ABSTRACT
Promising advances have been made in recent years for a unique class of immunotherapies that use vaccination to combat substance-use disorders. Vaccines to treat addiction to nicotine, meth-amphetamine and morphine, or phencyclidine are at various stages of preclinical or clinical investigation. As it is furthest along in trials and more is understood about its biology, the emerging vaccine used as therapy for addiction–cocaine dependence is the focus here as a paradigm case that elucidates many of the questions raised by other proposed immunological interventions for substance abuse. Key issues posed by the availability of vaccines of this kind include their prophylactic use, therapeutic use and unintended socioeconomic consequences and the ethics of conducting research to bring such vaccines to market. A vaccine against cocaine addiction presents many social, legal and ethical issues. These issues are emblematic of those linked to the development and deployment of other vaccines that belong to the evolving category of immunotherapies that target substance-use disorders.
