The Addiction Solution, by David Kipper, MD (with Steven Whitney)
Rodale Press 2010, 284 pages, $25.99
Reviewed by Patricia Gauss, August 2011
Written by David Kipper, MD, a Beverly Hills doctor who specializes in addiction, The Addiction Solution provides a simple, straightforward account of the brain science underlying addictions. He also proposes that certain individuals are extremely susceptible to addictions, and shows how we get addicted, in part, because of pre-existing chemical imbalances in the brain.
The body’s ability to achieve homeostasis includes not only things like body temperature, blood sugar levels, heart and respiration rates, but also the fluctuations in brain chemicals. If there is a chemical imbalance or deficiency, and homeostasis cannot be achieved, it can cause mental illnesses like depression. It can also lead to addictions, especially if other factors are present, such as genetic predisposition and environmental factors such as stress, peer pressure, family behaviors and exposure to addictive substances. He makes a compelling case for his thesis: “Addiction originates in brain chemistry, is determined by genetics, and is triggered by stress.”
The brain chemistry is fascinating. He looks at what he calls the “big three,” dopamine, serotonin and noradrenalin. Basically, whichever neurotransmitters are out of whack give rise to an addict’s “drug of choice.” The reason for this is that the chemical composition of the drug closely mimics the neurotransmitter that the addict is (unconsciously) trying to self-medicate. Cocaine mimics dopamine, diazepam (Valium) is close in composition to noradrenaline, and Heroin is similar to serotonin. Alcohol abuse is also likely due to a serotonin imbalance. In fact, in each case, the drug appears to be a ramped-up version of its corresponding neurotransmitter. The abused substances offer faster and better relief to the imbalanced neurotransmitters than the brain itself can provide!
It follows then, that knowing what substance someone is addicted to provides a valuable clue to the best treatment for that particular addiction. For tranquilizers, alcohol and opiates, SSRIs and SNRIs are indicated. For stimulants like cocaine and methamphetamines, there are a variety of drugs including Ritalin, Wellbutrin, Seroquel and Abilify (treatment options also depend on whether the patient is ADHD or bipolar).
This information may be common knowledge to the medical community, but it was the first time I’d read about similarities between neurotransmitters and abused substances. The author does a fine job of bringing the elements of his thesis statement (brain chemistry, genetics, and stress) together to provide profiles of people who became addicts. He concludes the book with a number of case studies, including a hypothetical treatment scenario for AA’s Bill W., which illustrate those factors. I’m sure the answers are not always this clear-cut, but the book certainly provides a good starting point for detox and treatment.