Miller David, Miller Merlene, Blum Kenneth, Badgaiyan Rajendra D, Febo Marcelo
Division of Addiction Training & Educational Services, Nupathways, Inc., Indianapolis, IN, USA.
Department of Psychiatry and McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, FL, USA; Division of Neuroscience- Based Therapy, Summit Estate Recovery Center, Los Gatos, CA, USA; Department of Psychiatry, University of Vermont, Burlington, VT, USA; Department of Neurological Research, Path Foundation NY, USA; Dominion Diagnostics, LLC, North Kingstown, RI, USA; Division of Nutrigenomics, La Vita RDSS, LLC., Salt Lake City, UT, USA; Igene LLC, Austin, TX, USA.
J Reward Defic Syndr. 2015 Oct 21;1(3):87-94. doi: 10.17756/jrds.2015-015.
There are approximately 14,500 clinics and programs in America that provide treatment for all types of addictive behaviors we call "Reward Deficiency Syndrome (RDS)". While most of these have good intentions to provide needed help to the victims of RDS, we propose herein that most of their efforts, especially during periods of aftercare, are not based on the existing scientific evidence. We use "aftercare" to refer to any form of program or therapy following primary treatment including 12-Step programs. Very few programs actually provide any evidenced-based treatment approaches during this most vulnerable period in recovery. In this trieste we are suggesting that a hypodopaminergic trait (genetic) and/or state (epigenetic) is critical in terms of continued motivation to use/abuse of alcohol or other drugs and can lead to relapse. While there is evidence for the approved FDA drugs to treat drug addiction (e.g. alcohol, opiates, nicotine) these drugs favor a short-term benefit by blocking dopamine. We argue instead for the utilization of long-term benefits that induce "dopamine homeostasis", or in simpler terms "normalcy". We suggest that this could be accomplished through a number of holistic modalities including, but not limited to, dopamine-boosting diets, hyper-oxygenation, heavy metal detoxification, exercise, meditation, yoga, and most importantly, brain neurotransmitter balancing with nutraceuticals such as KB220 variants. We embrace 12-step programs and fellowships but not as a stand-alone modality, especially during aftercare. We also provide some scientific basis for why resting state functional connectivity (rsfMRI) is so important and may be the cornerstone in terms of how to treat RDS. We postulate that since drugs, food, smoking, gambling, and even compulsive sexual behavior could reduce rsfMRI then modalities (following required research), that can restore this impaired cross talk between various brain regions (e.g. Nucleus accumbens, cingulate gyrus, hippocampus etc.) should be incorporated into the aftercare plan in all treatment programs in America. Anything less will ultimately lead to the so called "revolving door" for as many as 90% of treatment participants.
美国大约有14500家诊所和项目为我们称为“奖赏缺乏综合征（RDS）”的各类成瘾行为提供治疗。虽然其中大多数都旨在为RDS受害者提供所需帮助，但我们在此提出，它们的大多数努力，尤其是在康复后的护理阶段，并非基于现有的科学证据。我们所说的“康复后护理”是指初次治疗后的任何形式的项目或疗法，包括12步康复计划。在康复的这个最脆弱阶段，实际上很少有项目提供任何基于证据的治疗方法。在本文中我们认为，低多巴胺能特质（遗传）和/或状态（表观遗传）对于持续使用/滥用酒精或其他药物的动机至关重要，并可能导致复发。虽然有证据表明美国食品药品监督管理局（FDA）批准的药物可治疗药物成瘾（如酒精、阿片类药物、尼古丁），但这些药物通过阻断多巴胺来实现短期益处。相反，我们主张利用能诱导“多巴胺稳态”（或者更简单地说“正常状态”）的长期益处。我们认为这可以通过多种整体方式来实现，包括但不限于促进多巴胺分泌的饮食、高氧疗法、重金属排毒、运动、冥想、瑜伽，以及最重要的，使用诸如KB220变体等营养补充剂来平衡大脑神经递质。我们支持12步康复计划和互助团体，但不作为唯一的方式，尤其是在康复后护理阶段。我们还为静息态功能连接（rsfMRI）为何如此重要提供了一些科学依据，它可能是治疗RDS的基石。我们推测，由于药物、食物、吸烟、赌博，甚至强迫性行为都可能降低rsfMRI，那么（在进行所需研究之后）能够恢复大脑各区域（如伏隔核、扣带回、海马体等）之间受损的相互交流的方式，应该纳入美国所有治疗项目的康复后护理计划中。否则，最终将导致多达90%的治疗参与者陷入所谓的“旋转门”困境。
