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LECTURE 3
Addiction: dependence and tolerance develop with use. These factors cause the withdrawal symptoms that develop when
the patient stops taking the drug.
Is it the substance, or it is the user? It is both. Can’t lose sight of the fact that the substance needs to be focussed on too.
Has its own substance or pattern of use. Part of addictive picture. Can’t only focus on the mental/emotional/behavioural.
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• Mindfulness based meditation + CBT: good starting point for patients that want to quit.
• Addiction recovery program: not very accessible for average patient, in Ontario.
• CAMH: offers a lot of great resources for us and for patients. 5 sites
• Renaissance centre: abstinence program. Check in, stop using. Have urine tests. Option for lower-income patients.
• MAARS: Metro addiction referral service for all addictions.
http://www.camh.net/About_CAMH/Guide_to_CAMH/Addiction_Programs/Addiction_Treatment_Programs/guide_maa
rs_clinic.html
• Substitute replacement therapy: give 5HTP and serotonin to manage symptoms as part of a system.
• Restorative medicine: how can we restore the balance of co-factors etc. to restore functioning of brain.
• The more treatments you use, the better, without overwhelming patient.
• Ensure that your patients are there for themselves, not for family, because they are made to be there, etc. They need
to have commitment.
• What are reasons they have become addicted? If it is to pharmaceutical that was prescribed, may be more
physiological addiction if they didn’t seek out drugs: they were prescribed for condition, they didn’t seek out addictive
substance.
• If a patient is addicted to a drug that was prescribed (eg. For anxiety), the symptoms of original condition will likely
come back as they go off drugs: symptoms were suppressed if they didn’t go through entire process of dealing with
emotions the first time.
• Addition: behaviour/emotion first, then object/activity (not always the case, eg. After accident, start drugs)
• Primary drive: may have started drinking because of anxiety, but may now have secondary drive (physiological
depletion of GABA: can focus on this with naturopathic treatment.
• All behaviour serves a purpose, by nature we are not destructive. If we are engaging in destructive pattern, on some
level, it is preventing a greater harm that we perceive.
• Essence of drugs: homeopathic remedies have been made from many drugs.
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• Drugs deplete kidney essence, and the heart. Cocaine depletes Heart Yin.
• Wipeout syndrome: from long-term use of drugs
• Patient taking many drugs long term, has moved to harder drugs from others when he developed tolerance, wipeout
syndrome to drugs. Completely exhausted, depleted. Start by nourishing the patient, nourish the Yin, but don’t
stimulate first. Stimulating first will cause more of a deficiency. Acupuncture: maybe not first treatment as it requires
Yin, blood, Qi. If they are lacking material essence, won’t help. Have to use herbs first to support the deficiency.
• B-vitamins? Stimulating! After IV treatment, would have anxiety and panic attacks. Put him on nutritive treatment plan
for months.
• Can’t start liver detox if their elimination functions are already overwhelmed.
• Decrease craving: replacement/substitute therapy. If they are addicted to nicotine (increases blood sugar, increases
adrenal function), stimulate adrenal glands, stabilize blood sugar. Also very important to restore nutritional
deficiencies (B6 from carb/alcohol addiction) B vitamins, Vitamin C, zinc (co-factors of serotonin metabolism)
• Alcohol is GABA agonist (anti-anxiety). Can take glycine (pre-cursor to GABA)
• Herbs: patient on anti-anxiety meds coming off, give nervine (see Dr. Saunders’ notes). Muscle relaxant too?
(Diascorea, skullcap,
Chronic gastritis and digestive weakness: from coffee, nicotine, alcohol, marijuana withdrawal
Bronchitis, pneumonia: smoking, cocaine, alcohol, marijuana
Malnutrition (common in many addicts). People on anti-depressants: trend towards carb-rich diet. Insulin can help uptake
of serotonin, tryptophan from blood stream.
Support elimination, alkalinize
Anemia: secondary to gastritis, poor diet
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TCM approaches addictions from different perspective.
Other clinical tip: remove stasis before you nourish yin. Nourish yin before increasing yang.