title: Addiction Treatment in America: After Money or Aftercare?
abstract: There are approximately 14,500 clinics and programs in America that provide treatment for all types of addictive behaviors we call "Reward Deficiency Syndrome (RDS)". While most of these have good intentions to provide needed help to the victims of RDS, we propose herein that most of their efforts, especially during periods of aftercare, are not based on the existing scientific evidence. We use "aftercare" to refer to any form of program or therapy following primary treatment including 12-Step programs. Very few programs actually provide any evidenced-based treatment approaches during this most vulnerable period in recovery. In this trieste we are suggesting that a hypodopaminergic trait (genetic) and/or state (epigenetic) is critical in terms of continued motivation to use/abuse of alcohol or other drugs and can lead to relapse. While there is evidence for the approved FDA drugs to treat drug addiction (e.g. alcohol, opiates, nicotine) these drugs favor a short-term benefit by blocking dopamine. We argue instead for the utilization of long-term benefits that induce "dopamine homeostasis", or in simpler terms "normalcy". We suggest that this could be accomplished through a number of holistic modalities including, but not limited to, dopamine-boosting diets, hyper-oxygenation, heavy metal detoxification, exercise, meditation, yoga, and most importantly, brain neurotransmitter balancing with nutraceuticals such as KB220 variants. We embrace 12-step programs and fellowships but not as a stand-alone modality, especially during aftercare. We also provide some scientific basis for why resting state functional connectivity (rsfMRI) is so important and may be the cornerstone in terms of how to treat RDS. We postulate that since drugs, food, smoking, gambling, and even compulsive sexual behavior could reduce rsfMRI then modalities (following required research), that can restore this impaired cross talk between various brain regions (e.g. Nucleus accumbens, cingulate gyrus, hippocampus etc.) should be incorporated into the aftercare plan in all treatment programs in America. Anything less will ultimately lead to the so called "revolving door" for as many as 90% of treatment participants.
authors.affiliation: Division of Addiction Training & Educational Services, Nupathways, Inc., Indianapolis, IN, USA.
authors.forename: David
authors.initials: D
authors.lastname: Miller
authors.affiliation: Division of Addiction Training & Educational Services, Nupathways, Inc., Indianapolis, IN, USA.
authors.forename: Merlene
authors.initials: M
authors.lastname: Miller
authors.affiliation: Department of Psychiatry and McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, FL, USA; Division of Neuroscience- Based Therapy, Summit Estate Recovery Center, Los Gatos, CA, USA; Department of Psychiatry, University of Vermont, Burlington, VT, USA; Department of Neurological Research, Path Foundation NY, USA; Dominion Diagnostics, LLC, North Kingstown, RI, USA; Division of Nutrigenomics, La Vita RDSS, LLC., Salt Lake City, UT, USA; Igene LLC, Austin, TX, USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Blum
authors.affiliation: Department of Psychiatry, University of Minnesota School of Medicine, Minneapolis, MN, USA.
authors.forename: Rajendra D
authors.initials: RD
authors.lastname: Badgaiyan
authors.affiliation: Department of Psychiatry and McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, FL, USA.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Febo