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One anti-cocaine vaccine, already shown to be safe for humans, prevents people who snort coke from getting high. Researchers are also testing vaccines for nicotine. And results look promising for the eradication of PCP abuse and methamphetamine addiction. The National Institute on Drug Abuse has funded much of the development costapproximately $4.5 million since 1996. "Just as medications have been developed for other chronic diseases, such as hypertension, diabetes, and cancer," writes NIDA in its five-year strategic plan, "drug addiction is a disease that also merits medication for its treatment."
Looking at social ills through a medical lens is not a new phenomenon. By studying disorders from alcoholism and compulsive gambling to attention deficit disorder and depression, scientists have discovered not only genetic factors responsible for so-called abnormal behavior, but also the way such behavior affects the brain's neural map. According to Dr. Frank Vocci, director of NIDA's Treatment Research and Development division, the antidrug vaccines can provide a powerful weapon against substance addiction, especially when combined with therapy and psychiatric medicine. And vaccines, which unleash an onslaught of drug-busting antibodies, can do what traditional treatment can't. "If a patient is in an emergency room with high methamphetamine levels and experiencing a cardiovascular crisis," says Vocci, "antibodies would bind the drug up and cause the individual to excrete it." In other words, an injection of antibodies could reduce the specter of death by overdose to a bad '70s flashback.
Though scientists have long used vaccines to trick the immune system into thwarting lethal diseases, the antidrug vaccines are a new breed, designed to attack pleasure-inducing chemicals that the brain craves. Some of these new vaccines use antibodies that bind to the illegal drug, render it inactive, and then leave the bloodstream. Others remain potent for years. This is the type of vaccine that purged the Western world of polio and smallpoxand may put a choke hold on civil liberties.
The human affinity for altering perception reaches far back in the evolutionary chain. If antidrug vaccines become widely available, parents will be able to decide whether their kids will be able to get higheven as adults, even recreationally. And governments could target certain communities for vaccination. "Who is going to get it?" asks Dr. Peter Cohen, an adjunct professor at the Georgetown University Law Center, who has written on the legal implications of the vaccines. "Those who have a history of cocaine abuse? Those who may be statistically likely to become addicts? Or do you vaccinate everybody?"
Cohen argues everyone should get the shots, but so far the only human tests have been done on addicts. In one experiment by Yale University this spring, researchers vaccinated 34 former cocaine abusers living in a residential treatment facility. That vaccine, called TA-CD, generates antibodies that grab onto the upper as soon as it enters the bloodstream, preventing the drug from bumrushing the brain.
The new vaccines have limitations. Namely, addicts could still get high if they did enough lines. Enter Dr. Donald Landry, associate professor of medicine at Columbia University's College of Physicians and Surgeons, who's researching so-called catalytic antibodies. With a load of them in your bloodstream, you'd have to snort a lot of coke to feel any effect. So much so thatfinancial limitations (you'd have to spend a ton of money) and physical needs (you'd have to stop and breathe) would kick in. "Everyone attempting to quit cocaine can use the catalytic antibody," Landry says.
But if you can't get high from cocaine, you can get drunk on alcohol or stoned on pot. Substance-abuse counselors say a vaccine alone won't solve the problem of drug abuse, and shouldn't end up replacing more expensiveand extensivetreatments that deal with the factors that lead to addiction. "We're not going to run out of new and inventive things that are going to make people high, but that doesn't mean a vaccine won't help for some people," says Peter Kerr, a spokesman for the New York branch of Phoenix House, who compares the use of antidrug vaccines to relying on the synthetic opiate methadone to treat heroin addicts. "The primary emphasis is relieving symptoms. Counseling is an ancillary factor."
Unlike methadone, which is used to fight debilitating withdrawal symptoms, or Anabuse, which causes an alcoholic to become violently ill upon drinking, some vaccines can last a lifetime. There's no turning back. And if the choice of a child is in the hands of a parent, or that of a prisoner in the hands of the government, then involuntary vaccinations become the result. "It's hard to justify vaccinating a million children when only a small percentage are at risk, even in an area where cocaine use is endemic," says Landry.
The vaccines also raise questions of privacy. "Once you're vaccinated, you have antibodies in your blood that would show up in a drug test," saysCohen. "The least controversial solution is universal vaccination: You wouldn't be stigmatizing any one group."
Yet mass vaccinations have always been controversial. "That's treating people like cattle," says Joe Lehman, a spokesman for the Cato Institute, a libertarian think tank. Lehman believes that there would be pressure to get an antidrug vaccine, especially when it comes to insurance companies (who might offer special premiums to the vaccinated) or employers (who in the age of mandatory drug testing have obvious motives). Though mass, forced vaccinations may be unlikely, a scenario in which individuals feel pressured to get the vaccine is no less chilling in its implications.
Civil libertarians, on both the left and right ends of the political spectrum, aren't the only ones concerned over universal vaccination. Critics of childhood vaccinationsalternative medicine advocates, concerned parentsare growing in number. The National Vaccine Information Center promotes parental awareness about vaccination risks and the right to refuse shots. Barbara Loe Fisher, president of the center, is outraged by the idea of antidrug vaccines. "To add a vaccine to the mix that doesn't fit into early-childhood diseases seems amazing," she says. "That we can get a vaccine to solve every social problem is short-term thinking."