Why Activists Are in an Uproar Over the 'Addiction Vaccine'

A recent Times article about a vaccine that may help curb addiction provoked a rabid response among many recovering readers. Why?

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This week in its Science section the New York Times ran an article tantalizingly titled "An Addiction Vaccine, Tantalizingly Close." The piece profiled the research of a pioneer in anti-addiction vaccines, Dr. Kim Janda, a professor at California's prestigious Scripps Research Institute.

Janda has been obsessively working on a vaccine against one addictive drug or another for some 25 years. He saw the concept of a vaccine against, say, cocaine or heroin as a no-brainer, "simplistically stupid," he told the Times. Since vaccines had already proved they could assist the immune system to mount antibody defenses against something as complex as a living virus, there was no reason to doubt that the same mechanism could neutralize a coke or smack molecule.

The Times quotes no less an addiction luminary than Dr. Nora Volkow, the neuroscientist director of the National Institute on Drug Abuse, who called Janda "a visionary" and expressed solid confidence that his trailblazing would eventually bring anti-addiction vaccines to the market, revolutionizing treatment. Endorsements don't come any better than that -- and Janda has also enjoyed plenty of federal funding along the way.

In fact, he had little choice. Big Pharma has long snubbed addiction vaccines -- partly because vaccines tend to be one-shot products that earn chump change compared to the billions raked in by daily high-cholesterol pills, and partly because addiction is a marketer's nightmare, involving as it does a stigmatized disease and a "criminal" market, no matter how big. Janda raised money from venture capitalists to advance his most promising vaccines into clinical trials, but the start-ups tanked when the vaccines failed.

Unfortunately, Janda has a slew of vaccine failures to show for his many years of single-minded dedication to the cause. He also has no successes -- at least if success is defined as, say, an anti-nicotine vaccine on pharmacy shelves. In this respect, the "Tantalizingly Close" is so much happy talk. And one of the most striking things about the long Times piece is how skeptical -- how downright negative and even nasty -- the vast majority of the 60-plus readers' responses were. From scientists and sobriety veterans alike, the consensus seemed almost to be that a vaccine for addiction was nothing but pie in the sky and therefore a fool's errand. Also detectable was a subtle disapproval of the dream itself -- a judgment that would be rightly condemned as bigoted if voiced against a vax for AIDS or cancer.

This is all very curious. Anyone who reads the Times regularly, and even those who just scan the comments posted by readers, knows that these are people who often, as odd as it may sound, think before they type. The discussions tend to be more diverse and provocative than the articles themselves. But the readers of "An Addiction Vaccine, Tantalizingly Close" were an audience of all boos and raspberries. Yet surely many, if not most, of them would agree that addiction is, at least in part, a disease -- a pathology in certain brain functions -- that medical treatments (such as Chantix for nicotine addiction and Vivitrol for alcoholism) are beginning to emerge as tools, however blunt, in the multi-front battle against it.

There are currently more than 400 experimental vaccines against addictions in the pharmaceutical pipeline; few will ever make it far enough to be tested in humans, and of those that do, nine out of 10 will fail. Those are the odds of drug development. But hand it to Janda for first plowing the field -- and more than that. Janda came up with the platform necessary to adapt the vaccine model to the daunting specifications of cocaine, nicotine, heroin, meth, and other major substances.

The initial problem confronting Janda was that these drugs, once in the bloodstream, make terrible targets because they are way too small for the immune system to even detect them. Zoom -- they fly straight to the brain. But Janda figured out a way to bulk up these minute molecules by attaching them to a big, fat, harmless protein, like a small plane flying a giant banner at the beach. In addition, Janda had to find the right mix of chemicals to create an adjuvant, which is an additional lure to get the immune system jumping. "It's not like some magical premise," the sweetly humble Janda told the Times. "And the beauty of it is you're not messing with brain chemistry."

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Walter Armstrong is articles editor of The Fix.

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