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Behavioral Addiction and Brain Function

Behavioral Addiction and Brain Function

February 12, 2016

Understanding Behavioral Addiction and Brain Function

Addictive behavior is a compulsion to repeat a rewarding non-drug related behavior repeatedly despite any consequences to the person’s physical, social, financial or mental well-being.  There are genetic factors involved here. The gene transcription factor known as ΔFosB has been identified as being one of the critical factors in the development of addictive states in both behavioral and drug related addictive behaviors.  Overexpression of this gene in the nucleus accumbens is both necessary and sufficient for the neural adaptations seen in addictive behaviors and drug addicts. A recent study suggested a cross-sensitization effect between drug-related behaviors and a natural reward which was mediated by ΔfosB. Besides this increased expression of  ΔfosB, there are many other similarities in the neurobiology of behavioral/drug addictions. 

One of the most important discoveries in the diagnosis and treatment of addictions is the recognition of the drug-based reinforcement and, more importantly, the reward based learning process. There are several structures within the brain that are important in the conditioning process of behavioral addiction. These are called sub-cortical structures.  These sub-cortical structures taken together are called the reward system.  This reward system is something that we all have—it is a necessary survival process, much like digestion. 

Behavioral Addiction and Brain Function

One system being subjected to major study is the amygdala.  The amygdala is a sub-cortical structure that is involved in emotional significance and associated learning.  Research shows that dopamine-sensitive projections from the ventral tegmental area make possible a motivational or learned association with a specific behavior. This means that dopamine neurons play a significant role in the learning and sustaining of many acquired behaviors. 

Three stages 

There are three stages to the dopamine reward system:

  • the initial burst of dopamine
  • triggering of behavior
  • further, impact on the behavior

This means that the most common result of dopamine-based learning is to create addictive properties associated with certain behaviors. The way it works is that once the brain is electrically stimulated (possibly through the addictive behavior), there is a burst of dopamine.  This burst of dopamine further triggers the behavior involved, which encourages these already-stimulated neurons to increase the stimuli.  Once the behavior is triggered, it is very difficult to work away from the dopamine reward system. 

The other side of this equation is the newly found idea that the human brain can anticipate rewards, and can be triggered by the brain’s early detectors of the reward, and can start triggering the behavior that starts the dopamine reward system.  In some cases, it may lead to issues due to error.  These errors can be used as teaching signals to create complex behavior tasks over time. 

Diagnosis 

At the time this article was written, the diagnostic models used do not have the necessary standards to identify behaviors as addictions in a clinical setting. Behavioral addictions have been proposed as a new class of diagnosis in the DM-5, but the only category included in this class is gambling addiction. Internet gaming addiction has been proposed in the appendix as a condition for further study, but this does not help in the diagnosis and treatment of other behavioral addictions such as sex addiction, or the various types of eating addictions. 

Behavioral addictions are sometimes called impulse-control disorders.  These disorders, which include gambling, consumption of alcohol, sex addiction (not limited to but including the use of pornography and sexual intercourse) eating disorders, use of computers and video games, use of the internet, shopping, exercise and stealing (shoplifting) are increasingly recognized as being treatable addictions.

Brain Function

 In August of 2011, the American Society of Addictive Medicine issued the statement that defined all addictions regarding brain changes.  Their statement read in part, “Addiction is a primary, chronic disease of brain reward, memory, motivation, and related circuitry.”  This means that all addictions are potentially susceptible to treatment with pharmaceuticals.

 This is the first time that the American Society of Addictive Medicine has taken the position that substance abuse is not just about substance dependence.  It is about how the brain function of addicts differs from the brain function of non-addicts.  The emphasis here is not on the external factors that act on the reward system but on the system itself.  Food, sexual behaviors, shoplifting, and even chronic hair-pulling can all be linked to this “pathological pursuit of rewards” talked about in this new definition of addiction.

 The thing is, we all have this reward system.  It is a survival mechanism, creating the desire for things that offer satisfaction, like food and sex.  However, in a healthy person, there is a feedback system that limits our consumption.  In an addict, these feedback systems seem to either be absent or, in fact, dysfunctional to the point that instead of “enough” the addict wants “more”.  This is what leads to the unhealthy pursuit of these items. So anyone who has one addiction is vulnerable to others, but this also points to the possible development of effective treatment for addictions that have historically been hard to manage.

Understanding Behavioral Addiction and Brain Function

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Biblical-sexuality

The Biblical View of Sexuality

February 10, 2016

Understanding Biblical sexuality

When one reads across the Bible, a wide range of topics are presented throughout is chapters. It primarily contains teachings that guide the human race on how to morally live. One human fundamental topic that has been explored throughout the scriptures book is sexuality. The Bible gives teachings on how human can exist morally as far as sexuality is concerned. There are those scriptures citing that talk of sexuality in great details. According to the Bible, sex as a practice is mainly viewed as a reproductive practice through which God, on the creation time intended for man to use to feel the Earth. Apart from reproduction, sex was also a manifestation of love between two married individuals and was sacred.  Here down is how the Bible views sexuality.

According to the Bible, Genesis, sex was supposed to be practiced by married individuals, who after becoming husband and wife, became one flesh. This infusion into one flesh or soul was enabled through making love. Gen 2:24, 25 reads, “A man will leave his father and mother and be united to his wife, and they will become one flesh”. Sex, as portrayed in the Bible, is, therefore, a tool for bonding a husband and wife into a lasting relationship.

Sexuality in the Bible is also viewed as a manifestation of marriage. Couples, according to the Bible, become married through an act of making love to each other. In the book of Exodus, the Bible says that having sex is in its self a form of marriage. It says, in the book of Exodus 22: 16, 17, “If a man seduces a virgin who is not pledged to be married and sleeps with her, he must pay the bride-price, and she shall be his wife. If her father utterly refuses to give her to him, he must still pay the bride-price for virgins. So the bible’s view on sexuality does differ greatly with the view taken by the contemporary world.

The Bible also portrays sex as a Godly gift that should be treasured and shared between two individuals who love each other and most importantly, husband and wife. Genesis talks of making love as a show of a man’s love to his wife, and the joy the two get as a result of doing the act. Gen 24: 67 say, “Isaac brought her into the tent of his mother Sarah, and her married Rebekah. So she became his wife, and he loved her, and Isaac was comforted after his mother’s death.”

Biblical sexuality

The Bible, therefore, emphasizes the purity of people and should therefore only be practiced when and only if one is married. Meaning that pre-marital sexual activities is not encouraged by the bible. And even those who get married are allowed by the Bible to practice fidelity in marriage. So married couple should only have sex with their marriage partners. Sex, therefore, had two purposes mainly, having children and for pleasure in marriage.

Sexual vices such as rape are also talked about in the bible. The Bible condemn such acts and just like in the contemporary society, the scriptures also provide for penalties subjected to those commit such offenses. In the ancient society, rape was punishable by death. The book of Deuteronomy clearly spells out the penalty. In Deuteronomy 22: 25, 27 we are told that, “But if out in the country a man happens to meet a girl pledged to be married and rapes her, only the man who has done this shall die, for the man found the girl out in the country, and though the betrothed girl screamed, there was no-one to rescue her.” The book also in different chapters, speaks strongly against other sexual immoralities such as pre-marital sex, and cheating among the married.

Prostitution is also condemned very strongly in the Bible. Viewing sex as a sacred gift given to man by God purposely for pleasure and reproduction after marriage, the bible is against prostitution as a practice. In the book of Leviticus, God gives Moses set of rules to help the Israelites live with high morals. One of the immoralities they are warned against is prostitution. In Leviticus 19: 29, it reads, “Do not degrade your daughter by making her a prostitute or the land will turn to prostitution and be filled with wickedness.”

Sexual immorality is also advised against in the Bible. In the book of first Thessalonians, the Bible advice humanity to desist from sexual immorality. 1 Thessalonian 4: 3-5 says that ” It is God’s will that you should be sanctified: that you should avoid sexual immorality; that each of you should learn to control his own body in a way that is holy and honorable, not in passionate lust like the heathen, who do not know God.” This sums up sexuality as viewed by the Bible.

Understanding Biblical sexuality

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Zoloft_bottles

MEDICATION TREATMENT FOR SEX ADDICTION

February 1, 2016
  1. SSRI
  • An SSRI (Seroetoninergic) A seroetoninergic medication is any medication that modifies the effects of serotonin in the body. Serotonin is a chemical produced by certain brain cells which acts as a neurotransmitter. Neurotransmitters facilitate communication between the axons of brain cells. As such, serotonin is one of the regulators of mood, appetite, and sleep. Another primary effect of serotonin is to regulate the intestinal tract movements. Serotonin uptake in this area of the body increases gastrointestinal motility among other things. Serotonin’s cognitive functions include memory and learning.  Modulation of serotonin at brain synapses is thought to be the function of a class of antidepressants which are called SSRIs, The list of SSRIs is:
    • Prozac-one of the first antidepressants on the market, the activity of prozac was first observed in 1975 by scientists at the Eli Whitney Co. The USA granted the Eli Whitney Co a patent on Prozac in 1985, which expired in 2001. Generic versions are now availble. Prozac is used for the treatment of :
      • major depressive disorder
      • obsessive compulsive disorder
      • bulemia nervosa
      • panic disorder
      • menstrual dysphoric disorder
      • trichotillomania after cognitive therapy has failed

Zoloft_bottles

  • Paxil
    • Paxil has been on the market since 1992. It is marketed by the company SmithKleine Beecham, which changed its name in 2001 to GlaxoSmithKleine.  Generic versions of Paxil have been available since 2003 when it’s USA patent expired. Paxil is used for the following conditions:
      • Depression
      • Panic Disorder
      • Social Anxiety Disorder
      • Obsessive-Compulsive disorder
      • Menopausal Hot Flashes
      • Childhood Obsessive-Compulsive disorder
    • Zoloft
      • Zoloft has been available since 1991, when Pfizer introduced it. It is a very popular drug, having been prescribed over 41 million times in 2013.  This makes it the most popular antidepressant in the US and the second most prescribed psychiatric medication on the US retail market.  It is used for:
        • Major depressive disorder in adult outpatients
        • obsessive-compulsive disorder
        • panic disorder
        • social anxiety disorder
        • These last 3 disorders are considered appropriate for both children and adults to receive Zoloft..
          • Celexa
          • Celexa has been available since 1998. There are no generic equivalents to Celexa at this time. Celexa was first synthesized i1972 by the scientists at Lundbeck Pharmaceutical company and was first marketed in Denmark in 1989.  It was first marketed in the US in 1998. The patent expired in 2003, but no generic versions were found.  Celexa is approved for the following uses:
            • Major depression
            • Panic disorder

It also has the following off-label uses:

  • anxiety
  • panic disorder
  • dysthemia
  • premenstrual dysphoric disorder
  • body dysmorphic disorder
  • obsessive-compulsive disorder
    • It has been found to reduce the symptoms of diabetic neuropathy
  • Luvox
  • This drug was first synthesized in 1983, and introduced to the market in Switzerland and West Germany that year. It was approved by the FDA in 1994, and is available in India. One of the oldest SSRI, it was the first to be approved for obsessive-compulsive disease in children.
    • In the US, its only FDA approved use is as a treatment for OCD in both children and adults. However, in other countries it is also used for:
      • Major Medical Depression
      • panic disorders
      • social anxiety disorder
      • PTSD
      • obsessive-compulsive spectrum disorders
      • some evidence suggests it may be a useful adjunct to schizophrenia, helping to improve the negative depressive and cognitive symptoms of the disorder.
    • Lexapro
    • Lexapro was developed in a close cooperative effort by Lundbeck and Forrest Laboratories. This development took place in 1997, and the application to the FDA was submitted in 2001. It was approved by the FDA for use in major medical depression in 2002 and for generalized anxiety disorder in 2003.  In 2006 Forrest Laboratories was granted an 828 day extension on its patent.  That extension expired in 2011.  So far, no generics have been formulated.
      • This drug is used for the following diagnosis:
        • Major medical depression—US
        • Generalized Anxiety Disorder—US
        • Other countries
          • Major Depressive Disorder
          • Generalized anxiety disorder
          • Social Anxiety Disorder
          • Obsessive-Compulsive Disorder
          • panic disorder with or without agoraphobia
        • Naltrexone
        • Naltrexone is a drug used either as a daily oral medication or as an injectible “depot drug” on a monthly basis, or as a newly developed implant which must be renewed every several months. The advantage of the depot drug and the implant are that the patient is not required to see the doctor as often as they would if they were on the naltrexone pill. There is also an increased compliance rate as the patient only sees the doctor once per month or once every several months. Since this drug (as all psychopharmacuticals) has better results when the drug levels in the blood are steady, the implant gives the best results followed by the drug depot and then the pill.
        • Naltrexone is used for the prevention of alcohol consumption and the prevention of opiate relapse after detox.
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Correcting Neurotransmitter Imbalances with IV Amino Acids

March 14, 2015

Correcting Neurotransmitter Imbalances with IV Amino Acids

When taken, drugs will alter the normal the bodily functions. That is no news to even those who use drugs of abuse, in fact the basic definition of a drug is; any substance that when taken will interfere with the normal functions of the body. However some drugs do not only alter minor body functions but go a step further in inhibiting the functions of neurotransmitters to a greater extent.  Most of the drugs that can mimic or interfere with the functions of the neurotransmitters in any way are mostly drugs of pleasure that are prone to abuse and are hence illegal in many parts of the world. The brain and the entire nervous system functions in a way that the entire body needs them to work properly, you can’t imagine how fast the coordination between the central nervous system and the peripheral nervous system is but most important fact to note is that any interference within the nervous system even only to a neurotransmitter goes a long way in affecting the entire body. The brain has various mechanisms through which it accomplishes all the functions of the body. The effect of drugs on the neurotransmitters can be underestimated by those who haven’t known how the neurotransmitters work, here is how the neurotransmitters work.

Neurotransmitters

How Neurotransmitters Work

Neurotransmitters are very crucial in the nervous system. They are the chemicals that transmit messages from one nerve cell to another. Nerve cells are known as neurons. The nerve impulse travels from the first nerve cell through the axon, a single smooth body arising from the nerve cell to the axon terminal and the synaptic knobs. Each synaptic knob communicates with a dendrite or cell body of another neuron, and the synaptic knobs contain neurovesicles that store and release neurotransmitters. The synapse lies between the synaptic knob and the next cell. For the impulse to continue traveling across the synapse to reach the next cell, the synaptic knobs release the neurotransmitter into that space, and the next nerve cell is stimulated to pick up the impulse and continue it. An interference with the neurotransmitters can adversely affect the flow of message within the nervous system. This is what most drugs of abuse do. They affect the harmonious flow of information from the brain to the rest of the body maiming its normal functions. Let’s look at how drugs affect specific neurotransmitters in the nervous system.

How Drugs affect Dopamine and GABA

One of the neurotransmitters that are highly targeted by drugs of pleasure is Dopamine. To some people it is known as the ‘bliss neurotransmitter’. It is responsible for good feeling, the euphoric feelings that drug addicts seek from various drugs of abuse. Dopamine has great influence on well-being, alertness, learning, creativity, attention and concentration. Levels of dopamine should be optimal in the brain since when the level of dopamine is low it can leave us craving food, sex or stimulation. When the dopamine level is too high it can cause addictive behaviors. It has been observed that patients who are put on medications to boost dopamine level especially the Parkinson’s patient, they will form an addictive behavior like gambling when the levels of dopamine shoots beyond the optimal level. Dopamine boosts the feelings of pleasure but when the levels are too high it may result in Paranoia or a suspicious personality. Dopamine is also released when there is high stress. Therefore the level of dopamine should be regulated to ensure sound health. This is where the functions of inhibitory neurotransmitters set in, however with influence of drugs this coordination between excitatory neurotransmitters and inhibitory neurotransmitters is maimed.

Nicotine influences mood, cognition, and body function by binding to and activating nicotinic acetylcholine receptors (nAChRs) located on neurons in the brain. When activated by either nicotine or the endogenous neurotransmitter acetylcholine, the nAChR opens a channel that allows ions to pass through the neuron’s membrane from the exterior to the interior of the cell and trigger changes that activate the cell. When you take tobacco or other drug with nicotine the nicotine will have interactions with nAChRs and therefore any nicotine dependence treatment should focus on altering these interactions.

Nicotine produces rewarding effects by interacting with nAChRs on neurons in the brain’s mesolimbic reward system. This system comprises dopaminergic neurons that originate in the ventral tegmental area often shortened as VTA and release the neurotransmitter dopamine in regions involved in information processing, memory, and emotions, such as the nucleus accumbens (NAc), hippocampus, amygdala, and prefrontal cortex (PFC). Increases in dopamine levels within the mesolimbic system give rise to rewarding effects. Nicotine directly enhances dopamine levels in the mesolimbic system by interacting with nAChRs on the dopaminergic neurons and causing them to release more of the neurotransmitter. Nicotine also modulates dopamine release indirectly by binding to nAChRs located on excitatory glutamatergic and inhibitory gamma aminobutyric acid (GABAergic) neurons in the ventral tegmental area. These glutamatergic and GABAergic neurons originate from a number of brain areas, such as the NAc, hippocampus, PFC, amygdala, ventral pallidum, and pedunculopontine tegmental nucleus, and regulate the activity of dopaminergic neurons.

Neurotransmitters

Restoring nicotine addiction can’t be done with IV amino acid to restore NER balance

Nicotine is one of the most available addictive substances. You can find it in tea but it can be found in greater proportions. Unfortunately, Nicotine addiction is never easy to fight. And the bitter truth is that nicotine addiction can’t be fought successfully without IV amino acid to restore NER balance. IV amino acids are the best in restoring the balances in the neuroendocrine system. The IV amino acids are the best in detoxification and getting rid of the effects of nicotine and curbing nicotine addiction by ensuring the balance of neuroendocrine chemicals.  With IV amino acid, dopamine has been noted to be the major cause of addiction can be regulated. IV amino acids is used as an  outpatient program which focuses on biochemical detoxification of the body and brain hence perfect treatment for nicotine addiction.

Any addiction treatment must focus on restoring the general well-being of the patient that can only be achieved by restoring the neurotransmitters affected. This is why we at AWAREmed are dedicated to ensuring that we offer the best neuroendocrine restoration. Dr. Dalal Akoury (MD) is one of the few doctors that have embraced the benefits of NER in fighting addiction. Call on her and be helped in finding the best solution for nicotine and other substances addiction.

Neurochemical and Imbalances Involved In With Nicotine & Smoking

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Substance Use Disorder Treatment with Nervine Herbs

February 27, 2015

Substance Use Disorder Treatment with Nervine Herbs

The basic knowledge of drugs is that they are substances that interfere with the normal functioning of the body. This therefore means that after using some drugs and substances a person’s behavior will be altered by the substances he has used. However it should be known that there are far more damages that drug and substances use cause to an individual health wise. Substance use disorder, also known as drug use disorder, is a condition in which the use of one or more substances leads to a clinically significant impairment or distress. In this context contrary to common knowledge that substance can mean any physical matter, the term substance here is used to mean drugs. Substance Use Disorder refers to the overuse of, or dependence on, a drug leading to effects that are detrimental to the individual’s physical and mental health as well as the effect on other people’s welfare.

The diagnosis of substance abuse disorder has improved treatment of patients. Before his approach to treatment of addiction related cases, doctors used to treat addiction and other clinically significant abuse as separate issues but with substance use disorder diagnosis, doctors can simultaneously treat both addiction and non-addiction related dysfunctional substance abuse in patients. the rule of this approach of treatment is that the doctor will identify the specific cause of problems to an individual for example if a person is alcohol-related issues then he Is termed to suffer alcohol use disorder  while a person suffering from cocaine is termed to be suffering from stimulant use disorder.

Nervine Herbs

a person suffering from any substance use disorder will exhibit at least three and at most eleven specific symptoms related to the use of the substance with the most prominent examples of these symptoms being substance cravings, an inability to curb substance intake, the development of tolerance to a substance’s effects, serious life disruptions that stem from substance use, use of substances in clearly dangerous circumstances and devotion of significant time or resources to either using a substance or recovering from substance intake. However, people affected by the minimum number of symptoms have mild substance use disorder, while people affected with many or most of the required symptoms have major or severe substance use disorder but all of these people need substance use disorder treatment in order to be free from the effects of the drugs they are using.

Treatment of substance use disorder with nervine herbs

What are Nervine Herbs?

The Nervines are herbs that are very essential in supporting the nervous system. The nervines may work as tonics and to create a mild calming effect. The tonic nervines may include the Skullcap and the oat tops while Catnip and chamomile can be used for mild calming of the nervous system. Apart from these two categories there are also nervines that work as strong sedatives on the nervous system, they may include the Hops and the Valerian among others. Generally the nervine herbs are used to relieve nagging muscle tension and spasms, circular thoughts, insomnia, and the occasional worry that has become a part of day to day life. Some of these herbs provide multiple nervine actions, such as Skullcap which relaxes the muscles, helps calm worried thoughts, and nourishes the nervous system. Others such as Oat Tops, are not necessarily relaxing to the physical body, but help restore and support healthy nerve functioning when taken on a regular basis.

The nervous system is Composed of the all the nerve tissues in the body and plays very critical roles in the body. They are composed of the nerve tissues that receive stimuli and transmit stimuli to the nervous systems and to initiate responses. The central nervous system consists of the brain and the spinal cord and functions as the points of collection of all the nerve impulses. This is how the nervous system works; the sensory nervous system receives the stimuli, the central nervous system interprets them while the motor nervous system initiates responses.

The nervous system are very vital in the body and so they ought to be performing at optimum always, however due to some of the substances that a person may use such as drugs and alcohol the communication between these nerve tissues may be tampered with leading to rise of some complications in a person . Therefore there is need for the entire nervous system to replenished, relaxed and strengthened and nothing does that better than the nervines. The nervines are herbs that are specifically for the nervous system. They correct all the defects in the nervous system as well as strengthening the nervous system.

Nervine Herbs

Here are some of the useful Nervine Herbs

Catnip – this nervine is a very gentle sedative that is used in solving insomnia related problems. Some drugs may often leave the user with sleeplessness after along use. Catnip could be the answer. It’s also good for headaches.

California poppy – this herb has anti-anxiety, sedative, and analgesic properties. It’s used to promote relaxation in those seeking rest from nerve pain.

Passion flower – This stunning plant offers anti-spasmodic power and is helpful with tension headaches, occasional nerve pain, nervous restlessness, and restful sleep. Good for many symptoms of substance use disorder.

Lavender – Calming herb that is often used in aromatherapy applications for its mild calming action. This herb is uplifting hence good for low moods. It is good for mild anxiety and improves sleep quality.  For persistent depression use lavender with holy basil and damiana.

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. In case you are struggling with addiction just call on Dr. Dalal Akoury (MD) at Myrtle Beach, South Carolina for help.

Substance Use Disorder Treatment with Nervine Herbs

 

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