Researchers Get to Work on Opioid Overuse Vaccine With $25 Million NIH Grant

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A $25 million grant from the National Institutes of Health Helping to End Addiction Long-term Initiative (HEAL) is funding new research to develop a vaccine that may help patients overcome their addiction to opioids, a class of highly addictive pain medications. The vaccine targets fentanyl, a synthetic opioid that is approximately 50 to 100 times more powerful than morphine.

The research to develop a twice-per-year opioid use disorder vaccine is headed by scientists from the Precision Vaccines Program at Boston Children's Hospital. These investigators are joined by a University of Houston professor of psychology, Therese Kosten, Ph.D., and colleagues Greg Cuny, Ph.D., associate professor of medicinal chemistry in the UH College of Pharmacy, with Dr. Colin Haile, MD, research assistant professor of psychology. Dr. Kosten and colleagues at UH received approximately $1.8 million from the grant to develop the combination of the adjuvant with the vaccine.

According to the scientists, a potential anti-opioid vaccine would stimulate the generation of potent antibodies that can target and bind to opioid molecules. In doing so, these antibodies can prevent the opioid molecules from crossing the blood-brain barrier, thereby helping to protect both the brain and the nervous system. Additionally, the opioid-blocking effects may mitigate the risk of respiratory depression commonly associated with opioids after they reach the brain.

Fentanyl creates an additional challenge to overcome in clinical practice, as this synthetic opioid is pervasive in street drugs, further contributing to opioid overdoses in patients prescribed the medication. 

In recent years, the Centers for Disease Control and Prevention (CDC) named fentanyl the deadliest drug in the U.S., surpassing heroin and oxycodone in its lethality. Between 2013 and 2016, the CDC said fentanyl was responsible for a 113% per-year increase in deaths. 

"Fentanyl is different than heroin or other opioids in the way that it stimulates the nervous system,” said Dr. Kosten, in a statement. “It activates the same receptors in the brain as heroin or morphine but does so by a different mechanism, which makes drugs that can reverse a heroin overdose, like Narcan, almost ineffective against it.”

Dr. Kosten said that the vaccine research would assess multi-dose strategies, single-dose immunization, heterologous vaccination strategies, and the impact of waning immunity from the vaccine. 

If ultimately approved for use, the vaccine could offer a beacon of hope for people dealing with addiction. Opioid-related deaths have risen during the coronavirus disease 2019 pandemic, making a vaccine all the more critical for reducing the mortality and morbidity burden associated with the pandemic’s collateral damage. 

According to CDC data, an estimated 87,000 people have died of drug overdoses in one year ending in September 2020. In contrast, the agency said overdose deaths were dropping in 2018 for the first time in decades.

An opioid vaccine represents just another wake-up call for drug manufacturers, all of whom have been charged with fueling the opioid crisis in the states. In a recent $50 billion California lawsuit,  Johnson & JohnsonEndo International, AbbVie’s Allergan unit, and Teva Pharmaceutical have been charged with claims of engagement in deceptive marketing practices that further contributed to the progression of this crisis. More than 3,400 similar lawsuits are currently pending in the U.S., with more cases expected to enter the courts in the next few months.

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