Addiction vaccines. Heart attack and vine.

Its entertainment this week with a favourite artist and song of mine, written by Tom Waits and covered by Screaming Jay Hawkins; “Heart Attack and Vine” . The appeal of the song to me is the description, almost celebration of addiction and degradation.

The truth that addiction is not wholly linked with social standing is nicely described in “Doctor, lawyer, beggar man, thief” and the rest you can listen to and read.

It got me thinking when I listened to the song recently, about progress or the lack of it, with addiction vaccines. These have been mooted for some time, and the promise of an addiction vaccine to cocaine and nicotine, is ever present.

 

Liar, liar with your drawers on fire
White spades hangin’ on the telephone wire
Gamblers reevaluate along the dotted line
You’ll never recognize yourself on heartattack and vine

Doctor, lawyer, beggar man, thief
Philly Joe remarkable looks on in disbelief,
If you want a taste of madness, you’ll have to wait in line
You’ll probably see someone you know on heartattack and vine

Boney’s high on China White, Shorty found a punk
Don’t you know there ain’t no devil, that’s just Screamin’ Jay when he’s drunk
Well this stuff will probably kill you, let’s do another line
What you say you meet me down on heartattack and vine

See that little Jersey girl in the see-through top
With the peddle pushers sucking on a soda pop
Well I bet she’s still a virgin but it’s only twenty-five to nine
You can see a million of ‘em down on heartattack and vine

Better off in Iowa against your scrambled eggs
Than crawling down the boulevard on a pair of broken legs
You’ll find that ignorance is bliss every goddamn time
You’re waitin’ for the RTD on heartattack and vine

Boney’s high on China White, Shorty found a punk
Don’t you know there ain’t no devil, that’s just Screamin’ Jay when he’s drunk
Well this stuff will probably kill you, let’s do another line
What you say you meet me down on heartattack and vine

Liar liar with your pants on fire
White spades hangin’ on a telephone wire
Gamblers reevaluate along the dotted line
You’ll never recognize yourself on heartattack and vine

Doctor, lawyer, beggar man, thief
Philly Joe remarkable looks on in disbelief,
If you want a taste of madness, you’ll have to wait in line
You’ll probably see someone you know on heartattack and vine

See that little Jersey girl in the see-through top
With the peddle pushers sucking on a soda pop
Well I bet she’s still a virgin but it’s only twenty-five to nine
You can see a million of ‘em down on heartattack and vine

Boney’s high on China White, Shorty found a punk
Don’t you know there ain’t no devil, that’s just Screamin’ Jay when he’s drunk
Well this stuff will probably kill you, let’s do another line
What you say you meet me down on heartattack and vine

 

 

So where are at regarding vaccines against nicotine,cocaine, and opiate addiction?

 

  1. NICOTINE: July 2012 marked a flurry of media attention to clinical trials of an active nicotine vaccine. The researchers at Weill Cornell Medical College used an engineered virus as the carrier, which carried as it’s payload, information that directed the vaccine to hepatocytes, which are liver cells. The antibody’s genetic sequence then inserts itself into the nucleus of hepatocytes, and these cells start to churn out a steady stream of the antibodies. This process allows the body – so far only mice – to continually produce antibodies which target the nicotine molecule as soon as it enters the bloodstream. The mopping up of nicotine, on the fly, stops levels rising to the point where they can cross the blood brain barrier. So no hit. A word of caution. This may work in mice but further tests in rats, then primates – monkeys and chimps – will need to be done before it could be tested in  humans. Trials of other non-living passive vaccines similar in action to the way tetanus vaccines work, have so far failed to show any improvement on existing methods of stopping smoking.
  2. COCAINE: The Wall Street Journal no less, published this view by an addiction specialist who made the point that were a vaccine against cocaine be effective, then two things might happen. One is that as in the way that Prozac changed the way people views depression, from character defect to a medical condition, so would an effective cocaine vaccine “medicalise” this area of addiction to a treatable diagnosis. The second is that the Pharma industry would look at economics of producing said vaccine more favourably. Active vaccination using the method described for nicotine is the ideal way of producing a change in liver cells to make them continually produce antibodies against cocaine. That is to use a vaccine as the DNA payload carrier to add addictive antibody production to the liver cells repertoire.
  3. Opiates: Here it gets vague and despite the DM article in 2012 saying that a vaccine is “5 years away”, there has not been as much progress as in nicotine and cocaine. As the commentators in the DM article point out there are plenty of antagonists – drugs that block the effects of opiates, such as naloxone - but the real deal is staying away from the lifestyle surrounding non clinical opiate usage. As one commentator points out

“Subutex does act in the same way.getting off heroin is not the hard part I find it harder staying off it,You have to change your lifestyle ,friends and want to get clean in order to stay clean, you need to tackle the under lying problems and have positive mental attitude,Goodluck to anyone who is in this vicious circle.,,,I done it.”

My summary is that we are still a long way of proving the vehicle – a genetically engineered harmless virus – is safe and acceptable. The payload is another matter, but in truth I believe that the progress made public by the Weill Cornell Medical College is the most promising bit of news to reach us on the matter of addiction vaccination.

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