title: Toxicant-induced loss of tolerance.
abstract: Drug addiction and multiple chemical intolerance (abdiction) appear to be polar opposites--the former characterized by craving and dependency, the latter by aversion. However, when the two are viewed in juxtaposition similarities emerge, revealing a common underlying dynamic, one which appears to be a new paradigm of disease. TILT, or toxicant-induced loss of tolerance, bridges the gap between addiction and abduction and has the potential to explain a variety of illnesses, including certain cases of asthma, migraine headaches and depression, as well as chronic fatigue syndrome, fibromyalgia and "Gulf War syndrome". This paper argues that both addiction and chemical intolerance involve a fundamental breakdown in innate tolerance, resulting in an amplification of various biological effects, particularly withdrawal symptoms. While addicts seek further exposures so as to avoid unpleasant withdrawal symptoms, chemically intolerant individuals shun their problem exposures, but for the same reason--to avoid unpleasant withdrawal symptoms. These observations raise critical questions: do addictive drugs and environmental pollutants initiate an identical disease process? Once this process begins, can both addictants and pollutants trigger symptoms and cravings? TILT opens a new window between the fields of addiction and environmental medicine, one that has the potential to transform neighboring realms of medicine, psychology, psychiatry and toxicology.
authors.affiliation: Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, Texas 78229-3900, USA. millercs@uthscsa.edu
authors.forename: C S
authors.initials: CS
authors.lastname: Miller
mesh_terms: D001362:Avoidance Learning; D004361:Drug Tolerance / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D018777:Multiple Chemical Sensitivity / Q000276:immunology / Q000503:physiopathology*; D018923:Persian Gulf Syndrome / Q000503:physiopathology; D019966:Substance-Related Disorders / Q000276:immunology / Q000503:physiopathology*