Cocaine Vaccine Raises Some Interesting Questions

Science marches on … There was report out in January about a vaccine trial in mice. The vaccine created antibodies to cocaine. The idea is that by giving it to those in treatment, they won’t be able to backslide and it will help them maintain sobriety. The question is whether this approach is the be-all and end-all it is touted as.

Here’s the logic. If someone is genetically predisposed to cocaine addiction, this treatment will kill the possibility of using cocaine to get high. Sounds good, doesn’t it?

Well, there are precedents and the news isn’t good.

Disulfiram is a drug marketed as Antabuse. It interrupts the metabolism of alcohol so that someone taking the drug will get ill if they drink. Disulfiram blocks the breakdown of alcohol in the liver and any alcohol consumed is converted to acetone. The acetone builds up and drinkers then become violently nauseated.

Perfect solution, right? Well, it doesn’t work. At least it doesn’t work as a single therapy. Users either quit taking it or, when the addiction is a strong one, simply drink despite of the ill effects. Who said addiction would be so easily defeated?

So, my beef with wonder cures is that they are relied upon, not as the adjunct therapies they should be, but as “miracle cures” which they decidedly are not. If a vaccine against cocaine is marketed as a safe and effective cure, here is my prediction: doctors who otherwise would not treat addiction will start prescribing it. Patients who should be in a professional therapy and treatment situation will look at it as a cure – cheaper and quicker than spending time in behavioral therapy. And most of those will fail.

It’s the failing that does the damage. Addicts are prone to using failure as an excuse to quit trying and to slide deeper into addiction. It’s an ongoing battle to repeat a course of treatment after a lapse. But it’s a battle that needs to be fought, sometimes many times.

As an adjunct to licensed treatment, this will be great, but only as one prong in a larger strategy. The idea of a one-size-fits-all treatment is, in my opinion, bogus.

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