
must be a conspiracy!!!

Edit: Fixed formatting of quote.

~~~
andrewflnr
I would really hope the pharma company couldn't be held liable. It's not like
increased cocaine usage is a side-effect. It's a voluntary response to the
drug's stated purpose. Of course you never know if common sense will actually
be applied in such a case.

~~~
Symmetry
Its not so much a matter of it causing legal problems directly, as much as the
press getting wind and starting in investigation that causes people to demand
that their elected officals Do Something. Remember a while back when those
anti-depressants were found to be associated with increased suicide risk? I
was surprised that there was an outcry since " _A dangerous time in depression
occurs when a patient is coming out of the deepest part of the experience. At
that point, they can mobilize their newly acquired energy to take their own
life._ "[1] But, I never saw anything about that aspect in the news coverage.

[1][http://emedicine.medscape.com/article/288598-overview#aw2aab...](http://emedicine.medscape.com/article/288598-overview#aw2aab6b3)

------
nlh
I instantly (and incorrectly) assumed that this was some conspiracy theory-
laden story about how big pharma doesn't want to stop cocaine use and the war
on drugs is too profitable and etc. etc. etc., but thankfully I was wrong.
Here's the key line from the story:

    
    
      the dilemma is clear: What would happen if the media got
      wind that inoculated drug users were buying even more coke
      than before. It would be a public relations nightmare for
      any business.
    

So that's it - and it makes sense. Vaccine makes cocaine less effective, so
people buy more (in the short term) to try and get the same high, until they
finally realize that doesn't work and give up using it. Long term good, short
term PR nightmare.

~~~
tdicola
Yep I agree, the problem is this vaccine cures the drug effects but not the
addiction or desire for drugs.

~~~
ghostDancer
I think the best case for this vaccine is a therapy with vaccine and a
supporting group or counsel, and this is made more for people trying to give
up the habit (dependency) or for people not to start.

------
badclient
I guess once you are hooked the vaccine can be challenging and lead to
overdose.

But if you take this before getting hooked, it can just register in your mind
that coke isn't fun and there is no high.

It's like my relationship with cigerettes. First few times I took it I was
really nervous I would get hooked. Ultimately I found little joy from smoking.
So I'm not much of a smoker but I'll average 5-10/cigarettes a month from
social situations. My rule is that I can never buy cigs or smoke them at my
will since it will mean I'm lusting for it. On the other hand if a friend
offers one occasionally, I can smoke it.

------
munin
"What would happen if the media got wind that inoculated drug users were
buying even more coke than before. It would be a public relations nightmare
for any business."

not to mention a public health nightmare! cocaine has effects on more than the
brain.

also, their study is pretty sketchy:
<http://www.ncbi.nlm.nih.gov/pubmed/19805702>

why are there so many individual differences? why does it work on some people
but not others? shouldn't a vaccines effect be pretty standardized?

also, why after 20 weeks are the placebo and high-ig concentrations equal in
terms of cocaine-free urine samples?

with questions like these, it seems pretty obvious why no one wants to roll
into stage III with this in its current form. it's shitty to hear when it's
your life's work but ... it sounds like it needs more work.

~~~
Daniel_Newby
_shouldn't a vaccines effect be pretty standardized?_

No! Evolution guarantees that the immune system is not standardized.

------
felipemnoa
If nobody will manufacture it then it is time to start a startup. Even with
the potential PR problems of patients going broke buying more cocaine at
first, they will probably be able to find investors. Remember that the google
founders at first tried to sell their search engine. Nobody would buy so they
had to start google.

They could probably even put the patients in a rehab facility to prevent them
from buying more cocaine. Also, this problem should be the first thing that
should mentioned to anybody that is listening to prevent the media of acting
like they just broke the news on "the evils of using this vaccine that the
manufactures were trying to hide" (you know how sensationalist they are) If
they do that then news organizations will probably not be able to make a big
deal about it.

~~~
Symmetry
Startups as we normally think of them don't really work when you have to spend
tens or hundreds of millions of dollars to get your drug past FDA approval
before you can start making money.

------
mbreese
If the vaccine works, the big question is: who will buy it? The biggest market
that I'd see is addicts who commit crimes and are required to have the
treatment as part of a court ordered program. How big is that market? Pharma
isn't about to spend millions on a phase III trial for a fairly small market.

If they really want to see their vaccine approved for use, maybe they should
start their own company to produce it. If there is enough of a need for the
vaccine, the should be able to find funding (VC or grants).

Now, I could really see their nicotine vaccine doing very well, since there
are lots of people who would voluntarily take a vaccine to stop smoking.

~~~
knowtheory
People don't seem to get how awesome this is. Sell it to parents. You can
guarantee (for some period of time likely) that your children have an
artificial tolerance for drug use w/o any ill effects.

The only implication I would want to think about more is what happens next. If
all or most high schoolers had been inoculated against hard drug use, does
that just mean that people would buy larger quantities? Would the market
simply adjust? Would more new designer drugs enter as alternatives?

~~~
chimeracoder
People would just shift to other drugs.

This concept is nothing new; an analogous drug that provides tolerance for
heroin already exists. But heroin addicts who are forced to take methadone (as
opposed to those who take it to assuage withdrawal symptoms) typically just
turn to other drugs.

This drug would be useless for parents - it shouldn't be used to try and force
someone else not to use cocaine, since they'll just turn to other drugs. Its
only potential use case is the current drug user who wishes to stop but is
afraid of the withdrawal period.

~~~
btilly
Citation needed.

This is the first time that I've heard the claim that giving someone methadone
actively causes them to go to substitutes.

------
rflrob
Might not an effective approach be the _opposite_ of this vaccine? Rather than
trying to down-modulate the effects of (addictive substance here), if you
instead up-modulate undesirable effects, then even a small dose would have
less pleasure than before. Disulfiram (Antabuse) seems to be mentioned a lot
in this thread, and that intuitively seems like a saner approach than "make it
so they need more to get the same high".

------
djeikyb
I have little formal knowledge in the area, but wouldn't a cocaine vaccine
ruin any medical potential for that class of drug?

~~~
maaku
That was my first concern. Cocaine is one of the oldest anesthetics, and still
used in some limited circumstances. But there are a lot of derivative drugs,
e.g novocaine that nearly ever dentist uses, which are basically cocaine
without the dopamine high. Would this vaccine change novocaine's effectiveness
in the patient?

~~~
sorbus
It would be fairly easy to determine whether the antibodies bind to commonly
used drugs that are derivatives of cocaine (this is basically what ELISA
testing is for, and computer simulations would give you a general idea of
whether it would bind or not). I would assume that this sort of testing would
have been done prior to it being tested on humans, or at the very least would
be done before it enters into common usage.

------
cmsj
Discussions of "big pharma" aside, this seems like a classic case of treating
symptoms and not causes. If you consider that the cases likely to present for
vaccination are the more serious ones, you're going to be preventing people
from taking one drug. If they have a serious need they will just take a
different drug. Inoculate them against all the common drugs and they'll start
mixing household chemicals and then you have a dramatically worse situation
(google for the effects of 'krokodil' if you have a strong stomach). It would
probably be better to help these addicts work through their problems so they
don't need drugs. Leaving them unable to fill a need through conventional
means just forces them down unconventional paths.

Why do we have such an obviously backwards approach to drug abuse? :(

~~~
Daniel_Newby
_Why do we have such an obviously backwards approach to drug abuse? :(_

Because the intelligentsia have been taken over by a religion that says people
are born pure and can be punished back into virtue if they get contaminated.
Growing up in quiet high-IQ enclaves, their personal history is that
unpleasant consequences teach better behavior. It is outside their life
experience that there could be people who are too stupid to see logic, too
distracted to notice lessons, too impulsive to act on logic, or too neglected
in early childhood to develop susceptibility to social influences.

------
xelipe
As patents start to run out on some of the most profitable drugs, big pharma
is looking for a new business models and new drugs. In addition to the cocaine
vaccine, there are reports that they are working on a vaccine for alzheimer's.

What I also find new about the Cocaine Vaccine is that traditionally vaccines
are composed of biological agents that mimic or resemble a decease-causing
microorganism. Cocaine addition and alzheimer's are not caused by a
microorganism which would indicate that big pharma are cooping the word
'vaccine' for a new class of drugs.

~~~
cwp
Did you read the article? "Vaccine" is the appropriate word - the idea is to
bind cocaine to inert cholera to make the immune system produce antibodies. It
doesn't cure the addiction, it just makes cocaine ineffective.

------
btilly
It would be wonderful if they could produce an alcohol vaccine.

I then would like to see a law mandating its use for all people who who have a
DUI.

Unfortunately the quantities of the active drug in your system when you abuse
alcohol is orders of magnitude higher than for nicotine or cocaine. So it
could well be that your body's immune system simply gets overwhelmed. (That or
there could be real health consequences from the immune reaction.)

But it would be nice if it existed.

~~~
davidhollander
> _I then would like to see a law mandating its use for all people who who
> have a DUI._

The problem is that such vaccine wouldn't only work when you are in a vehicle
or prevent you from making other stupid decisions. This really wouldn't
address the root cause and would be a pretty egregious violation of an
individual's freedom of thought.

The idea of the state having authority to permanately biologically alter an
individual to control his or her behavior is a throwback to the time of
lobotomies, which even the Soviet Union banned in the 1950s.

~~~
scarmig
"Even the Soviet Union" is a bit misleading, though I understand where you're
coming from. The USSR banned lobotomies in 1950, while in the USA it was
banned... never (though some states individually did). In fact the USSR was
the first major country to ban lobotomies. Lobotomies legally happen even
today in the USA, though there's no longer the epidemic of wanton misuse.

I just say this because it's easy to get into the rut where anything the
Soviet Union did was bad and everything the USA did was good. There's no
reason per se to expect Soviet doctors to be particularly evil compared to
American ones. Which isn't to justify the many many evil things the Soviet
state did perpetrate.

