Amy Winehouse Dead: Should Drug Users Be Vaccinated Against Addiction?

As further information emerges following Amy Winehouse's untimely death, the issue of whether addicts should be vaccinated to help them recover remains largely unresolved.

The 27-year-old, who had a troubled history of drug and alcohol abuse, died on Saturday of undisclosed causes. She died alone, her body ravaged by emphysema and alcohol abuse. Many were quick to point out that, within the context of a particularly terrible news cycle, her death was a preventable tragedy.

"What did anybody expect?" went one typical response, "Known heroin user and alcoholic dies, is this news?" read another.

But to gloss over the singer's untimely death with such glib proclamations is to miss the tragedy inherent in every addict's life story. Drug addiction is a problem that affects every single one of us, whether directly or indirectly, and the fact that Winehouse was a well-known recording artist doesn't reduce or magnify the significance of her death.

Winehouse had numerous stints in rehab in an effort to overcome her addiction. But surely a vaccine capable of blocking heroin's effects could provide a long-lasting and sustainable adjunct to heroin addiction therapy? Some authorities, such as bioethicist Arthur Caplan of the University of Pennsylvania, have proposed pressing addicts into taking drugs like naltrexone, which curb the highs they crave.

The recent publication of research on a heroin vaccine and an anti-cocaine drug has again brought the issue to the public's attention.

Kim Janda and colleagues at the Scripps Research Institute in La Jolla, California have developed a vaccine composed of hapten - a heroin-like molecule that aggravates the immune system - bound to "a carrier protein and mixed with alum, an adjuvant that further stimulates the immune system," New Scientist reports.

The vaccine, once absorbed into the body, tricks the immune system into treating heroin molecules as if the drug were an invasive organism. The addict's body learns to swarm the rogue heroin molecules with antibodies, isolating them in the blood stream before the drug's effects can reach the brain.

Research

Janda's research team fitted rats with catheters that delivered a dose of heroin straight into the bloodstream whenever the rodents pushed a lever. All the unvaccinated rats pushed the heroin lever frequently and eagerly, whereas only three of the seven vaccinated rats dosed themselves like addicts (Journal of Medicinal Chemistry, DOI: 10.1021/jm200461m).

Human trials

Researchers are optimistic that the trial's success can be replicated on a wider scale. Medical experts favour the development of anti-addiction vaccines because, unlike pharmaceuticals that target the central nervous system, vaccines generally produce "fewer side effects and longer-lasting benefits."

But despite the trial's success, the treatment still requires some fine-tuning before it can be used in the wider population.

Experts are concerned that addicts could overdose in an attempt to overcome the vaccine's effects. New Scientist mentions one study where cocaine addicts that received an experimental vaccine wound up with 10 times as much cocaine in their blood than usual in an attempt to get high.

"Before any vaccine is put on the market we need to get these ethical considerations worked out," says Kathleen Kantak of Boston University. "It should always be the individual's choice to be immunised. The treatments will only be successful if the individual is motivated to quit, otherwise they will find ways to get around it."