An opioid vaccine, new drugs for chronic pain, yet alcohol use disorder not a priority for NIH HEAL Initiative?

A week ago, I was drinking my morning cup of tea while reading several ‘addiction news’ articles
(as this is part of my morning routine) when I came across something novel. I saw a press
release on an opioid vaccine that targets fentanyl, which is being developed by the National
Institutes of Health (NIH) Helping to End Addiction Long-Term Initiative.

According to Heal.NIH.Gov, “The Helping to End Addiction Long-Term Initiative, or NIH HEAL
Initiative is an aggressive, trans-agency effort to speed scientific solutions to stem the national
opioid crisis. Almost every NIH Institute and Center is accelerating research to address this
public health emergency from all angles.”

The main goals of the NIH HEAL Initiative are to improve prevention and treatment for opioid
misuse and addiction and enhancing pain management. It aims to create new medications (for
opioid withdrawal, cravings, relapse prevention, overdose, pain management, and more) and
optimize treatment and treatment outcomes.

This is a big deal for individuals with opioid use disorder (OUD) and/or chronic pain, however,
alcohol use disorder (AUD) treatment appears to get no love in the NIH HEAL Initiative’s 6-point
plan that is estimated to take 5-6 years.

Why The Massive Initiative?

On average, 130 people die from opioid overdose daily. Worse still, rates of opioid use disorder
and opioid overdose deaths spiked drastically in 2020 and continue to rise at alarming rates. In
2018, the Centers for Disease Control and Prevention (CDC) documented that it was the first
year in decades overdose deaths were finally decreasing. Unfortunately, that trend has not
continued.

A combination of the covid pandemic and massive amounts of black-market pills and heroin
being cut with fentanyl is no doubt two major contributors to these elevated rates of opioid
addiction and overdose deaths.

Fentanyl is a synthetic opioid up to 50-100x more powerful than heroin, so if a person doesn’t
know the heroin, oxycodone, etc. they bought from a drug dealer is laced with fentanyl, they are
in serious jeopardy of overdosing. Black market opioids cut with fentanyl have been so
devastating that the CDC has named it the deadliest drug in America.

Fortunately, innovations in medicines for preventing opioid overdose and for treating opioid
addiction are in the works. The most interesting of these medicines (to me at least) is an opioid
vaccine.

How Will The Opioid Vaccine Work?

The vaccine being studied by the NIH HEAL Initiative is an adjuvant opioid use disorder
vaccine. An adjuvant molecule boosts the immune system’s response to vaccines, a critical
component of the effectiveness of anti-addiction vaccines.

adjuvant (noun) – a substance that enhances the body’s immune response to an antigen.

The vaccine targets fentanyl and it protects the brain and nervous system by stimulating the
body to create powerful antibodies that target and bind to opioid molecules.

Next, it sequesters the opioid molecules in the blood in a peripheral area. This prevents opioids from crossing
the blood-brain barrier (BBB) and reaching the central nervous system (CNS).

Since it blocks opioids from reaching the brain, it also prevents the massive respiratory
depression caused by opioids getting into the brain, and that’s why it’s so beneficial for
preventing opioid overdose.

When Will The Opioid Vaccine Be Available?

It would be extraordinary if the NIH HEAL Initiative’s anti-opioid vaccine and other medicines it’s
working on for the prevention and treatment of opioid addiction were available now, however,
these things take time. The process of getting FDA approval for a new vaccine or drug is long
and costly.

Fortunately, the NIH HEAL Initiative appears to be more than capable of developing, studying,
and getting FDA approval for these drugs… medicines that will help with damage control of the
opioid epidemic that keeps raging on amidst the covid pandemic.

More Drugs for Opioid Addiction, Non-Addictive Drugs for Pain, Yet No
Alcohol Treatment Innovations?

I’m very excited to track the development of the opioid vaccine and the other opioid addiction
and chronic pain treatment solutions the NIH HEAL Initiative is working on, however, after
reading the entire NIH HEAL Initiative Research Plan and not seeing alcohol addiction treatment
in their overall strategies, I felt sad for that population. Why?

6% of adults in the U.S. have alcohol use disorder. 15… million… people. 88,000 people in
America die every year as a result of alcohol. It’s estimated that approximately 2.1 million
Americans have opioid use disorder.

Thus, there are over 700% more Americans with AUD than there are with OUD.
Fortunately, even though the NIH HEAL Initiative appears to be focusing its efforts on
preventing overdose deaths, opioid addiction, and chronic pain, people like Chris Scott, an
Alcohol Recovery Coach and founder of Fit Recovery, and Ken Star, M.D., a board-certified
addiction physician and founder of Ken Starr MD Wellness Group, are leading the way for
biochemical innovations in AUD treatment like customized alcohol detox supplement protocols,
neuro-nutrient therapy, nutrigenomics, and much more.

Conclusion

Rates of substance use disorders, as well as behavioral addictions like gambling and others,
are all rising across the board. America is undergoing a ‘Twindemic’ of addiction/overdose and
covid and these are both synergistic with each other. The covid pandemic is causing elevated
rates of substance use disorders and, according to the CDC, people with a substance use
disorder are more susceptible to catching covid and having negative outcomes with covid
infection.

The NIH HEAL Initiative is actively combating the addiction/overdose issue. Will its work pay
off? Only time will tell. I have high hopes for it to achieve all of the goals it has set out to
accomplish. It may not be focusing on alcohol use disorder treatment, but then again, one has
to start somewhere.

According to the NIH HEAL Research Plan, the first 2-3 years will be focused on chronic pain
and the next couple of years will be focused on opioid addiction. Perhaps alcohol treatment will
be next on the list? Yet again… only time will tell.

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