MeAndBobbyMcGee

Thanks for doing this AMA!

I know its not necessarily related to bacterial/viral vaccinations but I'm wondering what your thoughts are about using vaccines to treat substance abuse disorders? I've read studies about conjugating cocaine metabolites with carriers to promote immunity to the euphoric effects of cocaine and similar vaccines in development for other substances. Does there seem to be a lot of excitement in the field surrounding this area of research?

Suboxone is less easily abused. Suboxone is a combination of buprenorphine and naloxone. Buprenorphine acts as a partial agonist at opioid receptors which gives the patient their "high" while on treatment, which theoretically should reduce their desire for heroin. Methadone works in this way as well (although with some minor differences). To me, the interesting part of suboxone is the addition of naloxone which is a powerful opioid antagonist. When suboxone is taken orally (as directed) the buprenorphine produces its effects without interference from the naloxone; however, if a patient on suboxone injects it for a more rapid onset or injects heroin, the naloxone will block the effect of the opioids and cause withdrawal. Ideally this would reduce heroin use while receiving treatment.

It is also arguably safer than methadone because the partial agonist effect of the buprenorphine is less robust as the agonist effect of methadone. It is very possible to overdose on methadone or to use methadone and administer heroin and accidentally overdose that way, which is blocked with suboxone use by the naloxone.