Path Foundation New York to honor MBRC's Dr. Kenneth Blum

Dr. Kenneth Blum.jpgOn March 21, 2014 the Path Foundation of New York will host a one day conference entitled “Finding Adequate Reward:  Dopamine and Brain Health.”  Sponsors are the University of Florida College of Medicine and Weill Cornell Medical College.

After opening remarks by former New York Governor David Paterson, five presentations will be made by some very heavy hitters:

Dr. Nora Volkow, MD, Director National Institute of Drug Abuse

Dr. Paul Greengard, PhD Nobel Laureate, Vincent Astor Professor, Laboratory of Molecular and Cellular Neuroscience, The Rockefeller University

Dr. Mark Gold, MD, Chairman of the Psychiatric Department of the University of Florida Medical School

Dr. Kenneth Blum, Phd Adjunct Professor, University of Florida College of Medicine and McKnight Brain Institute

Dr. Eric R. Braverman, MD Assistant Professor of Integrative Medicine, Weill Cornell Medical College Assistant Professor, UF College of Medicine & McKnight Brain Institute

At the dinner, after a special presentation by Grammy-winner violinist Miri Ben-Ari, Dr. Blum will be presented with a Scientific Lifetime Achievement.  Dr. Blum is Malibu Beach Recovery Center’s advisor on neuroscience.  We will be showing up to salute him.

PATH is a non-profit foundation devoted to establishing how the brain functions and developingpath foundation image of head.png practical diagnostic and treatment methods that improve well-being and increase longevity.  According to the Mission Statement, the PATH Foundation NY believes a multimodal approach to health ensures effective long-term outcomes. The integration of a variety of therapies including nutrients, natural hormones, lifestyle changes, diet, and pharmaceuticals, when appropriate, guarantees a comprehensive method for individuals to participate in their own healing process.

"We are providing the tools for physicians, scientists, and the public to take charge of their health," states the PATH brochure for this conference.

 

Genetic Test Predicts Counselor Liz Winchell's Past

IMG_0376.JPGLast April Pat reported that Malibu Beach Recovery Center was chosen as one of ten treatment centers in the US chosen to participate in a clinical study to determine the effectiveness of a new test called GARS or the GENETIC ADDICTION RISK SCORE. Volunteers spit into test tubes which were then fedexed to Dominion Diagnostics in Rhode Island. Dominion used the saliva to evaluate 9 genes, and 17 (male) and 18 (Female) gene variants which it is  believed can predict an individual's predisposition to addiction.

Staffer Liz Winchell, now 17 years sober, was one of those who volunteered to be part of the study.  When Malibu Recovery Center Neuroscience Adviser Dr. Kenneth Blum sent Liz her results she was flabbergasted.

"The test revealed that I have a genetic sensitivity (what AA would call, "an allergy") to heroin and alcohol," she told me in an interview published in this blog last November.  "It also showed a marker for hyperactivity, with the possibility of ADHD, and impulsivity."

When I asked what made her volunteer to take the GARS test, she responded, "I know that science will one day confirm the hypotheses of 12 Step recovery:  That there are biological differences in people who become addicts. I was very excited to participate in this study."

I wondered if she believed before taking the test that results would show she were genetically predisposed to addiction.  

"Absolutely, the correlations with the specific drugs themselves are unmistakeable.  But even more interesting is the identification of the hyperactivity that explains my preference for, and paradoxical reaction to, stimulant drugs. It also explains my pattern of relapse, which was predominately without plan or conscious intention. More than anything, I think this piece of information will help others to build a recovery plan contingent upon impulse control."

For Dr. Blum, Liz's acknowledgement of the correlation between the test results and her own life and that of her famous father and grandfather, demonstrates the potential of the GARS model.  Without ever meeting or speaking to her, the scientific team had been able to blindly describe the Reward Deficiency Syndrome behaviors which shaped her life.   They are now calling for further study in what they believe to be "an important emerging field."

Liz's story was published today in the IIOAB Journal, 2013; Vol.4 (1):4-9.

12/12/2012 to 12/14/2012
12/15/2012 to 12/17/2012
12/18/2012 to 12/20/2012
12/21/2012 to 12/24/2012
12/25/2012 to 12/27/2012
12/28/2012 to 12/31/2012
1/1/2013

The title of the study is "Neurogentic Impairments of Brain Reward Circuitry Links to Eurogetic Impairments of Reward Deficiency Syndrme (RDS) as evidence by Genetic Addiction Risk Score (GARS).

 

Way to go, Liz!

 

Predisposition to Addiction: MBRC Staffer Liz Winchell Shares Results of Genetic Testing

IMG_0376.JPGOn April 5. 2012 my colleague Pat Olsen revealed in this blog that Dr. Kenneth Blum, PhD had chosen Malibu Beach Recovery Center as one of 10 U.S. treatment centers to participate in the first clinical study of a Genetic Addiction Risk Score (GARS) he has developed.  Funded by Dominion Diagnostics, GARS was patented in 2005 (Blum patented an earlier version in the 1990s).  GARS is designed to test 9 genes and 17 alleles (genetic variants) in men, 18 in women.  Using a simple saliva test, GARS can show predisposition to all reward deficiency syndromes from alcohol and drugs to smoking, sugar craving, high-risk sex, gambling, and ADHD.  It was Dr. Blum who in 1990, with Dr. Ernest Noble, first discovered the link between genetics and addiction.  

One of the first at MBRC to volunteer to take the GARS test was Counselor Elisabeth (“Liz”) Winchell.  The results of the tests are confidential, but as soon as they became available Liz asked Dr. Blum for hers.  She found the results so interesting that she allowed Dr. Blum to publish them.  The paper about Liz and her genetic predisposition to addiction will appear in an upcoming special Issue of the OMICS-Addiction Research & Therapy Journal.  The article is entitled: “Neurogenetic Impairments of Brain Reward Circuitry Links to Reward Deficiency Syndrome (RDS) as evidenced by Genetic Addiction Risk Score (GARS): A Case Study.” 

Joan:  Liz, how long have you been sober?

Liz:   I celebrated 17 years of consecutive sobriety last May 5th.

Joan:   Briefly describe your history with drugs and alcohol

Liz:  My first use was at age 13; I drank a wine punch and became violently ill. I did not drink again for several years. But I was diagnosed that year with bleeding ulcers and prescribed a barbiturate medication called Donnatal. Over the next 18 months five members of my immediate family (everyone except my mother, who completely lost her mind) died and I quickly found that taking handfuls of Donnatal helped me to forget.

From age 14-15 I used LSD and began stealing Tuinal and Seconal from my mother. I also tried Cocaine intranasally. From 16 -18 I used Quaaludes and other sedatives and was hospitalized multiple times from overdoses. I also began using prescription stimulants intravenously and had multiple police encounters. My mother sent me to treatment at Saint John's Hospital in Santa Monica but I ran away. (I was a chronic runaway)

At 18 I moved back to NYC and began shooting heroin and cocaine. Heroin made me violently ill, but it made me emotionally invulnerable like no other drug I had tried. Vomiting for hours when on it, and for days when I did not have it was a small price to pay for being able to 'function' without feeling a thing. (I was a singer in punk rock bands and working in music clubs, so this lifestyle was the norm in the late 70s and early 80s) I would drink alcohol every so often, but there was no question that I was literally allergic to it, even on small amounts I would experience alcohol poisoning type symptoms. 

In my 20s I began trying to stop using on my own. I did many methadone detoxes and fell into a pattern of being able to stop all drugs (except alcohol) for several months at a time. Invariably, I would go back to using. I began seeing Dr. Harvey Karkus, a celebrity psychiatrist in New York who ran a methadone clinic (my fellow patients were the guys from Aerosmith, among other big bands at the time).  Dr. Karkus saved my life. He took me under his wing.  Doing therapy with him, as well as having a professional 'friendship' with he and his wife made a huge difference in my ability to imagine a life without alcohol and drugs. I was kept on a low dose (35 milligrams) of methadone, and although I periodically 'slipped' by using pills and cocaine I started going to AA meetings. 

Although I did not stay sober until my 30s (with several AMAs from treatment at Hazelden, Cedar Sinai, etc) I did modify my using pattern. I relapsed 3 times at 3 years sober (each relapse lasting only a few days), but was finally able to maintain abstinence.

Joan: Briefly describe what the GARS test revealed.

Liz:  The test revealed that I have a genetic sensitivity (what AA would call, "an allergy") to heroin and alcohol. It also showed a marker for hyperactivity, with the possibility of ADHD, and impulsivity.

Joan:  What made you volunteer to take the GARS test?

Liz:  I know that science will one day confirm the hypotheses of 12 Step recovery:  That there are biological differences in people who become addicts. I was very excited to participate in this study.

Joan:  Did you think the results would show you were genetically predisposed to addiction?

Liz:  Absolutely. The correlations with the specific drugs themselves are unmistakable. But, even more interesting is the identification of the hyperactivity that explains my preference for, and paradoxical reaction to, stimulant drugs. It also explains my pattern of relapse, which was predominately without plan or conscious intention. More than anything, I think this piece of information will help others to build a recovery plan contingent upon impulse control.

Joan:  If you had received this information before you starting drinking and using drugs, would it have prevented you from becoming an addict?

Liz:  I know that telling my daughter repeatedly as she was growing up that she has a strong family history of addiction on both sides had an impact on her desire to try drugs. She has not used anything except marijuana (in college) and is a social drinker. However, she manifested the addiction with overeating. Her eating disorder almost killed her, and she now works a strong 12 Step program. 

So, yes, in general, having this information could impact the conscious decision to use drugs. However, if further research is done on cultures who do not have exposure to drugs and alcohol (Mormons, for example), it may be that the genetic compulsion might manifest in other obsessive behaviors.

Joan:  At what stage of recovery do you see this information being useful.

Liz:  I believe that knowing these things in early recovery, or even in treatment, could be useful. It could engage the addict and give him a scientific imperative of why he cannot continue to drink and use. It is helpful at any stage of recovery to explain, in hindsight, what history already shows. But it is somewhat anti-climatic. If I had known this in my very early recovery I am sure it would have made a difference. (as long as it was paired with therapy to address the deep-seated reasons I was using).

Joan:  Would you want your daughter to be tested?

Liz:  Absolutely. I would also like another assessment technique added that screened for other behaviors, like disordered eating, gambling, or sex addiction.

Joan:  When you look back at your parents and grandparents, from whom you inherited these genes, what do you see? 

Liz:  I am positive that the results of my genetic testing indicate a pattern in my family going back several generations.

I have done several genograms to map my family patterns, and Dr. Blum's research just confirms what drug and alcohol treatment professionals have always suspected:  I have inherited a genetic predisposition to compulsive behaviors.

Although I did not know my father Hyatt von Dehn well, he did tell me that he was an alcoholic in recovery. His driven personality was evident in his career as a hotelier (he founded the Hyatt Hotel chain). Hyatt had two sons from a different marriage, and the strain of addiction affected both as well as their families for several generations.  One of my half brothers did not drink to excess or use drugs, but he died from complications related to overeating. It may be interesting to note that my father was married seven times, which suggests compulsivity in itself.

My mother Eileen Jean "Walda" Winchell did not drink to excess or take narcotics, but she was chronically ill.  She was overprescribed opioid pain medications and become dependent on them. 

My maternal grandfather was columnist and media personality Walter Winchell.  He did not abuse alcohol at all, nor did he touch drugs of any kind. He was a workaholic though. I am sure that I inherited my intense energy from him. My grandfather was full of energy. This was manifested in a brilliant mind, pressured speech (which became his trademark), and a great passion for the injustices in the world, as well as those he perceived were done to him. Walter's father was an alcoholic and womanizer who brought shame to the family. The Winchell family came from a long line of Rabbis and published poets and scholars in the Ukraine. Although there is no addiction noted in that lineage, there were definitely problems with melancholia.

My maternal grandmother was the daughter of an alcoholic, although she did not grow up with her father. She rarely drank, but like my mother had many serious health problems and used prescription pain killers and sedatives to excess. Both my mother and her mother also were invested in staying very slim, and in my mother's case this bordered on disordered eating.

Finding out the results of my genetic testing has given me peace of mind, and helped me to begin a deeper acceptance of my own drug use. As a recovering addict/alcoholic I consider myself completely responsible for my choice to drink and use, but I now know absolutely that I must never drink and use again because of my genetic makeup.  The genetic test results provided me the information about my impulsivity that I can now utilize to continue to build a strong foundation for long-term relapse prevention. 

 

Photo:  Elisabeth ("Liz") Winchell

 

Dr. Kenneth Blum Joins Malibu Beach Recovery Center Team As Neuroscience Advisor

Dr. Kenneth Blum has joined Malibu Beach Recovery Center as its Neuroscience Advisor.  Dr. Blum has spent more than 20-years researching the link between genetics and addiction and, with co-author Dr. Ernest Noble, published a seminal study in the Journal of American Medical Association which established a correlation between the brain’s dopamine D2 Receptor Taq 1allele and addiction.  At Malibu Beach Recovery Center, Dr. Blum will keep staff apprised of ongoing research and findings relative to substance abuse and its impact on the brain’s all-important mood regulatory system, and how that knowledge can then be used for each patient’s benefit.     IMG_0019.jpg

Dr. Blum, age 72, became familiar with the Malibu Beach Recovery Center in 2009 and discovered that it is one of the few treatment programs in the United States based on neuroscience.  That same year, Dr. Blum endorsed Malibu Beach Recovery Center’s program.  In 2011 the Center’s treatment modalities were recognized as cutting edge after the American Society of Addiction Medicine formally redefined addiction as a chronic brain disease which impacts the brain’s reward circuitry.   

“The brain is the new frontier,” stated Dr. Kenneth Blum, “and through neuroscience we now have better ways and means of understanding and treating addiction.  As Malibu Beach Recovery Center’s Neuroscience Advisor, I have the unique opportunity to play a role in helping patients overcome addiction and achieve long term sobriety through a meld of neuroscience, healthy lifestyle choices, dietary changes, counseling and the teachings manifest in the 12-Step Program.”   

“We welcome Dr. Blum as a member of our team, “said Joan Borsten, CEO and co-founder with her husband, Oleg Vidov, of the Malibu Beach Recovery Center,” and are confident that his forward-thinking will benefit the individuals we treat.  His presence has already made a difference as we’ve incorporated neutraceuticals developed and patented by Dr. Blum’s research team to help raise the chronically low dopamine levels of our clients.” 

Currently, Dr. Blum is a Full Professor at the University of Florida’s  McKnight Brain Institute and an Adjunct Professor in its College of Medicine, Department of Psychiatry.  He coined the phrase “reward deficiency syndrome,” and has written 12 books and published more than 500 articles in peer review journals.  Often called "The Father of Psychiatric Genetics," Dr. Blum serves on 13 editorial review boards, is Editor-in-Chief of the Journal of Genetic Syndromes & Gene Therapy and Co-Editor-in-Chief of the new BMC Journal “Integrative Omics and Molecular Biology.”   He is also an honorary professor in the Department of Psychiatry, University of Vermont. 

 

Photo (left to right):  Oleg Vidov, Joan Borsten, Dr. Kenneth Blum, Margaret Madigan (Lifegen Department of Nutrigenomics) at the entrance to the Malibu Beach Recovery Center.

A Clinical Trial for Predisposition to Addiction

Joan has written about Dr. Kenneth Blum’s work in the addiction field previously on the Malibu Beach Recovery Center  blog.  She said that in 1990, he and a colleague found the first official link between genetics and addiction. Now the researcher has developed an assessment tool for determining a person’s predisposition to addiction called GARS, which is short for Genetic Addiction Risk Score.DNA scientist.jpg  

Malibu Beach Recovery Center has been chosen as one of 10 treatment centers to participate in a GARS study, funded by Dominion Diagnostics.  The study has two components.  Researchers at the University of Colorado (Boulder)  Institute of Behavioral Genetics will be evaluating the efficacy of  the GARS  test.  Inflexxion, a Massachusetts-based leader in creating scientifically validated soluti ons for critical areas of health care, will correlates test results with the Addiction Severeity Index.

GARS, patented in 2005, is designed to test 9 genes and 10 alleles (genetic variants).  It can show predisposition to all reward deficiency syndromes from alcohol and drugs to smoking, sugar craving, high risk sex, gambling, and ADHD.  A simple saliva sample is all that is required. 

“People that tend to have a high risk for drug or alcohol abuse or other addictive behaviors have a hypodopaminergic state or trait,” Dr. Blum said. "For instance, if they were born with a certain gene, the dopamine D2 receptor gene, and if they carry the A1 variant, they have 30 to 40% fewer D2 receptors than other people. Even if the dopamine is released normally, it doesn’t find receptors."

In other words, they are born with low dopamine function/s, and one of the ways the brain tries to boost the reward sensation is by self medicating  (abusing one or more of the substances or behaviors available to them). In turn, that gives them a pseudo-feeling of well-being and they become addicted. Thumbnail image for genetic testing.jpg

The test is significant for several reasons. Besides identifying people at high risk for addiction, as Dr. Blum says, it could alert addiction professionals that people with one or more of the reward deficiency genes should be watched more closely for relapse. Pain management and other doctors could give a GARS test before deciding whether or not to prescribe narcotics, benzodiazapines and barbituates.   

Joan has pointed out other benefits. If you know that you, and thus your children carry the gene, you could start educating them earlier about the dangers. 

On the other hand, if you want a job as a UPS driver, they might not hire you if they know you’re predisposed to addiction.  So far the Genetic Information Nondiscrimination Act of 2008, known as GINA, safeguards an individual’s genetic information.  Just recently an MBRC client who works for Fedex was notified to provide Fedex with all of her treatment records -- except the results of any genetic testing because it is prohibited by GINA.

 

Joan Borsten contributed to this story

Swedish Study: Alcoholics Predisposed to Addiction Relapse More Frequently

Here is a new addition to my “Dopamine for Dummies” series.  Bear with me.  I have tried to make this important information easily accessible to laymen like myself.

You will remember that in 1990, when Dr. Kenneth Blum, PhD and Dr. Ernest Noble, PhD found the first official link between genetics and addiction, they were focused on the DRD2 gene, originally called the “alcoholic gene” by the media but correctly called the “reward gene” in their "Journal of American Medical Association" article. Many years of additional research have stemmed from that seminal study, confirming the original findings.Thumbnail image for Thumbnail image for University of Gothenburg.jpg

The results of a pilot study were published in the current edition of "Alcohol and Alcoholism".  Research scientists from the Department of Psychology at Sweden’s University of Gothenburg, studied the relapse rate of adults diagnosed as “alcohol dependent.”  The number of people studied was small -- 10 women and 40 men recruited from two Swedish 12 Step programs.  All 50 participants were required to provide blood for genotyping, and to be without severe on-going physical and psychiatric disorders other than alcohol and nicotine dependence.

Variations of a gene are called polymorphisms.  In this study only the Taq1A polymorphism of DRD2 “alcoholic” gene was studied. 

18 of the 50 alcoholics were found to carry the Taq1 1A polymorphism.  The other 32 alcoholics were not carriers.

The study found that after one and a half years, 33 of those who participated in the study had relapsed.  16 of the relapsers carried the Taq 1 1A polymorphism -- meaning that only 2 of the 18 genetically pre-disposed to addiction did not relapse. In other words  89% of the subjects that carried the DRD2 A1 allele relapsed. That is a very big and sad number.

By comparison only 53% of those who do not carry the gene (17 of the 32) relapsed.

None of those who relapsed were found to have been triggered by the influence of psychological or socio-demographics.  Additionally the study revealed no differences between those who relapsed and those who did not in terms of self-efficacy, mental health, stress, personality, and cravings.

The University of Gothesburg authors concluded that their study suggests an association between the DRD2 gene and relapse.  They suggest that other polymorphisms of the DRD2 gene now be studied.Thumbnail image for Thumbnail image for dopamine receptor gene.jpg

The authors of the study wrote:  “The reason for the increased relapse rate in the carriers of the [“alcoholic gene”] remains to be elucidated.” 

Additionally – and this is important -- they cite two recent studies.  One demonstrated that carriers of  the same gene variant have a “diminished drinking refusal self-efficacy" (translation:  a diminished capacity to stop drinking). The other demonstated that healthy individuals who are carriers of the gene show “impairment in reversal learning situations. “

The authors concluded:  “The two studies suggest that alcohol-dependent individuals who carry the ”alcoholic gene” can benefit from more intensive psychological treatment aimed to improve drinking refusal self-efficacy and learning to focus on maintenance of abstinence.    The importance of improving treatment of the alcohol-dependent subjects who are carriers of the gene is seriously underscored by the findings of the highly increased mortality rate of those subjects.”

We agree.  To achieve long term sobriety, alcoholics predisposed to addiction need to not only become part of the fellowship of Alcoholics Anonymous, but to seek treatment of their dopaminergic dysfunction.

 

NOTE:  After I posted this blog Dr. Blum told me that the DRD2 gene has 7 polymorphisms, 4 of which occur frequently enough to be the subject of ongoing clinical testing about the relationship between the gene and relapse.  He said he has identified more than 30 additional genes which show predisposition to addiction, some or all of which would also be important candidates for the studies on the likelihood of relapse.

 

 

Malibu Beach Recovery Dietâ„¢: A Delicious Way to Help Sustain Long Term Sobriety

While teaching the cooking class last Sunday at the Center, I looked at our clients, all busy chopping and dicing, and as usual marveled at how quickly they start looking and feeling healthy.   I’m talking shiny eyes, glossy hair, and glowing skin within 7-8 days of arriving at an alcohol and drug treatment center.  fresh vegetables.jpg

The Malibu Beach Recovery Diet is one of three spokes in the holistic wheel which makes our treatment program unique.  The other two spokes are the yoga breath work and food supplements (we currently have most clients taking synaptose, a very effective food supplement developed by Dr. Kenneth Blum. PhD  to correct imbalances in the brain’s reward system by reducing cravings and creating an overall feeling of well-being).

This holistic overlay, developed in Europe, expedites brain repair and allows clients to quickly achieve enough clarity to get maximum advantage from the program of individual therapy, family therapy, process groups, and the 12 step work which are also integral parts of treatment. 

Just as when you have hypertension, high cholesterol or diabetes, changing your diet and getting more exercise of the right kind can influence the numbers, we have found that our alumni stay sober if they continue to follow the principles of the Malibu Beach Recovery Diet, do some kind of yoga each week, take recommended food supplements and attend AA or NA meetings.fresh fruit.jpg

The basis of the Malibu Beach Recovery Diet is the Gycemic Index ("GI"), a scoring system that ranks foods based on their effect on blood sugar levels. The GI covers only carbohydrates—most of the foods you eat — such as fruits and juices, potatoes, rice, pasta, breads, and cereals that contain sugars, starches, and different types of fiber. That’s because foods that are high in carbohydrates have the greatest impact on your blood sugar. Other foods, such as fats and proteins, have little effect on blood sugar.

When you eat carbohydrates, they are broken down in the mouth, stomach, and intestine to smaller units that the body can use for fuel. These units are a sugar called glucose. Glucose supplies power to every cell in the body. Without it, you wouldn’t be alive.

Scientists have learned, though, that different carbohydrate foods cause blood glucose levels to rise at different rates. Some foods cause glucose levels to rise quickly after you eat them. The result is a virtual “gush” of glucose into the bloodstream. Other carbohydrate foods cause glucose levels to rise more slowly—a “trickle” so to speak.  The GI is a system that separates the “gusher” foods from the “trickler” foods. By eating less of the gushers and more of the tricklers, you can keep your after-meal blood glucose levels more in check.

Because the Malibu Beach Recovery Diet is not about losing weight, we don‘t ask alumni to count calories or pay attention to the values of the GI index.  All they have to do is follow some simple rules designed to keep their moods balanced and their blood sugar at normal levels.  The goal of the diet (combined with the daily yoga breath work and food supplements), is to raise and sustain the chronically low dopamine levels of addicts and those suffering from depression and anxiety.    Over the years Dr. Blum’s research has concluded that it is not only alcohol, street drugs and prescription drugs that depress endogenous Dopamine levels (dopamine is one of the most important "feel good" brain chemicals) but poor eating habits.canard a l'orange.jpg

The Malibu Beach Recovery Diet is based on eating three meals a day and several snacks, comprised of an abundance of allowed products which enrich and enhance the culinary possibilities and introduce ingredients that may not have been a habitual staple in their past nutritional habits.   No more endless cups of coffee and energy drinks, no more fast food, no more candy and sugar. 

To keep it simple, alumni have access to an online cookbook which includes all the rules of the Malibu Beach Recovery Diet, simple but elegant recipes, shopping lists for what to buy from Trader Joe’s, Whole Foods, and standard supermarkets.  We will be adding shortly advice on how to order when dining out.

Many  people – incoming clients and professional visitors – have confessed that the first time they were invited to the Center for a meal, they filled up enroute with a Big Mac or Subway sandwich.  They were expecting a “diet” that was healthy but tasteless, composed of foods they would never voluntarily eat. 

I don’t remember anyone leaving without complimenting French chefs Cyril Landrat and Yannick Marchand for an amazing food experience.  This includes the delicious deserts the chefs have learned to make without white sugar, brown sugar, or even honey.floating island.jpg

Many also remark on the attractive ways foods are presented.  I find that after spending 30 or more days at the Center, clients begin to appreciate the value of presenting each meal in an eye-appealing, appetizing manner.   When I went to visit Rachel C., one of our alumni now living at no frills sober living in Los Angeles, she was tasked by the house manager to prepare lunch.  She apologized that the food was not gourmet or even healthy by Malibu Beach Recovery Center standards, but it was beautifully plated:  Several slices of apple were turned upward so the color of the bright red skin complimented the white of the tuna fish sandwich, and the orange Doritos.  Good going Rachel!

Here are recipes for a meal we recently prepared in cooking class.  Bon appétit.

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It's Official - Gambling is a Behavioral Addiction

I’ve heard it said that an addiction is an addiction, meaning that they’re all pretty much the same in one sense--they draw you in and take control. gambler.jpg

Dr. Kenneth Blum. PhD, the eminent scientist who first dicovered the link between genetics and addiction in 1990, has long held that gambling is a Reward Deficiency Symptom.  Now, in February 2010, Join Together explained that for the first time, gambling will have its own category in the DSM, the Diagnostic and Statistical Manual of Mental Disorders: behavioral addiction. (The DSM is the "Bible" for the medical industry and required when providers bill insurance companies.)

However, when you start reading about gambling, some of the differences between problem gambling and substance abuse or dependence are striking.  For example, medicinenet.com  says that people who take medications for Parkinson's disease or restless leg syndrome have developed compulsive gambling. Who’d have thought it? Also, that risk factors for a gambling addiction include antisocial personality disorder, schizophrenia, bipolar disorder, and cocaine or alcohol addiction.

But there’s a lot that’s similar about gambling and substance abuse, too. People can lose jobs and money as a result of gambling as they can with the other activities. Just as there are numerous addictive drugs, there are also many ways to engage in gambling, from casino games and slot machines, to monthly poker games, to lottery tickets. And then there’s horse racing and jail-alai and the office football pool.  Internet gambling has exacerbated the problem.

According to SAMHSA, the Substance Abuse and Mental Health Services Administration, in 2004, at least 30 states provided services for gambling addiction. But as states are dealing with budget woes, addiction services are being cut. The New York Times reported that Nevada, for one, has proposed cutting financing, which doesn’t seem propitious when the state is the country’s gambling capital.

We may all know people who looked to gambling when they were desperate financially, in the hope of making a quick buck. And in these down times, a lot of people are tense about money. It’s not a time to cut gambling treatment programs.

Understanding the Addicted Brain

A potential client called the other day.  We will call her Samantha.  She is a prescription pill addict who by chance shares a doctor with Bill, the 22 year old I wrote about recently (“Addiction by Prescription: The Purdue Pharma-OxyContin Saga Continues’).   oxycontin2.jpg

 

Samantha was taking Oxycontin -- three 80 mg tablets/day plus up to five additional 10 mg tablets.  The list of operations she had undergone in a short span of time indicated she might be suffering from Munchausen  Syndrome, a psychiatric condition wherein those affected feign disease, illness, or psychological trauma in order to draw attention to themselves (or to get more prescription medication).  Her husband, the de facto caretaker of their son was threatening to leave and take their child with him. 

 

Because her insurance was too limited to cover treatment at our facility, I tried to steer her to other rehabs that would take her insurance, but she kept calling.  She wanted a “high end” rehab.  She and her husband wrote a check to cover detox and she checked in.

 

Two or three days later, well before Dr. Thom Lobe could get a baseline, still in the throes of detoxing off the synthetic opiates, she suddenly decided to leave.  There was no stopping her, no convincing her.   Everyone tried.  Other clients, who have been in treatment longer, understood.  They told me:  “That is her disease talking.”  And “Her disease is in control.”

 

They were right.  They have been in treatment long enough already to know that their addiction is a disease of the brain, more specifically it is a disorder of the brain’s reward system.sfo-limbic-brain-with-labels.jpg

 

I had been planning for some time to write an article simplifying for myself and others the science surrounding the “addicted brain.” Then when Dr. Roger Waite (a partner of Dr. Kenneth Blum) scored a home run explaining to clients and their families the role of the brain in recovery, I was inspired to stop procrastinating and start writing.   It was not easy.  I relied on some of Dr. Kenneth Blum’s many writings, Dr. Kevin McCauley’s 2008 “Is Addiction Really a Disease?” presentation at the Conference on Neuroscience and Recovery, and some pretty good information on the web.

 

Here is what everyone agrees on:

 

1)    The brain is the most complex organ in the body. It is the organ that allows us to think, have emotions, move, and even dream.

 

2)     The brain’s Limbic System (unconscious) develops and matures first. It is this part of the brain that governs our thinking process for the first 15-18 years of life. 

 

3)   The Limbic System understands, learns and responds on the most primitive level.  Though it cannot exercise rational judgment, weigh options or postpone satisfaction, it is in charge of survival and reward mechanisms. 

Pre frontal and limbic.jpg

4)   The Frontal Cortex is the most recent addition to the brain.  It evolved to evaluate how best to satisfy and cope with our conflicting demands for pleasure and relief.   In our late teens and early adulthood it becomes the body’s true center for command and control, responsible for functions such as reasoning, problem solving, judgment, impulse control.  It manages higher emotions such as empathy and altruism, causes us to feel love, have morality, decency, responsibility, spirituality.  It is where we make “conscious choices.” 

 

5)   When the Frontal Cortex fails in its ability to inhibit the drive to seek drugs, the decision-making processes pass to the unconscious Limbic system which associates alcohol and drugs with the principal source of pleasure and relief in life, and with survival itself.  

 

6)   The reward center of the brain which resides in the Lymbic System is compromised.   Dr. McCauley describes this as “Pleasure Deafness.”   He writes: “The patient is no longer able to derive pleasure from those things that have been pleasurable in the past…Addiction is a stress induced hedonic (pleasure) dysregulation.

 

7)   Dr. Blum puts it this way:  “If someone was to hold your head under water and prevent you from breathing your natural survival instincts would kick in and you would do almost anything to breathe again.  When the Limbic System’s Reward centers are diminished or shut down then the same “breathing” survival instincts activate in order to increase those feelings of Pleasure and Reward."

 

8)   When the Limbic system (the primitive brain) speaks the rest of the brain listens. It is much easier to understand someone’s irrational “Drug Seeking” behaviors when you understand the origins of that motivation.   The key to treatment for these individuals is to normalize these Limbic regions of the Brain so that the Frontal Cortex (Logic & Reasoning) can predominate.      

 

Samantha’s irrational determination to “survive” by leaving treatment in the middle of a difficult detox from powerful prescription pills was made by the Limbic (“survival”) part of her brain.    The drugs had shut down the ability of her Frontal Cortex to think rationally and be rewarded by dopamine surges which come from normal pleasures.   Her behavior was that of someone with low dopamine levels, either  because she was genetically predisposed to addiction, or had depleted her dopamine levels with drugs, poor nutrition, and lack of appropriate exercise.

 

Here is what Samantha looked like to us "normies," clients nearing the end of treatment, and staff in recovery already many years[1]:

 

 

SOBER PERSON

ADDICT

Frontal Cortex Does the Thinking

Limbic System In Control

Free Will Exists                      

No Free Will

Responsibility

No Responsibility

Can stop         

Can’t Stop

Punishment & Coercion DO work

Punishment & Coercion DON’T work

Sounds familiar?

 


[1] Adapted from Dr. Kevin McCauley ‘s explanation of “Choice vs. Disease” 

Dopamine for Dummies - Understanding Dr. Kenneth Blum and the Reward Deficiency Syndrome

Dr. Kenneth Blum.jpgDr. Kenneth Blum, PhD, the internationally recognized authority and researcher on neuropsychopharmacology and genetics, came to lunch the other day with his colleague Dr. Roger Waite.    Here is what Dr. Blum had to say about our program:

"I am very impressed at what you have been able to accomplish. Especially in the non-pharmaceutical and non-nutraceutical arenas (diet, nutritional supplements and breathing techniques).  Everything you have follows the Dopamine Agonist Modus Operandi.  Your treatment program builds dopamine levels.   Your low-glycemic lunch was out of this world…You have what is really going to turn a person’s life around. That includes, and that is, a lifestyle change -- and more importantly -- an easy program that an individual can follow for the rest of their life."

Now coming from Dr. Blum, who has near icon status at the Malibu Beach Recovery Center™, this is BIG.   I have long known that the holistic component of the Malibu Beach Recovery Center System for Treating Addiction™ is an outgrowth in great measure of Dr. Blum’s many years of breakthrough research into the relation between genetics and addiction and to his discovery of the “Reward Deficiency Syndrome.”  Most addicts he has studied have chronically low dopamine levels.  Our combination of diet, yoga breath work, and food supplements was specifically designed to help our clients raise their dopamine levels and re-balance their brain chemistry, enabling them to once again feel happy and get pleasure from something other than seeking and using their drug of choice. 

I barely passed “Physics for Poets,” a class offered by UC Berkeley to help liberal arts majors fulfill General Education science requirements. So, to write this important blog about Dr. Blum’s visit to the Malibu Beach Recovery Center, I had to spend a lot of time on Google, on Dr. Blum’s website and talking to Dr. Waite.  Here is the result, which I have dubbed “Dopamine for Dummies.”  I hope no one will be offended.

Dr. Blum, who has devoted his life to studying the relationship between genetics and addiction, is credited with co-discovering the so-called “alcoholic gene” in 1990.  That was the year he authored with Dr. Ernest Noble, former director of the NIH's National Institute of Alcohol Abuse and Alcoholism (NIAAA) and researcher from UCLA, a study published in the prestigious Journal of the American Medical Association, which found correlations between the Dopamine D2 Receptor Taq 1 A1 allele (a gene) and alcoholism.

Dopamine is sometimes called “the reward chemical,” the “pleasure molecule,” and the “anti-stress” molecule. It is the primary neurotransmitter found in the brain that is responsible for happiness and other emotions.  It is essential for the normal functioning of the central nervous system. Dopamine provides feelings of enjoyment and reinforcement that motivate a person proactively to “feel good.”   

Several years after discovering the “alcoholic gene,” additional studies led Dr. Blum and others to conclude that it was a misnomer and there is, in fact, no such thing as a “single” alcoholic gene.  Dr. Blum came to believe that the genetic anomaly previously found in alcoholics is also present in drug addicts and other people with compulsive or impulsive disorders, including overeating and obesity, attention-deficit disorder, pathological gambling and many more.  He has since clarified that this gene is more accurately defined as the “reward gene.” To date there are over 2,866 published peer reviewed articles claiming that the Dopamine D2 receptor gene is associated with addiction and reward dependence behaviors.   

In 1995, Dr. Blum defined the condition that occurs when genes do not work together as a cohesive unit as a “Reward Deficiency Syndrome.”  He hopes that this condition will one day be recognized officially as a disease.  His evidence indicates that over 1/3 of the U.S. population has some form of Reward Deficiency Syndrome, and that genetic factors account for between 40 and 60 percent of a person's vulnerability to addiction, including the effects of environment on gene expression and function.

The Brain.jpgIn a healthy person, Dopamine and other neurotransmitters  “cascade” like water cascading from one pool to another in a waterfall.  One neurotransmitter flows into an area of the brain and triggers release of another neurotransmitter.  The flow begins with Serotonin.  When it is released in the hypothalamus area of the brain, Enkephalins are released and initiate the transmission of GABA, which acts like a traffic cop.  GABA is important as it fine tunes the release of Dopamine.  GABA allows just enough dopamine to be released to provide reward, comfort, and pleasure from ordinary activities and a degree of calming to fight off unwanted stress. People who suffer from Reward Deficiency Syndrome cannot cope with the accompanying angst, agitation and emotional pain.  Their brains are unable to produce enough Dopamine, Serotonin, Norepinephrine, and Endorphins. 

When levels of these "feel good" chemicals are low or blocked from the brain's receptors by genetic or environmental influences; stress, pain, discomfort and agitation are the result.  To provide temporary relief  people with low dopamine levels self-medicate with substances that will produce a short-lived Dopamine response including  alcohol, illicit drugs, prescription drugs, junk foods, sugars, carbohydrates, caffeine, nicotine or other stimulants. These substances produce negative behaviors such as poor sleeping patterns that further depress their own endogenous Dopamine levels.  Exposure to prolonged periods of stress and alcohol or other substances can also lead to a corruption of the "cascade.”

Some people with low Dopamine levels do not self-medicate with alcohol and drugs, but become clinically depressed and anxious. 

These behaviors bring with them the possibility of more long-term consequences.

Both genetics and environment greatly affect what Dr. Blum calls the “brain’s reward cascade.”  Therefore, it is often quite difficult to determine what is the root cause of Reward Deficiency Syndrome. However, if Reward Deficiency Syndrome has its origins in your genetic makeup, according to Dr. Blum’s research people have the power to change their genes' expression. That is, they have the ability to respond to whatever life circumstances they may be in right now and change them to something better through healthier choices -- be it healthier nutrition (nutrigenomics) or healthier thoughts, emotions, and lifestyle choices (epigenetics). Either way, the choice and the power are theirs.

Dr. Blum has long believed, and many studies have proven, that in order to overcome genetic predisposition to addiction, certain amino acids and other nutraceuticals must be used to bolster the brain’s ability to increase or decrease certain neurotransmitters or enzymes that control the brain’s reward cascade. 

That is why at the Malibu Beach Recovery Center™, we have always given our clients an individually tailored regimen of food supplements and amino acids, which enhance the ability of the our low-glycemic Malibu Beach Recovery Diet™, along with a yoga breath work program to raise Dopamine levels. We then give our graduating clients the tools they need to sustain their now “normalized” Dopamine levels: an online cookbook with rules, recipes, shopping lists; real time DVDs of an abbreviated yoga breath work program that can be done at home every day; and a list of appropriate food supplements and amino acid products.  Clients who continue to follow the diet, do yoga, take specialized food supplements and become involved in the 12 Step Fellowship have a real chance of long term sobriety. But, more importantly, because of the normalization of their brain chemistry they are happier and can now enjoy and live life.

Before they knew about the Malibu Beach Recovery System™, Dr. Blum and Dr. Waite advocated a non-specific “healthy diet” and non-specific regular exercise to accompany a regimen of taking SynaptaGenX (formerly known as Synaptose), the nutrigenomic neuroadaptogen they developed based on Dr. Blum's many years of research to increase the endogenous production of Dopamine and reduce negative Reward Deficiency Syndrome behaviors.  The scientific evidence they have thus far accumulated, they say,  demonstrates that SynaptaGenX changes the plasticity of the brain synapses while balancing the endogenous neurotransmitters, positively affecting the Brain Reward Cascade. After touring the Malibu Beach Recovery Center™, Dr. Blum decided that the low-glycemic Malibu Beach Recovery Diet™ and the Exercise program based on yoga breath work were the perfect companions to Synaptose™.  He wrote: “I was thinking in the addiction field each of us has the missing part to the global standard of care in this industry.”

Dr Blum stated, “The end result of all these various treatments offered by your clinic will assist the patient to become drug free because they feel so much better due to increased brain function. They do not get so depressed, stressed or anxious that they resort to drug relapse. This type of Neurotransmitter agonistic therapy you have here at Malibu Beach Recovery Center™ reaches far beyond just overcoming an addiction; it prepares the individual for the first time to have a chance at living a happy and joyful sober existence for the rest of their lives.”

We hope he is right.  To find out we have started to give some alumni SynaptaGenX™ in addition to the yoga equipment, cookbooks, and a list of the best 12 Step meetings in their local area. Stay tuned for their feedback.