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Dopamine and RDS

Dopamine Genes Affect Clinical Outcomes in Reward Deficiency Syndrome

dopamineDopamine is crucial neurotransmitter and hormone in the body. This hormone serves many purposes. It plays a role in the pleasure and reward pathway of the brain as well as in memory and motor control. And any decline in this hormone presents the body with myriads of ill-health conditions. This hormone however is greatly affected by drugs of abuse, most drugs that are taken to produce induced euphoric feelings in a person works in such a manner that they increase the production of the dopamine neurotransmitter, when this neurotransmitter is produced up to certain levels it will get depleted in the long term and hence the problem sets in. Specifically, the euphoric properties of cocaine and other drugs of leisure lead to the development of chronic abuse, and appear to involve the acute activation of central dopamine (DA) neuronal systems. They proposed that DA depletion results from overstimulation of these neurons and excessive synaptic metabolism of the neurotransmitter. When this happens may suffer ill-health conditions. These may include; poor nutrition, stress, lack of sleep and the habitual use of antidepressants, symptoms such as depression, mood swings, poor attention and food cravings will also occur. Some of the major symptoms of dopamine deficiency are depression, chronic boredom, and a loss of satisfaction, apathy, chronic fatigue and low physical energy with no desire to exercise the body. To correct these problems, it is necessary for this hormone to be supplemented so that the normal levels are restored. In addicts the use of buprenorphine to treat opioid dependent individual is common and is approved by the FDA. While to many people it has been working well with many studies supporting its use has now been reported that using buprenorphine for a long time will jeopardize the life a person as cases of severe withdrawal symptoms have been common. Researchers have found it necessary to embrace genetic testing to reveal reward circuitry gene polymorphisms especially those related to dopaminergic pathways as well as opioid receptor(s) as a way of improving treatment outcomes.

Researchers have currently proposed the use of dopamine agonists instead of antagonists like buprenorphine that is mostly used with naloxone can offer long term solution to dopamine deficiency. While it is well established that dopamine deficiency or a hypodopaminergic trait leads to aberrant substance seeking behaviors (RDS) and intact mu opiate receptors are important for maintaining “dopamine homeostasis”, scientists have suspected that opioid-dopaminergic interaction must be involved in buprenorphine response. In this regard they have provided some evidence that a putative dopamine agonist, KB220Z shows long-term potential as an opioid replacement compound especially in subjects having a genetically determined hypodopaminergic trait like RDS.

In a research study done by Kenneth Blum, Marlene Oscar-Berman, William Jacobs, Thomas McLaughlin and Mark S. Gold, it was found that dopamine genes can affect clinical outcomes in reward deficiency syndrome and therefore it is safe to use less powerful dopamine agonist dopaminergic genes in helping patients with low dopamine levels on a long-term basis.

Dopamine agonist therapy

Based on these earlier studies both Blum et al has continued to propose dopamine agonist therapy rather than dopamine antagonistic therapy currently favored by the approved FDA drugs as medical assisted treatment. Specifically, they proposed that D2 receptor stimulation can be accomplished via the use of KB220Z which is a complex therapeutic nutraceutical formulation that potentially induces DA release, causing the same induction of D2-directed mRNA and thus proliferation of D2 receptors in the human. This proliferation of D2 receptors in turn will induce the attenuation of craving behavior. In fact, this model has been proven in research showing DNA-directed compensatory overexpression which is a form of gene therapy of the DRD2 receptors, resulting in a significant reduction in alcohol as well as cocaine craving behavior in alcohol and cocaine preferring rodents.

This research done by Blum and his team suggested that utilizing less powerful dopaminergic repletion therapy to promote long term dopaminergic activation will ultimately lead to a common, safe and effective modality to treat Reward Deficiency Syndrome (RDS) behaviors including Substance Use Disorders (SUD), Attention Deficit Hyperactivity Disorder (ADHD), Obesity and other reward deficient aberrant behaviors. This concept is further supported by the more comprehensive understanding of the role of dopamine in the NAc as a “wanting” messenger in the meso-limbic DA system. This team had a hypothesis that D2 receptor stimulation signals negative feedback mechanisms in the mesolimbic system to induce mRNA expression causing proliferation of D2 receptors.

dopamineAs revealed by the researchers stress and dopamine D2 receptor levels play a significant role in alcohol seeking behaviors. Another researcher Delis and his team observed that in the presence of a stressful environment, low DRD2 levels are associated with increased ethanol intake and preference and that under this condition, increased ethanol consumption could be used as a strategy to alleviate negative mood this also supports dopamine agonist therapy not antagonistic. It is therefore safe to use dopamine agonists instead of dopamine antagonists in treating those with low dopamine levels as they are much safer.

Finally, We at AWAREmed Health and Wellness Resource Center are committed to availing help to addicts by availing some of the most integrative approaches to healing an addict. We advocate for natural healing to all kinds of addiction. Call on Dr. Dalal Akoury (MD) at Myrtle Beach, South Carolina for help.

Dopamine Genes Affect Clinical Outcomes in Reward Deficiency Syndrome

 

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Withdrawal Syndrome

Withdrawal Syndrome, Withdrawal Seizures and the CIWA Scale

Withdrawal syndromeWithdrawal syndrome refers to is a set of symptoms that occurs when a person discontinues using a drug or when he reduces the dosage of the drug. Not all drugs will result in withdrawal symptoms but some prescription drugs and other drugs of recreation will result in withdrawal syndrome when one discontinues using them. For example a person who has been using alcohol for a long time will suffer withdrawal syndrome when he reduces the amounts he takes or when he stops taking alcohol completely. Normally the withdrawal syndrome will result in the patient taking more of the drug and for a longer time. In case of alcohol the withdrawal syndrome may make the addict to continue using alcohol as an escapade or other to mitigate the effects of the severe withdrawal symptoms.

People using different drugs will suffer withdrawal syndrome when they stop using the drugs or when they reduce the dosage, however there will be different symptoms. For example a person who has stopped using opiates will exhibit such symptoms as; Shaky hands, Sweating, Mild anxiety, Nausea and/or vomiting, headache and Insomnia. On the other hand a person who has stopped using opiates will exhibit the following withdrawal syndrome symptoms; muscle ache, restlessness, anxiety, lacrimation (eyes tearing up), runny nose, excessive sweating, inability to sleep and yawning very often. Withdrawal syndrome will most likely affect someone who has used the substance of abuse for so long that he has got dependent on the drug. It does not only happen to those who ate suing the recreational drugs alone but can also happen with prescription drugs. For example many people who are prescribed opioids to help manage their pain end up exhibiting withdrawal syndrome symptoms and in most cases have to be helped to quit using the drugs that were once given with medical intentions.

Withdrawal seizures

Withdrawal seizures may occur as a withdrawal syndrome symptom. It refers to the convulsions that occur when a person has stopped using a drug he has been using for a long time. It is common to users of opiates and alcohol addicts. As for alcoholics it occurs in up to one-third of alcoholics when they abruptly reduce their alcohol intake, the effects of which peak within 24 hours after the most recent alcohol ingestion. These seizures are in most cases brief or partial. It however should not be taken lightly since if not taken care of in good time an alcoholic who suffers seizures may develop delirium tremens. Most alcohol withdrawal seizures normally resolve spontaneously or respond well to benzodiazepines but the risk of delirium tremens should not be overlooked. In most addicts it is said that withdrawal seizures is responsible for their physical injuries such as burns and wounds.

Withdrawal delirium

Withdrawal delirium is common among alcoholics. In fact it is the most severe form of withdrawal syndromes associated with alcoholism. It causes sudden and severe problems in your brain and nervous system. It is approximated that five percent of hospital patients being treated for alcohol withdrawal also experience Alcohol withdrawal delirium. Alcohol Withdrawal delirium is also known as delirium tremens or Delirium tremens. It is a medical emergency.

Alcohol withdrawal delirium is mostly caused by sudden stop in alcohol consumption after a long time of heavy drinking. However other causes may include; reduce their alcohol use too quickly, don’t eat enough when reducing alcohol use, have a head injury and infections. A person suffering from alcohol will show the following symptoms among others;

  • hallucinations
  • nightmares
  • fever
  • fatigue
  • nausea
  • restlessness
  • chest pain
  • excitement
  • fear
  • sudden mood changes
  • delirium
  • sensitivity to light
  • sensitivity to sound
  • sensitivity to touch
  • anxiety
  • agitation
  • irritability
  • confusion
  • delusions

Treating alcohol withdrawal delirium

Firstly, you should know that withdrawal delirium can cause death and so treatments should only take place in hospital. It is also crucial that the patient should access treatment as soon as possible. When a delirium tremens patient has been taken to hospital the doctors may employ the following means to treat him;   anticonvulsants to prevent or stop seizures, sedatives to calm agitation and treat anxiety, antipsychotic medications to prevent hallucinations, medication to reduce fever, treatment for other alcohol related conditions and rehabilitation to help you stop drinking and avoid future cases of the disease striking again.

Clinical Institute Withdrawal Assessment for Alcohol

Withdrawal SyndromeOften abbreviated as CIWA, Clinical Institute Withdrawal Assessment for Alcohol is an item that is used in assessment and management of alcohol withdrawal. The main purpose of the CIWA scale is to provide an efficient and objective means of assessing alcohol withdrawal. The scale is used to test for severity of the common withdrawal syndrome symptoms independently after which the aggregates will be used as an insight into the severity of alcohol withdrawal. The ranges on the scale show what should be done at each level to manage the withdrawal symptoms for example administering benzodiazepines. The maximum score on the CIWA scale is 67; while any score less than 15 is termed a mild alcohol withdrawal, moderate with scores of 16 to 20, and severe with any score greater than 20. The ten items evaluated on the scale are common symptoms and signs of alcohol withdrawal, and are as follows:

  • Nausea and vomiting
  • Tremor
  • Paroxysmal sweats
  • Anxiety
  • Agitation
  • Tactile disturbances
  • Auditory disturbances
  • Visual disturbances
  • Headache
  • Orientation and clouded sensorium

Finally, Here at AWAREmed Health and Wellness Resource Center we are committed to availing help to addicts by availing some of the most integrative approaches to healing an addict. We advocate for natural healing to all kinds of addiction. Call on Dr. Dalal Akoury (MD) at Myrtle Beach, South Carolina for help.

Withdrawal Syndrome, Withdrawal Seizures and the CIWA Scale

 

 

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Understanding At-Risk Drinking, Alcohol Abuse and Dependence

Differences That Exists Between At-Risk Drinking, Abuse and Dependence

Alcohol drinking has different effects when taken at different levels. Doctors have credited moderate drinking of alcohol to be healthy. Some of the health benefits that are associated with moderate drinking include the following; moderate drinking of alcohol improves blood lipid profile by increasing HDL also known as good cholesterol and decreasing LDL popularly known as bad cholesterol. It also decreases blood clotting by reducing platelet aggregation, reducing fibrinogen which causes blood clotting and increasing fibrinolysis. Fibrinolysis is the process by which clots dissolve. Moderate drinking also helps in increasing coronary blood flow, reducing blood pressure, and reducing blood insulin level. However when a person drinks alcohol without moderation then all the benefits will be overweighed by the dangers that come with heavy drinking.

Differences That Exists Between At-Risk Drinking, Abuse and Dependence

There are different levels of drinking and each level exhibits different characteristics, as you begin drinking alcohol your behavior changes, the more you drink the more you will need and this is what brings about addiction. Let’s say you may begin by drinking once in a week, your thirst for alcohol will grow and before you know it you will be drinking five times in a week and this may increase gradually till you become dependent on alcohol. As the levels change so do the dangers escalate. The more you take the greater the risk. Here are the different levels of drinking.

At-risk drinking

This refers to consumption above the low-risk guidelines. At-risk drinking is consumption of alcohol in quantities that are potentially harmful to the person using alcohol. A person at this stage may not experience some of the known severe effects of alcohol consumption but if nothing is done to help a person who is at this stage of alcohol drinking to stop drinking then he may graduate to higher levels of drinking.

A man would be said to be at-risk drinker when he drinks as much 4 drinks a day or 14 drinks per week. On the other hand a woman will be said to at-risk drinker when he consumes as much 3 drinks any day or more than 7 drinks per week. Research has revealed that about 1 in 4 people who exceed these limits already have alcoholism or alcohol abuse, and the rest are at greater risk for developing these and other problems. Again, individual risks vary. People can have problems drinking less than these amounts, particularly if they drink too quickly.

Some of the risks that an at-risk drinker will have to deal with include;

He risks being dependent on alcohol if all is not done to help him evade alcohol use completely. He also risks succumbing to injuries this is because drinking too much increases your chances of being injured or even killed. Alcohol is a factor, for example, in about 60% of fatal burn injuries, drowning, and homicides; 50% of severe trauma injuries and sexual assaults; and 40% of fatal motor vehicle crashes, suicides, and fatal falls.

Another risk is the risk the risk of poor health such as depression and even sleep disorders, other risk is the risk of contacting sexual infections while alcohol has taken toll. However it is good to note that of all the risk, the biggest risk is that of becoming dependent on alcohol as that will be hard to deal with due to severity of the withdrawal symptoms associated with it.

Alcohol Abuse

Alcohol abuse refers to hazardous or socially inappropriate behavior while drinking e.g., dangerous driving. A person who has reached the level of alcohol abuse will not know the bad manners he is involved in are as a result of his heavy drinking and they are mostly involved in bar brawls and fights as they will cease to be in control of their actions while under the influence of alcohol.

Alcohol dependence

Alcohol dependence is a psychological syndrome characterized by compulsive drinking and loss of control over consumption. At this level a person becomes dependent on alcohol so much that he cannot survive without it. Most of the time they will be seen drunk and they will no longer control the frequency and the amount of alcohol they control daily. This will make it even hard for them to maintain their jobs and supplement their family needs.

The difference between at-risk drinking, alcohol abuse and dependence

There are indicators that will let you differentiate whether a person is an at-risk drinker, an alcohol abuser or dependent on alcohol. We will use these indicators to help us find the difference between these levels of alcohol consumption.

Withdrawal symptoms- the withdrawal symptoms are not present in the at-risk drinkers, in those at alcohol abuse the withdrawal symptoms are absent too but in alcohol dependence withdrawal symptoms are mostly present.

Tolerance- in both at-risk drinkers and alcohol abuse there is mild tolerance to alcohol while in alcohol dependence there is marked tolerance.

Weekly consumption- at at-risk the weekly consumption is just above the low-risk guideline while alcohol abuse is characterized by binge drinking. In alcohol dependence a person will drink 40 or more drinks per week.

Drinks per day- at-risk drinker may take fewer than 4 drinks per day while at alcohol abuse a person will sometimes take less than 4 drinks daily. At alcohol dependence a person will rarely take less than four drinks a day.

Social consequences- at at-risk a person will not have social problems, while at alcohol abuse he will have occasional argument with wife and may face problems at work. At alcohol dependence the social consequences are quite severe, he may lose his job.

Alcohol abuse

Physical consequences- at at-risk the physical consequences may be mild, these may include; hypertension, insomnia and fatty liver. At alcohol abuse the physical consequences may include trauma and violence while at alcohol dependence the physical consequences may be severe, these may include cirrhosis and pancreatitis.

Alcoholism is a problem that many people are chained to. We at AWAREmed Health and Wellness Resource Center are committed to availing help to addicts by availing some of the most effective integrative approaches to healing an addict. Call on Dr. Dalal Akoury (MD) at Myrtle Beach, South Carolina for help.

Differences That Exists Between At-Risk Drinking, Abuse and Dependence

 

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