The statistics for abuse of psychoactive drugs–the legal ones, such as alcohol and prescription opiates,Â and the illegal ones like heroin and cocaine–are staggering.
According to a 2005 report, Americans spent America spent $57.3 billion on drugs of abuse betweenÂ 1988-1995. Of that, $38 billion was on cocaine, $9.6 billion was on heroin and $7 billion was onÂ marijuana. This does not include the money spent on abused prescription drugs. More recent reportsÂ from NIDA/NIAA (www.drugabuse.gov/DirReports/DirRep510/DirectorReport19.html) continue toÂ show very high rates of drug abuse among Americans of all ages, especially in teenagers.Â Though the numbers are alarming, they are not surprising if you consider that over 100 millionÂ Americans have genetic antecedents predisposing them to addictive behaviors. Every day, clinicians
are faced with people struggling with substance abuse problemsâ€”or the genetic predispositionsÂ that drive them.
In the past decade, extensive scientific research on neuroanatomy and neurotransmitters has foundÂ links between genes, the brain, social behaviors and psychological states, particularly to those statesÂ of â€œhappinessâ€ which we all desire. The goal of treatment for chemical dependency then should notÂ only be the difficult task of becoming â€œdrug free,â€ but of concurrently finding a quality of life that approachesÂ happiness without â€œwhite knuckleâ€ sobriety.
Using Genomics to Guide Treatment
Most traditional chemical dependency treatment programs are not holistic, and make no attempts toÂ tailor therapy based on individual differences in adrenal function, thyroid function, hormone imbalances,Â tissue levels of heavy metals like mercury, or genetic polymorphisms affecting the dopaminergicÂ system. All of these influence addiction behavior, and must be considered carefully.
Further, chronic administration of powerful pharmaceuticals results in down- regulation of D2 receptorsÂ and reduced dopamine release. This perpetuates rather than attenuates the core problem.
Clinically, we must recognize the biological and genetic individuality of people with addiction problems.Â We need to classify patients at genetic risk for drug seeking behavior prior to or upon entry toÂ chemical dependency programs, as the genomic patterns can yield important information for guiding treatment and improving outcomes. Objectivity in diagnosis of these disorders—which genomicÂ testing can provide—could help us improve our treatment outcomes.
There are genes controlling for every biochemical interaction in the reward cascade, including theÂ synthesis and release of the key neurotransmitters (serotonin, dopamine, GABA), production of neurotransmitterÂ receptors, and production of enzymes that clear and metabolize neurotransmitters inÂ the synapses.
There are genes controlling for every biochemical interactionÂ in the reward cascade
Based on exhaustive literature review and ongoing original research, we have found seven risk allelesÂ associated with six candidate genes that seem to strongly influence poly-drug abuse in largeÂ numbers of people. People addicted to drugs typically carry at least one of the following risk alleles:Â DRD2=A1; SLC6A3 (DAT) =10R; DRD4=3R or 7R; 5HTTlRP = L or LA; MAO= 3R; and COMT=G.
Based on this, we have been able to create a severity score system based on aggregate percentage ofÂ these alleles known as the Genetic Addiction Risk Score (GARS). The GARS system reflects the prevalenceÂ of different addiction-associated polymorphisms in a given individualâ€™s genome.
We tested this approach in a cohort of 26 patients, who represented two distinct ethnic populations:Â male Caucasian psychostimulant addicts, and Chinese male heroin addicts. In both groups, all of theÂ subjects had at least one risk allele; 74% had high risk profiles based on their GARS scores. Interestingly,Â we found that 56% of the men in both groups carried the DRD2 A1 allele, which is directly relatedÂ to abnormalities in dopamine signaling. This is despite the fact that they were addicted to veryÂ different types of drugs (Blum et al IIOAB 1: 1-22).
Repairing Altered Dopamine Pathways
If genetically-influenced deficiencies in dopamine reward pathways underlie many addiction behaviors,Â it makes sense to consider treatment approaches that increase dopamine release and improveÂ dopamine sensitivity.
Chemically dependent people can be treated with natural dopaminergic agonists like amino-acidsÂ therapy (AAT) to up-regulate neurotransmitter receptor density and increase dopamine release at theÂ NAc. This affects gene expression, reduces craving behavior, and induces a sense of well-being duringÂ and after treatment to prevent relapse (Blum et al. Postgrad Med. 2009; 121:176-96).
Evidence is emerging that SynaptaGenXâ„¢ a safe, natural, non-addicting, D2 agonist combinationÂ product may improve the health of individuals in recovery from RDS conditions, including those sufferingÂ the consequences of psychoactive chemical abuse.
There are currently 23 human studies of SynaptaGenX, including several placebo controlled, single-,Â double-, and triple-blinded clinical trials demonstrating the positive effects in the management ofÂ addiction problems. The trials were recently summarized by Chen and colleagues in the Journal of
Psychoactive Drugs (Chen TJH et al J. Psychoactive Drugs, 2011 (in press)]Â In a two year follow-up of 23 subjects who received SynaptaGenX, we found that 21 (91%) were
sober at 6 months with 19 (82%) having no relapse. Nineteen (82%) were sober at one year with 18Â (78%) having no relapse; 21 (91%) were sober at two-years post-treatment with 16 (70%) having noÂ relapse.
Functional MRI studies showed even more robust effects of SynaptaGenXâ„¢ in protracted heroinÂ addicts. Patients receiving the nutrient complex showed far more activity in the mesolimbic systemÂ (Caudate-Putamen) compared to matched group given a placebo. The putamen is a brain regionÂ dense with dopamine D2 receptors, and at least temporarily, the formula reverses brain abnormalitiesÂ typically seen in protracted abstinent heroin addicts.
New holistic techniques and concepts have emerged from scientific research that are being incorporatedÂ into recovery programs, enhancing brain function not only in the patients themselves, butÂ improving the psycho social health and well-being of the entire family.
By Kenneth Blum, Ph.D.
Reprinted with permission from Holistic Primary Care publication. To read the complete article go to:Â http://www.holisticprimarycare.net/topics/topics-o-z/psyche-some-a-spirit/1118-natural-dopaminergic-activator-improves-outcomes-of-addiction-recovery-