8 ms·

Researcher Develops Cocaine Vaccine

87 points by jamesbritt 15y ago

djeikyb 15y ago
I have little formal knowledge in the area, but wouldn't a cocaine vaccine ruin any medical potential for that class of drug?
- maaku 15y ago
  That was my first concern. Cocaine is one of the oldest anesthetics, and still used in some limited circumstances. But there are a lot of derivative drugs, e.g novocaine that nearly ever dentist uses, which are basically cocaine without the dopamine high. Would this vaccine change novocaine's effectiveness in the patient?
  - sorbus 15y ago
    It would be fairly easy to determine whether the antibodies bind to commonly used drugs that are derivatives of cocaine (this is basically what ELISA testing is for, and computer simulations would give you a general idea of whether it would bind or not). I would assume that this sort of testing would have been done prior to it being tested on humans, or at the very least would be done before it enters into common usage.
nlh 15y ago
I instantly (and incorrectly) assumed that this was some conspiracy theory-laden story about how big pharma doesn't want to stop cocaine use and the war on drugs is too profitable and etc. etc. etc., but thankfully I was wrong. Here's the key line from the story: the dilemma is clear: What would happen if the media got wind that inoculated drug users were buying even more coke than before. It would be a public relations nightmare for any business. So that's it - and it makes sense. Vaccine makes cocaine less effective, so people buy more (in the short term) to try and get the same high, until they finally realize that doesn't work and give up using it. Long term good, short term PR nightmare.
- tdicola 15y ago
  Yep I agree, the problem is this vaccine cures the drug effects but not the addiction or desire for drugs.
  - ghostDancer 15y ago
    I think the best case for this vaccine is a therapy with vaccine and a supporting group or counsel, and this is made more for people trying to give up the habit (dependency) or for people not to start.
- sili 15y ago
  The problem is that patiens on the vaccine would have higher risks of overdose because they now take so much more cocaine. Also I wonder what percentage of them would try to switch to some other drugs.
- code_duck 15y ago
  Cocaine users tend to already buy as much as they can afford, or can use without dying. Hard to increase sales from that level.
felipemnoa 15y ago
If nobody will manufacture it then it is time to start a startup. Even with the potential PR problems of patients going broke buying more cocaine at first, they will probably be able to find investors. Remember that the google founders at first tried to sell their search engine. Nobody would buy so they had to start google. They could probably even put the patients in a rehab facility to prevent them from buying more cocaine. Also, this problem should be the first thing that should mentioned to anybody that is listening to prevent the media of acting like they just broke the news on "the evils of using this vaccine that the manufactures were trying to hide" (you know how sensationalist they are) If they do that then news organizations will probably not be able to make a big deal about it.
- Symmetry 15y ago
  Startups as we normally think of them don't really work when you have to spend tens or hundreds of millions of dollars to get your drug past FDA approval before you can start making money.
mbreese 15y ago
If the vaccine works, the big question is: who will buy it? The biggest market that I'd see is addicts who commit crimes and are required to have the treatment as part of a court ordered program. How big is that market? Pharma isn't about to spend millions on a phase III trial for a fairly small market. If they really want to see their vaccine approved for use, maybe they should start their own company to produce it. If there is enough of a need for the vaccine, the should be able to find funding (VC or grants). Now, I could really see their nicotine vaccine doing very well, since there are lots of people who would voluntarily take a vaccine to stop smoking.
- skue 15y ago
  I've worked at an addiction clinic. Addicts often do want to quit. Witness the success of disulfiram (Antabuse) and the numerous nicotine cessation products. They might not All want to quit All the time, but many of them hit their bottom and look for help. The problem is that it's hard to stay sober even if you try.
- influx 15y ago
  One could imagine the government making this mandatory for all newborns just like the many other child hood vaccines. In 20 years, you would eliminate all cocaine addicts, as anyone trying cocaine would not get high the first time. Interesting idea, not sure how practical or ethical it is though.
  - marshray 15y ago
    I wonder if it would bind to some percentage of naturally-occurring stimulants in some percentage of the population. That's the kind of thing that can really can bring about the downfall of an entire civilization.
  - SeoxyS 15y ago
    That goes against so many ethical and legal codes... This is how you end up with a repressed society.
  - burgerbrain 15y ago
munin 15y ago
"What would happen if the media got wind that inoculated drug users were buying even more coke than before. It would be a public relations nightmare for any business." not to mention a public health nightmare! cocaine has effects on more than the brain. also, their study is pretty sketchy: http://www.ncbi.nlm.nih.gov/pubmed/19805702 http://www.ncbi.nlm.nih.gov/pubmed/19805702 why are there so many individual differences? why does it work on some people but not others? shouldn't a vaccines effect be pretty standardized? also, why after 20 weeks are the placebo and high-ig concentrations equal in terms of cocaine-free urine samples? with questions like these, it seems pretty obvious why no one wants to roll into stage III with this in its current form. it's shitty to hear when it's your life's work but ... it sounds like it needs more work.
- Daniel_Newby 15y ago
  shouldn't a vaccines effect be pretty standardized? No! Evolution guarantees that the immune system is not standardized.
btilly 15y ago
It would be wonderful if they could produce an alcohol vaccine. I then would like to see a law mandating its use for all people who who have a DUI. Unfortunately the quantities of the active drug in your system when you abuse alcohol is orders of magnitude higher than for nicotine or cocaine. So it could well be that your body's immune system simply gets overwhelmed. (That or there could be real health consequences from the immune reaction.) But it would be nice if it existed.
- alphaoverlord 15y ago
  There is an equivalent - its called Antabuse (disulfiram). It inhibits the enzyme that metabolizes ethanol, causing the bad side effects of 'Asian glow' to a more severe extent. The idea is to cause negative feedback for alcohol. Notice by its lack of blockbuster-ness and the fact that the market for alcohol is 1000x the market for cocaine, that this "cocaine vaccine" isn't good economics.
  - btilly 15y ago
    Antabuse only causes effects while you continue to take the medication. There is a world of difference between this and a treatment you take that provides prolonged resistance to alcohol.
- davidhollander 15y ago
  > I then would like to see a law mandating its use for all people who who have a DUI. The problem is that such vaccine wouldn't only work when you are in a vehicle or prevent you from making other stupid decisions. This really wouldn't address the root cause and would be a pretty egregious violation of an individual's freedom of thought. The idea of the state having authority to permanately biologically alter an individual to control his or her behavior is a throwback to the time of lobotomies, which even the Soviet Union banned in the 1950s.
  - scarmig 15y ago
    "Even the Soviet Union" is a bit misleading, though I understand where you're coming from. The USSR banned lobotomies in 1950, while in the USA it was banned... never (though some states individually did). In fact the USSR was the first major country to ban lobotomies. Lobotomies legally happen even today in the USA, though there's no longer the epidemic of wanton misuse. I just say this because it's easy to get into the rut where anything the Soviet Union did was bad and everything the USA did was good. There's no reason per se to expect Soviet doctors to be particularly evil compared to American ones. Which isn't to justify the many many evil things the Soviet state did perpetrate.
cmsj 15y ago
Discussions of "big pharma" aside, this seems like a classic case of treating symptoms and not causes. If you consider that the cases likely to present for vaccination are the more serious ones, you're going to be preventing people from taking one drug. If they have a serious need they will just take a different drug. Inoculate them against all the common drugs and they'll start mixing household chemicals and then you have a dramatically worse situation (google for the effects of 'krokodil' if you have a strong stomach). It would probably be better to help these addicts work through their problems so they don't need drugs. Leaving them unable to fill a need through conventional means just forces them down unconventional paths. Why do we have such an obviously backwards approach to drug abuse? :(
- Daniel_Newby 15y ago
  Why do we have such an obviously backwards approach to drug abuse? :( Because the intelligentsia have been taken over by a religion that says people are born pure and can be punished back into virtue if they get contaminated. Growing up in quiet high-IQ enclaves, their personal history is that unpleasant consequences teach better behavior. It is outside their life experience that there could be people who are too stupid to see logic, too distracted to notice lessons, too impulsive to act on logic, or too neglected in early childhood to develop susceptibility to social influences.
skue 15y ago
This is an opinion piece that doesn't even look at the science. The ClinicalTrials.gov entry they link to as their source only lists one peer-reviewed study, and its conclusion is this (http://www.ncbi.nlm.nih.gov/pubmed/19805702 http://www.ncbi.nlm.nih.gov/pubmed/19805702): Attaining high (>or=43 microg/mL) IgG anticocaine antibody levels was associated with significantly reduced cocaine use, but only 38% of the vaccinated subjects attained these IgG levels and they had only 2 months of adequate cocaine blockade That's not a stellar success. More importantly, if the Phase I trial revealed that some addicts had up to 5x the level of cocaine in their systems that's a big deal! Cocaine doesn't just do damage to your brain. It can trigger heart attacks and death by causing the blood vessels that feed your heart to spasm and reduce blood flow. If a person under 40 walks into the ER and complains of chest pain, one of the first questions any competent doc will ask is whether they have recently used cocaine. Apparently, they didn't see increased mortality in the small sample of people they studied -- but that doesn't mean it wouldn't kill significant numbers of people when deployed across a sizeable population. So in summary, we have a vaccine that's immunologically ineffective on the majority of recipients, which doesn't eliminate their cocaine use (just reduces it, p=0.048), and which can cause some users to boost their cocaine ingestion to very dangerous levels, and thereby quite possibly increasing cardiac morbidity and mortality (which the vaccine producer may be found liable for). Why aren't pharma companies lining up to produce this remarkable invention? It must be a conspiracy!!! Edit: Fixed formatting of quote.
- Daniel_Newby 15y ago
  Cocaine doesn't just do damage to your brain. It can trigger heart attacks and death by causing the blood vessels that feed your heart to spasm and reduce blood flow. Free cocaine does that. This immunization causes the body to produce cocaine-sequestering antibodies. ... some addicts had up to 5x the level of cocaine in their systems ... To understand the implications of that ratio, you need to know the total cocaine binding capacity, which would require considerably more exotic laboratory tests.
  - skue 15y ago
    A good point, but antibody sequestration isn't how they explained the vaccine's actions. Instead it's that the cocaine-antibody complex is too large to cross the blood-brain barrier. So it's unclear whether the antibody response (which the study showed was limited) would sequester the cocaine enough to eliminate its systemic effects.
rflrob 15y ago
Might not an effective approach be the opposite of this vaccine? Rather than trying to down-modulate the effects of (addictive substance here), if you instead up-modulate undesirable effects, then even a small dose would have less pleasure than before. Disulfiram (Antabuse) seems to be mentioned a lot in this thread, and that intuitively seems like a saner approach than "make it so they need more to get the same high".
xelipe 15y ago
As patents start to run out on some of the most profitable drugs, big pharma is looking for a new business models and new drugs. In addition to the cocaine vaccine, there are reports that they are working on a vaccine for alzheimer's. What I also find new about the Cocaine Vaccine is that traditionally vaccines are composed of biological agents that mimic or resemble a decease-causing microorganism. Cocaine addition and alzheimer's are not caused by a microorganism which would indicate that big pharma are cooping the word 'vaccine' for a new class of drugs.
- cwp 15y ago
  Did you read the article? "Vaccine" is the appropriate word - the idea is to bind cocaine to inert cholera to make the immune system produce antibodies. It doesn't cure the addiction, it just makes cocaine ineffective.
badclient 15y ago
I guess once you are hooked the vaccine can be challenging and lead to overdose. But if you take this before getting hooked, it can just register in your mind that coke isn't fun and there is no high. It's like my relationship with cigerettes. First few times I took it I was really nervous I would get hooked. Ultimately I found little joy from smoking. So I'm not much of a smoker but I'll average 5-10/cigarettes a month from social situations. My rule is that I can never buy cigs or smoke them at my will since it will mean I'm lusting for it. On the other hand if a friend offers one occasionally, I can smoke it.

87 points by jamesbritt 15y ago

I have little formal knowledge in the area, but wouldn't a cocaine vaccine ruin any medical potential for that class of drug?

maaku 15y ago
That was my first concern. Cocaine is one of the oldest anesthetics, and still used in some limited circumstances. But there are a lot of derivative drugs, e.g novocaine that nearly ever dentist uses, which are basically cocaine without the dopamine high. Would this vaccine change novocaine's effectiveness in the patient?
- sorbus 15y ago
  It would be fairly easy to determine whether the antibodies bind to commonly used drugs that are derivatives of cocaine (this is basically what ELISA testing is for, and computer simulations would give you a general idea of whether it would bind or not). I would assume that this sort of testing would have been done prior to it being tested on humans, or at the very least would be done before it enters into common usage.

nlh 15y ago

I instantly (and incorrectly) assumed that this was some conspiracy theory-laden story about how big pharma doesn't want to stop cocaine use and the war on drugs is too profitable and etc. etc. etc., but thankfully I was wrong. Here's the key line from the story: the dilemma is clear: What would happen if the media got wind that inoculated drug users were buying even more coke than before. It would be a public relations nightmare for any business. So that's it - and it makes sense. Vaccine makes cocaine less effective, so people buy more (in the short term) to try and get the same high, until they finally realize that doesn't work and give up using it. Long term good, short term PR nightmare.

tdicola 15y ago
Yep I agree, the problem is this vaccine cures the drug effects but not the addiction or desire for drugs.
- ghostDancer 15y ago
  I think the best case for this vaccine is a therapy with vaccine and a supporting group or counsel, and this is made more for people trying to give up the habit (dependency) or for people not to start.
sili 15y ago
The problem is that patiens on the vaccine would have higher risks of overdose because they now take so much more cocaine. Also I wonder what percentage of them would try to switch to some other drugs.
code_duck 15y ago
Cocaine users tend to already buy as much as they can afford, or can use without dying. Hard to increase sales from that level.

felipemnoa 15y ago

If nobody will manufacture it then it is time to start a startup. Even with the potential PR problems of patients going broke buying more cocaine at first, they will probably be able to find investors. Remember that the google founders at first tried to sell their search engine. Nobody would buy so they had to start google. They could probably even put the patients in a rehab facility to prevent them from buying more cocaine. Also, this problem should be the first thing that should mentioned to anybody that is listening to prevent the media of acting like they just broke the news on "the evils of using this vaccine that the manufactures were trying to hide" (you know how sensationalist they are) If they do that then news organizations will probably not be able to make a big deal about it.

Symmetry 15y ago
Startups as we normally think of them don't really work when you have to spend tens or hundreds of millions of dollars to get your drug past FDA approval before you can start making money.

mbreese 15y ago

If the vaccine works, the big question is: who will buy it? The biggest market that I'd see is addicts who commit crimes and are required to have the treatment as part of a court ordered program. How big is that market? Pharma isn't about to spend millions on a phase III trial for a fairly small market. If they really want to see their vaccine approved for use, maybe they should start their own company to produce it. If there is enough of a need for the vaccine, the should be able to find funding (VC or grants). Now, I could really see their nicotine vaccine doing very well, since there are lots of people who would voluntarily take a vaccine to stop smoking.

skue 15y ago
I've worked at an addiction clinic. Addicts often do want to quit. Witness the success of disulfiram (Antabuse) and the numerous nicotine cessation products. They might not All want to quit All the time, but many of them hit their bottom and look for help. The problem is that it's hard to stay sober even if you try.
influx 15y ago
One could imagine the government making this mandatory for all newborns just like the many other child hood vaccines. In 20 years, you would eliminate all cocaine addicts, as anyone trying cocaine would not get high the first time. Interesting idea, not sure how practical or ethical it is though.
- marshray 15y ago
  I wonder if it would bind to some percentage of naturally-occurring stimulants in some percentage of the population. That's the kind of thing that can really can bring about the downfall of an entire civilization.
- SeoxyS 15y ago
  That goes against so many ethical and legal codes... This is how you end up with a repressed society.
- burgerbrain 15y ago

munin 15y ago

"What would happen if the media got wind that inoculated drug users were buying even more coke than before. It would be a public relations nightmare for any business." not to mention a public health nightmare! cocaine has effects on more than the brain. also, their study is pretty sketchy: http://www.ncbi.nlm.nih.gov/pubmed/19805702 http://www.ncbi.nlm.nih.gov/pubmed/19805702 why are there so many individual differences? why does it work on some people but not others? shouldn't a vaccines effect be pretty standardized? also, why after 20 weeks are the placebo and high-ig concentrations equal in terms of cocaine-free urine samples? with questions like these, it seems pretty obvious why no one wants to roll into stage III with this in its current form. it's shitty to hear when it's your life's work but ... it sounds like it needs more work.

Daniel_Newby 15y ago
shouldn't a vaccines effect be pretty standardized? No! Evolution guarantees that the immune system is not standardized.

btilly 15y ago

It would be wonderful if they could produce an alcohol vaccine. I then would like to see a law mandating its use for all people who who have a DUI. Unfortunately the quantities of the active drug in your system when you abuse alcohol is orders of magnitude higher than for nicotine or cocaine. So it could well be that your body's immune system simply gets overwhelmed. (That or there could be real health consequences from the immune reaction.) But it would be nice if it existed.

alphaoverlord 15y ago
There is an equivalent - its called Antabuse (disulfiram). It inhibits the enzyme that metabolizes ethanol, causing the bad side effects of 'Asian glow' to a more severe extent. The idea is to cause negative feedback for alcohol. Notice by its lack of blockbuster-ness and the fact that the market for alcohol is 1000x the market for cocaine, that this "cocaine vaccine" isn't good economics.
- btilly 15y ago
  Antabuse only causes effects while you continue to take the medication. There is a world of difference between this and a treatment you take that provides prolonged resistance to alcohol.
davidhollander 15y ago
> I then would like to see a law mandating its use for all people who who have a DUI. The problem is that such vaccine wouldn't only work when you are in a vehicle or prevent you from making other stupid decisions. This really wouldn't address the root cause and would be a pretty egregious violation of an individual's freedom of thought. The idea of the state having authority to permanately biologically alter an individual to control his or her behavior is a throwback to the time of lobotomies, which even the Soviet Union banned in the 1950s.
- scarmig 15y ago
  "Even the Soviet Union" is a bit misleading, though I understand where you're coming from. The USSR banned lobotomies in 1950, while in the USA it was banned... never (though some states individually did). In fact the USSR was the first major country to ban lobotomies. Lobotomies legally happen even today in the USA, though there's no longer the epidemic of wanton misuse. I just say this because it's easy to get into the rut where anything the Soviet Union did was bad and everything the USA did was good. There's no reason per se to expect Soviet doctors to be particularly evil compared to American ones. Which isn't to justify the many many evil things the Soviet state did perpetrate.

cmsj 15y ago

Discussions of "big pharma" aside, this seems like a classic case of treating symptoms and not causes. If you consider that the cases likely to present for vaccination are the more serious ones, you're going to be preventing people from taking one drug. If they have a serious need they will just take a different drug. Inoculate them against all the common drugs and they'll start mixing household chemicals and then you have a dramatically worse situation (google for the effects of 'krokodil' if you have a strong stomach). It would probably be better to help these addicts work through their problems so they don't need drugs. Leaving them unable to fill a need through conventional means just forces them down unconventional paths. Why do we have such an obviously backwards approach to drug abuse? :(

Daniel_Newby 15y ago
Why do we have such an obviously backwards approach to drug abuse? :( Because the intelligentsia have been taken over by a religion that says people are born pure and can be punished back into virtue if they get contaminated. Growing up in quiet high-IQ enclaves, their personal history is that unpleasant consequences teach better behavior. It is outside their life experience that there could be people who are too stupid to see logic, too distracted to notice lessons, too impulsive to act on logic, or too neglected in early childhood to develop susceptibility to social influences.

skue 15y ago

This is an opinion piece that doesn't even look at the science. The ClinicalTrials.gov entry they link to as their source only lists one peer-reviewed study, and its conclusion is this (http://www.ncbi.nlm.nih.gov/pubmed/19805702 http://www.ncbi.nlm.nih.gov/pubmed/19805702): Attaining high (>or=43 microg/mL) IgG anticocaine antibody levels was associated with significantly reduced cocaine use, but only 38% of the vaccinated subjects attained these IgG levels and they had only 2 months of adequate cocaine blockade That's not a stellar success. More importantly, if the Phase I trial revealed that some addicts had up to 5x the level of cocaine in their systems that's a big deal! Cocaine doesn't just do damage to your brain. It can trigger heart attacks and death by causing the blood vessels that feed your heart to spasm and reduce blood flow. If a person under 40 walks into the ER and complains of chest pain, one of the first questions any competent doc will ask is whether they have recently used cocaine. Apparently, they didn't see increased mortality in the small sample of people they studied -- but that doesn't mean it wouldn't kill significant numbers of people when deployed across a sizeable population. So in summary, we have a vaccine that's immunologically ineffective on the majority of recipients, which doesn't eliminate their cocaine use (just reduces it, p=0.048), and which can cause some users to boost their cocaine ingestion to very dangerous levels, and thereby quite possibly increasing cardiac morbidity and mortality (which the vaccine producer may be found liable for). Why aren't pharma companies lining up to produce this remarkable invention? It must be a conspiracy!!! Edit: Fixed formatting of quote.

Daniel_Newby 15y ago
Cocaine doesn't just do damage to your brain. It can trigger heart attacks and death by causing the blood vessels that feed your heart to spasm and reduce blood flow. Free cocaine does that. This immunization causes the body to produce cocaine-sequestering antibodies. ... some addicts had up to 5x the level of cocaine in their systems ... To understand the implications of that ratio, you need to know the total cocaine binding capacity, which would require considerably more exotic laboratory tests.
- skue 15y ago
  A good point, but antibody sequestration isn't how they explained the vaccine's actions. Instead it's that the cocaine-antibody complex is too large to cross the blood-brain barrier. So it's unclear whether the antibody response (which the study showed was limited) would sequester the cocaine enough to eliminate its systemic effects.

rflrob 15y ago

Might not an effective approach be the opposite of this vaccine? Rather than trying to down-modulate the effects of (addictive substance here), if you instead up-modulate undesirable effects, then even a small dose would have less pleasure than before. Disulfiram (Antabuse) seems to be mentioned a lot in this thread, and that intuitively seems like a saner approach than "make it so they need more to get the same high".

xelipe 15y ago

As patents start to run out on some of the most profitable drugs, big pharma is looking for a new business models and new drugs. In addition to the cocaine vaccine, there are reports that they are working on a vaccine for alzheimer's. What I also find new about the Cocaine Vaccine is that traditionally vaccines are composed of biological agents that mimic or resemble a decease-causing microorganism. Cocaine addition and alzheimer's are not caused by a microorganism which would indicate that big pharma are cooping the word 'vaccine' for a new class of drugs.

cwp 15y ago
Did you read the article? "Vaccine" is the appropriate word - the idea is to bind cocaine to inert cholera to make the immune system produce antibodies. It doesn't cure the addiction, it just makes cocaine ineffective.

badclient 15y ago

I guess once you are hooked the vaccine can be challenging and lead to overdose. But if you take this before getting hooked, it can just register in your mind that coke isn't fun and there is no high. It's like my relationship with cigerettes. First few times I took it I was really nervous I would get hooked. Ultimately I found little joy from smoking. So I'm not much of a smoker but I'll average 5-10/cigarettes a month from social situations. My rule is that I can never buy cigs or smoke them at my will since it will mean I'm lusting for it. On the other hand if a friend offers one occasionally, I can smoke it.