Stopping Addiction Before It Begins: The Future is now

Abstract

Genetic Addiction Risk Severity (GARS) (Blum et al, 2014; Blum, Badgaiyan, Agan, Frantantonio, Simpatico, et al. 2015; Blum, Baron, Lott, Ponce, Siwicki, et al. 2019) screens for Reward Deficiency Syndrome (RDS) predisposition risk, for polymorphic variance within eleven alleles of the ten most common genes, in mental disorder. The RDS paradigm shift is concerned with treating the underlying neurogenetic and epigenetic challenges of dopaminergic dysfunction, as well as dysfunction in other neurotransmitter channels (Blum, Baron, McLaughlin, & Gold, 2020). Cutting edge psychiatric genomics recognizes that RDS is one preexisting causal influence for addiction (Tsermpini, Adla, & Patrinos, 2022). Consideration of preexisting neurogenetic challenges which affect low dopamine availability or epigenetic insults are not addressed in traditional old school, Minnesota Model twelve steps treatment modalities (Gilley, 2020), nor it is addressed in the current DSM 5th Edition (APA, 2013) (Gondre-Lewis, Bassey, & Blum, 2020). Scientists in the know are hopeful that RDS will be included in the next edition of the Diagnostic and Statistical Manual of Mental Disorders, as exponential increases in research studies from interactive sciences such as psychology, neurology, genetics and epigenetics have greatly enlarged perspective (Mancheno, Navas-Leon, Fernandez-Calderon, Gutierrez, Sanchez-Garcia, et al 2021). Sometimes progress is slow in funneling progressive cutting-edge applications from the research world into the practitioner world (CASA Columbia, 2012). Unfortunately, it is the patients who suffer, as the opioid overdose deaths of more than 100,000 this year alone, attest (Gupta, Bowirrat, Llanos Gomez, Baron, Elman, Giordano, et al 2022; Blum, Fried, Madigan, Giordano, Modestino, Steinbergy, et al 2017; Moran, Blum, Valdez Ponce, Lott, Gondre-Lewis, Badgaiyan, 2021). Not only have there been advancements in treatment models, from the Minnesota Model of the 1950’s, the Harm Reduction Model of the 1980’s (Paquette, Daughters, & Witkiewitz, 2022) and the Neurodevelopmental Model of addiction of the 2000’s (Leyton, 2012, 2014), there have been advancements in unifying theory. The evolution of the history of addiction recovery treatment would never be complete without mentioning the foundational dopamine depletion hypothesis (Dackis, & Gold, 1985; Diani, 2011; Volkow, Fowler, & Wang, 2002), which led to way to the current leading theory of Reward Deficiency Syndrome, which includes consideration of genetic (Dick, & Agrawal, 2008; Uhl, Liu, Walter, Hess, & Naiman, 2002) and epigenetic causal influences (Edwards, Roy, Boyett, Badgaiyan, Thanos, Baron, et al 2020; Vaillancourt, Ernst, Mash, & Turecki, 2017). RDS unifies all addictions, both substance and non-substance under a common rubric (Blum, Bowirrat, Braverman, Baron, Cadet, Kasmi, et al (2021). The Reward Deficiency Syndrome paradigm shift takes into consideration, underlying genetic, biological, physiological, and neurological mechanisms of the brain reward cascade (BRC). In this genomic era of addiction medicine, the new standard of excellence in addiction treatment begins genetic screening (Gilley, 2022 a, b, c). RDS treatment plans are built upon the foundational genetic and epigenetic causal influences (Gilley, 2021, b, c). RDS-Solution Focused Brief Intervention (RDS-SFBI) administers bio-neuro-psychological therapy which assists the client in achieving dopamine homeostasis (Gilley, 2019). Since RDS effects the individual over the entire lifespan, it should be treated as a front-line modality (Blum, Raza, Schultz, Jalali, Green, Brewer, et al 2021), by primary physicians, and teams of RDS specialists (Gilley, Bowirrat, Gupta, Giordano, Dennen, Braverman, Badgaiyan, McLaughin, Baron, & Blum, 2022).