By Kenneth Blum, PhD
The statistics for abuse of psychoactive drugs–the legal ones, such as alcohol and prescription opiates, 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 between 1988-1995. Of that, $38 billion was on cocaine, $9.6 billion was on heroin and $7 billion was on marijuana. This does not include the money spent on abused prescription drugs. More recent reports from NIDA/NIAA (www.drugabuse.gov/DirReports/DirRep510/DirectorReport19.html) continue to show very high rates of drug abuse among Americans of all ages, especially in teenagers.
Though the numbers are alarming, they are not surprising if you consider that over 100 million Americans have genetic antecedents predisposing them to addictive behaviors. Every day, clinicians are faced with people struggling with substance abuse problems–or the genetic predispositions that drive them.
In the past decade, extensive scientific research on neuroanatomy and neurotransmitters has found links between genes, the brain, social behaviors and psychological states, particularly to those states of “happiness” which we all desire. The goal of treatment for chemical dependency then should not only be the difficult task of becoming “drug free,” but of concurrently finding a quality of life that approaches happiness without “white knuckle” sobriety.
Using Genomics to Guide Treatment
Most traditional chemical dependency treatment programs are not holistic, and make no attempts to tailor therapy based on individual differences in adrenal function, thyroid function, hormone imbalances, tissue levels of heavy metals like mercury, or genetic polymorphisms affecting the dopaminergic system. All of these influence addiction behavior, and must be considered carefully.
Further, chronic administration of powerful pharmaceuticals results in down- regulation of D2 receptors 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. We need to classify patients at genetic risk for drug seeking behavior prior to or upon entry to chemical dependency programs, as the genomic patterns can yield important information for guiding treatment and improving outcomes. Objectivity in diagnosis of these disorders—which genomic testing can provide—could help us improve our treatment outcomes.
There are genes controlling for every biochemical interaction in the reward cascade, including the synthesis and release of the key neurotransmitters (serotonin, dopamine, GABA), production of neurotransmitter receptors, and production of enzymes that clear and metabolize neurotransmitters in the synapses.
Based on exhaustive literature review and ongoing original research, we have found seven risk alleles associated with six candidate genes that seem to strongly influence poly-drug abuse in large numbers of people. People addicted to drugs typically carry at least one of the following risk alleles: 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 of these alleles known as the Genetic Addiction Risk Score (GARS). The GARS system reflects the prevalence of different addiction-associated polymorphisms in a given individual’s genome.
We tested this approach in a cohort of 26 patients, who represented two distinct ethnic populations: male Caucasian psychostimulant addicts, and Chinese male heroin addicts. In both groups, all of the subjects had at least one risk allele; 74% had high risk profiles based on their GARS scores. Interestingly, we found that 56% of the men in both groups carried the DRD2 A1 allele, which is directly related to abnormalities in dopamine signaling. This is despite the fact that they were addicted to very 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, it makes sense to consider treatment approaches that increase dopamine release and improve dopamine sensitivity.
Chemically dependent people can be treated with natural dopaminergic agonists like amino-acids therapy (AAT) to up-regulate neurotransmitter receptor density and increase dopamine release at the NAc. This affects gene expression, reduces craving behavior, and induces a sense of well-being during and after treatment to prevent relapse (Blum et al. Postgrad Med. 2009; 121:176-96).
Evidence is emerging that SynaptaGenX™ a safe, natural, non-addicting, D2 agonist combination product may improve the health of individuals in recovery from RDS conditions, including those suffering the consequences of psychoactive chemical abuse.
There are currently 23 human studies of SynaptaGenX, including several placebo controlled, single-, double-, and triple-blinded clinical trials demonstrating the positive effects in the management of 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)]
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 18 (78%) having no relapse; 21 (91%) were sober at two-years post-treatment with 16 (70%) having no relapse.
Functional MRI studies showed even more robust effects of SynaptaGenX™ in protracted heroin addicts. Patients receiving the nutrient complex showed far more activity in the mesolimbic system (Caudate-Putamen) compared to matched group given a placebo. The putamen is a brain region dense with dopamine D2 receptors, and at least temporarily, the formula reverses brain abnormalities typically seen in protracted abstinent heroin addicts.
New holistic techniques and concepts have emerged from scientific research that are being incorporated into recovery programs, enhancing brain function not only in the patients themselves, but improving the psychosocial health and well-being of the entire family.
Reprinted with permission from Holistic Primary Care publication. To read the complete article go to: http://www.holisticprimarycare.net/topics/topics-o-z/psyche-some-a-spirit/1118-natural-dopaminergic-activator-improves-outcomes-of-addiction-recovery–