Vaccines are playing a central role in the fight against COVID-19. They also may hold promise to help relieve the opioid overdose crisis that has worsened along with the pandemic.
That’s the argument that two psychiatrists make in a recent JAMA article, “The Hidden Epidemic of Opioid Overdoses During the Coronavirus Disease 2019 Pandemic.” Antifentanyl vaccines have shown promise in trials, but none are commercially available.
At the outset of the COVID-19 pandemic, it seemed likely that decreased access to illegal drugs, increased telemedicine access and loosened federal methadone restrictions would reduce opioid overdoses, argue the psychiatrist authors Dr. Thomas Kosten and Dr. Ismene Petrakis in the article. But instead, overdoses have climbed. In May 2020, there were 42% more overdoses than in the same month a year prior.
Fentanyl, the synthetic opioid analgesic that the Drug Enforcement Administration says is 80 to 100 times more potent than morphine, is driving the bulk of overdose deaths. But the most common treatments for opiate use disorder, buprenorphine and methadone, do not inhibit fentanyl distribution to the brain.
Vaccines to combat the effects of fentanyl have the potential to improve the situation. Animal experiments involving antifentanyl vaccines have shown promising results, but there is little support for such vaccines.
COVID-19 vaccine development initiatives have received more than 1,000 times more support than antifentanyl vaccine projects, the JAMA article concluded. Yet, the templates for such vaccines were developed 50 years ago.
One central challenge is the stigma against opioid use disorder, which has arguably worsened after the COVID-19 outbreak as many clinicians have deprioritized addiction treatment during the pandemic.
Current treatments for opioid use disorder have not been insufficient to contain the worsening opioid overdose crisis. “We need to return our attention to this hidden epidemic that was very much in the public eye before the COVID-19 pandemic struck and that COVID-19 appears to have worsened,” Kosten and Petrakis conclude.