The word addiction is derived from the Latin word, addicere, which means "bound to" or "enslaved by". For those of you reading this article, I cannot think of a more precise way to describe my own experience with addiction. The feeling of being all consumed by my addictions, despite the adverse consequences resulting from my behaviour. Often, I could see no way out, other than to continue engaging in a behaviour which would ultimately diminish my self-control and withdraw me further from myself and others. Since I have been in recovery, I have developed a passion for educating myself, and others, about addiction and potential strategies for addressing underlying biochemical factors which may influence continued engagement in a behaviour. Addictive behaviours can relate to substance abuse (alcoholism and drug abuse) and/or non-substance abuse behaviours (workaholism, problematic gambling, internet use and gaming, sex and pornography), with the former more commonly identified with addiction. One substantial biochemical anomaly identified for patients diagnosed with addiction is the presentation for Reward Deficiency Syndrome (RDS).
Reward Deficiency Syndrome (RDS)
Reward Deficiency Syndrome (RDS) describes a group of behaviours that result from the lack of adequate pleasure or satisfaction in life. It is understood that RDS may promote addictive obessive behaviours and impulsive behaviours including substance abuse and non-substance behaviours. Biochemically, RDS is most likely the outcome of dysregulation among a series of neurotransmitters namely, Dopamine, Gamma Amino Buytric Acid (GABA) and glutamate. One commonly understood premise is that for aberrant cravings and drug seeking to be curbed the neurotransmitter, Dopamine, must be regulated.
Recent findings indicate that decreased production of Dopamine programs the brain to become more sensitive to external and internal stressors. Elevated stress, leading to stress intolerance, is often addressed by scientific researchers as culpable in relation to continued engagement with a behaviour. Moreover, substance and non-substance behavioural addictions left untreated are likely to result in long term changes in brain function, leading to "a compulsion to engage" in a behaviour, and/or heightened frequency for relapse. For this reason, stabilising Dopamine function becomes an important task in remedying some of the biochemical elements associated with addiction. This being so, multiple research teams have worked towards developing chemical interventions which target the balance between Dopamine, GABA and Glutamate, noting that imbalances in glutamate heighten likelihood for relapse post periods of abstience.
It is important to identify that the above information does not exhaust the chemical cascade involved in substance and/or non-substance abuse behaviours. Chemicals including brain derived neurotrophic factor (BNDF), methylation pathways inclusive of homocysteine and s-adenosylmethionine (SAMe), as well as various other chemicals and genetic variations can influence stress response and contribute towards uncontrolled and compulsive substance and non-substance seeking behaviours. Nevertheless, given that Dopamine, as one example, has been identifed as an "anti-stress and pleasure molecule", research has dedicated much of its efforts to chemical interventions that stimulate the production of Dopamine in an attempt to increase feelings of wellbeing and stress reduction.
Approximately 2 months ago, I began researching for this article. My research question was, "Can Nutraceuticals, Used as an Adjuvant Therapy, Minimise Substance and Non-Substance Abuse behaviours". Using the search engine database, Google Scholar, and applying the key words, nutraceuticals, addictive behaviours, substance abuse, non-substance abuse behaviours, cocaine, nicotine, methamphetamine and gambling, resulted in 41 papers published between 2015 and 2018. Aftering sorting by relevance and using additional exclusion criteria a total of 8 papers were determined as relevant. Papers which could not be fully extracted using Google Scholar were accessed through the University of Newcastle, Newcat Database. If a relevant primary study was referred to from the papers reviewed, I included its findings in the following table Nutraceuticals for Substance and Non-Substance Behaviours.
As you can see, by clicking on the above link, the table outlines nutraceutical interventions for a range of substance and non-substance behaviours including eating addiction, alcoholism, heroin addiction, cocaine addiction, problem gambling, and even shopping addiction (the case study outlined provides a remarkable finding for a patient diagnosed with multiple morbidities including ADHD and Major Depressive Disorder). Of all the findings listed between 2001 and 2016 it appears that the adjuvant nutraceutical KB220 is most effective in abating substance and non-substance abuse behaviours. KB220 is a Dopamine Antagonist Agent (DAA) and is capable of normalising brain function by restoring the production of Dopamine at the major reward sites of the brain, of particular note the nucleus accumbens. The administration of KB220 both intravenously and orally has resulted in reduction in excessive craving behaviours and even improvements in brain wave activity equivalent to the effects of 10 to 20 neurofeedback sessions. Of any of the findings listed in the table, with the possible exception of N-Acetyl Cysteine (NAC) in some circumstances, KB220 is theoretically most effective in rectifying RDS (Reward Deficiency Syndrome).
Beyond the behaviours outlined in the table, Nutraceuticals for Substance and Non-Substance Behaviours, is the finding that 11th International Classification of Diseases will now include reference to the addictions - internet-gaming, sex addiction and pornography addiction. A working group on substance and non-substance abuse behaviours have proposed provisional criteria for internet gaming disorder, promoting its inclusion within section 3 of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Internet gaming addiction has been defined as persistent and recurrent gaming over a period of at least 12 months that continues despite adverse consequences. The highest probability for depressive, musculoskeletal and psychosomatic symptoms has been found among weekend gamers, especially those engaged in gaming for 5 hours or more.
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