De-Mystifying Addictive Disorders

Duty to Warn/Health News

De-Mystifying Addictive Disorders:

With Logical Strategies for Prevention and Treatment

Gary G. Kohls, MD

People who are addicted to nicotine, alcohol, street drugs, psych drugs or simply have addictive potential may be lacking certain nutrients that the brain requires to manufacture the normal brain chemicals called neurotransmitters. The major neurotransmitters that affect mood, the ability to control one’s impulses, sleep quality and behavior include serotonin, melatonin, dopamine, norepinephrine and epinephrine (adrenalin) and can only be increased through the ingestion of certain amino acid-containing foods and/or the ingestion of certain amino acid-containing nutritional supplements.

The brains of people who have been abused, psychologically or spiritually traumatized, neglected, isolated, labeled “mentally ill” or are going through the mental anguish of drug withdrawal syndromes have the seemingly inexplicably need to self-medicate their sadness, nervousness, nightmares and empty lives. In fact, they may not be able to produce enough of their essential neurotransmitters because of dietary deficiencies or the use of neurotransmitter-depleting drugs. Therefore, malnutrition or previous drug use are likely to contribute to an increased incidence of abnormal moods, behaviors, sleep disorders, abnormal perceptions of pleasure or pain and the likelihood of engaging in acts of apathy, rage, resentment, cruelty or any of a multitude of forms of violence, including arson, theft, assault, murder and suicide.

The acute ingestion of alcohol (as well as many other prescription tranquilizers) temporarily and artificially increases the amount of calming neurotransmitters into the synapses of certain brain nuclei. Dopamine, on the other hand, is the major neurotransmitter that can reliably cause artificially energizing “highs” as well as natural and appropriate mood elevation. The dopamine molecule, when secreted in sufficient concentrations into the dopamine synapse, can cause “highs” ranging all the way from mild pleasure to ecstasy and orgasm, and the most rapidly-acting artificial highs are obtainable through the administration of drugs that have what are called dopamine-reuptake inhibitor functions.

Drug-Induced Highs and the Inevitable Crashes That Follow

Unfortunately, for every drug-induced high there is also a predictable and inevitable crash that results in the individual feeling artificially “low”. People with drug-induced highs and lows or other drug-related behaviors are often diagnosed as being mentally ill with depression or anxiety or mania or psychotic disorders.

Chronic or even intermittent use of such brain-altering drugs can be expected to result in the gradual depletion of the very neurotransmitters that are required for the drugs to work. In addition, there are predictable, very serious and unintended microanatomic (and eventually even macroscopic) brain damage that can occur with the chronic use of many types of psychoactive drugs, especially in high doses or in combinations (see my Duty to Warn column of July 22, 2010 entitled “Anatomy of an Epidemic: It Turns out that the Drugs Are the Problem”). Because of the reuptake pump inhibition mechanism of action of most drugs in the psychostimulant and antidepressant classes, we can predict why they stop working or cause dependencies, tolerance and withdrawal symptoms. Unfortunately the way the brain was intended to work is seriously altered by the over-stimulation of the receptor sites in the synapses because of the chemical tampering which keeps the nerve from functioning normally by preventing the physiological recycling, storage and subsequent reusing of the neurotransmitters.

The Similarities Between Psychostimulants and Antidepressants

I have heard many patients testify to the fact that psychostimulants and so-called SSRI antidepressants give them a temporary sense of feeling “better than well”. Both classes of drugs have as their base structure an amphetamine molecule (which consists of a benzene ring with an attached carbon side chain and any number of other chemical groups attached that affect how it works in the brain and body). However, usually initial feeling of improvement notoriously tends to “poop-out” far too soon with the need to have the dose increased or a second or third drug added to maintain the effect of counter adverse effects.

The infamous psychostimulant drug cocaine and the other amphetamine-like drugs like Dexedrine, Methamphetamine, Ecstasy, Fen-Phen, Ritalin (methylphenidate), Adderall, Straterra, Wellbutrin and Vyvanse all have benzene rings as their base molecule and so do all the second generation “antidepressants” like Prozac, Paxil, Zoloft, Luvox, Celexa, Lexapro, Effexor and Pristiq.

These stimulating (often “agitation-inducing”, mania-causing, insomnia-inducing, potentially psychosis-producing) drugs work by artificially “goosing” certain mood-elevating neurotransmitters, especially dopamine, norepinephrine and serotonin, but unfortunately, because of their over-stimulation effects, they also deplete the stored-up natural brain chemicals.

And because of this depletion effect, especially in the case of dopamine, there will occur the equally predictable sense of withdrawal or “poop-out” depression, fatigue, tiredness, cognitive disorders and the sometimes urgent need for another quick fix, probably needing a higher and/or a more frequent dosing schedule, which leads to eventually having to take the drug just to avoid the crash symptoms rather than being able to achieve the increasingly unachievable high.

The Huge Problem of Nicotine Addiction

A common example of this phenomenon is the addicted 1 - 2 pack per day smoker, who has nicotine cravings every hour, day and night. Nicotine is a highly addicting, short-acting dopamine reuptake inhibitor drug. Its legendary addictability, which makes cure so difficult (and which, by the way, is NOT related to lack of will power!) is directly related to the rapidity of absorption into the dopamine nerve cells of the brain through the pulmonary and systemic circulation.

The smoker inhales the cigarette smoke into the lungs, and hundreds of toxic chemicals, including the addictive nicotine, directly enter capillaries of the pulmonary circulation and rapidly into the newly oxygenated systemic circulation and thus into the brain and body. Many of the chemicals in the smoke, including the nicotine, cross the blood-brain barrier into the brain in a matter of seconds. This rapid absorption of high doses of nicotine also can happen via the rich capillary system of the nasal (nose) mucosa just like the absorption of the highly addicting compounds cocaine and Ritalin, when they are snorted or injected. The major factor in the addictability of such drugs is the rapidity of absorption into the brain. If psychostimulant or other drugs are ingested orally, the drug only reaches the brain slowly and therefore the same addicting “high” is not achieved.

The rapid absorption results in an un-physiologic concentration of large amounts of dopamine being released into the synapse, where it lingers far longer (because of the reuptake inhibition mechanism of action) than the few microseconds that nature intended. The normal anatomy and physiology of the drugged synapse is drastically altered, both short-term as well as long-term, and in many cases the anatomic and physiological changes can become permanent.

Nicotine is a very short-acting drug, and thus the stimulating effect drops off quickly. Therefore, there is also a rapid withdrawal effect that occurs soon after the last cigarette was smoked, and so the unfortunate nicotine addict (who might not have been told how hard it was to quit) has to light up again just to avoid the uncomfortable nicotine withdrawal symptoms that keep him hooked. Honest smokers will admit that the wonderful nicotine high that he or she experienced at the beginning no longer occurs. Smoking now is continued to avoid feeling so bad during the hourly withdrawal symptoms that explain the disordered sleep that is so common in psychostimulant addicts. Indeed, they are going through withdrawal every hour of the day and night. Frequently waking up to have a cigarette or having to smoke 2 or 3 cigarettes first thing in the morning (along with their caffeine fix) is often interpreted by many nicotine addicts as anxiety-reducing rather than what is the fact of the matter: the person is trying to self-medicate away the dysphoria (“feeling bad”) that accompanies all drug withdrawal syndromes. I have often heard smokers say, “I feel calmer when I am smoking,” and they do, but they are medicating withdrawal and not being tranquilized.

Addictive Foods From BigFood Inc

Some foods can cause similar cycles of temporary food-induced mood elevations and food-withdrawal mood crashes. For many so-called “eating disordered” patients there are frequently measurable cravings for sugar or other highly processed, nutritionally depleted, yet mouth-watering, (chlorine-) bleached white sugar and flour. Virtually anyone in our culture is capable of becoming a victim of food addictions in our malnourishing, toxic food-saturated, obesity-inducing, fast food epidemic. Everybody has experienced the “sugar highs” and hypoglycemic lows of the Standard American Diet (SAD).

The sugar high phenomenon is particularly problematic for young American children who have been raised on high-calorie, acidifying, high glycemic index fast foods that are nutritionally-depleted because they are highly processed with chemical preservatives, carcinogenic nitrites (that makes dead meat look pink), artificially sweeteners, monosodium glutamate (MSG) and chemical flavor- and fragrance-enhancers. Most of America’s children never eat healthy organic food. The high shelf-life foods and drinks at the average grocery store are often pesticide-laden, acidified with osteoporosis-inducing phosphoric acid and artificially colored with synthetic dyes that have been proven again and again to induce aberrant behaviors (especially inattention and hyperactivity) in children and others.

And then there is the existence of caffeine in the ubiquitous soda pop of small children whose brains have not been hard-wired yet. It should come as no surprise that America has 5 % of the world’s population but uses 90% of the world’s Ritalin - thank you Ciba/Geigy/Novartis.

Obesity- and diabetes-inducing foods include such highly advertised and promoted family favorites as high-carbohydrate “food” like pizza crust, French fries, double cheeseburgers, Big Macs, high fructose corn syrup (HFCS), bleached (and therefore chlorinated) white flour, white bread, buns, cakes, cookies, pastas and muffins and, when fats or oils are added to enhance flavor and texture, it is usually toxic long shelf-life transfats that are used. It should come as no surprise that type 2 diabetes, which was nearly unheard of in America 100 years ago, is exceedingly common in our FastFood Nation today. Thank you Food, Inc. You have created a monster, a situation where our over-privileged children pout and tantrum when they can’t get their addictive multicolored chocolate frosted sugar bomb cereal for breakfast when they want it. And then parents wonder what happened when the resultant brain malnutrition gets them diagnosed as “mentally ill” - a problem that is virtually unsolvable without education about real nutrition and drastic long-term family eating habit changes.

BigFood, Inc. the smiley-faced food corporations that, with no apparent conscience, have control over what is available in the grocery stores, convenience stores, restaurants and school lunch programs that provides food to 95% of the population. This multi-headed corporate behemoth has successfully brain-washed most of us into embracing – and happily eating - the most profitable, least nutritious, fantastic-tasting toxic foods we can swallow because of their cunning advertising strategies. The most innocent victims of BigFood Inc’s corporate agenda – again - are the children and the children of the children who grew up on – and somehow see nothing wrong with – the TV dinner/Fruit Loops/MacDonald’s hamburger/Pizza Hut/Coca-Cola/KFC/Fast Food culture. And they are the ones most likely to be falsely diagnosed and treated as “ADHD - unknown etiology”, “depressive disorder – unknown etiology” or “conduct disorder – unknown etiology”. What is most tragic, of course, is that the diagnosis of food, drug and culture-induced ADHD or other behavioral/mental dysfunction will usually result in the prescribing of one of the now known-to-be-neurotoxic, growth-retarding and potentially addictive psychostimulants mentioned above.

“I feel better when I’m eating” foodaholics commonly experience dysphoria and distressing hypoglycemic crash symptoms that are preventable by frequent eating, a form of self-medication.

Two of the common food additives that can be addictive while also making food taste good include monosodium glutamate (MSG) and the artificial sweetener NutraSweet (aspartame). They are in thousands of BigFood Inc food products.

The Insulin/Serotonin Connection

Serotonin is a calming, pain-reducing, appetite-satiating, impulse-controlling natural brain and body neurotransmitter, whose amino acid precursor, tryptophan, is more readily absorbed into the brain when insulin, which is secreted in response to rising glucose in the bloodstream, is secreted from the pancreas. The sense of calmness that can happen while eating high glycemic index foods (with a rapid rise in blood glucose after ingestion) can be attributed to an increase in serotonin production in the brain because of the fact that insulin facilitates the entry of the serotonin precursor tryptophan into the brain, thus resulting in raised serotonin levels. Of course, the positive effect is short lived and doesn’t actually increase the total serotonin content of the body. Only the ingestion of the precursors of serotonin can do that.

The Second Brain: The Guts

The gastrointestinal system is sometimes called the second brain because many of the neurotransmitter systems in the brain are also found in the intestines. One of them is the serotonin system, which is critically important in peristalsis, pain and other aspects of bowel function. Approximately 90% of the serotonin in the body is in the guts, whereas less than 5% is in the brain. Serotonin reuptake inhibitor (SSRI) drugs thus affect the intestines drastically, accounting for the almost invariably large number of unwanted gastrointestinal adverse effects from those drugs.

But the intestines are often severely disturbed in malnourished alcoholics, antidepressant drug-users and other addicted, malnourished patients. The SSRI drug-induced abnormalities in the intestines, besides leading to cramps, indigestion, bloating, diarrhea and constipation, may also cause malabsorption of essential nutrients, including healthy fats, protein, carbohydrates, folic acid and important vitamins. This disruption, together with a damaged and more permeable (“leaky”) gut, can allow a whole variety of toxic substances to cross from the intestines into the blood stream, creating food-related diseases such as gluten or milk sensitivity - in which incompletely digested food molecules that are toxic to the body and brain can cause very difficult to diagnose illnesses.

The body has defense mechanisms to get rid of toxins, including synthetic drugs, whether prescribed or over the counter. They include antibiotics, hormones, pesticides, herbicides or any of the hundreds of thousands of untested poisons that industry pollutes our air, water, soil and food with. The list of toxins includes the stuff we put into our mouths. BigFood, BigPharma, BigEnergy and the chemical industry have been polluting our environment for generations and work hard, through advertising campaigns, political campaign contributions and powerful lobbyists everywhere to prevent regulatory agencies from doing their jobs to protect us humans and the planet from their toxins.

What Can We Do?

There are many nutritional supplements that should be considered essential for the treatment of the addicted person (as well as for prevention of disease for the rest of us). Possible dietary supplements that should be considered include the amino acids that are the only precursors of serotonin, melatonin, dopamine, norepinephrine and epinephrine (ie, tryptophan, 5-hydroxytryptophan, tyrosine and phenylalanine). Vitamins are critically important, especially B1, B6, B12, C, E and folic acid. Essential minerals, especially magnesium, calcium, zinc and potassium and a variety of antioxidants and trace minerals can be found in high quality multivitamin/multimineral capsules. And of course, Omega 3 fatty acids are critically important.

Eliminating refined sugars, high fructose corn syrup, processed grains, bleached breads and flours, caffeine, synthetic sweeteners and long-shelf-life foods are important actions. Replacing such foods with organic foods consisting of nuts, berries, root vegetables, fruits and other raw foods plus high quality protein and herbal teas that are high in antioxidants.

In other words, as has been mentioned before in this column, try to follow these 10 Suggestions: 1) Eat as organic as you can afford (ie, avoid pesticides, herbicides and fungicides), 2) eat as vegetarian as you can tolerate, 3) eat food as local as you can find, but be sure to 4) eat sufficient amounts of high quality protein. In addition, 5) don’t eat anything that hasn’t been around for a hundred years (such as genetically modified foods). 6) Don’t eat anything that is artificially colored or flavored with synthetic additives. 7) Avoid anything that has ingredients on the food label that you can’t pronounce. 8) Stay away from processed meats and other foods, and 9) avoid high fructose corn syrup flavored food and drink. And 10) be wary of any food that has a very long shelf life.

And support your local organic farmers and the pioneering efforts of the Whole Foods Co-op (which other BigFood Inc. supermarkets are being belatedly being forced to emulate). Support the Farmer’s Markets, community gardening programs and try to start your own backyard garden. And support aware family-owned and operated local restaurants such as the Chester Creek Café and the Duluth Grill that offer healthy, nourishing, locally-grown organic eating.

And lastly, become aware of the need to supplement your likely deficient diets with nutritional supplements at locally-owned and operated health food stores such as The Essence of Health, Betty Lou’s, Cloquet Natural Foods, The Organic Carrot, Sunrider Foods, and the Whole Foods Co-op.

______________________________________________________________________

Dr. Kohls is a retired physician who practiced non-drug, holistic mental health care for many years in the Duluth, MN area. Most of his patients came to him asking for help with their addictions to prescription psychiatric drugs.