Hormonal Intervention and restoration Evidence-based Endocrine restoration is a part of addiction treatment interventions and should be initiated for all patients referred to specialty care treatment of SUDs.
Addictions need to be tackled appropriately or the chances of recovery of the affected individual may be further thinned. There have been many researches into the best treatments for people who are suffering from Substance Use Disorders (SUDs). Many of these treatments are still in the testing and evaluation stages while some are considered okay. Since there is no one-size-fits all treatment, it is appropriate to understand the needs and peculiarities of each patient before administering any kind of SUDs treatment.
The Hormonal Intervention and Restoration Technique is one of the Evidence Based Treatments which involves endocrine restoration for the affected individual. It is believed that the hormones have a lot to do with addiction. It was discovered that individuals suffering from SUDs usually have a significant amount of Vitamin and mineral deficiencies. This has caused professionals to research deeply into this area, looking for alterations in neuro-circuitry and nutrition-based hormones such as leptin, insulin and ghrelin, in people dealing with SUDs to see if there are alterations in eating behavior while using drugs, when they are recovering and when they are trying out long-term abstinence.
Virmani et al iterated that drug abuse appears to be a major factor causing risk to the metabolic syndrome which may also cause cardiovascular diseases. Considering that gain in weight as SUD individuals begin abstinence from drugs is one major source of personal suffering, it is therefore important to get a more detailed understanding of how drug addiction affects dietary intake.
This is one of the nutrition based hormones secreted in the body by the adipose tissue. Its major role is to increase those rates of metabolism. In humans, plasma leptin has been positively associated with fat. It is anorexigenic because it is responsible for initiating response to starvation. De Arujo et al showed that a hungry individual with moderate leptin levels will attribute a higher reward value to intake of food as against someone who is satisfied (as seen in people when high dopamine release occurs). This may explain why people who are addicted hardly feel hungry after they must been exposed to the substance they are addicted to. There is high dopamine release and there is a feeling of satisfaction which makes them feel full rather than hungry even when they have not eaten. High levels of leptin has however been found to have no significant effect on metabolism and feeding in an individual. In alcoholics, increased leptin concentrations have been found to decrease the urge for alcohol and cause withdrawal in females.
Ghrelin and leptin play vital roles in neuroendocrine regulation of energy homeostasis as well as food intake. Ghrelin works differently from leptin. Its job is to stimulate appetite in people by activating orexigenic neurons within the hypothalamus. Its receptors have been majorly identified in VTA, amygdala and hippocampus. Since Ghrelin is stomach-derived, its levels usually decrease after eating, thereby creating a satisfaction feeling. The sight of food has been found to elevate ghrelin levels in the body of humans that are non-obese. In obese volunteers, at the sight of food, ghrelin levels are lowered. Alcohol dependent patients have been found with increased ghrelin levels whenever they are intoxicated and in early stages of abstinence. The levels increase during the first week of withdrawal from alcohol.
Although insulin is much more widely studied than ghrelin and leptin, its Central Nervous System effects cannot be understood fully. It is known to have a lot to do with regulating blood glucose and just like leptin; it has an adiposity signal and is known to attenuate food reward. Insulin secretions are repressed by the leptin gene therapy. This method can be used to deal with diabetes. In subjects where leptin and insulin levels are low, craving for food intake is increased. Insulin and dopamine work hand in hand to make sure both the urge to be involved in consumptive behavior and the calibration of the appropriate reward is in place. Alcoholics that are practicing abstinence have been found to exhibit blunted responses in their blood glucose when they were exposed to 2-deoxy-D-glucose by intravenous means. The blunted responses were exhibited to both glucagon and insulin. The link between alcohol misuse and sugar misuse and the blunted responses show that there is negative impact of substance use on the endocrine system. This underscores the need for intervention in the diet of SUDs and helping them to abstain till they recover.
A proper study of these hormones can be harnessed in treating patients with substance use disorders. At every given point during exposure to the addictive substance and while the individuals are trying to abstain, there are spikes in levels of ghrelin, insulin and leptin. These can be tweaked and used effectively in treating patients.