The Physical Dependence Chapter One continued

This is the section that will need some updating.  Much more research is available now, particularly with the mesolimbic dopamine system.  At some point, I will try to write an update for those who are interested.  This MDS will clarify why one can be addicted to anything.

In the section entitled, “The Doctors Opinion” of the Alcoholics Anonymous book, it reads, “that the body of the alcoholic is quite as abnormal as his mind. It did not satisfy us to be told that we could not control our drinking just because we were maladjusted to life, that we were in full flight from reality, or were outright mental defectives. These things were true to some extent, in fact, to a considerable extent with some of us. But we are sure that our bodies were sickened as well. In our belief, any picture of the alcoholic which leaves out this physical factor is incomplete.” (1) From the beginning, we seem to know that there was more to our powerlessness over our substances than just what we have discussed in the previous chapter. The older AA guys described this “something physical” as an allergy. They believed that alcoholics had some type of allergy that caused them to continue drinking despite all that was falling apart around them. I used to tell people that I was allergic to drugs and alcohol. When I drink it, I break out in felonies! Setting the humor of that remark aside, those of us who have struggled with moderate use have come to the conclusion that moderation is not in our make-up. When we use, we use to “get the job done.” To use to a point of extreme intoxication. The very idea of moderate use makes no sense to us. What is the point? If we are going to use, then let’s do it! If not, then we are just wasting good substances. Not only do we live by this motto, but it becomes the pattern of our use. Namely, that when I start, I can’t stop. In fact, the very idea of stopping is absolute lunacy to me. Once I take that first drink, I will continue to use until I’m completely wasted. What we are trying to say, in this section, is that this mindset with its subsequent action, has a physical, if not genetic root. That’s right, it has to do with the way that our bodies process drugs as opposed to the way that non-addicts process those same substances. It came as a welcome relief to me to find out this had to do with my genetic makeup and not my own lack of will power or weakness. It was physiological. Again, the Doctors Opinion, “We believe, and so suggested a few years ago, that the action of alcohol on these chronic alcoholics is a manifestation of an allergy; that the phenomenon of craving is limited to this class and never occurs in the average temperate drinker. These allergic types can never safely use alcohol in any form at all; and once having formed the habit and found they cannot break it, once having lost their self-confidence, their reliance upon things human, their problems pile up on them and become astonishingly difficult to solve.” (2) It would be a mistake to only limit the discussion to alcohol, all of the intoxicating substances seem to have a very similar biochemical response in the bodies of those prone to these issues. Let’s review some of the science on the matter.

From his book, “The Science of Addiction”, Carlton Erickson writes, “New research has found that genes for two neurotransmitter receptors are probably involved in the causes of alcohols dependence. These two receptors, GABA-A, and a form of the gene that codes for the serotonin transporter (SERT, also known as 5-HTT), may produce abnormalities in the mesolimbic dopamine system that cause people to be unable to stop drinking. Other neurotransmitter receptors have also been implicated.” (3) Everybody got that! Clear as mud! I‘ll offer a humble explanation. What this means is that alcohol, and probably other substances as well, trigger two brain receptors to release GABA-A and SERT 5. These are little do-dads (parts of cells called receptors) in the brain that trigger the brain to release more of the “I feel like the greatest person alive” chemical called Dopamine. Dopamine is what triggers that wonderful and great feeling, we like to call “a buzz.” It is what I was experiencing with “Cool Don” at the arcade. This release of Dopamine is so wonderful that we begin to crave more of it. Well, how did we get this release of dopamine in the first place? By using! Hence, in order to get more of the feeling, we continue to use and the idea of stopping, is goofy to say the least. This is what we call the phenomena of craving. It never happens when drugs are outside of your body. It happens as soon as we put that substance into our bodies. That is when the craving begins and drinking/using in moderation is not within our scope of practice. This is a biochemical response triggered by our genetic make-up. In other words, you can’t help it, you are powerless to the way your body process substances.

Here is a little more on Dopamine, “We believe that some people who are born with lower D2 (dopamine receptor) levels are more vulnerable to alcohol or drug abuse,” A team led by Dr. Panayotis K. Thanos of Brookhaven National Laboratory (news – web sites) in Upton, New York, reports the findings in the current issue of the Journal of Neurochemistry. Dopamine is part of the brain’s “reward system,” playing what is thought to be a key role in mood and motivation. Previous research has suggested that people who are vulnerable to addiction may have fewer-than-normal brain receptors for dopamine. The theory is that this pushes them to make up the difference by using substances–including alcohol and other drugs–that elevate dopamine levels in the body. In the new study, researchers used gene therapy in rats to show that the level of dopamine receptors in the brain determined the animals’ motivation for getting alcohol. The rats drank far less alcohol after scientists increased their dopamine receptor levels by injecting the gene for the dopamine D2 receptor into the animals’ brains. This gene delivery allowed the rats’ brain cells to churn out more D2 receptors in the nucleus acumens, a brain structure known to be involved in feelings of pleasure.” (4) The supposition put forth here is that addicts are born with “less than normal” amounts of the “thing” that releases Dopamine in our brains. Because our levels of Dopamine are too low, when we use substances, the level of Dopamine increases which makes us “feel better.” Even good old weed, which is only an herb and doesn’t hurt you. Yeah right! (see chapter six for details) has a similar response.

Again, Dr. Erickson, “These people (referring to folks who chronically stay in trouble regarding the amount of weed they smoke) have a dysregualtion of endocannabinoids or cannabis receptors in their mesolimbic 1 A system (Maldonado, Valverde and Berrenderro, 2006) (5, parenthetical note mine for clarification) Everybody got that! Of course, your average everyday pothead would understand this with absolute clarity and certainty. Just Joking. What is being said is that even weed triggers a very similar response, it makes those who smoke it crave more of it after they have experienced the effects on their brains.

We could go on and on quoting scientific journals, studies, and articles which reiterate the same thing. First, that this is a genetic response. It can’t be helped. It is the bodies biochemical, neurological, neurophysiologic reaction to the ingestion of substances upon the genes that we have inherited. Every time the substance is placed in the body, the body will respond the same way. The person with this genetic make-up will have this response and automatically be incapable of moderate use. They will use like it is their jobs, on a professional level. The individual with this genetic makes has an extremely low probability of being able to use drugs successfully. They simply can’t use in moderation. Hence, the idea of successful use must be smashed and the idea of moderation be equally destroyed. These ideas don’t match our genetic make-up.

Mainly, these genes are passed down from the father’s side of the family. I can’t quote a particular study to validate it, but it seems to be my experience, both personal and professional. One of the reasons that we have bad relationships with our fathers is because of their addictive lifestyles. Hence, the genes that drove them are the same genes that drive us. This is powerless. It is in your genes. My mother’s side of the family is pretty normal. My father’s side of the family is replete with alcoholism. I get it from that side of my family. My allergy to the substances comes through that paternal genetic link.

The old Chinese saying goes, “First a man takes a drink, then the drink takes the man.” In essence, this is what we are saying in this section. We are validating our powerlessness from a physical standpoint because we can’t change our genes. We will always consume to the point of acute intoxication every time we use because our bodies drive us to do so. This is the allergy and this is the phenomena of craving. If you have it, your ability to use successfully is virtually non-existent.

We are not fools. We are acutely aware that many who are reading this will, in fact, use drugs again. This is not a requirement but a reality. So, here is our advice to those who are going to take the plunge again and try to use successfully. The next time you use, try to use in a controlled manner. Try to take two pills and quit. Try to stop abruptly and not touch it again. Try to just take two hits, two lines, two of whatever your substance of choice is, and see if you have this capability. Try it more than once and try it when you don’t expect to do it. This will test if you have this phenomenon. Again, we never encourage relapse. We acknowledge it as a sad fact with addicts. Hence, we try to make the most out of this situation. With this advice, the AA big book agrees. It states, “We do not like to pronounce any individual as alcoholic, but you can quickly diagnose yourself. Step over to the nearest barroom and try some controlled drinking. Try to drink and stop abruptly. Try it more than once. It will not take long for you to decide, if you are honest with yourself about it. It may be worth a bad case of jitters if you get a full knowledge of your condition.” (6)
Endnotes

1. Alcoholics Anonymous, Alcoholics Anonymous, Alcoholics Anonymous World services, Inc. New York, New York, third edition, page xxiv.

2. Ibid, page xxvi

3. Erickson, Carlton, “The Science of Addiction”, W.W. Norton and Company, New York and London, 2007, page 221.

4. As quoted from: author unknown; http://www.discussanything.com/forums/archive/index.php/t-1882.html

5. Ibid, Erickson, page 140.

6. Ibid, AA, page 31-32.

Advertisements
%d bloggers like this: