Asking students to catalogue the errors of fact and inference in the latest New York Times Magazine essay on addiction treatment would make a good final exam for a course on drug abuse.
1. NIDA has spent most of a billion dollars trying to develop an anti-craving drug for cocaine abusers, with exactly zero to show for it.
2. Brain imaging is fascinating science, but its practical relevance to the problem of diagnosing or treating substance abuse remains unproven.
3. Most substance abuse disorder is transient rather than chronic, and most recovery isn’t mediated by treatment.
But one terminological error stands out: calling the immunotherapies now under development against various drugs of abuse “vaccines.” It’s true that immunotherapy for addiction works on the same biological principle as vaccination for infectious disease: priming the immune system. But in ordinary usage a “vaccine” is something given before someone is sick as a preventive measure. Given that the immunotherapies will be moderately expensive, molecule-specific (an immunotherapy against amphetamine would have no effect on methamphetamine), and with limited periods of effectiveness, they won’t be useful preventively.
So calling the substance abuse immunotherapies “vaccines” against addiction gives exactly the wrong impression. Indeed, one of the concerns about developing immunotherapies in the substance abuse field is that parents will start to demand that their children be “inoculated” against one or another substance.