(Dalgarno Institute Comment – Medically Assisted Treatment or Opioid Substitute Treatments are not a long-term solution, and the sector knows it. In fact, these treatments are causing increasing harms in and of themselves, both unto addiction, as well as physiological and biological harms. If drug use exiting outcomes is not the goal and all vehicles employed to help the dependent individual exit drug use – including the imperative of ‘sunset clauses’ on the use of MAT’s, then ‘harm reduction’ becomes a ‘harm enhancer’. (See Combining Medications With 12-Step Model Treatment Improves OUD Outcomes) These failed policy practices continue to be largely left unscrutinised (at least in the Australian context), as a more ‘set and forget damage management’ model, and this is both unacceptable as a public health outcome and an individual recovery outcome)
Dopamine along with other chemical messengers like serotonin, cannabinoids, endorphins and glutamine, play significant roles in brain reward processing. There is a devastating opiate/opioid epidemic in the United States. According to the Centers for Disease Control and Prevention (CDC), at least 127 people, young and old, are dying every day due to narcotic overdose and alarmingly heroin overdose is on the rise. The Food and Drug Administration(FDA) has approved some Medication-Assisted Treatments (MATs) for alcoholism, opiate and nicotine dependence, but nothing for psychostimulant and cannabis abuse. While these pharmaceuticals are essential for the short-term induction of “psychological extinction,” in the long-term caution is necessary because their use favors blocking dopaminergic function indispensable for achieving normal satisfaction in life. The two institutions devoted to alcoholism and drug dependence (NIAAA & NIDA) realize that MATs are not optimal and continue to seek better treatment options. We review, herein, the history of the development of a glutaminergic-dopaminergic optimization complex calledKB220 to provide for the possible eventual balancing of the brain reward system and the induction of “dopamine homeostasis.” This complex may provide substantial clinical benefit to the victims of Reward Deficiency Syndrome (RDS) and assist in recovery from iatrogenically induced addiction to unwanted opiates/opioids and other addictive behaviors.