September 24, 2020
It’s recognised in our society today that addiction and substance abuse is prevalent, arising in anyone from any walk of life but can be more prominent in those suffering from the impact of depression, anxiety, PTSD and more. It is our mission to spread true drug education so people can take more care in what they do and have greater awareness to make the right educated choices for themselves. Along with this we want to guide people to rebuild their lives from addiction by providing the best support and tools to make this process easier and more successful.
To understand addiction, we need to understand the mechanisms at play and how the brain works. Rewards increase motivation to perform or repeat tasks and is broadly classified as natural or drug rewards(1). Natural rewards are vital for survival which include water, food and sex. In contrast, drugs are consumed for their ability to produce euphoria and pleasure(1). Although both natural and drug rewards activate similar systems within the brain, the stimulation that drugs create are often more powerful than what is produced by natural rewards(1). Considering this, drug rewards in the brain are so powerful they induce changes in neuronal communication that can alter controlled social use of the substance, to uncontrolled compulsive use in vulnerable individuals(1).
In recent decades, the role of the neurotransmitter glutamate has been extensively studied for the role it plays in aspects of drug addiction and how it may also be involved in mediating natural reward as well. Within the mammalian brain, glutamate is the main excitatory neurotransmitter that accounts for approximately 70% of synaptic transmission in the central nervous system(1). Drugs of abuse such a cocaine, nicotine, alcohol and heroin all alter glutamate transmission via different mechanisms. For example, cocaine blocks DAT and increases dopamine levels, this increase in synaptic dopamine levels activates presynaptic or postsynaptic D1 dopamine receptors, which indirectly increases glutamate transmission(1). When we look at nicotine which is another stimulant, it increases glutamate transmission by binding to excitatory α7 homomeric nicotinic acetylcholine receptors located on presynaptic glutamate terminals(1). Furthermore, alcohol and heroin along with other drugs of abuse all alter glutamate transmission in numerous ways.
As we can see, when individuals fall into the habitual nature of substance abuse, it will inevitably alter the function of glutamate. This dysregulation within this neurotransmitter system is what causes changes in the reward systems of the brain, increasing the urge to use the substance of abuse. So how can we help people suffering from substance use disorder (SUD)?
I would like to introduce to you N-Acetyl Cysteine (NAC), an amazing natural compound (amino acid) that has recently been studied for its ability to help people with addiction through regulating the glutamate system. NAC is effective in reversing neural dysfunction in people with SUD, as it is an antioxidant that impacts the glutamatergic functioning in the brain(2). Repeated use of an addictive substance may result in excess glutamate in the nucleus accumbens (an area in the brain critical for motivation and learning). By introducing NAC, it is thought to upregulate the glutamate transporter (GLY-1) that removes excess glutamate from the nucleus accumbens. As a result, it helps correct glutamate dysregulation which promotes abstinence or prevents relapse to a substance(2).
A number of studies demonstrate NAC’s great safety profile along with favorable tolerability in addition to being an over-the-counter medication/compound. Compared to placebo it was significantly superior in lowering craving symptoms which resulted in a reduction in SUD in people addicted to cocaine, nicotine and cannabis. The results of these studies coincide with the hypothesis of the involvement of glutamatergic pathways in the pathophysiology of addiction(3)(4)(5). It’s also shown effectiveness in surpassing methamphetamine cravings and considered a pharmacological treatment for dependency(6). This is huge when we consider methamphetamine is one of the most highly addictive psychostimulant drugs used around the world.
Alongside these neurological benefits, NAC also works as a liver detoxifier due to it being a precursor for glutathione (the master antioxidant in the body). As many substance of abuse are hepatoxic (causing liver toxicity), NAC has an additional benefit of supporting liver health(7)(8).
Considering this science, NAC may be a great tool for anyone suffering from addictive behaviours or tendencies, helping you take control of your life and mental health. This doesn’t just relate to substance addiction, but addiction of any nature, for example it has the possibility to help individuals who are addicted to technology and social media. Recommended doses in accordance to studies is 1000mg-2000mg per day on an empty stomach away from food. It’s Alchemic Health’s mission to help people with mental health issues, addiction being one of them. If you are looking for support, please do not hesitate to book a consultation today. I believe NAC’s intervention can help us take control over our impulses, allowing us to gain back our power in life.
Written by Luke Pavasovic
Director and Naturopath at Alchemic Health
facebook.com/alchemichealth
www.alchemichealth.com
References:
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4633516/
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5993450/
3. https://pubmed.ncbi.nlm.nih.gov/28898494/
4. https://pubmed.ncbi.nlm.nih.gov/24676047/
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4009342/
6. https://pubmed.ncbi.nlm.nih.gov/25556383/
7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241507/
8. https://www.ncbi.nlm.nih.gov/books/NBK548401/