Abstract
This study evaluated the effects of a putative activator of brain reward circuitry on outcomes in a 1 -y prospective comprehensive outpatient clinical program. As part of the Gene Narcotic Attenuation Program, Haveos (Synaptamine)™ was administered for the treatment of substance use disorder. Seventy-six patients (45 males and 31 females; mean age, 33 y [standard deviation, 7.0]) who had been given a diagnosis of serious substance use disorder were recruited. After exclusion of 15 patients who dropped out before the end of the study, self-reported craving decreased from program entrance to 12 wk (visual analog scale whereby 0 represents no craving and 5, the strongest craving) for 61 compliant patients (mean decrease, 2.85, 95% confidence interval [Cl], 2.65, 3.05); this improvement was significant (P < .001). Building up to relapse scores (each of 5 individual items and summary value) showed similar improvement after 1 y of treatment; the mean decrease in scores was significant for stress (t=3.3; P=.002), depression (t=4.0;P < .001), anger (t=4.4;P < .001), anxiety (t=4.5,P < .001), drug craving (t=5.4,P < .001), and summary building up to relapse (t=4.1;P < .001). Also, recovery score measures of energy level (t=8.4;P < .001) and ability to refrain from drug-seeking behavior (t=7.4;P < .001) showed significant mean increases from entry to 1 y. During the study, the alcoholic dropout rate was only 7% (4 of 57), which was significantly (Fisher’s exact test,P < .001) lower than the 73% (11 of 15) dropout rate reported for psychostimulant users. Although these results are significant, any interpretation must await the performance of rigorous double-blind studies.
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References
Office of National Drug Control Policy— 2004.The Economic Costs of Drug Abuse in the United States, 1992–2002. Washington, DC: Executive Office of the President (Publication No. 207303).
Grant BF, Stinson FS, Dawson DA, et al. Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: results from the national epidemiologic survey on alcohol and related conditions.Arch Gen Psychiatry. 2004; 61: 807–816.
Blum K, Cull JG, Braverman ER, Comings DE. Reward deficiency syndrome.Am Scientist. 1996; 84: 132–145.
Gardner EL. Brain reward mechanisms. In: Lowinson JH, Ruiz P, Millman RB, Langrod JG, eds.Substance Abuse: A Comprehensive Textbook. Hagerstown, Md: Lippincott Williams & Wilkins; 1997: 51–58.
Blum K, Sheridan PJ, Wood RC, Braverman ER, Chen TJ, Comings DE. The D2 dopamine receptor gene as a determinant of reward deficiency syndrome.J Royal Soc Med. 1996; 89: 396–400.
Comings DE, Blum K. Reward deficiency syndrome: genetic aspects of behavioral disorders.Prog Brain Res. 2000; 126: 325–341.
Volkow ND, Wang GJ, Begleiter H, et al. High levels of dopamine D2 receptors in unaffected members of alcoholic families: possible protective factors.Arch Gen Psychiatry. 2006; 63: 999–1000.
Blum K, Sheridan PJ, Wood RC, Braverman ER, Chen TJ, Comings DE. Dopamine D2 receptor gene variants: association and linkage studies in impulsive-addictive-compulsive behavior.Pharmacogenetics. 1995; 5: 121–141.
Di Chiara G, Impereto A. Drugs abused by humans preferentially increase synaptic dopamine concentrations in the mesolimbic systems of freely moving rats.Proc Nat Acad Sci USA. 1988; 84: 1413–1416.
Blum K, Noble EP, Sheridan PJ, et al. Allelic association of human dopamine D2 receptor gene in alcoholism.JAMA. 1990; 263: 2055–2060.
Blum K, Noble EP, Volkow ND, Url G, Comings DE. First conference on reward deficiency syndrome: genetic antecedents and clinical pathways.Mol Psychiatry. 2001; 6(suppl): S1.
Bowirrat A, Oscar-Berman M. Relationship between dopaminergic neurotransmission, alcoholism, and reward deficiency syndrome.Am J Med Genet B Neuropsychiatr Genet. 2005; 132: 29–37.
Cheng HY, Laviolette SR, van der Kooy D, Penninger JM. DREAM ablation selectively alters THC place aversion and analgesia but leaves intact the motivational and analgesic effects of morphine.Eur J Neurosci. 2004; 19: 3033–3041.
Blum K, Chen TJH, Meshkin B, et al. Manipulation of catechol-O-methyl transferase (COMT) activity to influence the attenuation of substance seeking behavior, a subtype of reward deficiency syndrome (RDS), dependent upon gene polymorphisms: a hypothesis.Med Hyp. In press.
Manzardo AM, Penick EC. A theoretical argument for inherited thiamine insensitivity as one possible biological cause of familial alcoholism.Alcohol Clin Exp Res. 2006; 30: 1545–1550.
Kim KS, Lee KW, Lee KW, et al. Adenylyl cyclase type 5 (AC5) is an essential mediator of morphine action.Proc Natl Acad Sci USA. 2006; 103: 3908–3913.
Brandacher G, Winkler C, Aigner F, et al. Bariatric surgery cannot prevent tryptophan depletion due to chronic immune activation in morbidly obese patients.Obes Surg. 2006; 16: 541–548.
Linazaroso G, van Blercom N, Lasa A. Hypothesis: Parkinson’s disease, reward deficiency syndrome and addictive effects of levodopa.Neurologia. 2004; 19: 117–127.
Salmon AM, Evrard A, Damaj I, Changeux JP. Reduction of withdrawal signs after chronic nicotine exposure of alpha-calcitonin gene-related peptide knock-out mice.Neurosci Lett. 2004; 360: 73–76.
Simonin F, Valverde O, Smadja C, et al. Disruption of the kappa-opioid receptor gene in mice enhances sensitivity to chemical visceral pain, impairs pharmacological actions of the selective kappa-agonist U-50, 488H and attenuates morphine withdrawal. EMBO J. 1998; 17: 886–897.
Ponce G, Jimenez-Arriero MA, Rubio G, et al. The A1 allele of the DRD2 gene (Taq1 A polymorphisms) is associated with antisocial personality in a sample of alcohol-dependent patients.Eur Psychiatry. 2003; 18: 356–360.
Werme M, Hermanson E, Carmine A, et al. Decreased ethanol preference and wheel running in Nurr1-deficient mice.Eur J Neurosci. 2003; 17: 2418–2424.
Goldman D, Urbanek M, Guenther D, Robin R, Long JC. Linkage and association of a functional DRD2 variant [Ser311Cys] and DRD2 markers to alcoholism, substance abuse and schizophrenia in Southwestern American Indians.Am J Med Genet. 1997; 74: 386–394.
Blum K, Chen TJ, Meshkin B, et al. Genotrim™, a DNA-customized nutrigenomic product, targets genetic factors of obesity: hypothesizing a dopamine-glucose correlation demonstrating reward deficiency syndrome (RDS).Med Hypotheses. 2007; 68: 844–852.
Goldman D, Urbanek M, Guenther D, Robin R, Long JC. A functionally deficient DRD2 variant [Ser311Cys] is not linked to alcoholism and substance abuse.Alcohol. 1998; 16: 47–52.
Green AI, Zimmet SV, Strous RD, Schildkraut JJ. Clozapine for comorbid substance use disorder and schizophrenia: do patients with schizophrenia have a reward-deficiency syndrome that can be ameliorated by clozapine?Harv Rev Psychiatry. 1999; 6: 287–296.
Blum K, Briggs AH, Trachtenberg MC, Delallo L, Wallace JE. Enkephalinase inhibition: regulation of ethanol intake in genetically predisposed mice.Alcohol. 1987; 4: 449–456.
Defrance JJ, Hymel C, Trachtenberg MC, et al. Enhancement of attention processing by Kantrol in healthy humans: a pilot study.Clin Electroencephalogr. 1997; 28: 68–75.
Blum K, Trachtenberg MC, Ramsay JC. Improvement of inpatient treatment of the alcoholic as a function of neurotransmitter restoration: a pilot study.Int J Addict. 1988; 23: 991–998.
Blum K, Trachtenberg MC, Elliott CE, et al. Enkephalinase inhibition and precursor amino acid loading improve inpatient treatment of alcohol and polydrug abusers: double-blind placebocontrolled study of the nutritional adjunct SAAVE.Alcohol. 1988; 5: 481–493.
Blum K, Allison D, Trachtenberg MC, et al. Reduction of both drug hunger and withdrawal against advice rate of cocaine abusers in a 30-day inpatient treatment program by the neuronutrient Tropamine.Curr Ther Res. 1988; 43: 1204–1214.
Brown RJ, Blum K, Trachtenberg MC. Neurodynamics of relapse prevention: a neuronutrient approach to outpatient DUI offenders.J Psychoactive Drugs. 1990; 22: 173–187.
Cold JA. NeuRecover-SA in the treatment of cocaine withdrawal and craving: a pilot study.Clin Drug Invest. 1996; 12: 1–7.
Blum K, Briggs AH, Elston SF, DeLallo L, Sheridan PJ, Sar M. Reduced leucine-enkephalin-like immunoreactive substance in hamster basal ganglia after long-term ethanol exposure.Science. 1982; 216: 1425–1427.
Spanagel R, Herz A, Bals-Kubik R, Shippenberg TS. Beta-endorphin-induced locomotor stimulation and reinforcement are associated with an increase in dopamine release in the nucleus accumbens.Psychopharmacology (Berl). 1991; 104: 51–56.
Seizinger BR, Hollt V, Herz A. Effects of chronic ethanol treatment on the in vitro biosynthesis of pro-opiomelanocortin and its posttranslational processing to beta-endorphin in the intermediate lobe of the rat pituitary.J Neurochem. 1984; 43: 607–613.
Hollt V, Haarmann I, Herz A. Long-term treatment of rats with morphine reduces the activity of messenger ribonucleic acid coding for the beta-endorphin/ACTH precursor in the intermediate pituitary.J Neurochem. 1981; 37: 619–626.
Schulz R, Wuster M, Duka T, Herz A. Acute and chronic ethanol treatment changes endorphin levels in brain and pituitary.Psychopharmacology (Berl). 1980; 68: 221–227.
Harrison PA, Hoffman NG.Cator Report: Adult Outpatient Treatment Perspective on Admission and Outcome. St. Paul: St. Paul Ramsey Clinic; 1988.
Simpson DD, Joe GW, Fletcher B, et al. A national evaluation of treatment outcomes for cocaine dependence.Arch Gen Psychiatry. 1999; 56: 507–514.
Blum K, Chen TJH, Downs BW, et al. Synaptamine™ (SG8839): an amino-acid enkephalinase inhibition nutraceutical, improves recovery of alcoholics, a subtype of reward deficiency syndrome (RDS).Trends in Applied Sciences Research. In press.
Blum K, Meshkin B, Downs BW. DNA based customized “gene therapy” utilizing a genoscore: a hypothesized paradigm shift of a novel approach to the diagnosis, stratification, prognosis and treatment of inflammatory processes in the human.Med Hypotheses. 2006; 66: 1008–1018.
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Chen, T.J.H., Blum, K., Waite, R.L. et al. Gene Narcotic Attenuation Program attenuates substance use disorder, a clinical subtype of reward deficiency syndrome. Adv Therapy 24, 402–414 (2007). https://doi.org/10.1007/BF02849910
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DOI: https://doi.org/10.1007/BF02849910