blog.bioethics.net

The cocaine vaccine

You might have seen the stories floating around recently about the development of vaccine that can blunt or eliminate the high from cocaine. Researchers at Baylor are now looking to get approval to start Phase III trials of the vaccine sometime during the next year. From a Houston Chronicle article:

The vaccine also could raise interesting ethical questions involving who should get inoculated and what happens if confidential information about those receiving it becomes known. Although developed for therapeutic purposes — the number of cocaine addicts in this country is estimated at more than 2 million — the vaccine eventually is expected to be used for prevention, as well.

The questions include whether parents would be allowed to have their children inoculated; whether it would amount to coercion to make it a condition for lighter criminal sentences; whether employers might happen upon such information and use it discriminatorily; and whether to use it on pregnant addicts to protect the fetuses.

The questions don't just reverberate about this vaccine: Tom Kosten also is at work on vaccines for methamphetamine, heroin and nicotine. Two other nicotine vaccines are being investigated by other scientists.

A 2004 report from the National Academies looked at the issues surrounding immunotherapy for treating addiction. From the report:

Enthusiasm for the new medications should not obscure the fact that fully informed and voluntary consent is necessary under any and all circumstances. These medications can produce long-lasting biological markers (raising issues of confidentiality and potential for discrimination) and might interfere with drug-testing methods. The free and informed nature of consent is of special concern if the medications are used in settings and circumstances that are inherently coercive. These therapies may offer great benefit, even when used in such settings. However, any such benefit needs to be balanced against the rights to privacy and liberty that have long been recognized in the provision of medical care. Particular complications may arise in obtaining consent from persons in the criminal justice system, from pregnant women, from women who are already parents and involved with the child welfare system, and from adolescents and children whose parents or guardians seek to administer these medications for “protective” use.

That last situation highlighted by the report -- about children -- seems especially interesting. Would you give such a vaccine to your children? Would you want to, in a sense, take that choice away from them? Every parent wants to protect their children from serious harm and there's little doubt that narcotic addiction falls into that category. So, sure, maybe a vaccine against cocaine and heroin is an easy choice. But, if such a vaccine existed for marijuana or nicotine, how about those?

Update: Over at the MindHacks blog, Vaughn Bell has more about vaccines against addiction and raises the possibility of an "arms race" between illicit drug producers and vaccine developers.

-Greg Dahlmann