Photo credit: Chuck Jines | chuckjines.com
A pre-K teacher explains that forty percent of the kids in her class are raised by family members or guardians who are not their biological parents. She doesn’t even need to explain why; the woman she’s talking to, Melissa, is caring for a niece and nephew who were abandoned by her heroin-addicted younger sister. In that same conversation, Melissa’s neighbor, Christine, offers, “That means forty percent have been found out. Who knows what’s going on with the other parents?”
In her reporting from West Virginia’s Eastern Panhandle, Margaret Talbot has collected these anecdotes and many more for “The Addicts Next Door,” published in the June, 2017 New Yorker issue. Each story documents the gravity of the public health epidemic as it plays out in one of the most affected American communities. It speaks in whispers as quiet as the neighbor who falls unconscious in his bathroom with a tourniquet wrapped around his forearm—and in cries as loud as the parents who witness a mother and father overdose during their Little League team’s first practice of the season, lying supine on the sidelines of a youth softball field.
Leading research scientists and healthcare providers are working together to save people from becoming hooked on opioids and dying of overdoses. They rely in part on studies with animal models.
There are two ways emergency responders, public health officials, and healthcare practitioners (in a hospital, rehab, and/or primary care setting) typically save the lives of people addicted to opioids—an umbrella term that refers to a class of substances that include heroin, but also a broader group of chemically similar, habit forming, and widely abused prescription drugs.
Nalaxone, commonly sold as Narcan, is the first lifesaving treatment. The drug can revive an adult who has overdosed and stopped breathing. Methadone, or Dolophine, is an opioid that can be used as maintenance therapy for long term addiction treatment and to help chemically dependent people wean themselves off the drugs. It’s often administered in Methadone clinics in what is often called “replacement therapy.” Narcan and Methadone each address different symptoms, often life threatening, that result from opioid dependence; neither can prevent or reverse addiction.
But scientists from The Scripps Research Institute and Virginia Commonwealth University recently published a study that could be game-changing in the treatment of opioid-dependent patients. Working with rhesus macaque monkeys, researchers developed a vaccine that was effective in blocking the high of heroin, which, they believe, could prevent drug use relapse when administered to recovering addicts.
Why were monkeys part of the study?
Rhesus monkeys are arguably the most similar to humans, said the study’s first author Paul Bremer. “Because the immunological, pharmacological and behavioral effects of the vaccine—in relation to heroin use—have now been established in monkeys, these effects would likely be similar in humans with the implication that the vaccine could be effective in mitigating heroin abuse.”
The use of non-human primate models has led researchers to critically important knowledge about how vaccines work, how the brain works, and what happens when it stops working properly. Research with monkeys over the years has also resulted in a comprehensive medical understanding of how addiction works, knowledge that was an integral component of the Scripps/VCU study—knowledge that could eventually be instrumental in efforts to halt the heroin and opioid epidemic.
A 2010 study by the National Institutes of Health (NIH) explained the role of animal studies in research pertaining to the pathophysiology of addiction and substance abuse:
In contrast to clinical studies, the subject population can be controlled for variables more easily. Animal models often focus on the ability of the drugs to directly control the animal’s behavior, an outcome that is consistent with the behavioral definition of addiction…Despite the considerable value of past and ongoing research in this area, research on drug addiction and substance abuse is often controversial, and researchers who study these topics are often the target of animal rights activities. Without a clear understanding of the biologic basis of drug dependence and addiction, the public may not perceive an equivalent value from this area of research as compared with better understood medical issues such as heart disease, diabetes, and cancer.
It’s not just the potential vaccine that would be impossible without animal research—healthcare practitioners, emergency medical technicians, and public health officials would likely have no pharmacological tools to treat people struggling with heroin and opioid addiction
The gains that have resulted from this research are expansive: The way in which drugs in this class act as behavioral “reinforcers” was first discovered by researchers working with rats. Rodent studies also led to new knowledge about vulnerability to drug abuse, thereby allowing physicians to identify risk factors associated with dependency or addiction and make prescribing decisions accordingly. Studies with monkeys and rats were critical to researchers’ understanding of the transition from controlled substance use to compulsive, uncontrolled, or binge patterns of drug use. And the effects of environmental triggers like stress on drug relapse were first demonstrated in animal models—as was the relationship between the discriminative stimulus properties and subjective effects of drugs, which paved the way for Methadone therapies often used to wean users off opioids by mimicking the heroin high with less potential for lethal overdose.
Progress toward lifesaving, long term treatments for opioid addiction is possible with the public and financial support for research with animal models—research that is responsible in large measure for existing therapies and research that has a critically important role in the development of a promising new vaccine. These efforts are buttressed by the dedication of scientists, healthcare practitioners, volunteers, public health officials, and physicians—working together in government agencies, private companies, universities, rehab facilities, hospitals, and clinics—to save lives and halt the scourge that opioid dependency and addiction have wrought on individuals, families, and communities across the country.