Kenneth Blum1,2,3,4,5,6,7,8,9, Marcelo Febo1, Lyle Fried7, Mona Li2, Kristina Dushaj2, Eric R Braverman2, Thomas McLaughlin10, Bruce Steinberg11, Rajendra D Badgaiyan9. 1. a Department of Psychiatry & McKnight Brain Institute , University of Florida College of Medicine , Gainesville , Florida , USA. 2. b Departments of Psychiatry & Behavioral Sciences , Keck School of Medicine of USC , Los Angeles , California , USA. 3. c Department of Clinical Neurology , PATH Foundation NY , New York , New York , USA. 4. d Human Integrated Services Unit , University of Vermont Centre for Clinical & Translational Science , Burlington , Vermont , USA. 5. e Division of Addiction Services , Dominion Diagnostics, LLC , North Kingstown , Rhode Island , USA. 6. f Division of Neuroscience-Based Therapy , Summit Estate Recovery Center , Los Gatos , California , USA. 7. g Division of Neuroscience Research and Addiction Therapy , The Shores Treatment and Recovery Center , Port Saint Lucie , Florida , USA. 8. h Institute of Psychology , Eötvös Loránd University , Budapest , Hungary. 9. i Department of Psychiatry , Wright State University Boonshoft School of Medicine , Dayton , Ohio, USA. 10. j Center for Psychiatric Medicine , North Andover , Massachusetts , USA. 11. k Department of Psychology , Curry College , Milton , Massachusetts , USA.
Abstract
BACKGROUND: There is need for better treatments of addictive behaviors, both substance and non-substance related, termed Reward Deficiency Syndrome (RDS). While the FDA has approved pharmaceuticals under the umbrella term Medication Assisted Treatment (MAT), these drugs are not optimal. OBJECTIVES: It is our contention that these drugs work well in the short-term by blocking dopamine function leading to psychological extinction. However, use of buprenorphine/Naloxone over a long period of time results in unwanted addiction liability, reduced emotional affect, and mood changes including suicidal ideation. METHODS: We are thus proposing a paradigm shift in addiction treatment, with the long-term goal of achieving "Dopamine Homeostasis." While this may be a laudable goal, it is very difficult to achieve. Nevertheless, this commentary briefly reviews past history of developing and subsequently, utilizing a glutaminergic-dopaminergic optimization complex [Kb220Z] shown to be beneficial in at least 20 human clinical trials and in a number of published and unpublished studies. RESULTS: It is our opinion that, while additional required studies could confirm these findings to date, the cited studies are indicative of achieving enhanced resting state functional connectivity, connectivity volume, and possibly, neuroplasticity. Conclusions/Importance: We are proposing a Reward Deficiency Solution System (RDSS) that includes: Genetic Addiction Risk Score (GARS); Comprehensive Analysis of Reported Drugs (CARD); and a glutaminergic-dopaminergic optimization complex (Kb220Z). Continued investigation of this novel strategy may lead to a better-targeted approach in the long-term, causing dopamine regulation by balancing the glutaminergic-dopaminergic pathways. This may potentially change the landscape of treating all addictions leading us to the promised land.
BACKGROUND: There is need for better treatments of addictive behaviors, both substance and non-substance related, termed Reward Deficiency Syndrome (RDS). While the FDA has approved pharmaceuticals under the umbrella term Medication Assisted Treatment (MAT), these drugs are not optimal. OBJECTIVES: It is our contention that these drugs work well in the short-term by blocking dopamine function leading to psychological extinction. However, use of buprenorphine/Naloxone over a long period of time results in unwanted addiction liability, reduced emotional affect, and mood changes including suicidal ideation. METHODS: We are thus proposing a paradigm shift in addiction treatment, with the long-term goal of achieving "Dopamine Homeostasis." While this may be a laudable goal, it is very difficult to achieve. Nevertheless, this commentary briefly reviews past history of developing and subsequently, utilizing a glutaminergic-dopaminergic optimization complex [Kb220Z] shown to be beneficial in at least 20 human clinical trials and in a number of published and unpublished studies. RESULTS: It is our opinion that, while additional required studies could confirm these findings to date, the cited studies are indicative of achieving enhanced resting state functional connectivity, connectivity volume, and possibly, neuroplasticity. Conclusions/Importance: We are proposing a Reward Deficiency Solution System (RDSS) that includes: Genetic Addiction Risk Score (GARS); Comprehensive Analysis of Reported Drugs (CARD); and a glutaminergic-dopaminergic optimization complex (Kb220Z). Continued investigation of this novel strategy may lead to a better-targeted approach in the long-term, causing dopamine regulation by balancing the glutaminergic-dopaminergic pathways. This may potentially change the landscape of treating all addictions leading us to the promised land.
Authors: Kenneth Blum; Thomas J H Chen; Brian Meshkin; B William Downs; Cory A Gordon; Seth Blum; Julie F Mengucci; Eric R Braverman; Vanessa Arcuri; Michael Varshavskiy; Roger Deutsch; Manuel Martinez-Pons Journal: Adv Ther Date: 2006 Nov-Dec Impact factor: 3.845
Authors: Kenneth Blum; Peter K Thanos; Rajendra D Badgaiyan; Marcelo Febo; Marlene Oscar-Berman; James Fratantonio; Zsolt Demotrovics; Mark S Gold Journal: Expert Opin Biol Ther Date: 2015-05-14 Impact factor: 4.388
Authors: Dinah Kanate; David Folk; Sharon Cirone; Janet Gordon; Mike Kirlew; Terri Veale; Natalie Bocking; Sara Rea; Len Kelly Journal: Can Fam Physician Date: 2015-02 Impact factor: 3.275
Authors: Thomas J H Chen; Kenneth Blum; Amanda L C Chen; Abdalla Bowirrat; William B Downs; Margret A Madigan; Roger L Waite; John A Bailey; Mallory Kerner; Swetha Yeldandi; Neil Majmundar; John Giordano; Siohban Morse; David Miller; Frank Fornari; Eric R Braverman Journal: J Psychoactive Drugs Date: 2011 Apr-Jun
Authors: Kay M Tye; Julie J Mirzabekov; Melissa R Warden; Emily A Ferenczi; Hsing-Chen Tsai; Joel Finkelstein; Sung-Yon Kim; Avishek Adhikari; Kimberly R Thompson; Aaron S Andalman; Lisa A Gunaydin; Ilana B Witten; Karl Deisseroth Journal: Nature Date: 2012-12-12 Impact factor: 49.962
Authors: Kenneth Blum; David Han; David Baron; Shan Kazmi; Igor Elman; Luis Llanos Gomez; Marjorie C Gondre-Lewis; Panyotis K Thanos; Eric R Braverman; Rajendra D Badgaiyan Journal: Curr Psychiatry Res Rev Date: 2022-06-21
Authors: Margaret A Madigan; Ashim Gupta; Abdalla Bowirrat; David Baron; Rajendra D Badgaiyan; Igor Elman; Catherine A Dennen; Eric R Braverman; Mark S Gold; Kenneth Blum Journal: Int J Environ Res Public Health Date: 2022-05-24 Impact factor: 4.614
Authors: Thomas McLaughlin; Kenneth Blum; Bruce Steinberg; Edward J Modestino; Lyle Fried; David Baron; David Siwicki; Eric R Braverman; Rajendra D Badgaiyan Journal: J Behav Addict Date: 2018-01-10 Impact factor: 6.756
Authors: Kenneth Blum; Jag Khalsa; Jean Lud Cadet; David Baron; Abdalla Bowirrat; Brent Boyett; Lisa Lott; Raymond Brewer; Marjorie Gondré-Lewis; Gregory Bunt; Shan Kazmi; Mark S Gold Journal: Front Psychiatry Date: 2021-03-30 Impact factor: 4.157
Authors: K Blum; M Gold; E J Modestino; D Baron; B Boyett; D Siwicki; L Lott; A Podesta; A K Roy; M Hauser; B W Downs; R D Badgaiyan Journal: J Syst Integr Neurosci Date: 2018-05-03
Authors: Kenneth Blum; Bruce Steinberg; Marjorie C Gondre-Lewis; David Baron; Edward J Modestino; Rajendra D Badgaiyan; B William Downs; Debasis Bagchi; Raymond Brewer; Thomas McLaughlin; Abdalla Bowirrat; Mark Gold Journal: Psychol Res Behav Manag Date: 2021-12-17