Psychology Today defines addiction as a condition that results when a person ingests a substance or engages in an activity that can be pleasurable but the continued use of which becomes compulsive and interferes with ordinary life responsibilities, such as work, relationships, or health.In a random week not too long ago, I was encountered by a series of patients with addiction to alcohol, cigarettes, and opioids.  All three patients were in different phases of their respective addictions: continued compulsion, in the process of quitting, and one who had already quit.  This got me thinking about the important work of Columbia University Professor, Dr. Carl Hart and his redefined meaning of addiction. Him along with many other experts have begun to question the notion that addiction is some kind of character defect. According to Hart, you don’t become a completely irrational person or thinker just because of your addiction. In his pivotal studies on addiction and behavior, he found that addicts were not driven only by drugs, that seeking pleasure from such activities were equal to pleasures sought through for example, food and sex.  Hart theorizes that when societal circumstances strip you of sense of community or responsibility, the addiction to substances such as crack cocaine takes a life of its own, giving you your purpose.  I put this theory in action when seeing those three patients.
First two cases involved loss of job, yet for the third patient, I don’t have a reasonable explanation.  Perhaps, an inner conflict of living with a partner who resists having children, devoid him of sense of purpose, leading to continued use of cigarettes, despite its negative consequences.  All three people led relatively normal lives, were not consumed by their addiction, and definitely exhibited signs of mild to moderate anxiety.  They felt helpless, powerless in their fight to control the addiction.  My role in helping them overcome their sense of helplessness, was to understand the circumstances which led to the addictive behavior, and to tackle the untreated anxiety more effectively.  Now if we believe like Hart explains, that focus should not be on the drug itself, but to build on a sense of purpose and responsibility for our work, family or any other passion in life.  Secondly, the emotional distress, anxiety, or depression must be addressed if any meaningful sense of recovery is to be attained.  Now, how we approach the mood disorder in these three cases is the next important question.  It is possible that as soon as someone is prescribed a strong medication to cope with their alcoholism, there is a chance that individual could become addicted to the new medication.  Naturally, I ventured into complimentary therapies for addiction, and found indeed there is a sea of remedies.
Holistic approaches to addiction are of great assistance throughout the stages of recovery, from detoxification to reducing anxiety, thereby improving mental well being. Recent scientific studies have demonstrated dramatically improved success rates with the addition of holistic treatment approaches.  For example, acupuncture alone or in combination with education was studied for its effect on smoking cessation in 141adults. Acupuncture and education, alone and in combination, significantly reduce smoking; and the effects were more pronounced in those who smoked more for a longer number of years.
In the realm of herbal remedies, studies point out that herbs in combination with other modalities including medication, nutrition, bodywork, acupuncture and relaxation may be most effective in regaining a sense of balance and wellbeing.  Clonidine-based therapies are used to treat the physical symptoms of withdrawal during opiate detoxification, but have not effectively addressed associated mental symptoms. The herbal extract Passionflower has been successfully used in the management of anxiety,
and in this study the use of a daily dose of 60 drops of passionflower extract with a maximum daily dose of 0.8 mg of clonidine showed a significant superiority over clonidine alone in the management of mental symptoms associated with detoxification.
Poor nutrition, a diet consisting of highly processed sugars and unhealthy sources of protein don’t allow for healthy brain function.  Amino acids that serve as the building blocks for powerful chemicals in the brain called neurotransmitters, including epinephrine and norepinephrine, GABA, serotonin and dopamine, are closely tied to addiction behavior.  Some researchers suggest amino acid nutrition therapy in the form of IV nutrition to help normalize and restore deficiencies in the neurotransmitters that spur cravings that can lead to addiction and relapse.
Finally, part of a holistic approach to recovery includes being in nature.  Finding a safe, serene and natural environment can refresh the soul and provide the opportunity to pursue whatever form of spirituality moves you.  Meditation has been my all time favorite go-to remedy for many ailments, especially addiction.
Over the years, my thought process on addiction has changed from my medical school training days largely based on my patients’ stories, innovative thinkers in psychology, and the vast potential of integrative medical approaches.  They have taught me about the complexity of addictive behavior, societal isolation, and mood disorders which all underly the condition. Most importantly, I’ve learned that defects in character or a 12-step program do not address the complexity of addiction.  As practitioners we hold the responsibility of helping our patients regain the balance of a healthy mind through understanding the root of their addiction, finding other passions in their lives, and cultivating a holistic therapeutic path.


Your Health Care Provider,
    Dr. Nasimeh Yazdani