Addictions, in their various manifestations, fulfill certain needs, real or imagined. Whether they are physiological, spiritual, or psychological, desire to alter one’s state is at the core of addiction. Understanding our genes and the ways they can and likely do impact our mental health can give profound understanding into these desires and treatment options to break the addiction cycle. While the genes themselves are static and unchangeable, the proteins that the genes create are more malleable than one might think. By understanding the genetic defects that many addicts have in common, one can develop a treatment strategy that bypasses and/or pushes these proteins to create the desired outcome naturally.
Addiction or Self-Medicating
When someone first faces the fact that they may have an addiction problem, there is always the assumption that the addiction is a form of self-medicating–an underlying mental health issue. Whether it is anxiety, depression, bipolar disorder, or some other form, there is no doubt that addictive substances significantly alter our mental health. The problem is that the addictive substances only work short term. Many times, addictive substances only make mental health issues worse because of the drastic swings in such a short period. The short term relief only makes the substance more addictive. The question is, does the addiction cause the mental health issue or does the mental health issue cause the addiction?
Researchers estimate that compared to the general population, patients with mental health disorders are twice as likely to suffer from a drug disorder. Similarly, patients with an addiction disorder are twice as likely to have a mental health disorder. Does one cause the other? Are there similar environmental triggers for both that predispose patients to these? While environmental triggers do contribute to both, there is mounting evidence to suggest genes play a significant role.
Links Between Genetics and Addiction
Genes are the codes our bodies use to create exact replicas of our proteins and other structures that make up our bodies. When the gene codes are altered it is called a single nucleotide polymorphism, or SNP for short. The effect of a SNP is to change the shape of the protein it codes for. With this change comes a change in the protein function. Sometimes it is slightly changed and un-noticeable, and other times it is significant and greatly alters how the body works. The degree of problems each SNP creates depends on what gene is affected and how it relates to your other genes. When it comes to addiction, the genes that affect neurotransmitter production as well as neurotransmitter receptor site binding are of particular interest to researchers and physicians working in the field of addiction. Here are some notable SNPs related to mental health and addiction:
Alterations in GABA receptor sites- GABA is the major inhibitory neurotransmitter in the brain, and GABA levels correspond with our state of relaxation. Alterations in the gene that code for these receptors are correlated with greater risk for alcoholism.
Alterations in COMT enzyme- COMT is an enzyme that breaks down dopamine, epinephrine, and other catacolamines. Patients with altered function of this enzyme have been linked with increased rates of schizophrenia, especially when exposed to marijuana during adolescence.
Alterations in MTHFR enzyme- MTHFR is an enzyme that takes inactive folate into active folate. This seemingly mundane process can cause significant problems to the way neurotransmitters are produced and broken down when it is altered. Because of this, genes’ impact on neurotransmitters SNPs here are associated with depression, anxiety, and addiction (as well as many other problems).
Finding out that you have a problem with your genes can be a scary process since genes are static. However, the problems are not so much with the genes but how well the proteins are functioning. In most cases the proteins are enzymes that convert one substance into another substance. The genetic alteration simply means it does this with less efficiency. With modern science we can bypass many of these enzymes by giving the end product in the form of a supplement directly. In other cases the enzyme activity can be enhanced.
Treating Your Altered Genes
The first thing to know is that the genes themselves are not the focus of treatment–the individual patient is. The genes lead us to the answers that help treat your mental health, if there is a problem there. If you struggle with addiction, chances are there is at least some level of mental health dysfunction. The cause may not be related to altered genes, but the desire to continuously alter one’s state is without a doubt a mental health problem. Genetic testing can be a piece of the puzzle or the whole puzzle. We are at a time now where genetic testing is relatively inexpensive, and at the same time, being covered more and more by insurance.
Understanding where the problem lies and using appropriate treatment interventions at the right time takes practice and skill, and most of all, listening.
About: Dr.Terranella has helped over 1,000 patients with detox from alcohol and drugs of abuse. For over 5 years at a residential substance abuse treatment center in Arizona, he has used both conventional and holistic medicine to speed up the recovery process.
He is formally trained as a naturopathic physician and an acupuncturist, and has spent much of his continuing education on understanding holistic and conventional methods of treating mental health conditions. The mechanics of the addict’s brain and how it impairs their ability to stay sober is of particular interest for him. He enjoys finding new ways to teach about and interrupt the cycle of addiction.
“Working with addiction in any form is a transformative process because it reminds us how venerable the mind and spirt can be. It also reminds us how regenerative they can be given the right nourishment.” Dr. Terranella, practices at Southwest Integrative Medicine in Phoenix Arizona.