The U.S. has been facing an opioid epidemic for years. Heroin continues to be one of the heaviest hitters when it comes to the addictive substance: in 2015, approximately 591,000 people abused the morphine-like narcotic, a shocking 6,000 of which were teenagers.

Although the rehabilitation process is long and arduous, advancements in science have allowed for an interesting solution: use drugs to get people off of drugs. Opiates work by attaching to receptors in the brain; once attached, they then send signals that create the classic ‘opioid effect’ — pain is blocked, breathing is slowed, and a general sense of calm arises. With this anti-depressant effect comes dopamine, the chemical responsible for feelings of pleasure and euphoria. By understanding how these receptors and neurotransmitters work, scientists have been able to develop three main medications to help people break their dependency.

• Methadone: Methodone is considered an opioid agonist, meaning it acts on opioid receptors in the brain (the same ones heroin and other opiates activate) in order to block cravings and withdrawal symptoms. Despite methadone’s similarity to opiates, it does not produce feelings of euphoria.
• Buprenorphine: Buprenorphine is a partial opioid agonist — it binds to those same opioid receptors but activates them less strongly, reducing cravings and withdrawal symptoms in a way that most patients tolerate quite well.
• Naltrexone: This drug is an opioid antagonist, meaning it works by blocking the activation of those opioid receptors in the first place. Rather than controlling withdrawal and cravings, it prevents any opioid use — that may occur when someone falls off the wagon — from producing rewarding, euphoric effects. Theoretically, naltrexone is supposed to give the patient time to consider their actions if they relapse, but most people suffering from addiction struggle to commit to its use.

The success of these drugs, among numerous others, depends on the patient’s ability to resist temptation; this is why they are so frequently prescribed as part of a treatment plan, usually alongside counseling or in-patient rehab.

However, science never sleeps, and given the fact that the U.S. holds over 45% of the global pharmaceutical market — and that our country has been hit particularly hard by this epidemic — it’s no surprise that we are constantly looking to make new breakthroughs in addiction treatment.

After the FDA discovered that opioid overdoses were five times higher in 2017 than in in 1999, the government agency issued draft guidance outlining new ways for drug developers to “consider measuring and demonstrating the effectiveness and benefits of new or existing medication-assisted treatments (MAT)” for individuals battling opioid addiction. One contender named Lucemyra (lofexidine hydrochloride) became the first non-opioid treatment for the management of opioid withdrawal symptoms, although many eyes are currently on the so-called heroin vaccine: by inciting an immune response to the presence of heroin, researchers at Walter Reed Army Insitute are hoping that the body can learn to protect itself.

“So then, if that person were to inject heroin, when it gets metabolized, the body would say, oh wait I remember that. We need to send antibodies to that substance,” Dr. Stephen Thomas explained.

Vaccines already prevent 2.5 million unnecessary deaths every year; the addition of one that could “cure” addiction would bump that number even higher, and could potentially allow hundreds of thousands of people to regain control of their lives.