Tackling the opioid crisis requires changing strategies and the way we think about addiction, says Columbia University professor Sandra Comer.
At least 100,000 people died from a drug overdose between May 2020 and May 2021 — up 22% from the year before, according to the Centers for Disease Control and Prevention. In the last two decades, nearly 1 million Americans have died from drug overdoses, with more than 70% of them involving opioids.
"One of the mistakes that people make when they think about drug users, 'Oh, it's somebody's choice to have this disorder.' That's not true," she said. "It's a medical disease and we need to treat it."
Medically assisted treatments can be effective but have a relapse rate of about 50%, Comer said.
"That's why we're continuing to look for new medications," Comer said.
That search led to a new type of treatment — a vaccine that targets the chemical makeup of oxycodone. Comer and her research colleague, Marco Pravetoni, are testing the vaccine on volunteers with substance use disorder.
"The idea behind the vaccine is that after a while, the body will produce an antibody to that particular chemical structure," Comer said. "If somebody uses oxycodone, the antibody will bind to that molecule and it won't allow it to get into the brain."
That means the drug would never get to the brain to stimulate the pleasure center.
Comer added that the vaccine provides a safety net for people who relapse despite currently available therapies.
"If they relapse, the vaccine hopefully will provide still some level of protection, at least against overdose. And maybe an opportunity for us to reengage them in treatment," she said.
The vaccine could be used with other medications that treat drug abuse, Comer said.
If it works, researchers hope to target other opioids, including fentanyl and heroin.
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