Imagine it, a world with no addiction – a world where you can roll up your sleeve, take an injection and not feel compelled to use a particular substance. This is what scientists have been working on for years. Gone are the days when vaccines were just for a handful of childhood diseases. Now researchers are trying to develop new vaccines for different kinds of addictions, heroin, cocaine and even nicotine for people who have tried and failed to quit smoking. and help them live longer. Scientists from the Baylor College of Medicine in Houston, Texas and the University of Connecticut were granted $500,000 every year for five years from the National Institute on Drug Abuse to help them pioneer vaccines against methamphetamine and nicotine in the hope that immunizing against addiction would save the U.S government $84 billion in the associated health care costs as well as lost productivity and earnings and the ensuing crime that occurs to feed the habit. An experimental heroin vaccine showed promise in rats when the rodents failed to relapse into addictive behaviours after vaccination. The idea behind addiction vaccine is similar to that of infectious disease vaccines. Once injected or inhaled, the preparation based on animal blood or tissue, triggers the production of antibodies that bind to the heroin and form molecules too large to enter the brain and so prevents the brain from having the dopamine rush that drives a person to seek out more of the drug. After the dopamine rush has been stopped in its tracks, the vicious cycle is broken. However, the reality may be very different from the theory. Heroin is Not Just an Illegal Drug Heroin is not just an illegal drug, it is used in a number of medical applications. Under its medical name, Diamorphine, heroin is used in various countries as an ingredient in spinal anaesthetics and to treat severe pain from heart attacks and post-surgery for the relief of incision pain. In the UK it is also used routinely in epidurals for women who have had caesareans and it is given by injection during childbirth. Morphine, the weaker form of heroin, extracted from the poppy flower is essentially the same thing but without the addition of the chemical acetic anhydride, is present in foods that contain poppy seeds. Poppy seed bread rolls hit the headlines in recent years after consumers experienced morphine-like pain-relieving effects from eating the bread, leading the Food Standards Agency to warn parents of the potential effects on their children. So, what then for a person who has had a heroin vaccine and who later has an anaesthetic? Will that mean that diamorphine containing analgesia will no longer be effective in the vaccinated patient? – particularly as anaesthetics are designed to act directly on the brain. What if the person eats a poppy seed roll? Could that trigger a food allergy? Vaccine science is not always exact and it is known from the more traditional infectious disease vaccines that in some cases the recipient will develop antibodies not only to the antigens but also to other ingredients present in the vaccine. For example, one study showed that people who received a gelatine-containing DTaP vaccine had antibodies to gelatine for more than three years after the injection. Some people with these antibodies go on to develop a subsequent allergic reaction when given a further vaccine containing gelatine. Gelatine – bone meal from animals – is present in many foods, including sweets, jellies and cakes and the formation of these antibodies could give rise to food sensitivities. The same could be true for addiction vaccines if the person inadvertently ingests the product they are vaccinated against. Mice and Men are Not the Same Another concern is the true accuracy of animal studies. The anatomical makeup of a human being and a mouse or rat are very different and often a positive result in an animal trial will not extrapolate to humans. The Northwick Park Trial disaster in 2006 passed animal tests satisfactorily but resulted in six men being rushed to intensive care after they were given an experimental drug. One man swelled up so much he became known as the ‘elephant man’. The long-term goal is to use addiction vaccines not only for those already affected but on young people who have never tried drugs to prevent them from becoming addicted in the first place. To some, this sounds like a wonderful opportunity, while others recoil in horror at the thought of giving their drug naive children a heroin or cocaine vaccine and not having trust that some kids can just say no. Ignoring the Root Cause One doctor, writing for the Los Angeles Times, admitted she was sceptical about the idea of addiction vaccines after working in a community where grinding poverty, violence, social inequalities and lack of opportunities were features of everyday life. These factors, along with the hopelessness that comes with them, are as strong a driving force as the dopamine neurotransmitter. The vaccine in itself may prevent addiction to a certain substance, but the person driven to substance misuse by poor health, pain or depression will still require a release from their spiritual and physical pain and if they can’t find it through their usual drug, may only go looking elsewhere. Drug Rehabilitation that Cares A drug rehabilitation program uses the latest in medical science to remove drugs from the system and manage withdrawal side-effects while nurturing the whole person through counselling, mentoring and relaxation in a calming environment. Social workers can also provide support to every family member that has been affected by a loved one’s addiction and look at the issues that brought them there in the first place to help bring about a permanent abstinence.