Category Archives: Research

Developing a vaccine for the “zombie drug” xylazine

Scripps Research chemical biologists design an early “proof-of-concept” vaccine that could lead to the first effective treatment of xylazine overdose in people.

“Evaluation of a Hapten Conjugate Vaccine Against the ‘Zombie Drug’ Xylazine” was co-authored by Mingliang Lin, Lisa M. Eubanks, Bin Zhou, and Kim D. Janda, all of Scripps Research.

April 03, 2024


LA JOLLA, CA—Xylazine is an FDA-approved sedative and pain reliever for use in animals, but it has severe adverse effects when used in humans. It is now illicitly being added to opioids, like fentanyl and heroin, as well as cocaine—leading to a sharp rise in overdose deaths.

Now, Scripps Research chemical biologists have developed a vaccine to block the effects of xylazine’s toxicity. The vaccine works by training the immune system to attack the drug, which is described in a new paper published in Chemical Communications on April 1, 2024.

“We demonstrated that a vaccine can reverse the symptoms of a xylazine overdose in rodents,” says study senior author Kim D. Janda, PhD, the Ely R. Callaway, Jr. Professor of Chemistry at Scripps Research. “There is currently no remedy for xylazine poisoning other than supportive care, thus, we believe our research efforts and the data we have provided will pave the way for an effective treatment in humans.”

The rapid increase in lethal drug overdoses attributed to xylazine combined with fentanyl prompted the White House Office of National Drug Control Policy to declare this combination an emerging threat to the United States. Xylazine intoxication presents similarly to opioid overdose, causing respiratory and central nervous system depression, and it can heighten the effects of opioids. However, naloxone—typically administered to reverse the effects of opioids—does not tackle the impact of xylazine, highlighting the need for effective measures to treat acute toxicity caused by xylazine.

Researchers suspect xylazine works by reducing blood flow to the brain, among other areas of the body. The drug also causes non-healing skin lesions and wounds, often located on the forearms and lower legs, that can require amputation in some cases—giving it the nickname “zombie drug.”

Although no treatment currently exists, targeted vaccines may offer a solution. Vaccines nudge the immune system to create antibodies to fend off invaders. Antibodies can target viruses, bacteria and toxins. However, sometimes molecules are too small to initiate an immune response, as is the case with xylazine. So, to circumvent this problem, the researchers created a vaccine using a design principle that Janda pioneered, which relies on pairing the drug molecule (called a hapten) with a larger carrier molecule (a protein) and an adjuvant.

In this study, the scientists combined a xylazine hapten with multiple different protein types, to see which combination would create a robust immune response against xylazine. The team tested three vaccine formulations (termed TT, KLH and CRM197, based on the protein involved) to see which vaccine cocktail could help rodents after being challenged with xylazine. One of the three vaccines (TT) significantly increased movement in mice given xylazine after 10 minutes, while two of the three vaccines (TT and KLH) led to an improvement in breathing.

The scientists also examined how these vaccines would limit xylazine blood brain barrier, (BBB) permeation, a filtering mechanism that scrutinizes drug penetration. When xylazine was injected, it immediately crossed into the brain to bind with receptors. Antibodies typically cannot navigate the BBB; however, two of the three vaccines (TT and KLH) showed a strong ability to stop xylazine from reaching its receptors in the brain, limiting its detrimental effects.

A provisional patent has been filed on the research. In the future, his team will build off this work to create a bifunctional antibody that will reverse both fentanyl and xylazine’s toxicity simultaneously, something that naloxone cannot do.

“A monoclonal antibody treatment could be given in tandem with the vaccine to provide both immediate and long-term protection from both opioid substance use disorders as well as opioid-xylazine overdoses,” says Janda. “This strategy could make a significant impact on the opioid epidemic.”  

Funding for the study was provided by the Shadek family and Pearson Foundation.

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What do I need to be a recovery coach?

Recovery Coaching within a Recovery Oriented System of Care - SHE RECOVERS®  Foundation

Posted by Melissa Killeen, MSOD, MPhil, NCPRSS

I published the second edition my book Recovery Coaching – A Guide to Coaching People in Recovery from Addictions in 2019. Since the first edition was released (in 2013) there have been several changes in certification requirements for recovery coaches, or peer recovery specialists. The training of coaches has become one of the fastest growing aspects of the coaching field. So what kind of training do I need to be a recovery coach?

Many of the organizations that offer addiction recovery coach training or peer recovery-support specialist training are listed on my web site . For many people interested in being a recovery coach, the training costs are an important factor. Deciding on the best training organization and the training necessary to fulfill the state certification requirements can be confusing. So I would like to attempt to clear up this confusion and will attempt to answer these questions in this post:

What are the guidelines I must meet to apply for recovery coaching training?

Applicants must meet the following guidelines to apply for a training course in order to be a recovery coach or a peer recovery support-specialist. These guidelines are shared by many training organizations and certification boards across the nation as a standard for what a potential recovery coach must have before applying for recovery coaching training:

High school diploma, GED or higher

Minimum of one year of direct knowledge of sponsorship and 12-step programs

Minimum one year of sobriety from substance use or one year sobriety in co-occurring mental health and substance use disorders (self-attestation)

Have a minimum of one year experience working with a family member, loved one or significant other that is addicted, is attempting to recover or who has loss their life due to an addiction(self-attestation)

What kind of training do I need to be a recovery coach?

Certification boards require the coach to receive peer recovery specialist or recovery coach training from an organization that is authorized by the state to give this training. This ensures the training will fulfill the requirements mandated by your state’s certification board. In order to find out what authorized training organizations are, go to your state’s certification board.

After your research, you will need to complete the following:

  • Each state and organization has different requirements. So first check with your state to ensure the courses you take will be accepted by the state credentialing board.
  • A certain amount of hours in coaching training (46-120 hours depending on the state) in topics such as addiction recovery theory, motivational interviewing, relapse prevention, cultural awareness, suicide prevention and HIV-AIDS education
  • 8-16 hours of coaching ethics.

The places in which you receive this training are quite diverse. In the links section of this web site,  ( https://www.mkrecoverycoaching.com/recovery-coach-training-organizations/ ) I list over 250 organizations offering recovery coach training. The courses can be virtual, or in a classroom. The costs for this training is diverse as well, from free (in Ohio) up to $4,000 per course. The length of the course could be three days or four months.

At no time does taking a recovery coaching course give you an immediate state certification board recovery-coaching credential. It gives you a document (called a certificate) that says you completed the training hours. There are many coaches who do not seek state board certification and use this document or certificate from a training organization as adequate proof they are knowledgeable in performing the duties of a recovery coach.

There is a central international credentialing organization, the International Certification and Reciprocity Consortium, commonly known as the IC & RC, which runs many state credentialing boards and has developed an exam for a Peer Recovery (PR) Certification. The IC & RC suggests applicants check with their state credentialing board for specific test-taking guidelines.

What differentiates a Peer Recovery Coach from a Professional Coach?

Why the “Professional Coach” title? The word “professional” will differentiate Peer Recovery Coaches with more coaching experience and more training from other peer coaches with credentials or certifications. Employers ( e.g., hospitals, providers, prisons) employ coaches, and for these employers  the term “Professional” signifies a higher level of competence and expertise.

There are trainings offered that can give a coach more information that may not be on the state certification board list but are very helpful. The kinds of training I found helpful as a new recovery coach are conflict resolution and management, anger management, intervention training, co-occurring disorders, behavioral addictions, the pharmacology of addiction, as well as knowledge about coaching families in relationships with addicted persons. There are also trainings on how to be a recovery coach in a hospital Emergency Department, working with Narcan revived patients, or working with people in prisons or the homeless. There are also organizations that offer Professional Coach certification (CCAR- Conneticut Community of Addiction Recovery, (https://addictionrecoverytraining.org/ ) and the International Coaching Federation that offers three different levels of life coach training: associate, professional- and master-level coaching certificates https://coachingfederation.org/

After you receive this initial Peer Recovery Coach training, additional trainings can open up to you. The more time you engage in being a recovery coach and the more educational credentials you receive; you move closer to the “Professional Coach” status.

Are there any additional credentialing organizations for recovery coaching certification?

NAADAC, the Association for Addiction Professionals, and the National Certification Commission for Addiction Professionals (NCC-AP) offer the Nationally Certified Peer Recovery Support-Specialist Certification. Similar to the state certification- however- the NAADAC certification is good to use in every state in the union. So a coach does not have to worry about reciprocity from one state to another. The requirements the  NAADAC recommends, in order to receive certification, mandates a coach read and sign a statement on the application affirming adherence to the Peer Recovery Support-Specialist Code of Ethics. The new coach will confirm they have taken the NAADAC six-hour ethics training course and have completed six hours of HIV/other pathogens education and training course (also available through NAADAC).Credentialing boards require supervisors of the coaches-in-training to sign a document verifying they have supervised the coach during the 200-hour period of the coach’s  practice training. Letters of recommendation are also items required by some credentialing boards. Other state boards require a recent photograph.

 NAPS, or National Association for Peer Support is an organization for peers focusing on mental health recovery peer support as well as addiction recovery support. They have education and credentialing standards that are listed at : https://www.peersupportworks.org/.

As always, check with your state credentialing board for specific requirements for credentialing training. Many states only accept training from an organization that have had their trainings screened by the state and authorized to be used as a credentialing training source.

What is the next step in the  process of being qualified, getting training, and then credentialed as a recovery coach or peer-recovery support specialist?

After you have completed the research as to what type of credentialling you want (e.g. state certification board, IC & RC or NAADAC), then seek out the training you can afford. Go to https://www.mkrecoverycoaching.com/recovery-coach-training-organizations/ for a list of addiction recovery coach training organizations

  1. Verify that you meet the qualifications to apply for the course (e.g. be 18-years-old, have a GED or high school diploma, one year sobriety from any addiction)
  2. Take and pass the course, retain the coaching certificate for future purposes
  3. Research places like Recovery Community Organizations or treatment centers to work or volunteer as a recovery-coach-in-training to receive your practice hours.
  4. Complete the recovery-coach-in-training supervised practice hours that are required by the state board or the NAADAC
  5. Apply to your state certification board or the NAADAC for the time to take the recovery coach exam(a fee will apply)
  6. Send in your application with paperwork verifying the completion of practice hours to the state credentialing board with a certification fee (the additional fee varies for every state, from $100-$250)
  7. If you pass the exam and meet all the requirements listed on the application, you will receive your recovery coaching or peer-recovery support specialist certificate
  8. In the next 2 – 4 years take the required courses for renewing this certificate. Refer to your state board or the NAADAC for more information on courses and renewal time frames. A renewal fee will be required.

So, whether you are working as a coach, looking to become one, if you are a family member, or an ally ready to learn about the recovery process, we can promise you the process to become a coach is a transformational experience.

Good luck on your journey.

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Video game addiction now an illness says World Health Organisation with conflicting treatments available

By Samuel Port

In a development that might worry parents, the World Health Organisation (WHO) has now classified video game addiction as an official illness.

But the message is very much don’t panic, it’s not an epidemic – it’s a pathological disorder – published in the 11th revision of their International Classification of Diseases book.

The gaming disorder refers to people whose lives have been consumed by video games to the point where their health is in jeopardy.

UK Addiction Treatment (UKAT) – an organisation that have offered private therapy centres for gaming addiction alongside drugs and alcohol rehabilitation – conduct an abstinence based policy across the board, an approach to treatment where one size fits all.

Claire Havey, UKAT Head of Communications, said: “Something in their lives has gone very wrong for them, they’re almost putting a plaster on an open wound and whether that plaster is gaming 18 hours a day or whether that plaster is injecting heroine: the wound is still there. They will carry on doing that and re-applying the plaster until [they believe] that wound is healed.”

The abstinence treatment extends to mobile technology. They are only allowed access to a smart phone one hour a day after completing the initial assessments and treatments. This hour is closely monitored by therapists to ensure they don’t play games.

However, Stockport based psychotherapist Barbara Wallace believes that an abstinence lead treatment can ultimately be more damaging for a patient’s long-term health.

She said: “They might have withdrawal symptoms. So depending on the person, we’d have a plan of action to ween the person off gradually or to just abstain.

“I’d look at what impact that is going to have on them. We wouldn’t know what the particular withdrawal symptoms were going to be.”

Comparing it to her treatment of sex addiction, she stated that patients would usually want to return to a healthy sexual relationship post treatment and the same applies to gaming addicts.

Wallace proposed a plan where patients cut the gaming time down and worked in healthier activities alongside it.

She said: “If you take away a coping mechanism, you might be setting them up to fail – if you think about it, drug addicts get methadone.”

Ultimately, both courses of treatment target the addict’s compulsion to receive the dopamine fix that gaming provides – examining their triggers.

Setting up the patient for life post-treatment is where the opposing treatment methods come in to contention.

Written By Samuel Port

For Mancunian Matters

Carlton House, 16-18 Albert Square, Manchester, M2 5PE

Copyright © Mancunian Matters 1997-2018.

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