The Disease of Chemical Dependency
Dr. Brian Earthman, Recovery Today Online (recoverytoday.net) July 9, 2010
I am excited to be a psychiatrist right now. For decades my field has lacked the tools necessary to observe how the brain functions. Now with brain scans such as SPECT imaging and fMRI we can actually see how the brain functions, not just the structures. We can see where the brain is deficient and how our treatments improve it. We have developed technologies that allow us to measure the weak electromagnetic fields present in the body and brain. We are beginning to understand how the electrical systems in the body and brain actually run the “command and control” operations of our various functions. Chemistry is part of the process of executing necessary actions for the body to do, but it is only part of the overall equation.
We can now see how the chemical dependency pathways light up when a chemically dependent brain is exposed to environmental cues but the non-chemically dependent brain stays quiet. I can use a small electrical current to calm a brain in withdrawal and accelerative its cognitive recovery. I have great hope that we are on the verge of making a meaningful impact in the lives of most patients with the disease of chemical dependency.
Chemical dependency clients are complex because their disease is initiated in pre-conscious areas of the brain such as the Ventral Tegmental Area (VTA) and Nucleus Accumbens (NAc). Because these pre-conscious areas are the starting point of the disease, the chemically dependent individual loses volitional control over their chemical use. They no longer have the ability to make rational decisions about when and how much to use; they cannot stop despite repeated efforts to halt their use. While chemical dependency is a devastating psychiatric illness in and of itself, up to 70% of clients with a chemical dependency problem also have a diagnosable psychiatric disorder. In addition to that anxiety, depression, and insomnia symptoms are almost ubiquitous in the early stages of sobriety. As many people know, if someone’s depression or anxiety is not addressed, they are significantly more likely to relapse into chemical abuse.
The mind and body are electrochemical systems. While the healthcare industry heavily favors a chemical approach to affect all change, decades of studies have shown that applying small amounts of electrical stimulation (in the microcurrent range) can produce exceptional results and provide relief and healing. Less than 500 microamperes of current can increase cellular amino acid transport and ATP production. More than that actually depletes these vital chemicals. We see increases in serotonin and endorphins along with decreases in norepinephrine and cortisol. A qEEG that measures brain wave activity shows a decrease in delta waves and an increase in alpha waves when microcurrents are applied. Increased alpha waves correlate to feeling much more relaxed. Decreases in delta waves occur when people become less tired and more alert. When microcurrent therapy is applied across the head and neck region it is called cranial electrotherapy stimulation (CES), and the CES device most commonly used in the US is the Alpha-Stim® brand. Dr. Todd Clements has seen objective positive changes in brain functioning after Alpha-Stim treatment with SPECT imaging.
The current field of electrical/magnetic therapies can be a little confusing. It is important to understand that there are many forms of electrical or magnetic based therapy and different applications for them. The classic electrical therapy that most people think of in psychiatry is electroconvulsive therapy (ECT). ECT is a large amount of current delivered to the brain over a short period in order to induce a seizure. This is done under anesthesia with muscle blockers and most clients need 8-10 treatments over a month. After that they typically return to medication therapy with maintenance ECT treatments continued every few weeks or months. There is also transcutaneous electrical nerve stimulation (TENS) which delivers a medium amount of current used to block pain signals going to the brain. Its effects usually last during and up to about one hour after treatment. Some psychiatrists are using the new repetitive transcranial magnetic stimulation (rTMS) for treating medication resistant depression. rTMS is done in the physician’s office daily for a month by a large machine that generates a focused magnetic field and typically costs over $10,000.00 for a single course of treatment. CES is a small amount of current delivered over 20-30 minutes. Cranial electrical stimulation devices (CES) are designed for personal use by the individual in the privacy of their home and the cost is as little as $600.00.
In my practice, I utilize a variety of interventions, but one of the most innovative and promising is CES. I like the Alpha-Stim® product which can be used as a stand-alone treatment or as an adjunct to psychopharmacological medications. It can be used as often as necessary to control pain – without any significant side effects. It can also be used daily to calm anxiety and relieve depression or insomnia. In chemical dependency I have found Alpha-Stim to be helpful in a variety of ways. It is a great non-medication treatment for anxiety, insomnia and depression. It will decrease the withdrawal symptoms experienced during the detoxification phase of chemical withdrawal. It can help with accelerating the return of normal cognitive function. It is a great relapse prevention tool that can be used on a PRN basis to decrease cravings. Research has shown that chemical dependence patients will stay engaged in treatment programs longer if they are using CES. In addition, Alpha-Stim has also been invaluable for the treatment of chronic pain issues in the prescription opiate dependant population.
CES treatment is very simple. The current is applied by clips that attach on the ear lobes. Used just 20 to 40 minutes every day, every other day, or on an as-needed basis, Alpha-Stim can help induce a pleasant, relaxed feeling of well being. In my experience, Alpha-Stim is well tolerated and very safe, having no significant side effects in more than 8,700 people involved in over 55 research studies. In contrast, drugs/medications used in the treatment of mood disorders have been proven to have a wide range of undesirable side effects and some can result in chemical dependency. Unlike many medications, an Alpha-Stim treatment leaves the mind relaxed and alert. My experience is that anxiety and insomnia generally come under control in 1 – 2 weeks and depression in 2 – 3 weeks of daily treatment at home. This is then followed by a reduced schedule for maintenance until the person is fully recovered and happy.
Much research is being conducted on the efficacy of this treatment. The studies are rigorous and most use the “gold standard” of double-blind placebo controls for comparison. A great overview of CES in the treatment of chemical dependency was written by psychiatrist Marshall Gilula, MD and neuroscientist Daniel L. Kirsch, Ph.D. and published in a 2007 issue of the journal, Practical Pain Management. For a more comprehensive look at the research done in anxiety, insomnia, depression, and pain go to www.hcbiocurrent.com.
About the Author
Dr. Earthman was born and raised in Texas. He received his BA in Biology from The University of Texas in Austin, before completing his MD at the Texas Tech University Health Science Center. His residency training was conducted in psychiatry through The University of Texas Health Science Center in San Antonio. His experience includes treatment of inpatient and outpatient psychiatric patients as well as the treatment of various addictions. Currently he maintains a private practice in Austin, TX and is the psychiatrist for Spirit Lodge Detox and Rehab. Dr. Earthman is an officer in the United States Army Reserves and had been on three combat zone deployments. At home and in Iraq he employs a comprehensive treatment approach that includes medication, counseling, lifestyle changes, and Alpha-Stim therapy.
