Substance use disorders (SUDs) have been a major public health challenge for decades and continue to cause significant morbidity and mortality worldwide. Due to limitations in pharmacologic treatment options, there remains a significant need for the development of novel immunotherapeutic approaches. In this review, we discuss the therapeutic potential of vaccines for SUDs. Although early preclinical animal studies were optimistic and successful, few vaccines have reached human clinical trials. Only nicotine and cocaine vaccines have successfully advanced to Phase 3 clinical trials and neither are currently available as a treatment option. Various innovative approaches in vaccine design have been made to overcome limitations and improve immunogenicity, including the use of nanoparticles, synthetic haptens, and more immunogenic adjuvants. While success has thus far been elusive, with substantial scientific advancements in vaccine technology, immunotherapy remains a promising and viable option for the treatment of SUDs
