![]() ![]() Dopamine receptors in the medial prefrontal cortex influence ethanol and sucrose-reinforced responding. ![]() Are we better off with coupling medical assisted treatment (MAT) that favors combining dopamine agonist modalities (DAM) as possible histone-deacetylase activators with the 12 steps followed by a program that embraces either one or the other? While there are many unanswered questions, at least we have reached a time when "science meets recovery," and in doing so, can further redeem joy in recovery.ġ2 steps Dopamine agonistic modalities (DAM) Fellowship Genetic testing God Neuroepigenetics Reward deficiency syndrome (RDS) Spirituality. "Like-minded" doctors of ASAM are cognizant that patients in treatment without the " psycho-social-spiritual trio," may not be obtaining the important benefits afforded by adopting 12-step doctrines. It begs the question as to whether "12 steps programs and fellowship" does induce neuroplasticity and continued dopamine D2 receptor proliferation despite carrying hypodopaminergic type polymorphisms such as DRD2 A1 allele. The purpose of this expert opinion is to briefly, outline the molecular neurobiological and genetic links, especially as they relate to the role of epigenetic changes that are possible in individuals who regularly attend AA meetings. This exploration has already been accomplished in part by Blum and others in a 2013 Springer Neuroscience Brief. We explore the impact that the molecular neurobiological basis of the 12 steps can have on Reward Deficiency Syndrome (RDS) despite addiction risk gene polymorphisms. In this expert opinion, we attempt to identify personal differences in recovery, by clarifying the molecular neurobiological basis of each step of the 12 Step Program. However, when controlled drinking fails, there may be successful alternatives that fit particular groups of individuals. When they present to a treatment program or enter the 12 Step Program & Fellowship, many addicts finally achieve complete abstinence. Some would argue that addicts can quit on their own and moderate their alcohol and drug intake. There are some who suggest that alcoholism and drug abuse are not diseases at all and that they are not consequences of a brain disorder as espoused recently by the American Society of Addiction Medicine (ASAM). 12 Director of Research, Drug Enforcement Administration (DEA) Educational Foundation, Washington, D.C, USA Departments of Psychiatry & Behavioral Sciences at the Keck, University of Southern California, School of Medicine, CA, USA.11 Department of Psychiatry, University of Minnesota College of Medicine, Minneapolis, MN, USA.10 Dominion Diagnostics, Inc., North Kingstown, RI, USA.9 Biobehavioral Medical Corporation, Metairie, LA, USA.8 Dominion Diagnostics, Inc., North Kingstown, RI, USA Institute of Health & Aging, University of California at San Francisco, San Francisco, CA, USA.7 Department of Psychiatry, School of Medicine and McKnight Brain Institute, University of Florida, Gainesville, FL, USA.6 Departments of Psychiatry, Neurology, and Anatomy & Neurobiology, Boston University School of Medicine, and Boston VA Healthcare System, Boston, MA, USA.5 National Institute for Holistic Medicine, North Miami Beach, FL, USA.4 Dominion Diagnostics, Inc., North Kingstown, RI, USA Meadows Edge Recovery Center, North Kingstown, RI, USA.3 Eötvös Loránd University, Institute of Psychology, Budapest, Hungary.2 Behavioral Neuroscience Program, Boston University School of Medicine, and Boston VA Healthcare System, Boston, MA, USA.1 Department of Psychiatry, School of Medicine and McKnight Brain Institute, University of Florida, Gainesville, FL, USA Department of Addiction Research and Therapy, Malibu Beach Recovery Center, Malibu Beach, CA, USA Dominion Diagnostics, Inc., North Kingstown, RI, USA IGENE, LLC., Austin, TX, USA RDSolutions, Del Mar, CA, USA National Institute for Holistic Medicine, North Miami Beach, FL, USA.
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