Fentanyl Vaccines | What This Could Mean for the Future of the Opioid Epidemic

To some, the idea of a fentanyl vaccine may sound like an innovative step in the fight against drug abuse. To others, the idea of creating vaccines to combat abusive drugs is, at best, wishful thinking. However, the severe impact of fentanyl has captured the attention of the entire world, and some medical professionals are now willing to invest their time and talents to make wishful thinking a reality. Here’s what you need to know about the research and development of fentanyl vaccines happening now, and what it could mean for reversing the deadly trends of drug overdoses.

Leading the Opioid Crisis

In  2017, the United States government acknowledged that the crisis involving opioids was a public health emergency. Even at that point, the danger of opioid drugs had already become a harsh reality in America. Much of this was thanks to the pharmaceutical drug known as OxyContin which was widely used in the 1990s. Although the drug was originally marketed as a safe pain management drug, the wake of abuse and overdoses related to the drug led to years of lawsuits and ongoing legal battles. But even before that, illicit forms of opioids like heroin or even the long-standing use of morphine were enough to show the world that opioids have a high potential for abuse. What’s worse, they seem to become more potent with every new form that hits the streets.

This is where fentanyl comes into the picture. Since the crisis acknowledge by the United States in 2017, things have gotten much worse regarding opioids. Not only has the crisis not gone away, but the drug that is leading the way in the opioid crisis, fentanyl, has risen to such a level of concern that the Drug Enforcement Administration (DEA) recognized August 21st as National Fentanyl Awareness Day, starting last year. What makes this drug so dangerous is both its high potency and its high rate of use. One of the big problems surrounding fentanyl is that many people actually use this drug unintentionally, thanks to drug lacing. In fact, even some Mexican pharmacies are reportedly selling fentanyl illicitly in place of other medications.

Unfortunately, nothing is off the table when it comes to the kind of street drugs cut with fentanyl; it could be everything from cocaine to cannabis and even fake Xanax pills. Because of this popular practice by dealers, death rates attributed to fentanyl overdose have skyrocketed in recent years.

How Vaccines Fit Into the War on Drugs

Overdose Reversal Drugs

Currently, there are two typical ways that the dangers of fentanyl are being dealt with. One is a safety mechanism that continues to save lives in the case of a fentanyl overdose. Naloxone is a life-saving medication that can reverse the overdose effects of opioids including fentanyl as well as others like OxyContin and heroin. This drug is on hand for most first responders, and training modules have begun being used in order to certify civilians to use this life-saving medication on those who are undergoing a deadly opioid overdose. 

(Mostly) Illegal Test Strips

The second option is less reactionary compared to Naloxone. While the opioid reversal drug is used to treat people in the aftermath of using fentanyl, fentanyl test strips are used by many people as a way to test drugs before using them. It should be noted that this is a much more controversial way of addressing the dangers of fentanyl, and the main reason for this is that fentanyl test strips are currently illegal in 42 states and Washington D.C. The reason for this has to do with the “off-label” use of test strips. Officially, fentanyl test strips are used in professional medical settings, such as emergency rooms. They are commonly used for urine tests in order to tell if someone has fentanyl in their system.

However, many people have begun using these test strips to determine whether the illicit drugs they are in possession of contain fentanyl. Because this usage of the test strips is considered off-label, they count as a form of drug paraphernalia. However, the legislative push to legalize fentanyl test strips seems to be growing more and more, with the Texas legislature being at the centre of discussion, currently. 

Door Number 3: Vaccines?

While overdose-reversal medication and test strips are better than nothing, they fail to rise to the level of effectiveness that the latest innovation to combat fentanyl: vaccines. The first official recognition of vaccines occurred in 1796 when the smallpox vaccine containing a small amount of the cowpox infection could protect people from the smallpox epidemic. Since 1796, vaccines have followed the same general method of building immunity with a small amount of a related virus. However, the motivation to research and develop vaccines that can combat fentanyl does not follow the same trajectory as other vaccines.

For decades, the idea behind abusive drug vaccines is to introduce antibodies that can mimic the molecular structure of the drug while keeping the drug from reaching the reward centres in the brain. This would theoretically stop a dependence mechanism from being formed, and prohibit the possibility of becoming addicted to a drug. The theory behind this research is that one’s own immune system would produce antibodies that could counteract the possibility of a high or an overdose. However, this decades-long research initiative has now moved into actual clinical trials. Specifically, researchers led by the University of Houston have developed a vaccine specifically focused on fentanyl. According to researchers the immunized rats involved in laboratory experiments have not demonstrated any adverse side effects from the vaccine, which seems to be a promising sign for what’s to come in the near future when human testing occurs.

What Will This Mean?

While getting fentanyl vaccines into the public sphere is still a long way off, it does seem that the latest progress over the last few years could prove to be monumental. Until then, it is hard to say just how effective these vaccines will be in combating the opioid epidemic, and the fentanyl epidemic in particular.

However, this makes the treatment of fentanyl addiction and other opioids more important than ever. While test strips and overdose reversal medications are a positive step in the right direction, neither of them is capable of addressing the root issue of substance use disorder (SUD). If you or someone you know is addicted to fentanyl, it is important to remember that using this drug can easily become life-threatening. Reach out to trained medical professionals as soon as possible in order to begin your pathway to recovery.  

Sources

United States Centers for Medicare and Medicaid Services. (2022 December 5). Ongoing Emergencies and Disasters. Retrieved https://www.cms.gov/about-cms/agency-information/emergency/epro/current-emergencies/ongoing-emergencies#:~:text=On%20Thursday%20October%2026%2C%202017,is%20a%20national%20health%20emergency.%E2%80%9D

National Drug Intelligence Center. (2001 January). OxyContin Diversion and Abuse. Retrieved https://www.justice.gov/archive/ndic/pubs/651/backgrnd.htm#:~:text=OxyContin%20was%20developed%20and%20patented,became%20available%20in%20July%202000.

United States Drug Enforcement Administration. (n.d). Fentanyl Awareness. Retrieved https://www.dea.gov/fentanylawareness#:~:text=National%20Fentanyl%20Awareness%20Day%20(May,to%20drive%20the%20overdose%20epidemic.

Delphi Health Group. (n.d.). Fentanyl Addiction: What Side Effects Should You Know About? Retrieved https://delphihealthgroup.com/opioids/fentanyl/

National Institute on Drug Abuse. (2023 February 9). Drug Overdose Death Rates. Retrieved https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates

KHN Morning Briefing. (2023 February 3). Some Mexican Pharmacies Selling Fentanyl, Meth In Place Of Real Meds. Retrieved https://khn.org/morning-breakout/some-mexican-pharmacies-selling-fentanyl-meth-in-place-of-real-meds/

National Institute on Drug Abuse. (2022 January). Naloxone Drug Facts: What is Naloxone? Retrieved https://nida.nih.gov/publications/drugfacts/naloxone

National Drug Court Institute. (n.d.) Naloxone Training for Treatment Court Professionals and Families. Retrieved https://www.ndci.org/resource/training/e-learning/naloxone-training/

Cato Institute. (2023 January 19). Fentanyl Test Strips Save Lives, Yet Most States Ban Them As “Drug Paraphernalia”. Retrieved https://www.cato.org/blog/fentanyl-test-strips-save-lives-yet-most-states-ban-them-drug-paraphernalia#:~:text=While%20the%20Centers%20for%20Disease,and%20the%20District%20of%20Columbia.

Kera News for North Texas. (2023 February 27). Bills legalizing fentanyl test strips flood the Texas Legislature. Retrieved https://www.keranews.org/politics/2023-02-27/bills-legalizing-fentanyl-test-strips-flood-the-texas-legislature

World Health Organization. (2021). A Brief History of Vaccines. Retrieved https://www.who.int/news-room/spotlight/history-of-vaccination/a-brief-history-of-vaccination#:~:text=In%201721%2C%20Lady%20Mary%20Wortley,had%20observed%20practice%20in%20Turkey.&text=Dr%20Edward%20Jenner%20created%20the,cowpox%20were%20immune%20to%20smallpox.

National Institute of Health. (2014 July 2). Vaccines Against Drugs of Abuse: Where Are We Now? Retrieved https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4063243/

PNAS. (2021 December 21). Using vaccines to harness the immune system and fight drugs of abuse. Retrieved https://www.pnas.org/doi/10.1073/pnas.2121094118

C&EN. (2018 February 19). Vaccines against addictive drugs push forward despite past failures. Retrieved https://cen.acs.org/articles/96/i8/Vaccines-against-addictive-drugs-push.html

University of Houston. (2022 November 14). Fentanyl Vaccine Potential ‘Game Changer’ for Opioid Epidemic. Retrieved https://uh.edu/news-events/stories/2022-news-articles/november-2022/11142022-fentanyl-vaccine-haile-kosten.php

 

Delphi Health Group. (2019 October 22). What is the Difference Between Substance Use and Substance Abuse? Retrieved https://delphihealthgroup.com/blog/substance-use-become-substance-abuse/

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