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Biological Approaches
Published in Tricia L. Chandler, Fredrick Dombrowski, Tara G. Matthews, Co-occurring Mental Illness and Substance Use Disorders, 2022
Tricia L. Chandler, Mary C. Hoke, Tara G. Matthews, Elizabeth Reyes-Fournier
Pharmaceutical and non-pharmaceutical interventions can be used in conjunction with other therapies or as stand-alone treatments. After WWII, the pharmaceutical companies turned their efforts toward developing psychotropic medication for the treatment of mental health disorders, which have become mainstream over the past 70-plus years. Yet prior to WWII and after, there was another biological approach being researched for efficacy in treating brain chemistry deficiencies resulting in mental health disorders called orthomolecular psychiatry. Nutrition has been ignored for decades in the correlation between brain chemistry deficiencies and the onset of mental health disorders. In this chapter, we will review medically-assisted treatment (MAT) and explore orthomolecular psychiatry and the role of nutrition in the treatment of co-occurring disorders. Specialized training, certifications, and/or referrals to other health-care providers are needed for these interventions, but their efficacy makes them critical to integrative treatment. The history and use of pharmacotherapy, orthomolecular psychiatry, and nutrition are described, followed by case examples and recommended reading.
Philosophy and Addiction
Published in Evelyn Brister, Robert Frodeman, A Guide to Field Philosophy, 2020
Recent studies in neuroscience have explored the relationship between brain chemistry and addiction. Addiction, these studies suggest, may be a consequence of a combination of genes and neurotransmitters. The move is to treat addiction as a chronic physical condition, one that needs regular monitoring and management, much like diabetes or asthma. The National Institute on Drug Abuse (NIDA), part of the National Institute of Health of the United States, defines addiction as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. It is considered a brain disease because drugs change the brain—they change its structure and how it works. These brain changes can be long-lasting, and can lead to the harmful behaviors seen in people who abuse drugs.(National Institute on Drug Abuse 2018)
Pharmacological interventions
Published in Ilana B. Crome, Richard Williams, Roger Bloor, Xenofon Sgouros, Substance Misuse and Young People, 2019
It is important for any clinician who starts these assessments to be able to recognise the key presentations in young people that are associated with the main groups of drug misuse (opiates, stimulants and cocaine, psychedelics and novel psychoactive substances, benzodiazepines, cannabis and alcohol) that are the topics on which this book focuses. The rationale for pharmacological intervention is then based upon the chemistry of the drug group that each young person is using, their presentation and their needs. Presentations are likely to be varied and complex and cover a range of medical states from acute intoxication, problems associated with regular use, and various states of dependence or states of withdrawal, depending upon the drug or combinations of drugs. In terms of brain chemistry, dopamine is viewed as the most important neurotransmitter that mediates substance dependence and exerts its effects mainly by stimulating a reward mechanism (see Chapter 10) and Figure 26.1.
Drug dependence as a split object: Trajectories of neuroscientification and behavioralization at the Max Planck Institute of Psychiatry
Published in Journal of the History of the Neurosciences, 2023
This omission also applied to translations into clinical practices: In the therapy manuals published later by the “drug dependence” group, there was frequent use of psychoeducation on the etiology of the disorder. For example, patients were to learn to explain behavioral terms such as “learned triggers,” “behavior chains,” and “reinforcing cues” verbally and in writing (Kraemer, Prop-Alternative, and de Jong 1980, 132). Although biological triggers were sometimes mentioned in the manuals of this time, references to neurophysiological or neurochemical triggers were lacking. Although neuroscientific models and references to the brain and “brain chemistry” are common in today’s manuals about behavior therapy in Germany—even in relatively current texts by former members of Brengelmann’s group (Täschner et al. 2010)—they had not yet appeared in texts from that period. No common etiological concept had yet been advocated at the MPIP that could have connected the different approaches.
Two Decades of Progress “Toward a National PTSD Brain Bank,” on the Occasion of Dr. Matthew J. Friedman’s Retirement
Published in Psychiatry, 2022
In their manuscript that stimulated Friedman and Harris’ commentary (2004), Osuch et al. (2004) pointed out that PTSD was the only enduring mental illness that contained environmental exposure (trauma exposure) in the diagnostic criteria. They posited that PTSD resulted not from physical damage to the body, but to the reaction of the CNS to these environmental exposures. To examine this hypothesis, access to brain tissue was necessary to examine changes in brain chemistry and gene expression as a function of this environmental exposure. While some outcomes could be measured or inferred from neuroimaging or biomarker measurements, histological confirmation in postmortem specimens was required to fully characterize the pathophysiology underlying PTSD. Osuch et al. (2004) thus advocated for a resource that collected brain tissue from PTSD cases, exposed controls (resilient to trauma exposure), unexposed controls, and controls with comorbid conditions (depression, substance use). These recommendations were embraced in the Friedman and Harris commentary, and the subsequent development of the VA PTSD Brain Bank reflected these recommendations.
Brain Environment Interactions: Stress, Posttraumatic Stress Disorder, and the Need for a Postmortem Brain Collection
Published in Psychiatry, 2022
Elizabeth Osuch, Robert Ursano, He Li, Maree Webster, Chris Hough, Carol Fullerton, Gregory Leskin
Although it might be assumed that schizophrenia and affective disorders are more “biologically” based and, thus, more likely to be accompanied by alterations in microscopic brain structure, there is an abundance of evidence that environmental stress can result in the modification of brain chemistry, gene expression and, particularly if occurring during development, even brain structure (Teicher et al., 2003). Similarly, the neurobiological basis of PTSD is an area of intense investigation in biological psychiatry. Brain regions that mediate affective responses, such as the amygdala, are affected by the experience of severely traumatic events, leading to a pathological form of emotional memory (Cahill et al., 1995; Davis, 1994; Davis, Walker, and Lee, 1997; Gallagher and Chiba, 1996; Phelps and Anderson, 1997; Rogan, Staubli, and LeDoux, 1997; Watanabe, et al., 1996). In order to better understand what we know about the effect of the environment on the human organism, the following section delves more deeply into several specific areas of scientific inquiry in both humans and other animals as they relate to the understanding of the interaction of environment and the neurobiology of human behavior. By reviewing this material, some of the progress—and some of the complexity—of this area of research becomes more evident.