Guinevere Gets Sober

Recovery news, reviews and stories, by Jennifer Matesa.

Can we cure drug addiction with drugs?

So the National Institute on Drug Abuse has given $3.7 million to a professor at the University of Maryland School of Pharmacy to make the first drug in the U.S. and maybe in the world for cocaine addiction from an ancient Chinese herbal remedy.

Corydalis

Corydalis—in Chinese, yan hu suo

This is the pretty little herb: it’s called corydalis—in Chinese, yán hú suo.

The active ingredient in this plant is called l-tetrahydropalmatine, or l-THP. Professor Jia Bei Wang and colleagues from the pharmacy and medical schools are going to take five years to study whether l-THP actually works to decrease cravings for cocaine. Apparently clinical trials could start within the year.

It’s interesting: l-THP, as corydalis herbal extract, is unregulated and available for purchase on the Internet. I wonder what kind of “drug” they’ll develop from it… considering traditional Chinese medicine practitioners have, according to my encyclopedia of herbal medicine, been using corydalis root successfully since the eighth century?

More from my encyclopedia about corydalis:

A painkilling herb that stimulates the circulation, controls spasms and nausea, and has sedative and antibacterial properties. Research also suggests action on the thyroid and adrenal cortex. Used internally as a sedative for insomnia, and as a stimulant and painkiller, especially in painful menstruation, traumatic injury, and lumbago.

This seems to jive with current thinking about l-THP—apparently the same orientation that Prof. Wang has—which says that the chemical blocks dopamine receptors (which by all accounts would give it sedative action). There are research papers out there that also suggest l-THP is good at ameliorating effects of chronic opioid administration in animals (so what’s called good for the crack addict will also likely be called good for the smack addict).

Jia Bei Wang

Jia Bei Wang, Ph.D.

This is important recognition for the validity of traditional Chinese medicine and its potential impact on Western practice, and I’m real happy for Prof. Wang. 🙂

But personally: I’d be kind of reluctant to take anything on a regular basis that fiddled with my dopamine receptors. Just because I’m personally kind of reluctant to take anything on a regular basis at all anymore. (I take a couple of anti-epileptics at low doses for my migraines and fibromyalgia, in fact the doses are so low that the pharmacist questioned whether one of them was even therapeutic… I have mixed feelings about taking pills every day, but the fact is, despite recovering from addiction, I still have pain.) And also, fiddling with dopamine receptors is a dodgy proposition. Dopamine is the neurotransmitter that controls desire, appetite, creativity, sexuality and joy. Man o man, fiddling with that… But if that stuff isn’t present, you’re stuck in the pit of anhedonia, you’re dying to experience life, and that’s why you snort your lines, I can see why you’d want to figure out some fast remedy for the cravings.

And about those cravings: I was taught that you can’t solve a problem with the same thinking that got you there.

In other words, to solve a drug problem, drugs might not be the best solution…

But here’s another point: I know cocaine addicts (and heroin addicts and Oxy addicts and alcohol addicts and fentanyl addicts, you name it) who don’t have those cravings or that anhedonia anymore. While it might be great to find a pill that would get rid of cravings—I know there are many people for whom they never dissipate—why aren’t they studying what’s going right in those of us who no longer have them?

Scientists are frequently holding up fMRI scans and pronouncing dire conclusions about the “warped pathways” in addicts’ brains. Have they followed up on us after we get the kind of help you can’t get in a pill? (And I’m not just talking about the spiritual solution… though that’s part of it, for me and many others. I’m also talking about good nutrition, good exercise, good sleep, being part of community, and productive work—all the stuff you can’t patent and sell in a bottle.)

Scan me. I’d be curious to see whether my own dopamine and opiate pathways are still warped.

1 Comment

  1. “And also, fiddling with dopamine receptors is a dodgy proposition.
    Dopamine is the neurotransmitter that controls desire, appetite,
    creativity, sexuality and joy. Man o man, fiddling with that… But if
    that stuff isn’t present, you’re stuck in the pit of anhedonia,
    you’re dying to experience life, and that’s why you snort your lines, I
    can see why you’d want to figure out some fast remedy for the cravings.”

    Yes, sure got that right.

    My Corydalis/Angelica combo just came in the mail. I love the idea of dopamine antagonists; like LDN, they seem a solid long term strategy, upregulate what you lack.

    “There are research papers out there that also suggest l-THP is good at
    ameliorating effects of chronic opioid administration in animals….”

    I figure the kappa-opioid receptor takes over, suppressing dopamine, cyclic amp pathway is upregulated, further increasing CREB and thus dynorphin expression.

    So, l-THP can help ameliorate all of that. I’m sure the most important aspect of its effect would be D2 receptor upregulation, which would inhibit the formation of cyclic amp.

    *fingers crossed*

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