Someday, if there were a way to prevent fentanyl overdose deaths, whether the drug was taken intentionally or by accident (even though fentanyl is in other drugs, no one would be able to use the drug) What will happen if we don’t inform the public? Although not yet ready for prime time, a vaccine against fentanyl is under active development and is expected to be tested in humans in 2025.
Thomas Costen, MD, Wagoner Professor, Psychiatry, Pharmacology, Neuroscience, and Immunology, Baylor College of Medicine, Houston, Texas. Vaccine developer. Animal testing has been completed and the vaccine has been transferred to the control of start-up company Obax. Human studies are likely to begin in 2025. Kosten and his team developed the anti-fentanyl drug, building on more than 36 years of innovative research in the discovery and development of vaccines specifically for substance use disorders.
Thomas Kosten, MD, Co-Director, Institute for Clinical and Translational Research
Source: Department of Psychiatry, Baylor College of Medicine, Houston, Texas, USA.
Anti-fentanyl vaccines are very important. Although the number of fentanyl overdoses is down somewhat from the highs of previous years, 74,702 people died from fentanyl in 2023 alone. Across the United States, fentanyl overdoses continue to kill far too many people of all ages.
The surge in fentanyl overdoses has reignited interest in vaccine immunotherapy, but despite optimistic starts in animal models over the past 50 years, human clinical trials have yielded disappointing results. Vaccines for nicotine, stimulants (cocaine and methamphetamine), and heroin have all been suspended.
The FDA has approved three drugs to treat opioid use disorder: naltrexone, buprenorphine, and methadone, but none of them can prevent fentanyl overdose. In contrast, future fentanyl vaccines are expected to be a major addition to the arsenal of weapons against overdose, addiction, and death.
“We are working diligently to widely vaccinate abusers. Stimulants like Adderall and counterfeit prescription opiates like OxyContin are spiked with illegal fentanyl, and anything that stops fentanyl Because there’s nothing else like it,” Kosten says.
When most people think of vaccines, they think of them as disease preventatives, blocking infections such as polio and rubella. These days, Covid-19 is all designed to protect against certain diseases. However, fentanyl is not like a virus, and the immune system usually ignores it. But by attaching fentanyl-like molecules to other proteins, scientists can make the immune system recognize the opioid as foreign and generate antibodies to fight it. In trials at Baylor, Kosten’s vaccine successfully blocked fentanyl-induced respiratory depression and fatal overdose.
Unlike current overdose treatments such as naloxone and nalmefene, a fentanyl vaccine could provide lasting protection against the drug. The vaccine is not effective immediately, but it takes about a month to become effective. So if someone who overdosed recovers in March, gets vaccinated, and then takes fentanyl again in July, they won’t overdose again because the vaccine blocks the drug. Fentanyl vaccines may also be used as part of treatment for recovering individuals in combination with other treatments such as methadone or buprenorphine.
Kosten and his team developed an anti-fentanyl vaccine, building on Kosten’s years of work in vaccine discovery and development. The idea of treating drug addiction with a vaccine is exciting, but not new. Research dating back to the 1970s at the University of Chicago showed that vaccines can stop monkeys from self-administering heroin. In the 1980s, researchers tried to develop vaccines for cocaine and nicotine. sadly they were not successful
After handing over the vaccine to private developers, Kosten returned to work on vaccines for stimulants like cocaine and methamphetamines, with years of research ahead.
Who takes the fentanyl vaccine?
One market for future fentanyl vaccines is patients being treated for substance use disorders. The vaccine may be administered after the evaluation phase of residential treatment for speedball or fentanyl poisoning. Similarly, it may be given to patients who are being treated with buprenorphine or methadone for opioid use disorder or who feel their disease is in remission. “We’re not going to keep vaccinating people forever,” Costen said. “It is effective for about six months, and then a booster dose of the vaccine is required to maintain its effectiveness for another six months.”
It may also be given prophylactically to first responders such as police and emergency medical workers. Although such people are not thought to abuse fentanyl, even accidental exposure to fentanyl has been shown to harm first responders.
However, most people who receive vaccinations against fentanyl are people addicted to fentanyl or others who may accidentally ingest fentanyl, which is often added as a bulking agent to drugs such as methamphetamine, cocaine, and MDMA (ecstasy). become drug users.
Addiction essentials
Importantly, the vaccine does not prevent you from receiving pain management if you develop a medical problem that causes severe pain. For example, if someone who received a fentanyl vaccine develops excruciating pain from appendicitis or kidney stones, they may be given an opioid other than the one who received the vaccine. Dr. Kosten says, “Any other non-fentanyl opioid would be effective as an analgesic.” Only fentanyl is blocked by the vaccine. ”
Combining existing treatments to treat addiction
Vaccines are being studied as a complement to existing treatments such as drug therapy, residential therapy, and behavioral therapy. Although vaccines for opioid use disorder and other addictions are still experimental, they are a promising frontier in addiction treatment.
Significant advances are likely to occur in the coming years as more new treatments enter clinical trials, researchers personalize treatments, and researchers develop new algorithms for treatment recidivism.
