Showing posts with label addiction definition. Show all posts
Showing posts with label addiction definition. Show all posts

Sunday, June 21, 2009

The Dapsone Analogy


Another way of looking at addiction.


Medical science tells us that there are diseases called “pharmacogenetic disorders.” A common one is known as glucose-6-phosphate dehydrogenase deficiency. This disorder is a human enzyme deficiency that reduces the ability of red blood cells to carry oxygen, resulting in severe anemia. Its origin is genetic, and it is found predominantly in Jews and African-Americans. People who have this disease don’t necessarily know it. They don’t get into trouble until they are exposed to a very particular kind of environmental insult: an oxidative agent. Like eating fava beans, for example. If a person suffering this disorder eats fava beans, as one addiction expert told me, sparing the technical details, “their red blood cells go to hell.”

Okay. But how can something be a disease if the people who supposedly have it are perfectly normal until they start messing with fava beans—or alcohol or heroin? To some people, that just does not sound like a disease. And there are, in addition, obvious environmental influences on the course of addiction. However, there are also strong environmental causes and impacts related to diabetes, hypertension, and a host of other common diseases.

As it happened, African Americans who served in Viet Nam who suffered from glucose-6-phosphate dehydrogenase deficiency found out about it fast, whenever they took an anti-malarial medication called Dapsone, a drug now used to treat certain skin diseases similar to leprosy.

Blacks with glucose-6-phosphate dehydrogenase deficiency would take Dapsone, which pulled the environmental trigger on their disease, and they would suffer acute hemolysis—the complete breakdown of their red blood cells. If they didn’t take Dapsone, or eat fava beans, they were fine—you couldn’t tell them from anyone else. (The same thing happened in Korea when service personnel suffering this deficiency encountered a different environmental trigger—the antimalarial drug primaquine.)

Now try this: What if eating fava beans for the very first time didn’t make certain people sick—it made them feel incredibly good; better than they had ever felt in their life? Better than they ever thought possible. What if that first experience felt like a life truly worth living; a surcease from years of sadness, a miracle drug, the healing hand of God? What if certain people, for reasons of abnormal biochemistry, had never experienced the typical feelings of happiness and contentment most people take for granted—until they ate fava beans. And then, for the first time in their lives, they felt better than okay.

If fava beans were a rewarding stimuli instead of aversive, the disease would still be a pharmacogenetic disorder, hidden from view in the absence of the environmental trigger. Once having tasted the bean, however, a stubborn minority of people would be drawn to eat it repeatedly. And the more they ate the beans, the more their bodies would become dependent upon the artificial reward the beans provided—until they reached a point where they simply could not function unless they had their beans.

Photo Credit: Astragen LLC

Friday, June 5, 2009

Addiction: Gwyneth Puts the Question


Is "chemical dependency" too narrow a concept?

Ordinarily, a post on this blog would not begin: "Addiction: What does Gwyneth have to say about it?"

But today, it does.

Addiction: What does Gwyneth have to say about it?

Well, I'll tell you. That came up recently on Ms. Paltrow's new health web site, Goop.com. Specifically, Paltrow set before a group of "sages" the following questions:

"Have you ever loved somebody who drinks until their usually charming personality is usurped by a monster? Or discovered that someone you adore is throwing up after every meal? Or wondered if you are stuck in a feedback loop of tension and unrest because you need the adrenaline of stress to function? How do we become enslaved by addiction? What is addiction?"

Here are some excerpts from the responses, which were many and varied, but overall quite fascinating:

Episcopal Priest Cynthia Bourgeault:

“As recent neuroscience has demonstrated, every habit lays down its own neural pathway i.e., it carves its own rut track in the brain--and the inertia around these pathways is considerable. The disruption of ANY happy pathway brings with it considerable discomfort and resistance. So you’re quite right in lumping together habits and addictions; the difference between them is more one of degree than of kind. One can be addicted to coffee, alcohol, porridge for breakfast, endorphins, heroin, meditation, exercise, sex or God! The difference is only that the classic ‘chemical dependency addictions’ add to our already full plate of cognitive and emotional distress and at the interruption of a habit, physiological distress as well.”

Deepak Chopra:

“Human beings become addicted because we are complex. Addictions are like a jigsaw puzzle where all the pieces are on the table but no one quite knows what the whole picture should be. Here are the main pieces:

1. The addictive substance or behavior
2. Brain chemistry
3. Social pressure for and against addiction
4. A vulnerable psyche
5. The X factor

Drugs change the brain by affecting receptors in your brain cells that exist for pleasure and the cessation of pain. If you take any substance long enough, the brain adapts by altering its receptors, and then the trouble begins. The burned-out addict is actually a burned-out brain.... Addicts can be brought to healing and self-knowledge. They can be weaned off substances and their brains (slowly) returned to a more balanced chemical state. Yet there remains the X factor. Call it a predisposition, karma, the unconscious or a perverse urge to self-destruction. For some addicts, the journey of addiction is existential."

Kabbalist Michael Berg:

"There is a saying, 'if today I have one then tomorrow I want two, and if today I have 100, then tomorrow I will want 200.' The addiction battles many of us fight are here to push us toward finding a deeper fulfillment, which comes from connecting to the real things in life: love, compassion, sharing and revealing our true essence.”

Psychologist Karen Binder-Brynes:

“I tend to gravitate toward a multi-leveled, biopsychosocial model as a theorem for explaining addiction. Although historically addictions were usually regarded in terms of psychoactive substances, such as drugs, that when ingested caused chemical alterations in the brain, the current thinking has broadened to include other compulsive behaviors such as pathological gambling, shopping, eating, etc....Why some people become more prone to addictions than others is a matter of great debate. The arguments range from a strict “disease” model suggesting a biochemistry of addiction, perhaps with genetic basis, to a “choice” model (Szasz, 1973) suggesting that the addict is a person who chooses a taboo substance or behavior to a low-risk lifestyle.... Denial and shame are often deterrents to seeking assistance. Never lose hope that you or a loved one can get help and beat an addiction. People can make miraculous recoveries from the powerful grip of addiction. I have seen it!”

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