Yes

by Darrin A Yarbrough

Created on: March 01, 2009

"Addiction is a primary, progressive, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and can sometimes be fatal. It is characterized by impaired control over use of the substance, preoccupation with the substance, use of the substance despite adverse consequences, and distortions in thinking." http://en.wikipedia.org/wiki/Addiction

Many factors contribute to addictive behavior. From a psychiatric standpoint, the belief is that addictive behavior stems from chemical imbalances in the brain that cause the addict to engage in "drug seeking" behavior attempting to self-medicate in order to restore balance within the brain. While there is no empirical evidence to support the chemical imbalance, there is an incomplete understanding as to why certain individuals will choose to engage in addictive behavior while others will not.

Studies have shown that mental afflictions such as bipolar disorder, ADHD, and ADD have a connection with "drug seeking" behavior. These psychological disorders tend to stem from deficiencies in the brains chemical nerve receptors. Drugs that inhibit the production of Serotonin, nor epinephrine, nor adrenaline, Dopamine, and GABA, tend to facilitate an improvement in the behavioral symptoms of the patient.

Recent studies have shown a clinical connection with afflictions such as ADD, ADHD, and Bipolar Disorder and the tendency for such patients to self-medicate in order to alleviate the symptoms of their condition. Alcoholism, nicotine, addiction to narcotics, cocaine, amphetamines, and related drugs tend to alleviate the symptoms these patients experience.

While there is no direct evidence showing chemical imbalances in the brain cause the symptoms related to these conditions, the disease model for treatment is proven effective for the rehabilitation of patients suffering from the disorders. Statistically, there are higher incidents of patients with these disorders given to engage in "drug seeking" behavior.

The fact that the substances chosen for abuse directly affect the chemical receptors in the brain in a manner similar to the way that SSRI's, and DRI's (selective serotonin reuptake inhibitors, and dopamine reuptake inhibitors) interact tends to support theories that there are deficiencies in these chemicals in the patient's brain.

The alternative that certain members of the populace are simply "fiends" who relentlessly seek to engage in "drug seeking" behavior is not only counterintuitive, but also downright ridiculous. Human beings simply do not choose to engage in fiendish acts of compulsive behavior by choice. Moreover, these patients may instinctively seek out plants, chemicals, and/or products that will restore the imbalance in their system.

While it does seem true that choosing to self medicate does exacerbate the conditions related to the imbalance, statistics tend to support the presence of an imbalance to begin with. This is why certain members in society will choose to take or leave a substance while others become hopelessly addicted. This obsessive, compulsive behavior does not always manifest in the use of drugs. Eating disorders, compulsive shoplifting, gambling, and many other afflictions all stem from similar deficiencies. The patient is merely subconsciously seeking relief from a feeling of unease stemming from, "something within not being right."

Drugs like nicotine, alcohol, narcotics, cocaine, amphetamines and others all tend to alleviate conditions affected by the chemical modification of Serotonin, Dopamine, nor epinephrine, and nor adrenaline in the patients brain. This is why it is critical that people suffering from addictive behavior should seek psychiatric assistance. Oftentimes, a correct diagnosis can generate access to pharmaceutical solutions to the problem far less life threatening than the choices self-medicating provide.

While it is certain alcohol will alleviate some of the symptoms associated with ADD, ADHD, and Bipolar Disorder, it is also certain this chemical will eventually kill the patient. Furthermore, the circumstances can deteriorate so significantly that self-medicating with the substance ceases to enable the patient to function.

One fascinating connection between extreme alcoholism and addiction to Opiates is the production of isoquinolines. In cases of extreme alcoholism, the patient ingests such large quantities of alcohol that the result is the production of isoquinolines synonymous with those present in drugs like morphine, codeine, heroin, and other Opiates.

Connections between Opiate addiction and alcoholism are well documented. Both drugs significantly affect the production of Dopamine in the brain affecting the reward response system. However, there are significant differences in the condition of the patient over time. While the consistent abuse of alcohol virtually guarantees deterioration of the patient's health and even possible death from withdrawal, no such documentation is evident for addiction to Opiates.

In addition, certain studies have shown the positive effects of certain opiates when used for therapy on patients suffering from psychological disorders. For example, Tramadol is used in Germany experimentally to treat depression. http://en.wikipedia.org/wiki/Tramadol

In the early 1950's morphine was one of the leading drugs to treat depression and anxiety falling out of favor due to its addictive properties. However, it is important to note that the leading reason for diagnosis of ADD, ADHD, and Bipolar Disorder in adulthood is typically depression stemming from an inability to navigate life-changing situations.

The patient unable to understand underlying reasons for difficulties, will typically become depressed seeking psychiatric assistance only to discover significant mental impairment such as ADD, ADHD, and Bipolar Disorder. It is important to understand these afflictions seldom bother the afflicted. It is everyone around them that has difficulty dealing with the patient's behavior.

Buprenorphine is another Opioid tested successfully at Harvard University for the treatment of depression in the 1990's. http://en.wikipedia.org/wiki/Buprenorphine
While evidence has shown these drugs are very effective for the treatment of certain mental conditions associated with certain mental afflictions. Certain legislative actions stemming from propaganda and political bias makes them unsuitable for the treatment of these diseases at this time. However, the point is that patients attempting to self-medicate the symptoms of ADD, ADHD, and Bipolar Disorder with narcotics are not too far from the target.

Unfortunately, cultural, political, and social prejudice, prevent any real progress in the use of these substances for treatment at this time. The point of illustrating the possible benefit of the narcotics listed above is not to endorse their use. Rather to illustrate the effectiveness of these drugs in certain clinical trials and how close a person self-medicating with these substances is to the actual pharmaceutical solution.

Currently, drugs used to alleviate conditions, as ADD and ADHD are amphetamines (unless the patient has a history of drug abuse), Atomoxetine, Buproprion, Clonidine, Protriptyline, and Methylphenidate. All of these medications will in fact alleviate the symptoms associated with the affliction to some degree. The significance of their effectiveness depends largely upon the chemistry of the individual. Moreover, this is not an exhaustive list of the potential medications, merely a cross section of a few.

Several addiction models exist in addition to the disease model however, the disease model seems to be the universally accepted model within the medical industry. Others are, the pleasure model, the genetic model, the experiential model, the opponent process model, the cultural model, the moral model, the habit or life-process model, and finally, the blended model. http://en.wikipedia.org/wiki/Addiction

While the actual mechanism for addiction is still a matter of debate. Progress in current times clearly shows the most successful model for rehabilitation and treatment of addiction is the disease model. Evidence from extensive research would tend to show that the most likely candidate for reasons stemming from obsessive, compulsive behavior tend to gravitate towards imbalances in the brains neurotransmitters.

Significant progress towards treatment and rehabilitation stem from an empathetic understanding of the patients condition. Political and cultural prejudice, have severely undermined progress in the area of drug addiction. It is important to realize that all legislation enacted in the United States to curb drug abuse and use stems from racial and cultural bias and not from use of the drugs themselves.

Laws enacted to restrict the use of morphine and heroin stem from the fear that Chinese immigrants would compromise the chastity of upper middle class white women (the major source of addicts at the time). Laws enacted to illegalize marijuana stem from a cultural dislike of Mexican Bracero's. Cocaine was outlawed due to a fear that black men crazed from the drug would rape and/or persecute white women as well.

Virtually every law enacted in the United States to control drug abuse stem from these social prejudices. None of them were enacted to curb and/or protect the public from the drug crazed dope fiend walking the streets. In fact, deprive any ordinary citizen of the correct dose of Dopamine in his or her brain and you will definitely witness some significant drug seeking behavior.

More important than the need to determine if alcohol and drug addiction is a disease or something else is training and educating our society on the real aspects of addiction and dependency behaviors. An important aspect of treatment for the afflictions above recognizes that both the drugs used to self-medicate, as well as the drugs used for treatment create dependencies.

This is because the human brain depends on these neurotransmitters to function. The difference between a dependency and an addiction is that a physical dependency will generate withdrawal symptoms without introducing drug seeking behavior and an addiction will generate withdrawals with the addition of drug seeking behavior.

Recognizing neither symptom is a problem so long as the patient is not deprived of the substance he or she needs identifies that necessity is a part of social interaction for the individual with the affliction. As stated previously, deprive any ordinary citizen of the correct dose of Dopamine in his or her brain and you will definitely witness some significant drug seeking behavior.

Learn more about this author, Darrin A Yarbrough.
Click here to send this author comments or questions.