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Vaccine-like shots help fight cocaine addiction

Rating

4 Star

Vaccine-like shots help fight cocaine addiction

Our Review Summary

This is a report about a study of a cocaine vaccine published in a leading peer-reviewed journal.  The report does a good job of relaying what the authors of this study want to publicize, namely that there is some effect on cocaine use among the minority of people given the vaccine who develop antibodies.  It is wise that there is little attempt to make this sound like the long awaited silver bullet that will relieve suffering.  There is a fairly good description of the study, with some room for improvement in terms of adverse outcomes, clinical trial design, and strength of the evidence.  A single disinterested, expert voice is represented in the story and that’s a plus.  Even with this journalistic restraint, the results are over-sold.  A more skeptical view was called for – highlighting that there really was no successful effect of the vaccine when all recipients were counted.    The description in quantitative terms of the benefit of this vaccine was clearer than it should have been given the complexity of the study outcome.  That so little has been found up to now to clearly help in cocaine dependence makes even the murmurings of hope significant.  In the final analysis, however,  to lead off an otherwise level-headed story with a socko-first sentence that inaccurately calls this trial the "first successful rigorous study" is a significant mistake.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story does not mention the cost of treatment or what would constitute a therapeutic dose of the vaccine. We are not told if patients would need more than one treatment. In this trial participants received 5 separate doses.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The story notes the benefits seen in the small group who remained in the study, but there was no significant challenge to the bold claims that "the researchers say their limited success is promising enough to suggest the intriguing vaccine approach could be widely used to treat addiction within several years." 

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

The story does not report some of the side effects noted in the trial, including muscle soreness and tenderness at the injection site. The story does not focus on the number of people who withdrew or on unaccounted attrition in the treatment group. We do not know if these participants experienced adverse events from the vaccine. The vaccine has not been administered to many people and we do not know long-term safety data or if the vaccine works beyond 24 weeks. 

No mention that the waning antibody response would suggest repeated and prolonged exposure to vaccine (booster shots) would be necessary, increasing the window for adverse events.

No mention of problem of false reassurance ("I’m vaccinated–no reason to pursue other treatments.")

 

Does the story seem to grasp the quality of the evidence?

Satisfactory

The story adequately described how the vaccine works and the study design. The story also lists absolute data. But the story misstates that there was any effect on cocaine "high"; that was not measured in this study. 

Does the story commit disease-mongering?

Satisfactory

Does not overstate the severity nor the prevalence of the disease.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

The story interviews several addictions specialists–some involved in the vaccine study, some not. The story appropriately provides attributions to researchers and vaccine makers who have a vested interest in the outcome of the efficacy trial and would stand to make money from wider use of this and similar vaccines to help with cocaine dependence.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story mentions the limited efficacy of treatment options for cocaine dependence. The story does note that the study participants were enrolled in a methadone maintenance program with relapse-prevention counseling.  Both are treatment options, but there is a high rate of relapse with the latter as a sole treatment approach.


Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The story appropriately notes that the vaccine is not currently available to opiod-dependent patients outside of trials. 

Does the story establish the true novelty of the approach?

Satisfactory

The focus of the story is the potential for a new treatment for cocaine dependence.  The story discusses that this treatment could be similar to a smoking cessation vaccine, which is not yet available to the public (not approved by the FDA, but "fast-tracked").

Does the story appear to rely solely or largely on a news release?

Satisfactory

The story contains independent reporting and does not rely on solely a press release.

Total Score: 7 of 10 Satisfactory

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