https://www.sciencebasedmedicine.org/is ... es-and-no/

Hi
I stumblled across this article about whether addiction is a disease or not and was fascinated by the comments in the Heilig book about Nal.-the mu opioid receptor gene. Has anyone read this book?

MD

Have not read it or seen it discussed in this way. I wonder what studies they are referring to? Also they are probably NOT studying TSM as such, but rather nal as normally prescribed: take it and abstain because it helps you reduce cravings. That is NOT tsm.

Yeah, the problem with studies is the focus (a bit of a built-in bias) and the length of the study, as well as the methods used. The info on the genetic variation in the mu opioid receptor is interesting and I'll wager there's some truth to that. Just like many folks don't get hooked on morphine, many don't get hooked on alch either, so there must be some difference in the action and proliferation of the receptors when alch comes into the picture.

Interesting read. As suggested in most respects either label is really irrelevant and instead finding effective treatment trumps all. On the other hand as someone who rejects the disease model I find it has psychological detriments that breed a host of consequences. Namely the notion of being helpless and sick perpetually. Further, particularly in AA it is used to facilitate the dismissal of any moral wrongdoing. "I suffer from a disease so ________ was/is not my fault as it relates to actions and behaviors separate from the actual chronic abuse of a substance. Personally, I'm grateful to have been able to excuse myself from that environment.

I've read that the majority of physicians reject the disease model and instead only abide by it largely because AA has inserted itself into their professional moral groundwork for half a century. "If you don't send patients to AA you are inflicting harm and thus violating your Hippocratic oath." I know when my physician acknowledged that not only The Sinclair Method worked, but that she was excited to have a medical treatment; she also revealed that she knew AA was largely ineffective and just didn't know what else to do.

Only 14 medical schools offer a class on addiction.

Interesting stuff. Im reading the book - its not saying Addiction is a disease like AA's line of thought . Its saying addiction changes your brain...... Will post when finished.
MD

This is along the lines of TCfA, it'll be interesting to hear your take on what he has to say.

JSP - TCFa?

The Cure for Alcoholism

Ha of course.
So I read the book. It was really interesting. I guess thes two quotes sum up what I was looking for

By now a meta-analysis of clinical treatment studies confirms that carriers of the less common mu-opioid receptor gene variant are twice as likely to respond to naltrexone as patients without this variant.36

Heilig, Markus. The Thirteenth Step: Addiction in the Age of Brain Science (p. 223). Columbia University Press. Kindle Edition.
Neither can we yet expect the individual physician to order a lab test to determine the genetic makeup of a patient. But the days when a genetic profile will be available in clinical practice are not too far off. And until then we should remember that a good history may do a good enough job of identifying naltrexone-responsive patients. If someone is male, has a strong family history of alcoholism, and had a stimulant-like response from alcohol when first beginning to drink, chances are the patient will respond.

Im not male but I certainly have the second two characteristics and have been a quick responder.

It was a good read.

MD

Heilig, Markus. The Thirteenth Step: Addiction in the Age of Brain Science (p. 223). Columbia University Press. Kindle Edition.