Addiction

[allegoric]

Does anyone have an opinion or personal experience with new medical treatments for alcoholism, i.e., the manipulation of neurotransmitters with medicines such as Campral or Gabatril?

I believe the correct answer is out there and there aren't enough addicts motivated to recover (scientifically) or have the forum to share this information.

I have been studying this area since 1996, have no college education, but can talk intelligently about it.

(Currently sober recovering alcoholic)

[Phi for All]

First of all, congratulations on your sobriety. I hope you are comfortable with it and aren't having a rough time living daily in a world where others are allowed to drink whatever they want.

 

Second, it sounds like you are looking for help beyond your own program and philosophy, and this can be dangerous. I know an alcoholic's willpower alone isn't trustworthy, and while drinking it's non-existent, but if you have at least three years under your belt you should have progressed beyond mere willpower and into what I call the adamant mode. If you can't get to a point where you are firmly convinced you'll never take another sip of alcohol and have no problems being around others who do, you may need to take more counseling or increase your program.

 

Third, since you consider alcoholism a disease, you must realize it's a disease that is easily cured. Just don't drink. There, all done. It's the continuing to not drink that is the hard part, and I feel that any use of artificial means is merely a crutch and weakens the resolve, making you more succeptible to that fatal phrase, "I think I can drink like a normal person now." Psychologically, if it's the meds that keep you from drinking, you'll have no defense when you run out, you forget to take them, you build up an immunity, you tell yourself the meds will keep you from going overboard, or any of the many other justifications occur. The meds become an excuse for your actions, the same way alcohol was.

[insane_alien]

messing with neuro transmitters is a bad idea, even when you know what your doing. We don't fully understand the functions of the brain yet so its a bit dodgy to mess with its communication systems. You never know what you might mess up. Personally, I believe that the only way to beat it is willpower as with any other addiction.

[YT2095]

it`s probably best to stick to the tried and tested methods, as a smoker and drinker myself I`ve no idea what alcoholism is actualy like (and don`t want to know 1`st hand anyway) I know what Nicotine addiction is though, so I can Imagine that it`s a really awkward condition esp when you consider that it`s legal and almost everywhere (unlike crack or herion etc...). having said that, if you`ve done 3 years so far with all that in your path, whatever you`ve been doing so far, seems to be the right thing and worth sticking to.

If it`s not broken, don`t fix it

 

from a Logical perspective at least.

[aj47]

You could always try hypnotherapy, my friends used it to quit smoking cigarettes and worked really well but i suppose it depends on te individual.

[ashennell]

Any drugs that effect neurotransmitter systems are very crude, very far from ideal medical solution for the conditions that they are designed to alleviate. Basically they are neuropharmacological sledgehammers.

 

---

 

Addiction and anxiety/depression are intelligent enemies - they use your brain against you. Examples that seem to be suitable to this discussion would be:

 

Treating temptations to drink during a course of drugs as proof that you cannot beat your addiction. i.e. playing on expectations of how well the drugs will work.

 

Telling yourself that you are stong enough to not need the treatment so you stop taking the tablets knowing that if you relapse you can blame the lack of medication instead of the lack willpower.

 

Emphasising the side effects of the medical so they become 'worse' then the addiction itself.

 

etc.,etc.,

 

I think pharmalogical treatments need to be balanced with councelling as well as a personal understanding of what addiction is and how it will work against you.

 

I guess the second pert of this post comes more from my personal experience than from a science textbook.

[FreqWhenSee]

Alcoholism is classified as a disease just as fat is now. We're products of psychological conditioning which alters the chemistry of our brains and neuro-networks. The key lies in de-conditioning. Discovering the deeper reasons for grabbing the bottle in the first place. Understanding why, and coming to terms with that is important not just for quitting, but in staying away from it.

 

Hypnotherapy by a very experienced professional (important!) is a great way. I equate neuro-transmiter manipulation equivalent to hooking up jumpercables to your nipples every time you want to drink. BTW electro shock therapy has been re-entered into "western medicine" as a form of treatment. Please take caution in "modern medicine."

[Glider]

Does anyone have an opinion or personal experience with new medical treatments for alcoholism, i.e., the manipulation of neurotransmitters with medicines such as Campral or Gabatril?

The problem with addiction is that it's only partly a physiological issue. Arguably, the larger part is behavioural.

 

There are drug interventions for many addictions. These can do several things; they can create an adverse reaction to the addictive substance (e.g. emetic effects), prodicing an aversion to the behaviour. They can manipulate NT release, preventing the substance from having a rewarding effect, or they can act as a substitute (e.g. methodone or NRT), reducing the cravings without providing the 'rush'.

 

The problem is that on their own, they are not very effective. The behavioural drives still exist. Throwing drugs at an addiction will not generally cure the problem because the problem is largely behavioural, not chemical.

 

The way addictive substances work is to trigger the reward system in the brain (VTA, MFB and NA). This sytem evolved to reinforce behaviours that were adaptive and provided an advantage with respect to survival: searching for and finding food, feeding, sex, and so-on. Drugs of abuse activate the reward system and so very quickly an association is formed between the reward and the behaviours that resulted in it, and these behaviours become strongly reinforced.

 

Using NT manipulation to block the reward does not address the fact that the reinforced behavioural drives still exist. Over time such manipulation would result in extinction of the behaviours, but as has been said, such drug intervention is a bit like using a sledgehammer. If you block the reward centres for too long, you are begging for depression (anhedonism, where no behaviour is rewarding).

 

There is a lot of research to show that where drug intervention must be used, it is most effective when combined with behavioural therapy. Drug therapy can give the individual 'breathing space' (i.e. a respite from cravings) but they need to use that respite to address the behavioural component of addiction. Without the behavioural component being addressed, the individual remains dependent, although now on the drug that aleviates symptoms of withdrawal.

 

One of the most effective regimes of behaviour change is the transtheoretical model, otherwise known as the 'Stages of Change' model (Prochaska & DiClemente, 1992). This is widely (and successfully) used now by the NHS in treating people with addiction problems.

 

The short answer is that there is no 'magic pill' shortcut. Addiction comes about through chemical reinforcement of behaviour, and to be effective, any path to recovery has to address the behavioural component as well as the physiological.

[aj47]

Often recovering alcoholics choose to take Disulfiram as opposed to drugs that manipulate neurotransmitters.

 

As far as I know it inhibits an enzyme and allows a certain chemical to build up in your blood. The results is, on drinking you automatically experience nausea headaches and vomiting. Therefore you associate alcohol intake with the unpleasnt effects and it quickly loses its appeal.

[ecoli]

Often recovering alcoholics choose to take Disulfiram as opposed to drugs that manipulate neurotransmitters.

 

As far as I know it inhibits an enzyme and allows a certain chemical to build up in your blood. The results is' date=' on drinking you automatically experience nausea headaches and vomiting. Therefore you associate alcohol intake with the unpleasnt effects and it quickly loses its appeal.[/quote']

 

but, is that even effective if you know you're taking it?

 

and also, couldn't that intefere with other types of alcohols (cooking alcohol. vanilla extract) that one might consume in other places, but aren't necesarilly dangerous.

[aj47]

I think the doesage required to feel any ill effects are around 1 or 2 units of alcohol (depending on the person) so i wouldn't think small amounts would have any effect.

 

Interestingly, apparantly almost all asians inherit an inactive form of the enzyme that is inhibited by disulpharim, which is why there are so few alcoholics in countries such as China and India.

[theman]

i have read about at least one incident involving a drug treatment for alcoholism where it ended in a fatality. i see no reason to treat an addiction with a dangerous substance, except in only the most life threatening of addictions. but i'm not well informed on the topic and could be very wrong

[Helix]

This is more responding to the OP than what others have said. Like others have said, congratulations on overcoming your problem; it's very hard to break an addiction because it becomes ingrained in your brain. That's the big issue with trying to finesse the neurotransmitters; addiction worms its way into other parts of the brain. Biochemically, the problem is the "conflict" issue" Dopamine, the neurotransmitter involved with addiction, is involved in a few other neurologic pathways, like the Tuberoinfundibular pathway (controlling maturity and hormones) and the Nigrostriatal pathway (involved with motor functions). So, even if you were able to inhibit dopamine, a pretty formidable task, you would have the problem of severely hampering the other dopamine-focused pathways.

 

The other aspect is that when your brain believes something is "beneficial" to your health it will send impulses to the memory section of the brain telling it to remember the chain of events that leads to that action. In the motor control area, a similar message is sent that allows it to preform what is remembered. So, it will be very hard to get rid of this ingrained response. It's near impossible to get rid of it medically so you would have to physically over-ride it by repeatedly not taking the drug and telling your body "See? I'm not taking this drug and I'm still healthy. So stfu and get rid of that response."