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David Baxter PhD

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Vaccines for addictions create the illusion that there's a quick fix for drug dependence
By Jowita Bydlowska, CBC News: Opinion
November 26, 2017

A so-called anti-cocaine vaccine has just been approved for human trials. The vaccine works by absorbing the drug in the bloodstream and blocks the dopamine-induced high when the user consumes cocaine.

Unlike a virus, or an inherited condition, or an environmental illness, addiction cannot be classified strictly within the parameters of cause and effect.

To put it more accurately: there are just too many causes for it, and we still don't have a consensus among addiction specialists as to what, exactly, it is. Yes, there is a nice and neat definition of "substance dependence" in the newest edition of the Diagnostic and Statistical Manual of Mental Disorders, but show me a definition in there that doesn't eventually get challenged.

Because of its complexity, addiction tends to attract all sorts of "cures." It makes sense, in a way: we know strep throat is caused by group A Streptococcus bacteria, for example, so we treat it with an antibiotic. But because the cause of addiction is less clear, it creates space for all sorts of quick-fix treatments.

Anti-cocaine vaccine
One such treatment is a so-called anti-cocaine vaccine — dAd5GNE — which has just been approved for human trials. The vaccine works by absorbing the drug in the bloodstream and blocks the dopamine-induced high when the user consumes cocaine. The idea is that the vaccine will block the "fun" of getting high.

But just because we can name the area of the brain that is affected by addiction doesn't mean that we have the map. In fact, the map of addiction is complex, confusing and it changes its coordinates. And a vaccine, or a pill, is not really a compass.

The problem with a cocaine vaccine — or other pills or vaccinations for drug dependency — is that they create the impression that anything other than abstinence will fix the problem. It won't.

Any single use can be death sentence for a person with addiction — just one more high could mean an overdose, just one more binge could mean a fatal car crash. One more could mean a full-on relapse.

The reality is a simple shot or pill will not magically turn a person with an addiction into a taxpaying, law-abiding Ned Flanders or Pollyanna. That's because addiction is more than just dependence on a drug: there are social components — including the way a person interacts with family, friends and community — as well as psychological components, such as compulsiveness, risk-taking behaviour and, most importantly, trauma. Trauma tends to be what compels people to seek out ways to comfort themselves, or numb themselves and check out.

People with addiction need fixes, and they can often be quite crafty. So we've ruined all the cocaine fun for you with a couple of shots? OK, so what about gambling? What about food? What about sex? The possibilities for dopamine rush are endless, really, and no vaccination or pill will stop the many causes of addiction, which can be lack of meaningful human connections, triggering environments, maladaptive social patterns and so forth.

Road to recovery
Because of the insidious nature of addiction, it is almost impossible to fight it on your own. Without removing yourself from your triggering surroundings, without supportive group of professionals and like-minded abstinent people around you, and without rigorous adherence to sobriety and healthy behaviours, recovery simply cannot happen.
A sober alcoholic and a clean cocaine addict is a miracle; a beat against all the odds. Taking a pill or getting a shot makes it sound as if a quick fix is an option but it is not: recovery is a grueling process that takes time. And it's a scary concept. For a person with addiction, the idea of abstinence goes against every inherent instinct, every learned maladaptive behaviour and every sick brain cell that screams that oblivion is the way to deal with life and its problems. But recovery can happen—just not with a shot or a pill; just not that quickly, not that easily.

About The Author

Jowita Bydlowska

Jowita Bydlowska is the author of Drunk Mom, A Memoir, and Guy, a novel. As a journalist she mostly writes on the topics of mental health, addiction and arts and culture.
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