Are addiction vaccines the “magic bullet” we’ve been looking for to reduce the damage drugs do to society? Can the new “abuse-resistant” forms of prescription painkillers help stem the tide of the prescription drug abuse epidemic? Writing for PsychCentral, Elements Behavioral Health’s CEO David Sack, M.D. argues that the answer to both is an emphatic “no.” The column offers an important reminder of the nature of addiction, and cautions that we shouldn’t buy into the supposed breakthroughs hoping to eliminate addiction without actually tackling the chronic brain disease itself.
Abuse-Resistant Opioid Painkillers
Given that prescription painkillers contribute to more overdose deaths per year in the U.S. than heroin and cocaine combined, developing “abuse-resistant” forms of these drugs seems like an important step forward in public health. However, these don’t always work, and even if they do, there is more than one source for an opioid fix. Dr. Sack calls attention to the 2010 release of the abuse-resistant form of OxyContin, which succeeded in its goal of reducing the abuse of OxyContin, but simply pushed users to heroin and other prescription opioids.
Although many experts are now calling for slow-release or addiction-resistant forms of other opioid medications, there is only one likely consequence of this: more users switching to heroin. If that becomes unavailable, they’ll move to other illicit substances or even “designer” drugs cooked up by amateur chemists.
A similar case can be made for addiction vaccines, which have been making significant progress over the past 40 years, promising to chemically block the effects of drugs and therefore remove motivation for taking them. While this could be beneficial for people who are dedicated to recovery but could use an additional tool in helping them overcome their addictions, Dr. Sack concedes, for others it will be just something new to circumvent.
It could be circumvented, too. The vaccines being developed only work against specific substances, so users could just switch to something else, but the bigger problem is that they just might just not take the vaccine in the first place. Additionally, addictions occur with behaviors such as gambling, sex, playing video games and a whole host of other things, and even in the absence of substances, users could turn to these. Vaccinations are specific, but the problem is much broader.
How We Really Need to Tackle Addiction
Both of these suggested solutions suffer from the same problem in that they don’t address what causes drug-seeking behavior in the first place. They merely try to cut off the supply, whether physically or biochemically, and fail to do anything to address the demand. They make the mistake of assuming that chronic drug abusers are attracted to specific substances, rather than using the substances to attempt to address or forget something within themselves. Cutting off an OxyContin supply will neither help an addict realize he’s using opioids as a poor coping strategy for his personal problems, nor will vaccinating him against its effects. The real problem runs deeper.
We know how to deal with addiction. Like other chronic illnesses, it requires long term treatment and prevention efforts. The real solution is helping users address their underlying issues in a healthier way, and that can take time. The only difference is that when the process is done, the individual will possess the tools to overcome the problem for good. There might be a slip-up or two (addiction is by nature a relapsing condition), but people will get better rather than simply finding themselves a different drug.
We might want to believe that there is a “magic bullet” solution to the problem of addiction, and we might even be inclined to try the easier method rather than tackle deep-seated issues, but the end will always be the same. We need to recognize that to overcome addiction, the underlying problem must be addressed, not just the manifestations of it. It might be harder work that way, but the difference is that this way you can really get better.