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A vaccine being tested in the United States to counter the opioid crisis

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The vaccine can serve as a safety net, explains Sandra Comer, professor of neurobiology at Columbia University, New York. The hope is that this one works for a longer duration than other treatments like methadone, where% of patients drop out”,”text”:”after about six months, 50% of patients drop out”}}’>after about six months, 50% of patients drop out, she adds.

40 years of research

The idea of ​​a vaccination to treat drug addiction originated in the late 1970s.

Scientists have demonstrated that non-human primates can be vaccinated against heroinsays Marco Pravetoni, professor of psychiatry at the University of Washington School of Medicine in Seattle.

Since then, several groups of researchers have been working on different vaccines. Marco Pravetoni and Sandra Comer’s team is focusing on oxycodone, or Oxycontin, a powerful opioid.

A syringe and a liquid in a capsule.

“We have demonstrated that the vaccine can block the rewarding effects of oxycodone,” explains Professor Marco Pravetoni.

Photo: Columbia University

In Canada, there are no approved addiction vaccine uses. The British Columbia Ministry of Mental Health and Addictions replied by email that it was monitoring research on the subject in the United States and around the world.

We don’t have a functioning addiction treatment system, laments Cheyenne Johnson, the executive director of the Substance Use Center of British Columbia (BC Center on Substance Use). We have few drugs to treat addiction.

Studying vaccines to treat addiction and support long-term recovery is one piece of the puzzle where the science is new, but which looks very promising. »

A quote from Cheyenne Johnson, Executive Director of the Substance Use Center

Harness the immune system

As with a virus, the vaccine allows the body to generate antibodies, this time directed against a specific drug. If the person consumes oxycodone after receiving the vaccine, the antibody will bind to the chemical structure of oxycodone and prevent it from entering the brain, explains neurobiologist Sandra Comer.

Marco Pravetoni with a researcher in a laboratory.

Marco Pravetoni has spent the last 10 years producing all the laboratory data to demonstrate the effectiveness of the vaccine.

Photo: University of Minnesota

Unlike other treatments such as methadone or naloxone, antibodies therefore will not reach or bind to opioid receptors, explains Marco Pravetoni.

The vaccines therefore block the rewarding effects of the drug on the body without interfering with the receptors in the reward centers of the brain.

However, while the data gathered by his lab looks promising, human testing is still in its infancy.

many problems

Vaccines against cocaine and nicotine, for example, have so far failed: There was great variability between patients in the immune response, says Sandra Comer.

The identification of biological markers, ie the presence of certain proteins and molecules linked to immune responses in patients, makes it possible to discern which candidates have a better response to treatment.

Paramedics try to save an overdose victim.

Paramedics attempt to rescue an overdose victim in downtown Vancouver, Wednesday, June 23, 2021.

Photo: The Canadian Press/Jonathan Hayward

Daniel Steel, a professor in the Faculty of Medicine at the University of British Columbia (UBC), believes that vaccines are not likely to be a major component in the treatment of drug use disorders.

One wouldn’t want to walk into an emergency room with serious injuries from a car accident without opioids, says the expert in medical ethics.

Long-term resistance to pain medication would therefore be problematic. According to Sandra Comer, other options such as morphine would be fully effective during surgical procedures.

Prevent overdoses

The vaccine currently targets only one chemical structure at a time. If you have had a trauma or mental health problem in your life and you are using opioids for self-medication, the vaccine will not prevent the use of other opioids, points out Daniel Steel, of theUniversity of British Columbia.

The research team in the United States is therefore also working on a vaccine that will target fentanyl. The first data [chez les souris et les rats] indicate that it could prevent or reduce the likelihood of fatal overdoses, mentions Marco Pravetoni.

Fentanyl and its derivatives were detected in 86.8% of overdose deaths in British Columbia between 2018 and 2021.

A patient-centered approach is needed, according to the executive director of the British Columbia Center for Substance Use, because imposed treatments, in correctional centers, for example, offer few good results.

An approach that would be encouraging for long-term treatments, provided that the patient chooses, concludes Cheyenne Johnson.

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