Does the biochemistry of acetaldehyde/acetate apply to the other drugs?
A good friend asks:
“I understand the lack of acetate production in alcoholic drinkers. Does this physiology apply to other drugs?”
I cannot so easily explain the other drugs and why addiction to those is so often linked to addiction to alcohol.
I am beginning to say, “My hypothesis of the conversion of alcohol to acetaldehyde to acetate is but one hypothesis, and may be just one biological component to addiction to psychotropic drugs. It is, however, at the least a useful paradigm through which to view the biochemistry, since it serves to explain the differences between the alcoholic and non-alcoholic. However, it may be far from the entire picture of biochemistry.”
We do know there must be brain damage, since we can observe the effects. We do know there is observable damage to the neo-cortex, as found via medical screening processes (I don’t recall which; Gorski reports on them). And we know that the other drugs take a more targeted approach to neurotransmitters than do other drugs. There may also be a connection to the nucleus acumbens and dopamine production by all the drugs in creating addiction, but it’s a process I don’t fully understand, nor does it really matter for someone trying to identify addiction. Naturally, it does matter for someone trying to find a biochemical cure for addiction.
A differential biochemistry could explain the varying behaviors among those who specialize in different drugs. Alcoholics are far more violent, in the aggregate, the dopers. Amphetamine addicts are for more destructive than are heroin addicts (excepting for the illegality of heroin and those heroin addicts who also use alcohol).
I asked him why he asked. He responded:
“I ask because this is important in explaining that addicts are biologically/genetically different from non-addicts. But if this is clear only about alcohol, then there is a problem. You seem to have found behavioral indications that there is a genetic difference even with drug use. But we don’t have biological evidence…”
It is a problem. Not only that, but there are some who seem to have become physically addicted to opiates but who do not display bad behaviors, except for the illegality. There are stories of addicted doctors in whom I cannot find misbehaviors who practiced, as full-blown “addicts,” for decades.
This is the reason I have so far only overtly redefined “alcoholism” and not “drug addiction.” My definition, if you recall: “Alcoholism is a genetic disorder that causes the afflicted person to biochemically process the drug alcohol in a way that causes that person to act destructively, some of the time.” If there are no destructive behaviors, there is no alcoholism. Of course, this begs the question as to what is “destructive,” into which category I include psychological abandonment of spouse and/or children in deference to the drug. We might say that “drug addiction is a genetic disorder” etc. Perhaps, all the same words apply. However, the biochemistry is apparently different. But then, why are almost all “other” drug addicts also alcoholics? (They may or may not regularly use alcohol, or use it at all, but it’s almost always a “fall-back” drug–the addict will use it in a pinch.)