A study reported this week in the Archives of General Psychiatry found that an experimental "cocaine vaccine" was mostly ineffective at reducing consumption of the drug. Less than two-fifths of the subjects injected with the vaccine, which is supposed to stimulate production of antibodies that bind to cocaine molecules and prevent them from reaching the brain, had enough of an immune system response to significantly reduce their cocaine use (as measured by urine tests). Even among those subjects, only half cut back on cocaine by 50 percent or more. "We need improved vaccines and boosters," the authors conclude. The lead investigator, Baylor College of Medicine psychiatrist Thomas Kosten, is nevertheless excited:
This is the first study that has ever been done with an illicit drug to show that a vaccine can be effective in humans. This is establishing the principle for all drugs of abuse, whether it's nicotine or heroin or methamphetamines. We've made vaccine for all of those things in animals, and we can put them in humans.
Vaccine boosters think the real money lies in an effective anti-nicotine treatment, which they believe would attract "inveterate smokers" who have repeatedly tried to quit with other methods. But as The New York Times notes (in the headline, no less), such a vaccine "does not keep users from wanting the drug." If all goes well, their cravings are not diminished in the slightest; they just can no longer satisfy them. And that's assuming the vaccine is fully effective (as opposed to maybe 10 percent effective, like the one in the study); if not, it could actually increase consumption by neutralizing a percentage of each dose. A partially effective nicotine vaccine could be hazardous to smokers' health if it encouraged them to smoke more so as to achieve the effect to which they're accustomed. In any case, it's not clear how appealing the idea of biochemically taking the fun out of smoking will be; the success of such a product hinges on consumers looking for a way to frustrate themselves.
Still, if it helped smokers (or other drug users) follow through on their own desire to quit, an effective anti-drug vaccine would be a welcome development. But I worry about the potential for nonconsensual use of such products, in light of the fact that so much "drug treatment" is imposed on people by the criminal justice system and the likelihood that mandatory vaccination of children to prevent them from ever being tempted by psychoactive chemicals would appeal to politicians who believe a drug-free America is just around the corner. The very concept of the anti-drug "vaccine," which portrays the drugs people voluntarily take because they enjoy them as pathogens invading their bodies, neatly fits with the general medicalization of addiction, which treats choices as diseases and therefore can easily be used to justify a forcible "cure."