Vaccinating against Vice The technology and political interest are there, but inoculating kids against bad habits might do more harm than good By Shannon Klie Betterhumans Staff 9/30/2004 11:23 AM Credit: Izabela Habur Sticking point: Behavior-altering vaccines could improve public health, but critics warn that they come at a cost The bell rings and Bobby rushes outside to meet his friends in the field behind the school. When he gets there some older boys are smoking. One of them smiles at Bobby and hands him a cigarette. "Wanna drag?" he asks. At 13, Bobby has never smoked before. Not wanting to look like a geek, he takes the cigarette. He inhales, sputters and coughs. The smoke burns his throat and makes his eyes water. He tries again. He doesn't cough, but the cigarette tastes horrible. Over time, other children become addicted but not Bobby. When he was younger, his parents vaccinated him against nicotine as part of a government-sanctioned program. He can't feel nicotine's pleasurable effects, so doesn't get addicted to cigarettes. Far-fetched? Not at all. Successful trials with nicotine and cocaine-specific vaccines could make Bobby's story a reality soon. And it was widely reported this summer that the British government could soon be considering a program to vaccinate children against addiction to nicotine, cocaine and other drugs. So the technology and political interest are there. But while the allure of using neuropharmacological treatments, such as drug-specific vaccines, as weapons in the ongoing war on drugs might be hard to resist, many scientists and ethicists believe that such government-mandated inoculation could cause more harm than good. The high cost of addiction Governments around the world are desperate to curb the rate of addiction and its soaring costs. In May 2004, the World Health Organization (WHO) reported that tobacco kills 4.9 million people each year—more deaths than caused by alcohol use, illegal drug use, suicides, motor vehicle accidents, murders and HIV combined. This number is expected to double in the next 20 years. In 1999, the US Centers for Disease Control and Prevention (CDC) estimated that smoking costs US$75.5 billion in excess medical costs and US$81.9 billion in mortality-related productivity each year. Governments in countries with national healthcare programs have added concerns. The Canadian Centre on Substance Abuse, for example, estimates that illicit drugs cost Canadians CDN$1.35 billion each year. Nicotine and cocaine create feelings of relaxation, pleasure and euphoria that make these drugs highly addictive. Nicotine activates nicotinic receptors in the brain, stimulating the release of neurotransmitters, such as dopamine, that generate positive sensations. Cocaine produces feelings of euphoria by binding to dopamine reuptake transporters, which results in a build-up of dopamine in the nucleus accumbens—the pleasure centre of the brain. The body's immune system is very good at responding to foreign threats and expelling them, but drugs such as nicotine and cocaine are too small to stimulate the immune system. But now, scientists have found a way to force the body to produce antibodies that attack these tiny, addictive molecules. A nicotine vaccine being developed by the Boca Raton, Florida-based pharmaceutical company Nabi, for example, consists of a nicotine compound attached to an immunogenic protein—a large protein that stimulates the immune system. When the vaccine is injected, it stimulates an immune response that releases nicotine-specific antibodies into the blood. When someone who's vaccinated smokes a cigarette, the antibodies bind to the nicotine and the resulting molecules are too large to cross the blood-brain barrier, so no neurotransmitters are released and the usual high associated with smoking is reduced or prevented entirely. A cocaine vaccine being developed by the British, Berkshire-based pharmaceutical company Xenova works in much the same way, only it targets cocaine molecules rather than nicotine molecules. This June, the company released the results of its most recent study, in which 58% of cocaine-addicted adults achieved and maintained abstinence during a 12-week period and 42% continued to be cocaine-free after six months. Xenova CEO David Oxlade told New York's Daily News that these are very promising results since the relapse rate with other treatment programs is between 70% and 100% after a few weeks. Neither Nabi nor Xenova would give an expected market date for their vaccines. Frank Vocci with the US National Institute on Drug Addiction (NIDA), which partially funds the Nabi nicotine vaccine, says it will take at least four years until the vaccine hits the market. He estimates that Xenova's cocaine vaccine might be available in five. Cost-savings versus cognitive liberty Before these vaccines become available for public consumption, governments and policymakers will need to develop strategies and ethical guidelines to determine how to use them. The benefits of healthcare and law-enforcement savings, as well as gaining political points with some of the electorate, could motivate many governments to proceed. But many scientists and ethicists say that this would be a mistake. When considering a program to vaccinate high-risk children against addiction, policymakers must consider the risk of stigmatizing a group of children, says Kathleen Glass, director of the Biomedical Ethics Unit at McGill University in Montreal. Glass says that the government would in effect be signalling out certain children and telling them, their parents and potentially the world that they are likely to become addicts. Since an immunized individual's status would appear in their medical records, this could lead to stigmatization and discrimination—possibly affecting whether or not someone could get a job or qualify for insurance. Stephanie Anderson, with the Davis, California-based Center for Cognitive Liberty and Ethics, agrees. "The labeling of 'high-risk' children is very disturbing in that it essentially amounts to cognitive profiling," she says. "It is not within a government's jurisdiction to guess what future decisions one might make and then react according to such suppositions. It is dangerous for the government to play doctor to our nation's children, but it is even more frightening for them to claim to be fortune-tellers." There is concern that a government-run vaccination program would in effect be a program of forced cognitive modification. The word "vaccine" suggests an irreversible and permanent immunity to certain drugs. Many people wonder whether a government, or even parents, should be allowed to make a choice for children that would affect their ability to enjoy some things for the rest of their lives. The Center for Cognitive Liberty and Ethics advocates three principles in a world of mind-altering technologies: brain privacy, autonomy and choice. Anderson says that a public policy of childhood vaccinations against addiction would violate all three principles and the negative consequences of the policy would far outweigh the benefit of possibly having fewer addicts. "To concede that the government, or any authoritative body, has the right to hardwire an individual's brain against possible behaviours or thoughts would be fatal to the core of our notion that we are a free people," says Anderson. But while the intent behind such a program raises important concerns about an individual's cognitive rights, existing technology wouldn't involve any permanent changes. The antibody levels associated with the vaccines currently in development peak about three months after injection and then steadily decline. Regular booster shots would be required through adolescence in order to maintain an optimum level of antibodies in the blood. And even when the antibody levels are high, teenagers could overcome them by using higher doses of drugs or by using drugs for which they haven't been vaccinated. "Parents would not therefore be making an irreversible decision to deprive their children of the choice to smoke tobacco or use cocaine as an adult or to use either drug for therapeutic purposes," says Wayne Hall, the director of the Office of Public Policy and Ethics at the Institute for Molecular Bioscience at the University of Queensland in Australia. This relieves the "mind control" issue of existing addiction vaccines, but it raises other practical concerns. Repeated vaccinations would be costly and inconvenient. Efforts to increase the duration of the vaccine and to create multiple-drug vaccines would result in extensive clinical trials to establish their efficacy and safety, thus increasing the vaccines' cost. Hall says that the high cost of vaccinating children and teens could therefore preclude public funding for a universal vaccine. This could result in higher socioeconomic children, who are at a lower risk for addiction, being the most likely to get vaccinated. The quick-fix dilemma Beyond mind control and cost concerns, there are also concerns about people relying too heavily on the vaccines. Growing evidence suggests that addiction, or at least a person's predisposition to becoming addicted, has a www.betterhumans.com/News/news.aspx?articleID=2004-08-06-2]strong genetic component. Scientists hope that the new vaccines will prevent someone already predisposed to becoming addicted from getting hooked on drugs by blocking their pleasurable effects. But vaccines are only a partial solution, as many psychosocial factors, beyond genetics, contribute to addiction. Glass says that if the vaccines were to replace all other forms of treatment, people might relapse or attempt to overcome the vaccines with higher doses of drugs once their unresolved psychological and social issues became too much to manage. There's also concern that using vaccines to prevent addiction is another sign of society's growing dependence on biochemical solutions to behavioral problems—there are different pills to make you thinner, happier and more at ease in social situations, and now there's a shot that will help you just say "no" to drugs. "We like to look for quick fixes and silver bullets when addiction is a huge social problem," says Glass. "Is it appropriate to vaccinate children for things that are basically social choices that they make?" Anderson points out that a policy of giving children drugs to prevent them from taking other drugs does them a great disservice. Instead of teaching children how to evaluate all the evidence and make informed decisions, such a policy teaches them that individual decisions have no place in a society where the government determines what is good and what is bad. "Giving them real information about drug use would prove far more effective in the long run," says Anderson, "than supplanting the freedom of thought to make individual decisions regarding one's own mind and body with a government-mandated syringe." Hall also has doubts about the efficacy, safety and cost of a program of childhood vaccinations against addiction. "The public has not been given an opportunity to consider the pros and cons of the measure and of competing, less coercive ways to achieve the reasonable goal of preventing various forms of drug addiction," he says. "Drug vaccines are most likely to make only a modest contribution to our efforts to improve addiction treatment." Based on these doubts, Hall says it would be unlikely for any informed government to institute a program to vaccinate children against addiction. But this doesn't preclude the use of vaccines as part of an overall treatment plan. These vaccines will eventually be available for therapeutic use and parents might request them for their children. But Hall stresses that they shouldn't be used in this preventative manner in adolescents until they have been used extensively in dependent adults. Vocci agrees that researchers should first use the vaccine in dependent adults as a therapeutic measure to help them quit. If this is successful then it should be used as a protective measure in high-risk adults—people who are abusing a drug but don't meet the criteria for dependence. Only after evidence was gathered from these two populations would Vocci consider recommending that the vaccines be used in adolescents and children. "Any kind of public health measure should have an evidence-base for the recommendation," Vocci says. "We're a long way off from gathering the evidence that one would need to make a recommendation that a program of childhood vaccination could be done."

How else am I gonna deal with the shitty existance which is called reality?

Used to see guys in the Navy who, under orders, had to report in every afternoon to the command's Chief of the Watch and have the Chief sign off as to having watched them take their prescribed dose of Anabuse - and then, that very night, see these same guys sitting next to me at the bar of the EM club drinking booze and getting blasted.

Vaccine my ass.

You want your kids not to touch cigarettes or coke - try 'five across the eyes' when you catch them doing these drugs.

Hell, I'd vaccinate myself.

Great!  

So how will we pay for all the Tobacco settlement and Cigarette tax funded programs in the next 20 years?

I think a true working vaccine against cigarettes will never see the light of day.

Quoted: Used to see guys in the Navy who, under orders, had to report in every afternoon to the command's Chief of the Watch and have the Chief sign off as to having watched them take their prescribed dose of Anabuse - and then, that very night, see these same guys sitting next to me at the bar of the EM club drinking booze and getting blasted. Vaccine my ass.

That is a very POOR reason for doubting that a vaccine could be made...

Also if you read the article it doesn't work as well against people who have already learned that drug use will get them high- they will still try and get high and eventually work through the sickness induced by the vaccene.  

This June, the company released the results of its most recent study, in which 58% of cocaine-addicted adults achieved and maintained abstinence during a 12-week period and 42% continued to be cocaine-free after six months.

But on people who have never felt the high from drug use, and do not associate the fealing with pleasure, it could be VERY effective.  Thats why children are the better target-once it has been proven safe for them.

i have terrible reactions to most vaccines.
when i was 5 months old i got a small pox shot.  it almost killed me.
i have had two flue shots and each one put me in bed for a week with 102-150 fevers.

i won't subject my kids to any shots the nanny state doesn’t absolutely require.

Well how about this then:

Regular booster shots would be required through adolescence in order to maintain an optimum level of antibodies in the blood. And even when the antibody levels are high, teenagers could overcome them by using higher doses of drugs or by using drugs for which they haven't been vaccinated.

So, instead of substituing a new drug for parenting, they'll be substituting one drug for another?

Not no, but fuck no.

God damn fucking drug companies.

I think an anabuse for all of them might be more effective.  Except cocaine.  If I'm not mistaken, I think it's still used in hospitals and denying the use could be problematic.

Like that word?  "Problematic"  I been hangin' around white shirts too long.  Anyway, don't they use a derivative of cocaine to bring patients out of anesthesia?

Quoted: Like that word?  "Problematic"  I been hangin' around white shirts too long.  Anyway, don't they use a derivative of cocaine to bring patients out of anesthesia?

They used to use it as a local anesthetic till people got addicted, but they still use stuff derived from Heroin.

Hell, I'd vaccinate myself.

+1

Yet another government program that allows people to no longer be responsible for their own choices.  Perhaps if a parent chooses to subject their children to this, then that is their choice, and expense.  However, mandating a program such as this is just one more government interference in private lives, especially if they are talking about only targeting certain types of children.  If a teen/adult has such poor self-control that they couldn't prevent themselves from doing drugs, all they will do, even if the vaccine works, is find some other kind of trouble to get themselves into.  What is next, vaccinating against adrenaline junkies?  Instead of pouring money into a no-win program such as this, how about getting parents to teach their children self-control and self-respect?

On a medical note, I saw nothing in the article about research into unintended consequences of such a vaccine.  There are some surgeries that use cocaine or drugs similar to cocaine; what if your child needed this type of surgery and couldn't get it because their vaccine didn't allow the drug to take?  Also, what about unintended consequences of other drugs that a person might need to take at some point in their life?  All that risk to prevent a child from taking drugs that he/she might not have taken if their parents had just paid attention to what they were doing?  

Not worth the risk on all fronts...

Quoted: i have terrible reactions to most vaccines. when i was 5 months old i got a small pox shot.  it almost killed me. i have had two flue shots and each one put me in bed for a week with 102-150 fevers. i won't subject my kids to any shots the nanny state doesn’t absolutely require.

150* ? Thats hot!  

echo6

You people seem to have a problem seperating the existance of a vaccine with what England is going to do with it.

Can you also tell what purpose addiction serves or why it isn't a disease any different than AIDS or cancer?

Quoted: Well how about this then: Regular booster shots would be required through adolescence in order to maintain an optimum level of antibodies in the blood. And even when the antibody levels are high, teenagers could overcome them by using higher doses of drugs or by using drugs for which they haven't been vaccinated. So, instead of substituing a new drug for parenting, they'll be substituting one drug for another?

There is no proof that there would be regular booster shots required, it may work with one shot.

The people in this story seem to be like those who argued against things like polio vaccines back in the 1960's.  Addiction is a disease if it could be prevented why not?

While a addict who you tried to use the vaccine on could chose to overpower the vaccine by taking more drugs, I fail to see how someone who had never felt a pleasurable experience from a drug would continue taking it.  Addicts would still try because they have the memory of a previous pleasurable experience.  Someone who never tried drugs till after they had been vaccinated would only know that trying to use drugs made them sick.

Quoted: i have terrible reactions to most vaccines. when i was 5 months old i got a small pox shot.  it almost killed me. i have had two flue shots and each one put me in bed for a week with 102-150 fevers. i won't subject my kids to any shots the nanny state doesn’t absolutely require.

You also apparently have no idea how rare a condition that is...

Yea, vaccinate against opiates and Cocaine.  Sure hope your kids don't break any bones or need pain relief as the vaccine makes those painkillers useless.

Quoted: Yea, vaccinate against opiates and Cocaine.  Sure hope your kids don't break any bones or need pain relief as the vaccine makes those painkillers useless.

I wasn't aware nicotine was a opiate?

Some drugs you are not going to be able to vaccinate against, Morphine may be one of them.

But what medicinal use is nicotine?  

No one has even a experimental vaccine against morphine yet.

Who's working on the liberal, shithead, vaccine??

I must obey the rules
I must be tame and cool
No staring at the clouds
I must stay on the ground
In clusters of the mice
The smoke is in our eyes
Like babies on display
Like angels in a cage
I must be pure and true
I must contain my views
There must be something else
There must be something good
Far away

If they had a pill that could cure addiction I would take two ....


SGatr15

Quoted: Hell, I'd vaccinate myself.

F'in A Right! +1

Quoted: Quoted: i have terrible reactions to most vaccines. when i was 5 months old i got a small pox shot.  it almost killed me. i have had two flue shots and each one put me in bed for a week with 102-150 fevers. i won't subject my kids to any shots the nanny state doesn’t absolutely require. You also apparently have no idea how rare a condition that is...

no i don't.  Nor do i know if it is genetic and can be transferred to my children.
but i am not risking their lives based on statistics.  

No. I would not vacinate my kids (I have three kids) for something that will power, discipline, and proper parenting should protect against.

Quoted: Quoted: Yea, vaccinate against opiates and Cocaine.  Sure hope your kids don't break any bones or need pain relief as the vaccine makes those painkillers useless. I wasn't aware nicotine was a opiate? Some drugs you are not going to be able to vaccinate against, Morphine may be one of them. But what medicinal use is nicotine?   No one has even a experimental vaccine against morphine yet.

Opiates I have seen mentioned in other drug vaccine articles.

Nicotine patches IIRC is starting to be used for ulcerative colitis.

As a former smoker, I wonder how many thousands I would've saved not only from buying smokes, but from a medical point of view.  I had a hard time recovering from a bout with bronchitis, and that helped me quit.  My father stopped smoking when he had a stroke, and my mother has emphysema and a quadruple bypass and she still can't stop smoking.  I grew up in a family where both parents smoked, and I was born prematurely with birth defects because my mother smoked.  If there was a vaccine available when I was in my teens, I may have volunteered to take it myself.

From a voluntary point of view, I don't see a problem with it.  If it were mandated by the government or required by a healthcare plan to receive benefits, I wouldn't be too happy if I didn't have a choice.

A Clockwork Orange.