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Biological Approaches to Addiction Treatment: Medications

A. Tom Horvath, Ph.D., ABPP, Kaushik Misra, Ph.D., Amy K. Epner, Ph.D., and Galen Morgan Cooper, Ph.D. , edited by C. E. Zupanick, Psy.D.

Biological approaches to addiction treatment attempt to correct or modify the presumed underlying biological causes of addiction. This approach follows a logical rationale. If we know what caused something to become broken, we can fix it. Then, we can repair or restore the broken "thing" to its original purpose and function. According to biological models of addiction, a "broken" or damaged brain causes addiction. For example, perhaps someone's brain chemistry makes a particular drug a little bit too rewarding. This would make drug use very difficult to resist. One way to fix this problem is to make drug use less rewarding. For instance, a person could take a medication that causes them to become sick if they consume the drug. Thus, this faulty brain chemistry is "fixed" via the addition of corrective chemicals; i.e., medications.

medication bottlesAmericans widely use all kinds of medications. These range from over-the-counter medications, to prescribed medications. Oddly enough, we don't always know exactly why a medication works the way it does. This does not mean that researchers randomly experiment with every chemical compound they can find. Researchers give considerable thought to how a particular chemical may affect the brain. They base their estimate on whatever is known about that chemical at the time of the study. Then, they conduct a randomized clinical trial (RCT) to evaluate whether or not the desired effect was achieved.

Pharmaceutical research is very expensive. This research is primarily funded by pharmaceutical companies. These companies stand to lose a great deal of money if the research does not result in an effective product. Similarly, they are positioned to make substantial profits if research uncovers a new drug that is effective. Therefore, pharmaceutical companies are not financially motivated to investigate just any chemical compound. Their investigations must ideally yield some proprietary compound that they can patent in order for the research to be profitable. For this reason, there is limited research regarding nutritional additives. Simply put, nutritional research isn't profitable. Despite this fact, it's possible that nutritional additives could achieve the same effect as more costly chemical compounds.

While nutritional additives may be helpful, there are some problems with this approach. The United States government closely regulates claims made about drugs. However, it does not regulate the nutritional industry with the same degree of scrutiny. Many claims have been made about the benefits of nutritional supplements. Thus, it may be tempting to consume nutritional supplements instead of medications. Unfortunately, the majority of these claims have not been evaluated using randomized clinical trials. This is not to say that nutrition has no effect on brain chemistry. It most certainly does. However, because research is limited in this area, it is difficult to determine the effectiveness and safety of nutritional additives.

Most pharmaceutical studies are funded by the pharmaceutical industry. In contrast, most studies of psychological approaches to addiction are funded by the government. These approaches are discussed in the Psychological Approaches to Addiction Treatment.