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PaperclipPerfector  2mo ago (text post)   2317 thread views

Small-Scale Question Sunday for September 1, 2024

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I am reading a lot of reporting now about "fentanyl vaccine". I am not sure what's going on there, can anybody explain it to me? Specific questions:

  1. I understand that vaccines work by training the immune system to recognize certain proteins associated with pathogens and have other immune cells to bind to them and destroy them (not quite sure how but maybe not important). But fentanyl is a relatively basic compound, wouldn't training immune system to grab on something this simple also have a danger for it to react on many other simple compounds and disrupt the normal function of the body chemistry? What happens to fentanyl once the immune system recognizes it - is it broken into basic hydrocarbons? Somehow captured and expelled? How does that work exactly?

  2. I assume it is supposed to somehow fight fentanyl addiction. However, assuming it's effective all it would do is make the addict not to be able to get high from fentanyl. They however still will stay addicted, both physiologically and physiologically, not? Wouldn't they immediately seek to get high on some other drug, of which there are dozens? Wouldn't they still suffer withdrawal since their body still craves fentanyl but now is not getting any effect from it - wouldn't that make them take higher and higher dose? Also, would any drug addict voluntarily undergo treatment that would leave them as addicted as before but without any ability to get a fix? How is it supposed to work to solve the problem?

From the article you linked:

Our vaccine is able to generate anti-fentanyl antibodies that bind to the consumed fentanyl and prevent it from entering the brain, allowing it to be eliminated out of the body via the kidneys.

This seems to be blocking the fentanyl crossing the blood-brain barrier. I haven't read much about this specific process but there's something called antibody conjugation that does this. From the article human clinical trials have not been done, suggesting this might not even work on people. (lots of things happen in rats that don't in humans.)

As for the second question, yes, lots of other problems, but that's not anything new. No one pill sorts out everything about one's life. Except Ozempic TM.

(This post brought to you by Novo Nordisk!)

  1. My lay guess would be something something expelled kidneys, since that happens both to non-immunized users today and is pretty much the standard. They threw some related drugs in for cross reaction, though the risk of unrelated immune response is probably something that can’t be seriously tested until later.
  2. While not a tested endpoint for this study, a lot of the paper nudges and winks to theorizing a small number of shots that would a) have a very long term effect, months if not years, b) reduces the high from fentanyl, and most importantly c) reduces the heart and lung function impact of fentanyl.

The latter matters a lot to harm reduction proponents. To their perspective, the problem is not that people get addicted, but that addicts often die, as the drug has a thin range of of recreational use before health risks kick in, and because it is often used as a filler/replacement for other more conventional opioids. These harm reduction proponents probably assume (hope) that users will substitute other drugs, at least some of the time.

(Charitably, they’d would provide this as an option to general opioid users to protect them from developing an addiction to fet or an acute case of death if encountering adulterated drugs. Less charitably, a three dose regimen is the sort of thing that could be judicially ordered, or even put in the kits with Narcan. Though the latter has enough legal risk cynics don’t have too much to worry about.

Also, would any drug addict voluntarily undergo treatment that would leave them as addicted as before but without any ability to get a fix? How is it supposed to work to solve the problem?

There is a medication that works this way for alcohol and some alcoholics do willingly take it.

A pill means you only need self control 2 minutes a day rather than 24 hours a day.

But you still are free to take other drugs, including other opiates? For an alcoholic, there's no easy substitute I presume.

The press release claims it's specific to fentanyl and that morphine in particular isn't affected, so that those opting for the "vaccine" can still get pain relief.

Morphine is probably harder to get on the street, but if memory serves heroin is an alternative, and it does get metabolized to morphine before it starts acting.

Disulfiram, the analogue for alcohol, isn't related in terms of how it works. It basically switches off the enzyme that makes it possible to break down alcohol, causing the mother of all Asian Flushes, and basically makes taking alcohol too unpleasant to countenance. I see no mention of such a mechanism here, it claims to simply bind up the fentanyl and stop it causing any effects on the body from what I can tell, but I'll have to read the paper later for more insight.

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