The idea that addictions are treatable brain diseases is foreign to most people. The definition of the disease itself – addiction is a chronic, often relapsing brain disease – is little understood, and as such, so are its treatment.

The following is a guest post by Judith Ann Miller, Ph.D., and CEO of Courage to Change Addiction Recovery Ranches.

Crossing the Bar: Understanding That Addictions Are a Treatable Brain Disease by Judith Ann Miller, Ph.D.

Over the last two decades, our understanding of alcoholism and addiction has expanded exponentially. That understanding has been largely influenced not by the humanities, but by science – both pure and applied. Research in the fields of neurology, genetics, psychiatry, pharmacology, and nutrition – and the emergence of neuro-imaging, which can capture the actual workings of the brain – have all converged to provide new data on the relationship between thought and behavior. Its implications for the treatment of addiction are profound. Addiction is no longer perceived as a moral problem; it is now recognized as a brain disease that can be managed and treated.

It was in fact, a (European-trained) clinical nutritionist, Dr. Charles Lieber, who upset scientific dogma by proving in 1974 that alcohol was toxic. Until then cirrhosis of the liver had been attributed to malnutrition. Lieber also conducted the underlying research that led to identifying bacteria as the cause of stomach ulcers, discovered the toxic interaction between alcohol and Tylenol, and with the legendary Marty Mann established the journal Alcoholism: Clinical and Experimental Research. From that point on the field of nutrition came to the forefront paralleled with cutting edge science in developing methods of recovery instead of just treating the symptoms alcoholism and addiction.

In general, once nutrients are ingested and broken down by the digestive system, they contribute to the overall functioning of the body. Some are used in the manufacture of hormones. And some, especially proteins, are broken down into their constituent amino acids that build and maintain cells. These amino acids are the building blocks of the neurons of the brain.

In order to function at its optimum, the brain’ s neurochemistry utilizes naturally occurring substances; enzymes co-factors, fatty acids, amino acids, peptides, vitamins, and proteins to create a wide array of organic acids, neurotransmitters, hormones, other brain chemistry markers that determine the quality of mental and physical health.  Once the brain/mind and body is satiated with the nutrients that it requires for survival, its response to addictive substances is greatly decreased.

Science has proven that certain amino acids deficiencies are the basis for addictive tendencies. Correcting those deficiencies provides neurotransmitter rebalancing and an opportunity for the systems of the body to function once again in homeostasis.

Amino acid therapy has been trialed since the 1950s, but the capability to work at the molecular level, which boosted so many of the sciences, has permitted nutritional researchers to identify deficiencies and target treatment as never before. Amino acid therapy provides actual physiological repair of the brain, as opposed to the masking that synthetic pharmacological medications accord.

Laboratory testing can determine exactly which amino acids are deficient, and dictate remediation. Further, precise dosages, in combination with interacting vitamins and minerals, can be compounded for specific individuals. Likewise through laboratory testing, progress in repairing the neurons and restoring healthy neurotransmissions can be monitored and is often measurable in weeks. This pioneering approach is slowly reaching mainstream addiction rehabilitation centers. But in the meantime, the clinics which have been trialing amino acid therapy over the last decade boast 5-year recovery maintenance rates as high as 80%, compared to the overall nationwide rate of 12%.

What AA intuited 7 decades ago; that alcoholism is a physiological disease, that it is chronic and incurable, is now scientifically verified, and furthermore, entrenched in the national bureaucracy.

However, the government’s attempts to deal with the mounting crisis of drug use and abuse, in the meantime, were stalled. The major institution charged with public policy, the National Institute on Drug Abuse (NIDA), was facing the wall of stigma attached to the disease, and the grandstanding of politicians who exploited this stigma by progressively criminalizing addiction.

In a brilliant move, Dr. Elias Zerhouni, the director of NIDA‘s umbrella, the National Institute of Health (NIH), snagged Dr. Nora Volkow for the position of director of NIDA. It may be one of the few instances where a hardcore researcher was projected into such a powerful political position. After Volkow assumed leadership of NIDA in 2003, everything changed.

A perusal of the current literature from NIDA drives home the message: Addiction is a chronic disease characterized by observable physiological changes…and it is a disease that can be treated. Volkow‘s vision, however, does not stop with science. The evidence is invariably followed by a Volkow-style argument for substantiating the science with therapy and community-based support; the treatment of the person as a whole and as a part of society.

Volkow brings all this together at the level of national policy. More than one U.S. congressperson has been swayed by her plea to join the interests of public safety and public health. More than one judge has held hard evidence in hand to warrant orders for treatment from the bench.

Americans like to think that the road to social sanity is paved with good intentions, but indeed it may also be paved with the cobblestones of hard and irrefutable science that will allow the addict to finally walk down the road of recovery.

Excerpted from Crossing the Bar, a report on scientific issues relating to alcoholism and addiction by Judith Ann Miller, PhD, CEO Courage to Change Ranches, Colorado, 719-541-4912.

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