Harnessing the Power of Antibodies to Combat Drug Addiction
The concept of using antibodies to block the harmful effects of addictive substances like heroin, cocaine, and nicotine has intrigued scientists for years. These drugs have claimed countless lives in America, and the nation is now facing an unprecedented drug crisis with over 100,000 overdose deaths in each of the past two years, largely due to the synthetic opioid fentanyl.
With substantial funding from the federal government, researchers are accelerating their efforts to develop vaccines and monoclonal antibody treatments to complement existing opioid treatment and overdose medications. However, it may take several years before these potential therapies become widely available.
Recently, the federal government allocated an additional $14.8 million for research into a monoclonal antibody that specifically targets fentanyl, the deadliest street drug in the country. This antibody binds to fentanyl molecules before they can affect the brain and disrupt breathing. Cessation Therapeutics, a biotech company based in North Carolina, has begun the first government-approved clinical trial to test a monoclonal antibody infusion targeting fentanyl in humans.
Monoclonal antibodies, which are proteins produced from cells in controlled conditions, have revolutionized the treatment of cancer and autoimmune diseases. They have also proven effective in combating infectious diseases, as demonstrated by their role in the fight against the COVID-19 pandemic. Researchers are currently conducting clinical trials for a monoclonal antibody treatment for methamphetamine, which is often used in combination with fentanyl.
Simultaneously, clinical trials approved by the Food and Drug Administration are underway for a vaccine targeting oxycodone, a prescription painkiller that played a significant role in the opioid crisis. Scientists are also developing vaccines for heroin and fentanyl.
These research efforts highlight the urgency of the drug crisis. However, they face numerous challenges. Research is costly, and bringing an antibody or vaccine to market is an expensive endeavor. Additionally, researchers struggle to keep pace with the rapidly evolving landscape of illicit narcotics, as new synthetic substances emerge faster than they can be studied. Skeptics argue that drug users may not willingly engage with these treatments or may switch to other substances, especially considering the high cost of antibody treatments.
Keith Humphreys, a professor of psychiatry at Stanford University, emphasizes that vaccines do not address the underlying issues of craving, withdrawal, or motivation for seeking care. He believes that resources should be allocated towards expanding access to existing medications and overdose reversal drugs like naloxone instead of pursuing vaccines that may not yield significant results.
Despite these challenges, scientists have been exploring the use of antibodies to combat the harmful effects of street drugs for decades. In the 1970s, a vaccine was developed that successfully blocked the effects of heroin in a self-administering rhesus monkey. However, the research also revealed that high doses of heroin could overcome the antibodies.
Efforts to develop vaccines against cocaine and nicotine have faced similar obstacles. Vaccines have not generated sufficient antibodies, and binding nicotine molecules with antibodies has proven challenging due to their prolonged presence in the body. Numerous attempts to develop nicotine vaccines have failed, including NicVAX, which performed no better than a placebo in a clinical trial.
Efforts to create a cocaine vaccine have also encountered difficulties. Trial results published in 2014 showed that only around 63% of vaccinated individuals achieved adequate levels of antibodies, falling short of FDA standards for approval. These setbacks have not deterred researchers like Thomas R. Kosten, who is working on a fentanyl vaccine, from advancing their studies.
Researchers believe that combating fentanyl may require fewer vaccine-generated antibodies due to the relatively small quantities of the drug typically ingested. This approach could be particularly beneficial for occasional cocaine users who fear the presence of fentanyl in their drugs. However, some scientists argue that monoclonal antibodies hold greater promise than vaccines due to their ability to act quickly, while vaccines may take weeks and multiple doses to generate sufficient antibody levels to counteract a drug.
Monoclonal antibodies, administered through IV infusions or shots, can be tailored to provide rapid and overwhelming effects. This is in contrast to vaccines that last longer but may be less effective and more expensive to produce, administer, and monitor. Proponents argue that the cost of antibody treatments may be justifiable for substances like meth or cocaine that currently lack effective medications. However, questions persist about whether individuals at high risk of overdose would be willing to undergo frequent treatments. Additionally, there is concern that users might switch to other drugs or increase their drug intake to overcome the effects of antibodies.
Significant progress has been made in the pursuit of monoclonal antibody treatments for different drugs of abuse. Clinical trials for meth monoclonal antibodies, undertaken by Intervexion Therapeutics, have shown promise. This biotech company has received approximately $60 million in federal funding and has completed two Phase 2 trials. Researchers hope to soon conduct a clinical trial for a fentanyl vaccine as well.
In conclusion, scientists have a long history of researching the use of antibodies to counteract the harmful effects of street drugs. While progress has been slow, recent developments and increased funding offer hope that antibody treatments or vaccines could become valuable tools in combating drug addiction and overdose. However, issues such as cost, adherence, and the evolving nature of the drug landscape must be addressed to maximize the potential of these interventions.
