September 15, 2021 — opioid-related drug more than enough Deaths in the United States reached an estimated record high of 69,031 people in 2020, topped 49,860 deaths occurred in 2019According to a new CDC report. most deaths involved synthetic opioids such as fentanyl.

President Joe Biden has pledged more than $10 billion to expand access to prevention, treatment and recovery services. money is important because people are getting Treatment For opioid use disorder Take high risk for recurrence, and that means a higher risk for opioid overdose.

Now, researchers are studying a possible bridge to successful recovery: a vaccine that can blunt the drugs’ ability to cause harm.

The first such vaccines are now entering clinical trials, arouse the hope of adding another tool in the adversaryAddiction Arsenal. But even if the vaccines prove to be safe and effective, their success may create some new problems to solve.

an advantage of Vaccines Trial investigator says their effect can last for several months Susan Comer, professor of neurobiology and psychiatry at Columbia University Irving Medical Center. The dropout rate for current medical treatments for opioid use disorder is up to 50% at 6 months, and a vaccine could protect people from overdoses and give them time to re-enter treatment.

“It acts as a safety net,” she says.

First vaccine to enter trial target oxycodone. Recruiting volunteers who have a diagnosis of opioid use disorder, but are not being medically treated and are still using opioids. a third of them will receive a placebo vaccine, one third will receive a low-dose injection of the vaccine, and the other will receive a high-dose vaccine.

A Shot Against Oxycodone

Researchers are primarily looking at the safety of the shot, but they are also looking at whether vaccination prevents the excitement that opioids typically produce. They hope to enroll 24 people initially, but increase to 45 people if the results look promising.

In response to the shot, the body produces antibodies, proteins that tag oxycodone and prevent it from reaching the mind. If the drug does not reach the brain cells, it cannot produce euphoria. And more important for the life-saving effects, it cannot block the brain’s signals to the body to breathe. The vaccine has already performed well in animal studies.

past trials of vaccines cocaine And nicotine failed. Those vaccines made it into the final clinical trial phase, but did not prove effective overall. So this time around, investigators plan to track antibody levels in participants, checking blood samples for signs of a good immune response to the vaccine.

But even though the first cocaine and nicotine vaccines didn’t work for everyone, there were some people they helped. This is why investigators involved in opioid vaccine trials want to track immune responses, say Marco Pravetoni, associate professor of pharmacology and medicine at the University of Minnesota Medical SchoolWhose team will assess the blood sample. Ultimately, he says, a doctor can also use this information to select a vaccine for a specific individual.

Pravetoni also states that oxycodone is one of three vaccines – the other two being heroin and fentanyl – Researchers hope to combine in a single shot. Recipients may need one shot a month for the first 3 to 4 months and then may need to receive an annual booster.

stop the pain

Vaccines also raise some issues that need attention, says Cody Venthur, assistant professor of pharmacy at the University of Wisconsin, which is not involved in vaccine trials.

“If you are vaccinated against oxycodone, for example, if you get into a car accident, you may not have access to adequate pain control,” he says.

Physicians may use other opioids pain managementBut limiting opioids that the vaccine targets is a “double-edged sword,” Venthur says, because vaccinated people can switch their opioid of choice to just one that doesn’t inhibit a vaccine.

Although these issues need to be addressed, if vaccines are successful, it will have an important role to play. venthur note a a survey of pharmacists and pharmacy students that he and his group conducted showing that respondents “overwhelmingly” viewed a potential vaccine as adjunct.

If vaccines become available, their application could extend beyond those who have opioid use disorder, Pravetoni says. He referred to the 2002 incident when terrorists captured a theater in Moscow and that Russian special forces are believed to have used an aerosolized form of fentanyl to disable everyone in the room. More than 100 hostages died, and the episode raised the specter of opioids used in chemical attacks. Pravatoni says vaccination could provide protection for first responders, law enforcement or others whose professions put them at risk for inhaling them, either accidentally or through such attacks.

These or other real-world applications for people at risk of exposure are many years away. Pravetoni says it took 10 years to reach this stage and estimates that in about 5 years, a vaccine that targets multiple opioid drugs could first enter clinical trials.

sources say

CDC: “Drug Overdose Deaths.”

Office of National Drug Control Policy: “Statement from Acting Director Regina LaBelle on Today’s CDC Overdose Death Data.”

Susan Comer, professor of neurobiology and psychiatry, Columbia University Irving Medical Center.

Clinical “Clinical Trials of Multicomponent Opioid Vaccine Components.”

Marco Pravetoni, associate professor of pharmacology and medicine, University of Minnesota Medical School.

Cody Venthur, assistant professor of pharmacy, University of Wisconsin.

BMC Medical Ethics: “Pharmacy stakeholder reports on ethical and rational considerations in anti-opioid vaccine development.”

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