Q for Neurologists, Psychologists etc: Beneficially dealing with Addiction?

Factual Questions
1

This thread reminded me of a question I’ve wanted to ask for some time from the experts in the field of neurology, medicine, psychology etc. about addiction.

Here’s what I understand:

There are genetic factors and enviromental factors in people developing addiction; that is, some people are disposed because of their biochemistry (L-Dopa inbalance, self-medication of alcohol and others for mental issues); some people are disposed because of their psychological structure, to become addicted.

The best illustration of this was the alcoholic children study: researchers looked at children from alcoholic parents (because of genetics/ biochemistry) who had grown up with their alcoholic parents and in foster families; and at children from non-alcoholic parents (the “normal” children) who had grown up in the same foster families (as siblings) and in the alcoholic families, and looked how many percents had become alcoholics themselves as adults.

The normal children in normal families had the lowest rate (still about 20% I think),
then the normal children in alcoholic families, and the alcoholic children in normal families had higher than that; and the highest was the alcoholic children in the alcoholic families.

We also know that the body produces endorphins all on its own; and through this high and other mechanisms, people can get addicted to non-addictive stuff like sugar, fat, (olives), and even to activities like running, gambling, WoW playing etc.

Based on this, would it be more beneficial to develop a completely harmless substitute that triggers the high in the body without any side issues on the physical side* - a synthehol? We already have methadon to replace Heroin, but I was thinking more generally.

Would it then be a good idea to identify all people with a high probability, either organically or psychologically (maybe a self-test or blood dip stick) of getting addicted to something in their life, and get them addicted to synthehol first? Would that make them safe from other addictions? Or would they add more addictions once the first barrier is broken?

I’m thinking here of the substitution effect that seems to happen often: people who quit smoking start drinking and vice vs., it seems to hard to stop all addictions in general, so even the advice is to concentrate on the most devastating issue first, and hope to treat the others later.

So any thoughts, studies, opinions on whether this would work, be a good idea or whether there is an even better solution being researched right now?

  • Obviously somebody so addicted to internet that they forget to eat and sleep will still ruin their body, but those are secondary effects. I mean the primary effects of chemicals onto the body.
2
  1. There is no universal reaction to ANY drug. For some people, penicillin is a lifesaver. For others it is deadly. etc
  2. A lot of the appeal of doing drugs, for some people, is that they are illicit. So, from a sociological perspective, not every addict would take to this solution.
3

The general answer to all “What if” questions that require a magical solution not found in reality is “it won’t work in our world.”

4

First, penicillin is a medical drug, not the recreational drugs I’m talking about.

Second, that a small percentage of population is allergic to penicillin doesn’t change that it’s the standard antibiotic* for most people.

So even if the new side-effect free drug wouldn’t work on 10% of the target group - would it still be a beneficial effect for the rest?

I mentioned methadon already; apparently it doesn’t help every addict. That’s why we have a clinically controlled center to give synthetic heroin** to that small group. (It’s given right there so people don’t sell it on the street; under strict conditions like the addict having a job and attempting to get his life in order etc.)

  • Leaving aside the problem of resistance by the bacteria, which is another separate issue.

** That means, it’s chemically identical to real heroin, but not grown in the fields, but produced in a university clinic lab.

Do you have a cite for this? Because at least in Germany (don’t know the numbers for the US), the numbers of both addicts and deaths for illegal drugs are about the factor hundred lower than the numbers for alcohol and cigarettes.

Partly that’s easy access: a teen who wants heroin or cocaine needs to know the right people or have the wrong friends; but a teen who wants beer/ hard liquor needs only to open his father’s liquor cabinet.

Partly it’s also social acceptance: shooting up in the park or in a train station toilet, and people will think you’re scum; drinking wine at a party or whisky in a bar means having fun and declining will get you labeled as mood killer.

5

Isn’t post nr. 3 a bit early for thread-shitting? :frowning:

First, I’m not talking about magical solutions. I used the fictional term of synthehol as allusion to Star Trek. We already do have Methadon as replacement for heroin addicts (together with therapy and other measures to get their life back) and it does have a moderate to good success.

We also keep researching and learning more about how the endorphin production and reception in the brain works, not only with mice and rats experiments, but also with things like MRI. So it’s not biologically impossible that in a few decades we know enough about brain chemistry to start manufacturing an artificial drug that triggers the high without side effects.

In fact, I’ve heard some experts describing the new synthetic drugs created in illegal labs in the late 80s and 90s as having a lot more high than the old-style cocaine or heroin, and worrying about how that would affect addicts.

So it’s not biologically impossible at all, it’s just not here yet.

Also, to compare depression. In the 70s and 80s - due to better understanding of brain chemistry from research! - new anti-depressant drugs came onto the market. Many therapists described them, thinking that patients would feel better. Instead, the suicide rate rose. Why? Because one symptom of depression is lethargy - the patients were suicidal before, but too lethargic to act on it. The meds removed the lethargy, but not the rest of the depression problem, so when the patients fell into the old pattern of suicidal thoughts, they actually went ahead and did it.

So the therapists changed strategy and use the meds only in careful combination with a therapy to change the underlying patterns.

So if we consider a psychologist or therapist today, dealing with a patient he recognizes as classical example of high risk for addiction. Obviously, a therapy could change the psychological structure that creates the risk - but it will take time. During that time, the therapist has to hope that the patient isn’t tempted into addiction by outside events.

Would the therapist be helped if he could recommend a pill to take three times a day that creates an artificial addiction to keep the patient from becoming a real alcoholic before the therapy is finished?
Or does the psychologist think that any triggering of the brain receptors is dangerous and the patient should try to avoid all temptations (difficult, since people can become addicted to everything).

Again, we already know that doctors who deal with alcoholics often recommend switching to a different addiction if the patient isn’t able to cope otherwise, and if the liver is about to fail, eating twinkies is less of a problem. They of course hope that eventually they can ease the patient away from the secondary addiction, too, and want the secondary addiction to be as safe as possible - but with some people, they have little hope due to certain biochemical or psychological structures.