Friday File

Book and blog recommendations for the weekend.

Books

I just finished reading a splendid book, Barbara Oakley’s Evil Genes: Why Rome Fell, Hitler Rose, Enron Failed, and My Sister Stole My Mother’s Boyfriend. Oakley, a systems engineer at Oakland University in Michigan, has done a great service for interested non-scientists by picking apart the intricate genetics of psychopathy and antisocial behavior.

Primarily a history of borderline personality disorder and the “great men” who suffered from it, Oakley takes the “nature-nurture” debate to the next level, asserting that bad behavior is a genetic propensity triggered by environmental influences—precisely the argument I make about addiction in my book, The Chemical Carousel: What Science Tells Us About Beating Addiction.

Oakley deftly beats back the usual panoply of objections to genomic research—that it is a slippery slope leading to eugenics, or that it is an excuse for bad behavior. Even worse, for many people, Evil Genes suggests that individual ethics are largely biochemically determined. The “successfully sinister,” as she calls them, have a baffling ability to charm their way to the top, and the author suggests some evolutionary reasons why this might be so.

Overall, Oakley makes a strong, eye-opening case for the importance of modern neuroscience in the quest to understand human behavior. This book should come as a serious shock to a generation of lawyers, judges and forensic psychologists who have spent a lifetime adhering to the “blank slate” view of human nature, when the “bad seed” analogy appears to be closer to the truth.

Blogs

Check out Brain Blogger for a look at “Topics from Multidimensional BioPsychoSocial Perspectives,” as the site is subtitled. Recent posts include articles about antibiotic overuse, gender reassignment, autism, torture, proprioception, neural plasticity, and my own article on marijuana withdrawal, which has drawn a panoply of heated responses.

A fascinating site with a multidisciplinary perspective.

addiction drugs

Should I Tell My Boss?

Health help in the workplace.

It’s no secret: Times are tough. The situation at work is uncertain at best, downright Machiavellian at worst. According to a recent survey by the American Psychological Association (APA), the primary source of stress for 80 % of Americans is—you guessed it—money.

Health Matters at Work, a program developed by Community Health Charities, is offering a four-part video podcast series on addiction, depression, and stress in the workplace. The goal of the Health Matters at Work program is to enhance the ability of “employers, employees, and their loved ones to connect to credible information and resources to improve their health and their lives.”

The podcast series focuses on work-related resources available through Mental Health America, the Depression and Bipolar Support Alliance, and the National Council on Alcoholism and Drug Dependence.

“The message we hope people hear,” said Robert Lindsey of the National Council on Alcoholism and Drug Dependence, “is that together we offer a broad network of support to people in communities across America, and we are all here for people that need our help.”

David Shern of Mental Health America said: “Mental Health is fundamental to health in every way. Increased levels of stress, depression, and anxiety all raise the risk of cardiovascular disease.”

Community Health Charities of America, located in Arlington, Virginia, is a consortium dedicated to assisting “people affected by a disability or chronic disease by uniting caring donors in the workplace with health issues and causes important to them and their families.”

A list of the group’s member charities can be found here.

Corporate partners include AARP, McDonalds, Exxon, HP, Siemens, and USA Today.


addiction drugs

Obama Comes Clean

Signs nicotine control act, admits he still lights up.

The new anti-smoking legislation, the Family Smoking Prevention and Tobacco Control Act, prevents the advertising of tobacco to children and puts tobacco under the purview of the Food and Drug Administration for the first time.

In signing the bill, Obama was compelled by reporters to admit to his nicotine addiction during a press conference. "Look, I've said before that as a former smoker I constantly struggle with it. Have I fallen off the wagon sometimes? Yes," Obama said in an article about the news conference by Sheldon Alberts of Canwest News Service.

Typically, for a smoker who can’t quite quit, Obama defended himself by saying, "I don't do it in front of my kids. I don't do it in front of my family."

Obama was said to have convinced his wife to support his bid for the presidency by agreeing to give up cigarettes—a campaign pledge he has not been able to keep, by his own admission.

During the Tuesday press conference Obama compared his addiction to nicotine to an alcoholic's need for a drink. "I don't know what to tell you, other than the fact that, you know, like folks who go to (Alcoholics Anonymous) you know, once you've gone down this path, then, you know, it's something you continually struggle with, which is precisely why the legislation we signed was so important, because what we don't want is kids going down that path in the first place."

During the press conference, an exasperated Obama sought to turn the questions away from his own lingering addiction. "First of all, the new law that was put in place is not about me. It's about the next generation of kids coming up," he said. "So I think it's fair . . . to just say that you just think it's neat to ask me about my smoking, as opposed to it being relevant to my new law. But that's fine. I understand. It's an interesting human interest story."

Graphics Credit: obamasmoking.com

addiction drugs smoking nicotine

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

addiction drugs

Addiction Touches Almost Everyone

75% of Americans know someone who is addicted.

A new survey by Lake Research Partners, sponsored by George Soros’s Open Society Institute and presented at the June 16 Conference of Mayors meeting in Providence, R.I., reveals that three of every four people surveyed said that they personally knew someone who has been addicted to alcohol or drugs.

More ominously, half of Americans “say they could not afford treatment if they or a family member needed it. They are also concerned that people addicted to alcohol or drugs may not be able to get treatment because of cost or lack of insurance coverage – a concern likely heightened by the current economic recession.” Moreover, financial concerns about treatment are highest among Americans with incomes less than $50,000. 67% of that income group said they would not be able to afford addiction treatment.

Among the survey’s other findings:

--Three‐quarters (75%) of Americans are concerned that people who are addicted to alcohol or drugs may not be able to get treatment because they lack insurance coverage or cannot afford it. Concerns about the affordability of and access to addiction treatment emerge throughout the survey results. Four in ten (41%) are very concerned.

--Nearly three‐quarters (73%) support including alcohol and drug addiction treatment as part of national health care reform to make it more accessible and affordable. This support cuts across all demographic groups. Lake Research Partners notes that this figure is quite high, “given the current economic climate and public concerns about government spending." One‐quarter (26%) oppose increased funding.

--Two‐thirds of Americans (68%) also support increasing federal and state funding for alcohol and drug prevention, treatment, and recovery services.

--Finally, more than nine in ten (96%) support providing specialized prevention, treatment, and recovery support to veterans and military returning from active duty (78% strongly support this effort).

The poll was sponsored by Closing the Addiction Treatment Gap , a program of the Open Society Institute. This program seeks to raise awareness around alcohol and drug addiction and its effects on family and communities. The telephone survey was conducted May 29-June 1, 2009 among a nationally‐representative sample of N = 1,001 adults 18 and older. The margin of sampling error is + 3.1 percentage points.

Graphics Credit: http://naturalpatriot.org/category/education/

addiction drugs

Smoke Alarm

The Cannabis and Tobacco Education Initiative.

My British friend James Langton, author of No Need For Weed, who maintains the excellent web site Clearhead for people with marijuana abuse problems, has launched a new site called Smoke Alarm.

The new venture is a non-profit company dedicated to the proposition of “offering credible information to the estimated 3 million people who regularly smoke tobacco joints here in the UK. We do this by directly educating through schools and colleges as well as indirectly through tobacco cessation professionals, drug agencies, and youth services.”

James Langton is in a unique position to help smokers in Europe, where the preferred drug delivery method for nicotine and marijuana is a joint of marijuana and tobacco rolled together—a smoking method that has never really caught on in the U.S. This preference for combining the two smokes into a “tobacco joint” creates “a powerfully addictive carcinogenic cocktail,” Langton writes on the new site. “Cannabis and tobacco are intimately connected and although the science of nicotine addiction is well understood, much less is known about how to help cannabis smokers with the psychological and physiological aspects of their dependency, and how the two substances interrelate to compound the difficulties in quitting either or both, together or separately.”

Langton’s book, No Need For Weed: Understanding and Breaking Cannabis Dependency, published by Hindsight Press, chronicles the author’s 30 years of experience as an addicted marijuana smoker, and explores the thoughts and difficulties of others who have suffered various degrees of marijuana dependency (See my support site on Marijuana Withdrawal).

“Cannabis continues to be an extremely popular drug with young people in the United Kingdom, and the fact that 44% of fifteen and sixteen year olds admitted to using the drug at some point in their lives when questioned for the 2008 United Nations International Narcotics Control Board report should not come as a surprise,” Langton writes. “Many young cannabis smokers do not consider themselves to be nicotine addicted simply because they mix their cannabis with tobacco. However, it's when the supply of cannabis is curtailed or they make an attempt to quit the drug that the nicotine pull gains dominance. This dynamic can set up a life-time nicotine cannabis relationship that remains one of the hardest for adult drug users to break.”

addiction drugs smoking nicotine

Allergies and Addiction

Is there a connection?

Most medical scientists agree that the primary cause of allergies is the unregulated release of histamine from mast cells, mostly likely caused by genetic malfunctions in the immune system.

What connection could that mechanism have to addiction? For starters, real toxins like drugs, and mistaken toxins like dust and ragweed, are both dealt with by the immune system, which attempts to cleanse the system of the “poisons.”

On a more mundane level, Alcoholics Anonymous has from the beginning referred to alcoholism as an “allergy of the body and an obsession of the mind.” More and more frequently, references are made to “allergy-induced addictions,” which supposedly include cravings for high-carbohydrate foods, sodas, and sugar foods in general, in addition to alcohol.

Joan Mathews-Larson and Mark Mathews, in “The Role of Allergies in Addictions and Mental Illness,” from the 2009 Praeger International Collection on Addictions, concentrate on food allergies, and argue that abstaining alcoholics turn instinctively to “allergy-provoking foods” like grains, sugars, and yeast—not coincidentally the basic ingredients of alcoholic beverages. This same basic class of foods—wheat, milk, barley and corn (from which we derive corn syrup) are capable of forming peptides that can bind to endorphin receptors.

Combining these trigger foods with alcohol can be a bad idea, the authors claim. “The starting point of most diseases is in the gut. Allergy foods factor heavily in the etiology of diseases because they damage the GI tract, and impair digestion.... Furthermore, combining allergy foods with alcohol heaps more stress on the immune system by doing more damage to the gut.” Thus, allergic alcoholics risks compounding the digestive damage unless they work to clear their diet of allergens.

The authors further allege that “If the allergic addictive person is deprived of the offending allergen long enough, he or she will go into withdrawal,” concluding that addiction and allergies “are the same problem based on similar molecules, following the same etiology.” Needless to say, this is a controversial theory. As one commentator on a health site described it, “This is counter intuitive on so many levels.”

While the research is controversial, and represents an unusual view of the etiology of addiction, there are plenty of addicts and alcoholics who suffer from allergies, and the extent to which this represents a double whammy to the immune is a question that remains largely unanswered.

Photo Credit: Allergy Asthma Zone

addiction drugs