Why haven't we solved the addiction crisis?

Blum, Kenneth; Bowirrat, Abdalla; Gomez, Luis Llanos; Downs, B. William; Bagchi, Debasis; Barh, Debmalya; Modestino, Edward J.; Baron, David; McLaughlin, Thomas J.; Thanos, Panayotis K.; Ceccanti, Mauro; Elman, Igor; Badgaiyan, Rajendra D.; Dennen, Catherine A.; Gupta, Ashim; Braverman, Eric R.; Gold, Mark S.

doi:10.1016/j.jns.2022.120404

Cited by 9 publications

(9 citation statements)

References 113 publications

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“…There are five “domains” in the RDoC, and each reflects a brain system in which functioning is impaired, to varying degrees, in various psychiatric conditions. In agreement with these concepts, it is our opinion that while the DSM features symptomology, it would be equally important to feature etiological roots as portrayed in the RDS model [ 71 , 72 , 73 ].…”

Section: Discussionmentioning

confidence: 64%

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Should Reward Deficiency Syndrome (RDS) Be Considered an Umbrella Disorder for Mental Illness and Associated Genetic and Epigenetic Induced Dysregulation of Brain Reward Circuitry?

Blum

Dennen

Elman

et al. 2022

JPM

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Reward Deficiency Syndrome (RDS) is defined as a breakdown of reward neurotransmission that results in a wide range of addictive, compulsive, and impulsive behaviors. RDS is caused by a combination of environmental (epigenetic) influences and DNA-based (genetic) neurotransmission deficits that interfere with the normal satisfaction of human physiological drives (i.e., food, water, and sex). An essential feature of RDS is the lack of integration between perception, cognition, and emotions that occurs because of (1) significant dopaminergic surges in motivation, reward, and learning centers causing neuroplasticity in the striato-thalamic-frontal cortical loop; (2) hypo-functionality of the excitatory glutamatergic afferents from the amygdala–hippocampus complex. A large volume of literature regarding the known neurogenetic and psychological underpinnings of RDS has revealed a significant risk of dopaminergic gene polymorphic allele overlap between cohorts of depression and subsets of schizophrenia. The suggestion is that instead of alcohol, opioids, gambling disorders, etc. being endophenotypes, the true phenotype is RDS. Additionally, reward deficiency can result from depleted or hereditary hypodopaminergia, which can manifest as a variety of personality traits and mental/medical disorders that have been linked to genetic studies with dopamine-depleting alleles. The carrying of known DNA antecedents, including epigenetic insults, results in a life-long vulnerability to RDS conditions and addictive behaviors. Epigenetic repair of hypodopaminergia, the causative basis of addictive behaviors, may involve precision DNA-guided therapy achieved by combining the Genetic Addiction Risk Severity (GARS) test with a researched neutraceutical having a number of variant names, including KB220Z. This nutraceutical formulation with pro-dopamine regulatory capabilities has been studied and published in peer-reviewed journals, mostly from our laboratory. Finally, it is our opinion that RDS should be given an ICD code and deserves to be included in the DSM-VI because while the DSM features symptomology, it is equally important to feature etiological roots as portrayed in the RDS model.

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Section: Discussionmentioning

confidence: 64%

“…In contrast, there is also evidence that epigenetic events can elicit adolescent hypodopaminergia. This complexity suggests that neuroscience cannot make a definitive claim that all adolescents carry a hyperdopaminergic trait [ 73 ].…”

Section: Discussionmentioning

confidence: 99%

Should Reward Deficiency Syndrome (RDS) Be Considered an Umbrella Disorder for Mental Illness and Associated Genetic and Epigenetic Induced Dysregulation of Brain Reward Circuitry?

Blum

Dennen

Elman

et al. 2022

JPM

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“…All these measures would be helpful to curb damage of the OUD at the population level, but still does not address the intrinsic limitations of existing treatments. Limited effectiveness of existing pharmacologic treatments and harm reduction approaches leaves a desire for more durable, novel treatment approaches especially as they relate to the required induction of "dopamine homeostasis" (57)(58)(59).…”

Section: Ways To Improve On Existing Treatment Approachesmentioning

confidence: 99%

Opioid use disorder: current trends and potential treatments

Lee,

Gold,

Blum

et al. 2024

Front. Public Health

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Opioid use disorder (OUD) is a major public health threat, contributing to morbidity and mortality from addiction, overdose, and related medical conditions. Despite our increasing knowledge about the pathophysiology and existing medical treatments of OUD, it has remained a relapsing and remitting disorder for decades, with rising deaths from overdoses, rather than declining. The COVID-19 pandemic has accelerated the increase in overall substance use and interrupted access to treatment. If increased naloxone access, more buprenorphine prescribers, greater access to treatment, enhanced reimbursement, less stigma and various harm reduction strategies were effective for OUD, overdose deaths would not be at an all-time high. Different prevention and treatment approaches are needed to reverse the concerning trend in OUD. This article will review the recent trends and limitations on existing medications for OUD and briefly review novel approaches to treatment that have the potential to be more durable and effective than existing medications. The focus will be on promising interventional treatments, psychedelics, neuroimmune, neutraceutical, and electromagnetic therapies. At different phases of investigation and FDA approval, these novel approaches have the potential to not just reduce overdoses and deaths, but attenuate OUD, as well as address existing comorbid disorders.

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“…adjudicated and the results will be published elsewhere. With this mind, we believe that futuristic out of the box thinking is tantamount to a better clinical outcome in the long-term as this alternative complementary medical approach be more universally accepted following additional studies [16,17] .…”

Section: Kenneth Blum Rajendra D Badgaiyan Et Almentioning

confidence: 99%