Substance Use Disorder (SUD) a big threat to society

Substance Use Disorder (SUD) is one of the major mental illnesses that is terrifically intensifying worldwide. It is becoming overwhelming due to limited options for treatment. Around 270 million (5.5% of the total worldwide population) have been exposed to Substance Use Disorders (SUD). Almost 35 million subjects are affected by SUDs . There are reported 0.5 million deaths due to SUDs (150, 000 female and 350, 000 male deaths) . In 2017, more than 42 million years of healthy life were lost due to SUDs, accounting for 1.3% of the worldwide disease burden. It is also estimated that among the 11 million with SUD, 5.6 million subjects live with hepatitis C and 1.4 million live with HIV . There is an ever-rising interest in SUDs, despite the unambiguous consequences of psychological, physical, social, and economic damages. Unfortunately, these detrimental effects continue to devastate the user’s life for a long duration after self-restraint or discontinuation of the SUDs . Further, relapse during treatment makes the drug-dependence unmanageable, which requires radical changes in the current regimens or the development of novel treatment methods. One of the fundamental reasons for the rise of SUDs worldwide is the lack of availability of impeccable therapeutic and diagnostic strategies. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is available, which confers a standard protocol for mental health diagnosis and classification. However, the growing problem of SUDs with unabated increase signifies a need for improvement and stringent criteria for diagnosis, treatment and management. Generally, drug addiction develops with continuous use for long periods with four levels of use occasional, recreational, regular, and addiction. The present investigations reveal that the neuronal mechanisms responsible for drug addiction focus on SUDs and relapse after withdrawal. Due to rapid progress in the developments of biological research approaches, especially neuroscience, we may progress to a new stage, where effective approaches are encouraged to be translated into productive clinical tools for treating drug addiction. Currently, a major challenge is translating basic research to clinical settings. There is no clear-cut understanding of SUD-induced pathology in the brain. The treatment for drug addiction is mostly based on pharmacological antagonism, where the chances of relapse remain adequately high. Pharmacological interventions are the main therapies for treating drug dependencies. In addition to that, drug addiction is profoundly affected by cognition, consciousness, and emotion. The behavioral strategies may have encouraging outcomes if provided with rigorous management.
The complexity of addiction disorders is the main impediment to understanding the pathophysiology of the illness. Hence, unveiling the complexity of the brain through basic research, identification of novel signaling pathways, the discovery of new drug targets, and advancement in cutting-edge technologies will help control this disorder. Additionally, there is a great hope of controlling the SUDs through immunotherapeutic measures like therapeutic antibodies and vaccines. Vaccines have played a cardinal role in eliminating many diseases like polio, measles, and smallpox. Further, vaccines have controlled many diseases like cholera, dengue, diphtheria, Haemophilus influenza type b (Hib), human papillomavirus, influenza, Japanese encephalitis, etc. Recently, COVID-19 was controlled in many countries by vaccination. Currently, continuous effort is done to develop vaccines against nicotine, cocaine, morphine, methamphetamine, and heroin. Antibody therapy against SUDs is another important area where serious attention is required. Antibodies have contributed substantially against many serious diseases like diphtheria, rabies, Crohn’s disease, asthma, rheumatoid arthritis, and bladder cancer. Antibody therapy is gaining immense momentum due to its success rate in cancer treatment. Furthermore, enormous advancement has been made in antibody therapy due to the generation of high-efficiency humanized antibodies with a long half-life. The advantage of antibody therapy is its instant outcome. The SUDs in society has a huge negative impact on society’s financial status. The SUDs treatment services, whether public or private, need cost information to achieve equivalence with medical attention . The burden of societal costs of SUDs concerns policymakers about the SUD treatment to combat the growing disease. The policy research utilizes societal costs to develop public health management strategies through cost-effectiveness studies of financial evaluation of alternatives. There are several challenges associated with vaccine development against SUDs. Most importantly, the vaccine should generate long-lasting memory B and T cells and produce high affinity and avidity Abs . The Abs should have high neutralizing and binding efficiency. Moreover, the Abs should show high association and low dissociation rates with the SUDs. Furthermore, selecting an appropriate adjuvant for humans that can elicit Abs of high efficacy and titer is another important task. Although drug addiction is a psychological sickness influenced by mental, emotional, economic, and environmental parameters, psychosocial factors play the most important part. Drug cravings and relapses cause exposure to conditioned cues even after successful treatment, and it needs uncompromising management. The pathophysiology of drug addiction is not clear yet. For example, the synaptic plasticity is dynamically changed after the psycho-stimulant administration. The vaccines could be better than pharmacological approaches due to their prophylactic and enduring impacts. The vaccines have provided a valuable service in controlling and eradicating many infectious diseases. Furthermore, the development of humanized and therapeutic antibodies may be another promising intervention. Millions of people are vaccinated globally to train their immunity against particular agents. It is reported that around 23.3 million deaths have been prevented by vaccines.
(The author is a Research Scholar at Deparment of Biomedical Engineering, Indian Institute of Technology (IIT), Ropar. The views, opinions, facts, assumptions, presumptions and conclusions expressed in this article are those of the author and aren’t necessarily in accord with the views of “Kashmir Horizon”.)
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