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Why haven't we solved the addiction crisis?

  • Kenneth Blum
    Correspondence
    Corresponding author at: Division of Addiction Research & Education, Center for Sports and Mental Health, Western University of Health Sciences, Pomona, CA., USA.
    Affiliations
    Division of Addiction Research & Education, Center for Sports and Mental Health, Western University of Health Sciences, Pomona, CA, USA

    Division of Nutrigenomics, The Kenneth Blum Neurogenetic & Behavioral Institute, LLC, Austin, TX., USA

    Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary

    Department of Psychiatry, University of Vermont, Burlington, VT., USA

    Department of Psychiatry, Wright University Boonshoff School of Medicine, Dayton, OH, USA

    Centre for Genomics and Applied Gene Technology, Institute of Integrative Omics and Applied Biotechnology (IIOAB), Nonakuri, Purba Medinipur, West Bengal 721172; India

    Department of Nutrigenomic Research, Victory Nutrition International, Inc., Bonita Springs, FL, USA
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  • Abdalla Bowirrat
    Affiliations
    Department of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel 40700, Israel
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  • Luis Llanos Gomez
    Affiliations
    Division of Nutrigenomics, The Kenneth Blum Neurogenetic & Behavioral Institute, LLC, Austin, TX., USA
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  • B. William Downs
    Affiliations
    Department of Nutrigenomic Research, Victory Nutrition International, Inc., Bonita Springs, FL, USA
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  • Debasis Bagchi
    Affiliations
    Department of Nutrigenomic Research, Victory Nutrition International, Inc., Bonita Springs, FL, USA

    Department of Pharmaceutical Sciences, Texas Southern University College of Pharmacy and Health Sciences, Houston, TX, USA
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  • Debmalya Barh
    Affiliations
    Centre for Genomics and Applied Gene Technology, Institute of Integrative Omics and Applied Biotechnology (IIOAB), Nonakuri, Purba Medinipur, West Bengal 721172; India
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  • Edward J. Modestino
    Affiliations
    Department of Psychology, Curry College, Milton, MA, USA
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  • David Baron
    Affiliations
    Division of Addiction Research & Education, Center for Sports and Mental Health, Western University of Health Sciences, Pomona, CA, USA
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  • Thomas McLaughlin
    Affiliations
    Division of Nutrigenomics, The Kenneth Blum Neurogenetic & Behavioral Institute, LLC, Austin, TX., USA
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  • Panayotis Thanos
    Affiliations
    Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions, Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biosciences, State University of New York at Buffalo, Buffalo, NY, USA

    Department of Psychology, State University of New York at Buffalo, Buffalo, NY., USA
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  • Mauro Ceccanti
    Affiliations
    Alcohol Addiction Program, Latium Region Referral Center, Sapienza University of Rome, Roma, Italy
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  • Igor Elman
    Affiliations
    Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA
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  • Rajendra D. Badgaiyan
    Affiliations
    Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital, Long School of Medicine, University of Texas Health Science Center, San Antonio, TX., USA

    Department of Psychiatry, Mt. Sinai School of Medicine, New York, NY., USA
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  • Catherine Dennen
    Affiliations
    Department of Family Medicine, Jefferson Health Northeast, Philadelphia, PA, USA
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  • Ashim Gupta
    Affiliations
    Future Biologics, Lawrenceville, GA 30043, USA

    Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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  • Eric R. Braverman
    Affiliations
    Division of Nutrigenomics, The Kenneth Blum Neurogenetic & Behavioral Institute, LLC, Austin, TX., USA
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  • Mark S. Gold
    Affiliations
    Future Biologics, Lawrenceville, GA 30043, USA
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Published:September 01, 2022DOI:https://doi.org/10.1016/j.jns.2022.120404

      Abstract

      The current addiction crisis has destroyed a multitude of lives, leaving millions of fatalities worldwide in its wake. At the same time, various governmental agencies dedicated to solving this seemingly never-ending dilemma have not yet succeeded or delivered on their promises. We understand that addictive behavioral seeking is a multi-faceted neurobiological and spiritually complicated phenomenon. However, although the substitution replacement approach, especially to treat Opioid Use Disorder (OUD), has importance for harm reduction in the short term, it does not bring about a harm-free recovery or prevention. Instead, we propose a promising novel approach that uses genetic risk testing with induction of dopamine homeostasis and an objective Brain Health Check during youth. Our model involves a six-hit approach known as the “Reward Dysregulation Syndrome Solution System,” which can identify addiction risk and target the root cause of addiction, dopamine dysregulation. While we applaud all past sophisticated neurogenetic and neuropharmacological research, our opinion is that in the long term, addiction scientists and clinicians might characterize preaddiction using tests; for example, administering the validated RDSQuestionarre29, genetic risk assessment, a modified brain health check, or diagnostic framing of mild to moderate Substance Use Disorder (SUD). The preaddiction concept could incentivize the development of interventions to prevent addiction from developing in the first place and target and treat neurotransmitter imbalances and other early indications of addiction. WC 222.

      Keywords

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