There is a drug-induced death in this country every 15 minutes,1 a trend that has risen steadily over the past decade. Despite a trillion dollars2 having been spent on this nation’s “drug wars” over the past six decades, more addictive and lethal compounds are used by Americans than ever before.3
Why are we losing the war against drug addiction?
One pioneering physician has a simple answer.
Life Extension® recently had the opportunity to speak at length with Dr. Marvin “Rick” Sponaugle. Board certified in both anesthesiology and addiction medicine, Sponaugle rejects addiction treatment that is based solely on counseling, the preferred methodology among almost all drug treatment facilities in the United States (97%).4
Instead, he combines state-of-the-art technology with safe, low-cost, natural interventions, including hormones, supplements, and restoration of gut ecology. The efficacy of his approach speaks for itself. While national relapse rates range as high as 90% by some estimates,5,6 Dr. Sponaugle has treated over 5,000 substance abusers—with a relapse rate of only 9%!7
According to Dr. Sponaugle, most detox and rehab programs are ineffective because they do not address the root problem. “Patients continue to relapse until their brain function is optimized. Otherwise, patients will continue to use drugs to stimulate underactive brain regions and to calm overactive brain regions. We have learned that successful addiction treatment requires diagnosis and treatment of multiple underlying biochemical and medical disorders.”
Official statistics support Sponaugle’s contention. The National Institutes of Health report that long-term drug abuse induces adverse chemical alterations in the brain that remain long after someone has stopped using drugs.6 This simple fact supports a multitargeted neurochemical intervention over behavioral approaches like counseling.
What Is Addiction? Dr. Sponaugle’s Viewpoint
Conventional medicine and most of society have long viewed addictions as pathological behavior over which the sufferer is expected to have a great deal of control. That, says Dr. Sponaugle, has led to conventional treatments that basically try to talk the patient out of a biochemical craving.
Sponaugle, who trained as an anesthesiologist, intensive care specialist, and pain management specialist, was horrified early in his career to see physicians allowing their addicted patients to undergo painful and dangerous withdrawal symptoms. This type of “cold turkey” withdrawal can be lethal to someone whose entire physiological system is out of balance due to substance abuse. In one instance, a nurse who had a heart transplant and was addicted to 3,200 mg/day of OxyContin® was placed in Dr. Sponaugle’s care by her university heart surgeons because they knew that traditional detox could harm her transplanted heart.
Sponaugle recognized that addictive behavior is the product of two major inputs to brain chemistry. First, a person’s inherited characteristics determine the ebb and flow of certain neurotransmitters in the brain. Second, acquired changes further amplify imbalances in those vital brain chemicals.
Sponaugle uses high-tech SPECT (single-photon emission computed tomography) scans of the brain to demonstrate changes in brain blood flow and neurotransmitter activity in patients with various kinds of addictions. Remarkably, there are characteristic patterns on those images that correlate with different addictive substances, and even with behaviors such as video game addictions.13-15
Most experts have used those SPECT scans to study the impact of the drug or the behavior on brain function. Sponaugle’s key insight, however, was to recognize that certain patterns of brain activity themselves make addiction more likely.
Sponaugle says some of these brain activity patterns reflect inherited patterns of brain chemistry. People who display these patterns, he says, simply learn that they can feel “more normal” when they use a particular chemical substance.
But that’s only half of the story, says Sponaugle. He feels it is also important to diagnose and treat acquired alterations in brain chemistry that further promote substance use. Such changes include those wrought by chronic exposure to pharmacologic drugs and other environmental toxins, and especially those produced by changes in normal gut bacteria.
Unless we address both inherited and acquired patterns of brain chemistry, Sponaugle argues, we will routinely fail to treat the underlying factors that sustain addictive behavior. The result? Addicts will continue to use chemical substances to “medicate” themselves to achieve a sense of normality, resulting in the kinds of high relapse rates we see in conventional addiction treatments.
Inherited Abnormalities in Brain Chemistry
According to Sponaugle, the overwhelming majority of his 5,000 successfully treated patients have areas of their brains that are either overactive or underactive.7 And that abnormal activity level helps determine the kind of drug, substance, or behavior a person may turn to in order to “normalize” their feelings.
The underactive areas most commonly involve the prefrontal cortex (brain region behind the forehead) and the pleasure or reward system of the brain. People with diminished activity in the nucleus accumbens (reward center) display what scientists call “reward deficiency syndrome,” or RDS.16 People with RDS have a hard time feeling “normal” responses to positive events, leaving them essentially hungering for happiness. Neurons in those low-activity areas are primarily driven by the neurotransmitter dopamine; addicts tend to display marked deficiencies in dopamine activity in both areas.17-19
As a result, says Sponaugle, people with RDS often seek to rebalance their brains with stimulating substances or behaviors that produce a dopamine surge in their pleasure center.7 For example, these patients might become addicted to cocaine, opiate drugs such as morphine or heroin, or stimulants such as amphetamines.
Dr. Sponaugle has demonstrated these effects graphically in a series of SPECT scans on his patients with addictions to cocaine and OxyContin®: all of them showed marked reduction in activity of neurons that rely on dopamine. Sponaugle refers to these areas as “dopamine holes,” and he uses them as a diagnostic feature as he seeks to rebalance his patients’ brain chemistry.
People with overactive brain regions have an entirely different set of problems and are likely to become addicted to “calming” substances, according to Sponaugle.7 Neurotransmitters involved in these areas are excitatory chemicals such as dopamine, histamine, glutamate, epinephrine (adrenalin) and norepinephrine.20 Their effect is to increase electrical activity of brain cells. At low levels of excess activity, patients may experience mild anxiety or insomnia. At higher levels, they may experience panic attacks or even live in a more or less continuous panic mode.7
This increased activity also shows up on SPECT scans, most notably in patients with high levels of anxiety or with panic disorders.21-23 Histamine is especially active in such patients’ brains.24-26 Dr. Sponaugle has a large file of SPECT scans showing overactive brain regions derived from elevated histamine activity in his patients addicted to “calming” substances such as alcohol, benzodiazepine anti-anxiety medications (e.g., Valium® or Xanax®), and again, opiates.
Acquired Abnormalities in Brain Chemistry
According to Dr. Sponaugle, people are “set up” for addictions by their inherited brain chemistry patterns. But that alone is not always enough to trigger an addiction. A “second hit” is usually required, typically in the form of imbalances in two important biological areas, the intestine and the endocrine (hormonal) system.
The human gut is frequently referred to as the “second brain,” because of its normally high production of serotonin and other neurotransmitters.27 Sponaugle says his clinical research suggests that “Addiction is more frequently caused by toxins from the gut than from any other single causation.”7
Alterations in the patterns of intestinal bacteria, coupled with ingestion of toxins from the environment, can produce what is known as intestinal hyperpermeability or “leaky gut,” a damaged intestinal lining that allows substances that normally would be eliminated in the stool to be absorbed into the bloodstream, with consequences in the brain.28,29 Bacterial overgrowth in the gut may also interfere with serotonin.30 According to Dr. Sponaugle, food allergies cause elevated histamine levels that lead to increased electrical activity throughout the brain. Histamine’s chemical structure is closely related to dopamine, and Dr. Sponaugle believes that histamine stimulates dopamine activity in the brain.
Dr. Sponaugle says that in his clinical experience, “alcoholism is linked with overgrowth of candida in the gastrointestinal tract.” He has observed that this GI disturbance is linked with deficiencies of two calming brain chemicals: serotonin and taurine. The combination of serotonin deficiency, taurine deficiency, and excessive histamine activation keeps the alcoholic in a state that feels like a constant alcohol-withdrawal pattern, says Sponaugle. “The need to drink becomes more intense, causing increased anxiety and insomnia.”
Dr. Sponaugle says that his clinic has found hormonal imbalances to be one of the most common causes of addiction in middle-aged women. This is hardly surprising, since hormones such as estrogen, progesterone, and pregnenolone are known to have powerful effects on brain function, yet traditional centers fail to evaluate female hormones. These “neurosteroids” are potent modulators of the neurotransmitters dopamine, serotonin, and gamma-aminobutyric acid (GABA), so when a woman’s hormones are out of balance, so is the electrical activity in her brain.31-33
Estradiol, for example, increases serotonin receptor activity in the brain.34 That contributes to a sense of well-being that can be rapidly lost in the premenstrual period and at the onset of menopause, when estrogen levels plummet. These are also the times in a woman’s life when she is most likely to suffer from depression, anxiety, and insomnia—all of which can be “self-medicated” with chemical substances that transiently “quiet” overactive brain regions: alcohol, Xanax®, and even opiate pain medication.