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Written by
Deborah Freudenmann BHSc
There are some drugs that are toxic to our brain. The use of these drugs can lead to functional and structural changes in the vital organs resulting in immense neurological damage.
The harmful consequences of these neurotoxic drugs are not limited to the brain. Several other organs and tissues of the body may get affected to varying degrees based on the pharmacological actions of the drug involved.
Have you ever had a big boozy night out? Tried out a few drugs or dabble every now and again in recreational drugs? Most people who drink or experiment with recreational drug use will never develop a problem or become an addict.
The big question we have to wonder is when does this recreational drug “use” transform into drug “abuse”, and when does it further develop into drug “addiction”?
Substance abuse is when a person routinely uses an intoxicating substance for recreational purposes, such as binge drinking, regular marijuana use, taking more medication than prescribed.
Addiction is the progression of this substance abuse where an individual will have symptoms and a pattern of compulsive, dysfunctional behaviours resulting from an uncontrollable and growing need towards the drug or drink.
Substance abuse / addiction is often considered a ‘moral failure’. However, this is far from true. All drugs carry the risk, as they affect an individual’s brain, by disrupting various pathways and often reward systems.
Being aware of the complementary and alternative therapies for substance abuse can be highly beneficial in such cases. Through functional medicine, you can provide some of the best individualized and targeted care to those who suffer from drug addictions and help them end the stigma while improving the quality of their lives.
Here is a discussion about the recreational drugs commonly involved in substance abuse and how they lead to a state of addiction. We will also have a look at the complementary and alternative therapies that can help patients recover and lead a normal life.
Nutritional support can play a critical role in the management of substance use disorder. Often, the process involves treatment and counselling by an integrative team. Functional medicine health coaches, healthcare professionals, psychologists can all offer foundational and specific support to an individual suffering from addiction. An important aspect to remember is that this is no time to create division between modalities. Instead together we want to educate and build a bridge based on trust, compassion, knowledge and understanding. Family support also plays a vital role in ensuring the long-term success of the treatment in such cases.
The treatment of substance use disorder involves identifying and eliminating the factors that can lead to or contribute to the worsening of the addiction. Thus, it is important to be aware of these factors as they can also trigger a relapse in the future even after the patient has recovered.
Some factors that can trigger addictions include:
As with most other health conditions, the treatment of substance use disorder also needs to be planned and customized keeping in mind the unique physical, emotional, and nutritional needs of the person.
It should be noted that each person is unique and hence, requires comprehensive assessment for the identification of co-existing conditions. Therefore, the treatment of substance use disorder may also involve social, physical, dietary, and psychological assessments.
The role of sound sleep in maintaining optimum health should not be neglected. Research studies suggest that sleep disturbances might increase the risk of substance use. These factors may also influence the effectiveness of the treatment.
Also, disruptions in the sleep pattern and disturbances in the circadian rhythm are often at their worst during the most critical initial phase of withdrawal. Treatment aimed at balancing the levels of hormones in the nervous system such as melatonin, progesterone, and adenosine and modifying light exposure could help to maintain the normal circadian rhythm and help the patient sleep well and avoid the symptoms of withdrawal.
Additionally, most drugs act as neurotoxins, particularly when used over several weeks to months. These drugs can affect the nutritional status of the body. Hence, there should be an emphasis on correcting nutrient deficiencies, improving gut functions, promoting heavy metal and chemical detoxification, and controlling cellular inflammation and oxidant stress to support faster recovery.
Addictive substances are known to cause neuroadaptation in the neurotransmitter systems. Most addictive drugs also act as functional dopamine agonists, for instance, the use of the substance triggers an over-production of dopamine, the neurotransmitter responsible for feelings of pleasure.
This flood of dopamine essentially trains your brain that the activity—drug of choice—is a desirable activity that should be done again. Over time, the brain stops producing dopamine naturally, and will only do so when the substance is used.
This is the dependence that leads to withdrawal. The symptoms occur because, without the drug, the person is incapable of feeling “good” or even “normal”. The person is pushed by these feelings (often incredibly strong feelings) to do something… anything… to feel that rush again.
Dopamine may also be involved in reward, motivation, motor activity, food intake, and emotions, whereas serotonin is important for sleep, appetite regulation, personality, and mood. This is why; individuals suffering from substance use disorder, usually get affected by reward deficiency syndrome, which is characterized by a decreased or insufficient dopamine state.
If someone regularly uses a drug there is always going to be a risk of substance abuse and addiction. There is no blame because the powerful and cunning disease of drug addiction lies within control. But how can you control your need for a drug, if it’s your very own neurological cells telling you to take the drug?
This is why the treatment of reward deficiency syndrome is usually focused on correcting dopamine levels. It also involves strategies aimed at regulating the functions and levels of neurotransmitters such as endorphin (enkephalin), serotonin, GABA, acetylcholine, glutamine, and dopamine.
Here are some therapeutic interventions that would assist in the faster recovery of patients struggling with drug or alcohol abuse.
N-acetylcysteine (NAC) regulates the key neurotransmitter systems involved in psychopathology by affecting the levels of glutamate and dopamine.
NAC can reduce oxidative stress induced by the long-term use of toxic recreational drugs and prevent the downregulation of dopamine transporters elicited by the excessive release of dopamine.
NAC is also a glutathione (GSH) precursor, which is the body’s own antioxidant.
Hence, it can play a significant role in reducing dopamine-induced neurotoxicity in patients with psychiatric disorders including substance use disorder, obsessive-compulsive disorder, bipolar, and schizophrenia.
There are 3 basic families of opioid peptides that are produced in the body including enkephalins, dynorphins, and endorphins.
Among these, enkephalins are involved in nociception (modifying pain response), the perception of rewards, and the mediation of behavioural reinforcement.
The inhibition of Enkephalinase can lead to the increased availability of enkephalin in the brain tissues thus reducing depression and the craving for recreational drugs.
D-phenylalanine possesses enkephalinase-inhibiting properties. Together with the ability of L-phenylalanine to increase dopamine levels in the brain, D-phenylalanine can support the brain reward cascade further.
The use of DL-phenylalanine, which is a combination of both the isomers of phenylalanine, can lead to a significant increase in the levels of enkephalin resulting in a marked reduction in drug-seeking behaviors.
The stimulation of GABA by glutamine and 5-HT receptors by L-tryptophan has also been shown to improve the effects of anxiolytic and anti-depressant treatments that further help patients in withdrawing from the substance of abuse.
Alcohol and recreational drugs can impact intestinal permeability.
For example; alcohol is broken down by gram-negative bacteria in the intestine. This can lead to the accumulation of acetaldehyde, which can damage the tight junctional integrity of the intestinal lining. This would increase the permeability of the intestinal wall allowing for the passage of endotoxins into the bloodstream.
This can contribute to the transfer of endotoxins from the intestine to the blood circulation and liver where these toxins may trigger inflammatory changes leading to long-term serious damage.
Alcohol may also increase the permeability of the intestinal walls which can worsen the systemic inflammatory response.
The use of Glutamine could be beneficial in such cases as it would help to maintain the structural integrity of the intestinal lining. Glutamine may also enhance microcirculation in the walls of the colon and improve barrier functions of the intestine thus preventing water and nutrient loss. Probiotics can also reduce inflammation and support the activities of short-chain fatty acids like butyrate thus promoting healing and recovery. Slippery elm might offer soothing protection to the mucous lining of the intestinal tract, thus reducing the risk of inflammatory conditions such as ulcerative colitis and Crohn’s disease.
Detoxification is considered a vital step in the drug recovery treatment.
Nutritional therapy can also offer an effective and safer withdrawal process by supporting detoxification and enabling the elimination of the drugs accumulated in the healthy tissues.
The build-up of these drugs can lead to the depletion of the body’s stores of antioxidants. As a result, the vital tissues and organs become vulnerable to inflammation, damage, and cancerous changes.
Ensuring the body receives enough supply of nutrients can support the detoxification processes and help in the elimination of these toxins from the body.
These nutrients include glycine, glutamic acid, methionine, calcium-d-glucarate, cysteine, taurine, magnesium, Vitamin B6, folate, and B12, Zinc, and Selenium.
Chronic alcohol intake can reduce the oxygen consumption in the mitochondria and increase mitochondrial susceptibility to form the MPT (mitochondrial permeability transition) pores, which are the key components of cell death programs.
Chronic alcohol intake may also depress the hepatic functions and contribute to the production of reactive oxygen species (ROS) thus worsening oxidative stress in healthy tissues.
It can cause a decrease in the total and mitochondrial GSH levels resulting in mitochondrial lipid peroxidation and faster progression of liver diseases.
Thus, there is a need to improve the body’s nutritional supply so that these changes can be reversed. Nutritional interventions should also be aimed at reducing oxidative stress and supporting the healing of the damaged tissues.
It has become apparent that chronic substance abuse occurs due to the faulty adaptation in the genetic and epigenetic landscape of the brain’s reward circuitry system. It is also associated with the dysfunctions in the cognitive and limbic regions.
Epigenetics could be an effective way through which lifestyle factors can be modified to turn on (or turn off) the specific gene expressions to reduce the risk of addictions. These epigenetic changes can form long-term “tags” at the molecular level in the body. Epigenetic changes in DNA can coordinate gene expression during the development of the brain. So, these epigenetic changes are likely to occur during the prenatal and perinatal periods.
This means having a family history of drug or alcohol abuse, especially by a parent, could have an effect on the development of the brain in the foetus. It may also modify the child’s risk of addiction during adulthood.
This is why, parents are advised to undergo a detoxification program before they plan conception.
New research studies have suggested that foetal exposure to alcohol may increase the risk of drug abuse later in life. The prenatal exposure of the brain to alcohol causes the endocannabinoids produced in the brain to create a different effect on the dopamine neurons involved in addictive behaviours. As a result, the dopamine neurons become more sensitive to the effect of recreational drugs.
Also, prenatal exposure of the brain can also reduce the effect of endocannabinoids by interfering with the functions of endocannabinoid receptors. Due to this, the excitatory synapses may lose the ability to be weakened, thus triggering a critical brain mechanism that can lead to the increased risk of addiction.
This form of genetically linked development of drug or alcohol abuse is termed Foetal Alcohol Spectrum Disorders. This may lead to behavioural and cognitive issues in children, as well as increased risk of mental health issues (depression, anxiety, ADHD and impulse control).
It is time to understand that drug or alcohol abuse is not the result of moral failure. It occurs due to the specific gene expression, nutritional deficiencies, or the altered response of the neurotransmitters in the brain.
Therefore, there is a need to identify the root cause of addiction and focus the treatment on eliminating the factors that can contribute to substance abuse.
Epigenetics is expected to play a critical role in allowing patients to overcome the withdrawal symptoms and lead a healthy life by allowing them to recover from substance abuse in a safe and more efficient way.
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2 Responses
I have been dealing with addictions since 2002, gradually learning to treat more and more addictions as we went along. In 2019 with the help of a retired doctor we started to get amazing results for Heroin and methadone addiction. Now we can literally deal with anything smoked, anything drunk, gambling and all pharmaceutical and recreational drugs right up to crack cocaine. We can also deal with heroin , methadone and subtex using an IV protocol. I thought I knew everything you could know about addictions but I have just learnt a lot more with your amazing artacle. Thank you.
Hello Shokat, what a rewarding profession you have! There is a lot someone can do to support addictions from various different drugs and levels of addiction, so it’s beautiful to hear how successful you and your clinic are. I believe there is one thing we should always remember, and that is… that we can never stop learning! Appreciate your amazing feedback on the article. Warmest regards, Deborah