The opioid crisis in America is evidence of how pharma companies prioritize profit, even at the expense of public health. Opioid medications are used to reduce pain, but routine use can lead to addiction. The crisis became an epidemic due to fraudulent marketing and institutional greed, which falsely branded opioid medications as non-addictive. While a lot of damage has been done, a research team led by Chenming “Mike” Zhang, a professor and Turner Faculty Fellow in Virginia Tech’s Department of Biological Systems Engineering, has developed a vaccine that blunts the euphoria of using opioids.
Opioid Locked– Immune System Ready to Fire
The immune system needs to know the threat, and it takes care of the rest. This concept underpins our immune response—it prepares the immune system to recognize a virus or bacterium. However, the opioid molecules themselves cannot trigger such a response and require a carrier protein such as tetanus toxoid. The process of combining opioid molecules with carrier proteins (haptens) is called haptenization, and it forms the foundation of vaccines meant to stop the “highs”.
The problem happens when the immune system mounts a response against the protein instead of the opioid. Dosage control across batches is also difficult to maintain. Professor Zhnag’s team prepared a new hybrid lipid-polymer nanoparticle to address this issue. Researchers were able to trigger a stronger response against oxycodone and fentanyl in mice using the nanoparticle vaccine. The findings have been published in the Journal of Controlled Release.
The virus-like structure of the nanoparticles helps prompt the immune system to produce antibodies against the targeted drug coated on the nanoparticle. Since the body does not generate antibodies against the lipid-polymer nanoparticle, the immune system directs 100% of its energy toward mounting an immune response against the drug.
Antibody Levels Remain Effective for Months
Preventing opioid molecules from crossing the blood-brain barrier limits how much of the drug reaches the brain and blocks the euphoric effect it carries. The vaccines are highly specific and do not interfere with other pain medications that a patient might require during medical treatment. Early results also suggest that effective antibody levels can last for several months, and Zhang believes further optimization could extend protection to a full year.
The vaccines are not intended to be used widely like a flu shot, or as a major prophylactic. The researchers plan to use them for people with opioid use disorder or those who might be at risk of opioid exposure. “Some of the oxycodone and fentanyl are so potent—you use it once or twice and you get hooked,” Zhang said. “If you can prevent people from getting hooked so quickly, that’s a big deal.”
The youth population might also be vulnerable to trying opioids, out of curiosity, peer pressure, or some other cause. Vaccinating them will make them numb to the opioid high, deterring future use.
The Vaccine Doesn’t Guarantee Sobriety
The vaccine merely blocks the euphoric effects of opioids. Researchers hope that blocking the “high” could reduce the desire for repeated use, lowering overdose rates and helping people with opioid use disorder become less reliant on the drugs. There is, in fact, no singular solution to the opioid crisis; the vaccine is another potential tool to address a public health problem that leads to over a hundred thousand deaths every year in the United States.
Zhang believes reducing deaths due to overdose can provide benefits that extend beyond individuals. He believes that reduced emotional trauma and lower medical costs will follow, along with increased workforce productivity. The lipid-polymer nanoparticles are also effective at reducing nicotine addiction, as shown in preclinical trials, making this a technique that can impact multiple intoxicants.
The Opioid Culprit: Purdue Pharmaceuticals
Looking back, the general public was “groomed” into opioid exposure by Purdue Pharmaceuticals (Purdue) as they marketed an opioid pain-relieving medication, OxyContin, as a non-addictive painkiller that could ‘revolutionize’ chronic pain treatment. As it was later revealed, OxyContin did carry a high risk of dependence. The company funded the American Pain Society to run a campaign promoting “pain” as a fifth vital sign after body temperature, pulse rate, respiratory rate, and blood pressure. The organization is now defunct.
Joint Commission joined in and set a standard to assess pain in 2001, though it didn’t suggest medicating pain with any sort of drugs. The non-profit also published a book a year earlier for doctors to buy as part of required continuing education seminars. As mentioned in an excerpt from CNN– the book cited studies that claimed “there is no evidence that addiction is a significant issue when persons are given opioids for pain control.” It also called doctors’ concerns about addiction side effects “inaccurate and exaggerated.” The Joint Commission removed the standard to assess pain in 2009.
Clearly, a misleading bubble of fraudulent claims and faulty standards led to the opioid crisis. Even when the regulations became tighter, people switched to other opioids like heroin.
A routine medicine meant to treat a non-fatal condition grew into a death pill. The vaccine comes at a time when the efforts aren’t aimed at reversing damage, but at minimizing more casualties.
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