The Free Three Things

Here’s some truth.

Psychiatrists, therapists, etc … aren’t really sure what causes depression and what the best course of treatment is for any given person.

Mental health does not lend itself to a diagnostic prescriptive model. It’s not clear what is happening and it is certainly not precise. It’s subjective.

The practitioner uses his/her “judgement” to prescribe a course of action.

There is some disagreement around “depression” (the “cause and cure”)

However, nearly everyone would agree that the ‘FREE THREE’ can help.

If you are struggling. Take action today

1. GO OUTSIDE / EXERCISE… move your body.
2. LISTEN TO SOME UPBEAT MUSIC
3. LAUGH. Schedule in some comedic relief. Watch a movie, listen to a funny podcast, watch some videos on YouTube.

Do this everyday for 30 days…. Money back guarantee!!!

ABOUT RICH JONES MA, MBA, LCAS, SAP
EVP & EXECUTIVE DIRECTOR, HERITAGE CARES

Executive Vice President (EVP) at Heritage Health Solutions, Inc.
Chief Strategy Officer Co-Founder at Youturn,
CEO at Wellness Partners Group
CEO/President at Jones Solutions Group
Former CEO at FAVOR Greenville

Visit Heritage Health at – Click Here

For Addiction Support Info – Click Here

Please Subscribe to the Recovery Cartel – Click Here

The post The FREE Three Things – Really, they’re FREE…. appeared first on The Recovery Cartel.

Start Over

💥💥💥I think it makes more sense to “start over” at the beginning of each new “birth year” rather than the beginning of each new year.

Each new year we reflect on the past year. We make new year’s resolutions.

We have this sense of starting over.

For me… it happens on my birthday.

53rd Year

Today day is day one of my 53rd year on the planet.

This past year has been the most difficult year of my life.

My 52nd year on the planet was brutal. I have come face to face with depression in a way that I never have before.

I’m not sure if I was in denial in the past. Perhaps I was embarrassed and never really got honest?

Another Level

Also … events in my personal life triggered things and pushed this shit to another level.

Men are not supposed to be depressed.

Men are not supposed to be anxious.

We should just get shit figured out and move on to the next task. Suck it up.

The S Word

I was definitely ashamed and the stigma kicked my ass.

Now … I do not give a f**k . Truly, I am going to be open and I’m not hiding anymore.

New Decisions

I’m going to make decisions that benefit my mental health. I’m going to work smarter. I’m going to take steps to reduce stress.

I have been on a hamster wheel of busy-ness and ambition that is relatively non-sensical.

Need to minimize and adopt a more simple lifestyle. And prioritize relationships.

Liberation

53 will be a year of liberation.

I intend to share the journey. In the event there are other men out there who are tired of the “suck it up” / real men don’t cry bullshit.

I cry ….

The post I Cry … and Start Over appeared first on The Recovery Cartel.

Better Than Bottom

We can do better than “hit bottom”. The Family Recovery Coach is becoming increasingly relevant in today’s battle with addiction.

You walk into a support group, your mind is racing and you are scared to death.

The terminology may be hard to follow. It comes at you from all angles.

Angles & Terms

• Detach…
• Don’t rescue…
• Don’t worry…
• Pray…
• Set boundaries…
• Don’t enable…
• Wait until they hit bottom and want it…
• You can’t control it…
• You can’t cure it…
• And you didn’t cause it…
• Let go and Let God…

Good advice! But, many of us need more.

We leave the meeting. Keep coming back and it will get better.

But in the meantime? Please consider the following.

Points to Consider On Family Recovery Coaching

1. Every family should have a family coach attached to them. Regardless of the status of the addicted individual.
2. The family should be able to self-referral and receive long-term, unconditional support. Without “intervention” being the end game.
3. A family coach should be supervised by a clinician(s).
4. There should be an evidence-based model guiding the coach.
5. Family coaches are not Alanon or Naranon sponsors.
6. Family coaches are not marriage and family therapists.

Qualified Recovery Coaching

They have lived experience to build on. They should meet certain qualifications and should be held to high expectations.

This is a professional discipline.

Families should shop around for services.

Be careful, the “Facebook Superstars” are NOT qualified to support families.

Family coaches should be reimbursed by 3rd party payers.

And the entire family should be the “identified patient(s)”.

Commercial insurance should step up.

That may not happen quickly or easily. But, progressive, forward-thinking partners are stepping forward.

The future will bring a paradigm shift.

Additional Info – Family Intervention Consultation

When a family situation is complex and the loved one’s addiction presents particular challenges. A formal family intervention may be helpful.

FAVOR Greenville’s Executive Director, Rich Jones, is an ARISE Interventionist. Offering consultation and support services at the FAVOR. Using a compassionate Invitational Intervention™, the ARISE Continuum of Care is a gradually-escalating process.

A process that leads your loved one into appropriate treatment and recovery.

The addicted individual is invited to join the process. Join in from the beginning with no surprises, no secrets, no coercion, and absolute respect and love.

For more details and information about the “Family Recovery Coach” , please visit – https://favorgreenville.org/recovery/family-support/

The post Considering The Family Recovery Coach appeared first on The Recovery Cartel.

Things Got Really Weird

When I finally “decided” to change my substance use and do this recovery thing, things got really weird.

🚁🚁Strange noises were ever-present in my head (like a helicopter buzzing around inside my skull-piece).

🐘🐘My face swelled up and I looked like the elephant boy (still not sure what that was all about).

No one could explain it. I was like.

“Hey doc— my face is all messed up and puffed-up like Botox gone bad.“

That doctor was useless.

People had theories. Like “it’s the drugs leaving your system. Seeping out through your pours and causing swelling”.

Now that was some straight up … made up …. shit right there.

No one knew what to say.

My Lopsided Head

They were like “oh snap… Rich’s head is lopsided”.

I slept, at best 4 hours a night.

With freaky ICP dreams at least 63% of the time. Juggalo. 🤡🤡🤡

In an effort to look like Fred Durst from Limp Bizkit I grew a beard and shaped it up with a razor. But I did that all crooked. Further impacting my asymmetrical head and face.

A Baffled Lot I Was

At around 60 days I had to change a tire once and had a full blown emotional breakdown.

And could not successfully complete the process. It baffled me.

I was found catatonic in my driveway.

I ripped a sliding door off a van in anger over a bottle of water. I had to bungee cord it to the other door so it wouldn’t fly open.

There’s much more ….

Give Yourself a Break

It took me a long time to feel “normal”.

A long time to feel okay. And now, okay comes and okay goes.

If you are struggling. Give yourself a break.

If you are feeling a bit “Not OK”, please check out all our support platforms below!

• FAVOR Greenville
• FAVOR Support Group
• FAVOR Anderson
• FAVOR Spartanburg
• FAVOR ~ Western PA Finding Peace ~ Family Peer Recovery
• Sages Army

The post IT’S REALLY OK TO BE NOT OK appeared first on The Recovery Cartel.

“Drug Use For Grown Ups”

Slow going. But I’m reading “Drug Use For Grown Ups”.

Truth is… There is a whole bunch of good stuff in Dr Carl Hart’s book.

The title may suck. And many people were offended by the sensationalized headlines (in all those articles that were posted).

But remember, that was meant to sell books.

Create attention, even if it’s negative attention.

Most I Agree, So Far!

So far: I agree with most of what he says.

The war on drugs is a disgraceful war on people. The arbitrary federal drug schedule needs thrown out.

Research and federal grants come with an agenda attached.

The industrial prison complex is out of control. The politics are twisted etc…

These type of things are on point and beyond controversy.

National Institute of Drug Abuse

It’s also compelling how he takes on the National Institute of Drug Abuse and their “expertise”.

He says some things I agree with.

Then he gets to the statistics related to using drugs ….

Many people do use with no obvious consequences. Most, in fact.

Why is this (truth on dangers of drug use) so hard to accept?

And why does saying this come with some anxiety?

Trouble Maker

I feel like I’m going to get in trouble.

I feel like I’m blaspheming.

Read the book. A fact check his shit.

There’s a little problem called facts.

Maybe it would be a better world if this stuff was never discussed? You know, the scared straight and just say no approach.

81,000 + Dead

I mean… over 81,000 people have died of overdose under that particular “modus operandi”.

So maybe we can crack the door just a bit for some crazy talk from the good doctor.

Then again, I’m early in the book. I may turn on Dr Hart…

I bet he’s worried. He’s sitting at home right now: “Man, I hope Rich Jones in Greenville SC is on my side….”. 😎

The post “Drug Use For Grown Ups” – A Review? appeared first on The Recovery Cartel.

The Momentum Story

What do I mean, Momentum? It starts like this. In 1999, I “hung around” recovery rooms. To get the heat off.

My opinion on recovery was pretty silly at that time.

If I were to summarize my take on recovery in 1999 it would be as follows: “It’s impossible for me to recover.

Recovery is for other people. A select few. Like winning the lottery”.

In 2001 my opinion shifted…dramatically.

Clarity

It wasn’t a moment of clarity. More like simply clarity. It did not come and go–like a moment. It was weird.

All the sudden, it was incredibly clear that substance use disorder was real.

More importantly, it was clear that I could recover. I could live with out drugs and alcohol. I’ve been in recovery since.

2002: Getting Started

In 2002, I started working full time in the drug and alcohol treatment industry and the mental health field.

I always had to work multiple jobs at the same time, because you couldn’t make a living on the entry level salary in this field. You don’t get paid much.

So you work part-time and constantly have side hustles to pay the bills.

I went back to school and got a Masters of Arts degree in Sociology with a concentration in addiction studies. Then I also earned an MBA with a concentration in healthcare management.

I was learning on the fly. I learned a lot. And I adopted the opinions of the industry.

The Traditionalist

I was a hard-core “traditionalist”. There was one way to recover. My opinion had evolved.

In 2004 things started to change a little bit. I became the director of an assertive community treatment team. Working with folks with long-term mental health / co-occurring disorders.

I was “forced” into an immersion/training program in motivational interviewing/harm-reduction.

It was clear that my personal recovery pathway was not the only way.

Questions Arise???

It was clear that many people required harm-reduction. It was clear that many, many people did not have the resources I had.

They did not have the recovery capital that I had.

It was unfair to assume they could follow the same path I took. At the end of the day, I still thought there was only way to recover.

But my opinion was evolving. The evidence was clear and I was a compassionate person.

Clearly, we needed to open our minds.

But I wasn’t sure how to make sense of all of this.

The Kids

In 2007, I started working full time with adolescents and that challenged my thinking even further.

A 16 year-old marijuana smoker is entirely different than a 40 year-old alcoholic.

The model must be different.

I got deeper into motivational interviewing and got trained in family systems.

My opinion evolved.

Clearly, the family was key and there were many ways to “get better”.

The Opioid Epidemic

2007-2012: The opioid epidemic ramps up.

Western Pennsylvania was Ground Zero. People start to die before they even get a chance to recover.

Several “kids” I knew well died. I felt like there was imminent danger all around.

The concept of “hitting bottom” starts to sound like non-sense.

So many things that seemed to be self-evident truths now seemed to be dangerous slogans.

The Company Line

Medication assisted treatment starts to get promoted at that time.

But many people in the rooms, and many professionals, reject the idea of MAT. They reject the idea of harm-reduction.

I simply can not make myself toe the company/industry line.

I start to say things that are not acceptable within in the traditional framework of recovery “thinking”. (ie…multiple pathways etc…).

I stop getting invited to speak at the conferences. My opinion evolved. My opinion was problematic.

It’s All About To Change

As a matter of fact. I start to get downright aggravated with conventional thinking.

2012: I land at FAVOR Greenville and I go next level.

My role as an “advocate” is hard to manage.

When do I speak out? How do I speak out?

I start doing “car rants”. I push back hard against conventional “recovery” wisdom.

It gets… a bit ridiculous. My opinion, has evolved. The pendulum has swung the other way.

2019-2020: My Opinion Evolves “Too Much”

The pandemic crushes me and my family. The stress, the co-occurring mental health.

It becomes apparent that the “pendulum” swung too far the other way as I become borderline obsessed with alternative models.

However, there is a big part of me that needs traditional models.

Both professionally (for referrals etc…) and personally (because it works). It is clear that I do not want the models to go away.

I Want to Add Things

I want to add things to existing systems. NOT destroy existing systems. But I’m not sure I communicate that clearly.

From 2020 through 2021 my opinion evolves again.

When my family needed help I get it through very traditional programming. And I am grateful the programs are there.

I realize that I believe in the conventional pathways. I really do.

There are some bad programs and people out there. Very bad. I mean, really horrible.

BUT, we need rehabs and we need abstinence based programming. And there are really high quality programs available.

WE NEED ALL OF THE ABOVE

My opinion has evolved. It is not “harm reduction” versus abstinence based recovery. It is not “medication assisted treatment” versus more traditional models.

We need all of the above.

I need all of the above and when my family was in need we needed all of the above.

We will continue to need all of the above.

I can admit when I’m wrong.

Maybe not as “promptly” as I should. But I will come around.

I can get “too pushy” with the moderation management vibe.

I don’t take back the message. But I do want to re-evaluate the way in which I deliver the message.

I can be very one-sided. I get fired up and I get on my “soap box”. And my soap box gets out of control. I need to be more balanced.

People Like Me

There are some people, myself included, who need to abstain from all substances in order to reduce harm.

Alcohol is a destructive force that would take over my life if I tried to moderate.

I know this because I tried to moderate for years.

And blackout drunk is not moderating. Sometimes we need to hang up the cleats and walk away from the game.

Better yet, run the other direction.

I Just Want To Be Clear

I believe in abstinence based, 12-step recovery. And I need to do a better job in communicating that belief. In my effort to promote multiple pathways I sometimes go to far.

We need to honor all pathways included the traditional routes of recovery.

Start the process of recovery and don’t quit.

Keep going and keep trying.

People do recover. In all kinds of ways.

Constant forward momentum.

And then there’s the family. That’s a whole other topic….

The post Constant Forward Momentum appeared first on The Recovery Cartel.

Multiple Pathways – Part 2

We say “multiple pathways of recovery”… As if we have to “pick a program” and follow that pathway perfectly. 12-step, clinical support, favor all recovery, coaching, individual therapy, SMART recovery etc … pick one.

Pick one snd do it right. Subconsciously, that’s the message we receive.

Some people pick a path.

And that’s all there is to it. Now and forever. They are on the path. That’s fantastic. Wonderful.

However….

However, many of us pick multiple paths.

And many of us take a route that is not defined as a pathway or program.

The truth is most people figure out their own pathway over time.

With formal program or without formal program. The elements of recovery are many and they are not uniform.

Recovery Is Not Static

Recovery is not static. We adjust. We try different things. And we do it over and over throughout our recovery.

And when I say recovery.

I mean recovery from trauma, substance use, mental health struggles, emotional struggles etc…

The most important thing is … keep moving forward.

Obvious Things

I have been a therapist for 20 years. And several things are obvious.

1. There is no one way to get better.
2. There is only momentum.
3. Hopefully, forward momentum.

And if you are trying to better yourself. I celebrate you and admire you. Regardless of the pathway, program or “plan”.

People get really down on themselves for “slips” or mistakes or not following the plan perfectly.

As if the plan came down from God as the 11th commandment.

We All __________!

• We all struggle.
• We all slip up.
• In some way or in some form.
• We are all a work in progress.
• You will figure it out.
• Go easy on yourself

The post Go Easy on Yourself, But Do Something! appeared first on The Recovery Cartel.

The Dopamine Diaries

“Dopamine” has been incorrectly promoted as the “pleasure chemical” in the brain.  I have said this and I have taught people (wrongly) that dopamine is associated with pleasure. 

First off, there are no chemicals in the brain. Better description would be something closer to “electrical pulses between cells” rather than “chemicals”. 

Second, dopamine does produce contentment.

The main function of dopamine is in “energizing us toward a goal”. 

It is more accurately described as the “reward” neurotransmitter. 

From an evolutionary point of view, dopamine made it possible for humans to seek out things like food, safe relationships, safe groups, and sex in a very dangerous, unpredictable and scarce environment.

It was not pleasure. It was reward. Dopamine made reward seeking possible.

In The Genes

The gene associated with dopamine is DRD4. The mutation, (allele), associated with a dysfunctional dopamine system is 7R.

Therefore, dopamine deficiency = DRD4-7R

Terminology:

• DRD4: DR (dopamine receptor) D4 (number 4).
• 7R: 7 – repeat allele  (“variation or version” ) of the DRD4 gene.
• 7R = Mutation.
• 7R is associated with poor dopamine accessibility (deficiency).

What Is It?

Dopamine is a key neurotransmitter.

It regulates cognition, attention, emotional processing, motor activation, short-term memory, behavioral inhibition and reward. (Wickens, 1990; Nieoullon, 2002; Dreber et al., 2009; Eisenberg et al., 2010b)

Dopamine is not the “pleasure” chemical.

It is involved in goal oriented activity and there is a pleasurable component / feel good component (energy, focus, excitability, confidence).

However, the idea of “pleasure” is a bit misleading.

DRD4-7R is a mutation present in 20.6% of the population.

The Wanderlust Gene

DRD4-7R has been called The Wanderlust Gene.

It’s called Wanderlust because this mutation is equated with adventure seeking, risk taking behavior and restlessness.

Dopamine has been getting more and more press over the past 5-10 years.

Here is a better description: Sensation Seeking.  I like that description. 

An insatiable pursuit of sensations.   

Dopamine & Addiction

Note: “The dopamine deficiency hypothesis” and the dopamine depletion explanation have been the cornerstones of the neurobiology of addiction for decades.

It is not typically talked about in a holistic manner. In that, the focus does not go beyond the addiction connection.

However, it has been the most common “scientific”/medical” explanation for addiction.

Yet, it is a controversial and frequently challenged explanation.

• There are multiple etiological explanations for addiction.
• There are sociological explanations.
• There are hardcore fundamentalist Christian explanations (sin).
• There are people who believe addiction is a social construct.
• And on and on…

A Tragic Comedy

Substance Use Disorder is contextual as well as an individualized experience. There is little certainty where matters of the brain are concerned. Addiction is a brain issue.

It is strange and dangerous when people present theories and explanations in a manner that implies certainty. There is no certainty to be found in terms of addiction treatment and recovery. It’s intuitive and recovery is an imprecise process. 

We understand only 5-10% of brain functioning.  We do not examine the brain when making a SUD diagnosis. 

Yet, we speak with 100% certainty on cause and cure. 

The arrogance and hubris of behavioral health = tragically comical. 

The Over-emphasis on The HIGHJACKED BRAIN

Absolutist application of the neurobiological brain disorder model has been problematic.

It is clear there is a “dopamine and addiction connection”.

However, this “connection” is over-used and over-blown.

It is inappropriately applied across the board in SUD settings. 

Dopamine Despair IS NOT UNIVERSAL

For example, nearly every person who walks into a rehab will be told their brain has been hijacked.

In reality, only a minority of the participants are dealing with classic dopamine depletion.  

The actual percentage of people with a true “brain-change” varies within any given population and treatment setting.

There are plenty of people who meet criteria for SUD severe; yet do not fall into a permanent state of dopamine despair. 

Going To Rehab?

People go to detox and rehab for a wide variety of reasons.

A few examples include: 

• To be physically safe during detox.
• To satisfy the requirements of a professional monitoring board.
• To satisfy the requirements of an angry spouse.
• To satisfy the requirements of a concerned employer
• And on and on…

It is reasonable to assume that a fair number of people who land in rehab – ARE NOT in the throws of full out dopamine distress.

Their brains have not been “forever” changed.

They have a medical condition that needs to be treated and stabilized. FULL STOP. Nothing more, nothing less. That is the purpose of acute care.

Beware The Broad Brush

This is why it is problematic to paint with such a far-reaching exceptionally broad brush.  

The reasons for a wide range of “dopamine depletion typology” include:

• Drug of “choice” (certain drugs dysregulate dopamine in more problematic ways—methamphetamine SPIKES for example). 
• Length of using career (the longer the using career the deeper the DRD4 problems)
• Genetic factors
• And a growing body of literature points to ethnic background, country of origin, etc..
• Along with cultural/societal factors (stress related to generational trauma/poverty). 

There are clearly people who have less baseline dopamine compared to the general population. 

“The Real Alcoholic” is how it has been described in some recovery circles.  

However, when we look beyond substance use disorders we see many other manifestations of the DRD4-7R phenomenon. 

“The Risk Taker” 
“The Workaholic”
“The Migrator” (ancient migration connection). 

People with Substance Use Disorder and people without substance use disorder have the DRD4-7R gene.

People who have never used alcohol or drugs and people who use the hell out of alcohol and drugs have the DRD4-7R gene.

This DRD4-7R Thing Goes WAY Beyond Addiction

20.6% of the population has DRD4-7R.

This conversation goes way beyond addiction.

And that is a good thing. We are human beings. Not DRD4-7R aliens.

We (people with SUD/people in recovery) are no different than our fellow man.

We are certainly no different than the 20% of Americans who make up the DRD4-7R group.

It’s not “addictive thinking”.  It’s DRD4-7R thinking.   

Stone Age Origins

Some History/Random Thoughts:

DRD4-7R appears on the “scene” for about 50,000 years ago.

They tell us there is a connection between migration and DRD4-R7. For instance, decreased dopamine action (presence of DRD4-7R allele) contributes to risk taking, recklessness, goal oriented behavior. All of which are necessary for migration.  

How do “they” know about the DRD4-7R allele and dopamine deficiency:

Psychology Today Is My JAM:

I found an article in Psychology Today that provides one of the better explanations:

Basically, “they” have employed new techniques and methodology to support this theory—focusing on gyrification. 

Quote from the PT article: 

“DRD4-7r is famous in neuroscience circles for being a problematic member of chromosome 11.

Palaniyappan et al. recently found that those with DRD4-7r and a diagnosis of ADHD had less prefrontal gyrification than those with a different DRD4 allele⁴.

Gyrification analysis is a relatively novel approach at assessing neural development by exploring the extent of cortical folding in contrast to volume analysis, which has been done traditionally using voxel morphometry.

Gyrification ceases and remains constant by around the second year after birth, but before this crucial milestone, gyrification can be disturbed by perinatal complications.

As gyrification is influenced by both environmental and genetic factors, the reduced folding in patients with ADHD and who have the DRD4-7r allele, seems to suggest that the 7r allele could be involved in this hypogyrification^”.  

Psychology Today – Jack Pemment, 2019

Here is link to the entire psychology today article:  https://www.psychologytoday.com/us/blog/blame-the-amygdala/201909/the-curious-personality-the-drd4-7r-allele

Side Note:  Who is the “they” mentioned above?  NEURO-SCIENTISTS of course. 

Dopamine Deficient Misfits

In reality, the DRD4-R7 allele is merely a marker for a neurobiological process and an accompanying set of behavioral norms.

Behavioral norms include restlessness, impulsivity, novelty seeking, risk taking and pleasure seeking.  

This DRD4-7R manifestation of the human condition is the result of many different factors.

These factors range from genetics to trauma to environment and culture.

There is no question that I have lived my entire life as one of the 20%.

I am surely one of the “Dopamine Deficient Misfits”.

My Case

In my case, I explain my dopamine “shortage” in the following manner:

The Rich Jones X Factor:

1. Genetics +
2. Early Trauma +
3. Early Use +
4. Toxic Environment/Messaging +
5. Larger Environment/Culture =
   A DEEP PROBLEMATIC DRD4-7R ISSUE

Larger Environment / Culture

What do I mean by “Larger Environment / Culture”. 

The 1980’s  were the twilight of the “suck it up” culture. Corporal punishment, for example, remained somewhat commonplace (beyond the pathology in any given home). 

It was a more domestically violent era. A more reckless era.

I grew up during the end times for free-range children. We played outside. We were left alone.

We found our way through the city. We drove motorcycles without helmets and seat-belts were an after-thought. 

Lot’s of opportunity for risk taking.

19 years in full sustained remission from opioid use disorder and alcohol use disorder.

I have no desire to use substances.  But I am still dopamine challenged. 

Why am I drawn to things that spikes dopamine?  I am drawn to all kind of things that spike dopamine. Big things and small things. 

Baseline Dopamine

When baseline dopamine accessibility is low (or lower than “normal”) the unconscious search to get a dopamine hit drives behaviors (increased impulsivity, risk taking, etc…)

Example: there is a clear connection between 7R allele (deficiency) and reckless spending.

Full article/link: https://www.frontiersin.org/articles/10.3389/fnbeh.2018.00034/full

Other random/weird behaviors (may or may not be a dopamine connection–not sure):

Why am I obsessively drawn to “motivational” videos.

Vikings soundtrack; Mulligan Brothers, and on and on…

If it’s “good” I will watch it over and over. In a very strange and obsessive manner.

Music : I will find a new song and listen to it over and over?

Sports. I had to play all day. Not only because I wanted to be a good athlete. I was obsessed. It went beyond the obvious athletic goals.

Side Note:  The problem of tolerance.  Drugs, alcohol, sex, screens, food all have very distinct limits. This has been written from the beginning. Hedonistic treadmill. Tolerance. Hedonistic Adaptation.

“The Real Alcoholic” 

Things we have heard, (very interesting things):

There is a bunch of information challenging the Alcohol Use Disorder and DRD4-7R connection (DRD4-7R variant) .

It’s just not completely clear how many people labeled “Alcohol Use Disorder” actually have progressed to the classic “alpha” alcoholic.

The classic “dopamine deficient” alcoholic—“The Real Alcoholic” 

Full article: https://onlinelibrary.wiley.com/doi/abs/10.1002/(SICI)1096-8628(19970919)74:5%3C483::AID-AJMG5%3E3.0.CO;2-P

Much More Work Needed

At the same time; there is a SUD/dopamine “connection” and more work needs to be done: 

Dopaminergic abnormalities are implicated in the pathogenesis of substance abuse.

Several genetic variants, especially DRD2 and DRD4, were previously reported in the literature as associated with substance abuse.

Carriers of the DRD4 7R allele showed greater susceptibility to alcohol dependence and opioid dependence.

Among carriers of the 7R allele, a higher rate of cigarette smoking was observed.

Ellis et al. described a connection between 7R and neuroticism and nicotine dependence, and Nederhof describes a connection to pathological gambling.

Full article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3560519/

Kids With ADHD

Kids with ADHD: There seems to be more universal agreement about the ADHD/Dopamine deficiency connection. 

Article below:  “Conclusions: Children with ADHD possessing the DRD4 7R allele require higher doses of methylphenidate for symptom improvement and symptom normalization.

This pharmacogenetic study demonstrates that the 7-repeat allele of the DRD4 gene VNTR polymorphism correlates with treatment outcomes. 

Here is the Link: https://www.liebertpub.com/doi/abs/10.1089/cap.2004.14.564

More on KIDS with ADHD https://www.nature.com/articles/4001350.pdf?proof=true

Research–MORE RESEARCH

There is not enough research to speak with certainty on dopamine.

But there is enough information available to support more extensive study and we need to pay attention to dopamine.

Some other considerations:

The frequency of allele variants varies among ethnic groups, which makes the study of their associations more difficult.

The 7R allele has low prevalence in Asia (2%), but high prevalence in America (48%) [link].

The 7-repeat allele has been reported to encode a receptor with lower affinity for dopamine. 

In vitro studies indicate that the sensitivity of the 7R allele is half that of the 2R and 4R variants [link].

The 7R allele is associated with various psychiatric disorders including ADHD, dependences, pathological gambling, alcoholism, drug dependence and bulimia nervosa [link – link].

Autism & Schizophrenia

Several studies also described associations with autism and schizophrenia [link–link].

However, in these disorders other genes have received more attention (e. g. [link]).

DRD4 length polymorphism has been described in connection with specific behavioral phenotypes.

Including externalizing behavior problems [link], the personality trait of novelty seeking, impulsive personality traits, anger, short temper and thrill seeking and aggressive and delinquent behavior, as compared to other genotypes (e. g. [link]). COMMON THEME: IMPULSIVE; RISK TAKERS ETC…

Kang et al. [link] found that the short allele was associated with significantly lower anger in tendency to anger and higher forgiveness traits.

However, the functions of all the individual variants have not been confirmed [link] and the effects of the variants on transporter levels cannot be generalized to neuropsychiatric disorders.

Despite the large number of empirical studies in this field, a review article on the dopamine D4 receptor gene DRD4 and its association with psychiatric disorders is still lacking from the literature; hence, the present article reviews current scientific findings in this area. 

Link to complete article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3560519/

Criticism

Common Criticism on the dopamine deficiency issue.

Heterogeneity problem: Kluger et al. , in a meta-analysis, stated that despite many authors having found the presence of longer alleles to be associated with higher novelty seeking scores, on average there is no association between DRD4 polymorphism and novelty seeking. The heterogeneity among the studies is very high.

Question extraversion and risk taking: De Luca et al., in a follow-up study, presented evidence indicating that there is a genetic influence of the DRD4 gene on human temperament at birth, at 1 month of age and at 3 years of age.

The study showed, only in part, previous results of a link between the DRD4 gene and human temperament.

None of the extraversion or exploratory behavior measures were related to the 7R form of DRD4.

ADHD & DRD4

ADHD is connected. But not surprisingly, still some questions and concerns:

VNTR polymorphism in the DRD4 gene associates with ADHD across numerous studies.

Association between ADHD and the 7-repeat allele has been widely documented.

The 7-repeat allele was found in 41% of ADHD patients, but in only 21% of the control group.

A meta-analysis of 21 studies revealed evidence of significant association; however, negative results were also published.

According to Faraone there is an association between ADHD and DRD4, but it is small.

Others Issues

Independent studies showed an association between the presence of allele 7 and personality traits associated with impulsivity.

Further studies are needed to confirm these findings and explore the role of specific gene-gene and gene-environment interactions and other co-occurring psychopathology among individuals with ADHD.

The spectrum (development disorders) may be impacted but little data exists.

Several studies found a positive association of the 7R allele of the DRD4 gene and autism, but the DRD4 exon 3 polymorphism is still unlikely to play a major role in the etiology of autism.

Good Stuff?

But there may be something good about DRD4-7R deficiencies.

Stress inoculation: According to various studies DRD4 variants can affect individual responses to stress or trauma, similar to several other gene variants.

Das et al. described the effect of the DRD4 gene and childhood environment interaction on resilience to stressors.

Armbruster et al found that carriers of the 7R allele together with the 5HTTLPR L allele exhibit lower cortisol stress responses.

Side Note: It appears I thrive in a crisis/acutely stressful situation.

Perhaps my DRD4-7R issues have an upside?  

Moderates, Influences & Arouses

The DRD4 genotype also moderates the association of experienced parental problems during childhood (e.g., parental depression, marital discord) with loss or trauma [61].

The 7R allele influences the development of personality in a way that provides protection against adverse outcomes [link].

Emotionally arousing situations/more sensitive if DRD4-7R :

Results showed increased brain activity in response to unpleasant images compared to neutral images in the right temporal lobe in participants with the DRD4-4R/7R genotype versus participants with the DRD4-4R/4R genotype.

The increase in right temporal lobe activity in individuals with DRD4-4R/7R suggests greater involvement in processing negative emotional stimuli.

Intriguingly, no differences were found between the two genotypes in the subjective ratings of the images.

The findings corroborate the response ready hypothesis, which suggests that individuals with the 7R allele are more responsive to negative emotional stimuli compared to individuals with the 4R allele of the DRD4 gene.

FULL ARTICLE: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4272659/

Evolution

Again, the evolutionary psychology is interesting.

All of the following traits/behavioral tendencies would serve a purpose in advancing the species. “SOMEONE NEEDS TO LEAVE THE CAVE”: 

The 7R allele is estimated to have emerged 40,000 to 50,000 years ago, which is the same time that major human migration occurred (Wang et al., 2004).

This genotype, including its homozygous and heterozygous variations, is found more frequently in populations who had to take great risks to travel long distances. Such as early immigrants to the Americas (Chen et al., 1999; Eisenberg et al., 2010a).

The association with risk taking was corroborated by research showing that individuals with the 7R allele of the DRD4 gene engage in more financial risk taking compared to those without this genotype (Dreber et al., 2009).

Humans with at least one 7R allele show increased levels of physical activity (Faraone et al., 2001; Kluger et al., 2002; Grady et al., 2003; Grady et al., 2005b; Li et al., 2006; Grady et al., 2013)

Also, they appear to be more reactive to environmental factors (Sheese at al., 2007; Belsky et al., 2009; Olsson et al., 2011; Grady et al., 2013).

The 7R allele is over-represented in the phenotype of Attention-Deficit/Hyperactivity Disorder (ADHD) (LaHoste et al., 1996; Faraone et al., 2001; Grady et al., 2003; Grady et al., 2005a; Li et al., 2006).

In addition, the 7R allele is associated with “limit pushing” behaviors including (among other things): disinhibition (Congdon et al., 2008).

Disinhibition will promote risk taking.

Contributes To Longevity

Intriguingly, a study by Grady et al. (2013) has shown that the 7R allele contributes to longevity by moderating the beneficial effects of an enriched environment in increasing lifespan.

The 7R allele of the DRD4 gene has been associated with the response ready hypothesis, which suggests that individuals with hyper-vigilance might be selected for by environments that are resource-depleted, time critical, or rapidly changing (Jensen et al., 1997; Wang et al., 2004).

It is speculated that the 7R allele and its association with the response ready hypothesis might have played a role in its positive selection and human migration (Chen et al., 1999; Ding et al., 2002; Wang et al., 2004; Grady et al., 2013).

More Psychology Today: 

Psychology Today:  DRD4-7r appears to have profound implications for the carrier, and seems to be involved in a number of fateful activities that could impact the carrier’s entire life.

A propensity for greater risk-taking, a heightened sensitivity to the environment, being at greater risk of attention and behavior issues, and demanding more parental attention in the formative years all set one up for an exhausting life – all because of one version of a receptor that isn’t as receptive to stimulation as the other versions.

In fact, the receptor, much like the carrier, does not seem to play well with others.

The 7r allele almost seems like a mischievous imp, inspiring and pushing the carrier into antisocial and asocial behaviors. 

Link: https://www.psychologytoday.com/us/blog/blame-the-amygdala/201909/the-curious-personality-the-drd4-7r-allele

Random Stuff

How do we get better? How do we get “normal”?

For clarification purposes: I DO NOT WANT TO GET BETTER.

Here is NORA VOLKOW on “Getting Better” and “Interventions” which address dopamine for addiction (food, drugs etc..)

Volkow: https://www.ncbi.nlm.nih.gov/pubmed/29142296

Test For Deficiency

How do I know if I have “dopamine deficiency”?

Example of a recommended test for Dopamine levels

• https://www.directlabs.com/bengreenfield/OrderTests/tabid/21021/language/en-US/Default.aspx

I will be making arrangements to take this test.

I will let you know how it goes. How much it costs etc…

Dopamine Mechanism

Great video on the actual mechanism of dopamine (it is not a pleasure neurotransmitter; rather an action/goal attaining neurotransmitter. 

It keeps us moving toward the “reward” (food, achievement, drugs, love/relationships etc…) 

• Robert Sapolsky:   https://youtu.be/axrywDP9Ii0  (dopamine basics-anticipation/delayed gratification)

Final Thoughts

At the end of the day, you need to speak with professionals, medical personnel, etc..

Find an integrative medicine doctor. 

Beware of people who talk with too much authority and act with too much certainty. 

These are uncharted waters.  Advocate for yourself.

I have come to my own conclusions. 

Now I need to develop my dopamine plan of attack. 

I will share this plan.  I am going to take a very holistic approach. 

Sign up for RECOVERY CARTEL (www.recoverycartel.com) to ensure you get the updates.

The post The Rich Jones Dopamine Diaries appeared first on The Recovery Cartel.

COVID-19: PICK YOUR TRIBE

In this strange new COVID-19 world, it is relatively stunning how quickly COVID-19 has been assimilated into America’s culture war.

Amazing how quickly the sides were drawn and the political positions defined?

AT the extremes, the talking points and group-think around this strange new COVID-19 world have been clearly defined.

Like every other social issue, nuance is not permitted. It’s black or white. Up or down. You are either in or out.

The following is a bit of an exaggeration, but only a little bit of an exaggeration.

This is essentially how every single discussion will play out until COVID-19 is contained and a vaccine is developed.

DEMOCRATS

If you are a democrat you must be against reopening unless every single “scientist” agrees that it is time to re-open.

You Will:

• Argue that “lives will be lost” if we open too early.
• Ignore the fact that it is impossible to eliminate risk completely and you will keep referring to some vague “we need to listen to the scientists”. .
• Let us all know that you get your information from “independent” or “academic” resources that can only be understood by other liberals.
  (Because y’all are of superior intellect).
• You will characterize people who want to “open it up” as being stupid, moronic and clearly not as enlightened as you are.

REPUBLICANS

If you are a republican you must be in favor of opening up NOW.

You Will:

• Focus on your liberty and freedom and act as if this is the Battle of Bunker Hill.
• You are a patriot and the rest of them are parasites who want to live off your tax money.
• Cash your stimulus check.
• Characterize those with other opinions as American-hating communists.
• You will make the strange connection between COVID-19 and other conservative issues, such as gun-rights. If they make us stay home they will take our guns?

FOR EVER & EVER, AMEN

There you have it. Every single cable news show from now until the end of time.

But what if?

These extremes don’t represent the majority. Whet if these tough guys and super intellects are the minority.

They just make for better television and better ratings for media coverage.

The complete elimination of reasonable disagreement makes politics something that is nearly impossible to tolerate.

ENLIGHTENED, NIHILISTS, EXTREMISTS, INDEPENDENTS

Is there a tribe of enlightened disinterest? A group that refuses to engage because of the silliness of engagement?

Where are the nihilists?

Alas, the nihilists are too non-committal and stand for nothing (literally).

Where is the group that rejects these extremes? It’s not the “independents”. That’s not a real thing.

There are no 3rd parties, no independents or nuanced positions.

Were there ever nuanced positions? Revisionist history and nostalgia says there were “back in the day”.

Apparently, Newt Gingrich changed all that (at least that’s what the New York Times told me–wait…the New York Times told me that—shit….).

FOR THE RECORD

I want “them” to keep “it” closed and be extra cautious.

But I don’t think people protesting to “open it up” are automatically “morons”. I don’t agree with them.

And I”m pretty sure there are some morons out there.

But I don’t have the ability to pick them out and make such statements. And I certainly do not think most of y’all who are saying they are morons are particularly intelligent.

If you were such an intelligent being, you would spend time thinking about their position, considering their position, refuting their position and you would not resort to childish playground type insults.

WOKE OR NOT

Isn’t the word moron politically incorrect and unacceptable in a civilized society?

Can someone who is more “woke” than me let us know if that word is acceptable?

In the end, it makes people feel better to put other people down and randomly assert superiority.

Just as it makes me feel better to randomly assert that I am somehow above all that tribalism.

I guess this is simply a way to cope with a very strange new COVID-19 world.

And we are all doing the best we can?

The post STRANGE NEW COVID-19 WORLD appeared first on The Recovery Cartel.

The Ripple Effect by Rich Jones

Things are starting to slowly turn in a positive direction. In terms of understanding the virus, advancing medicine/vaccines, increasing testing and related issues. Trending in a better direction.

You can’t shut-down such a large slice of economic activity without it leaving some pretty bad scars.

Projections of 20 plus % unemployment, 30% GDP contraction and the near elimination of small business in several sectors. Permanent change to airlines, hotel, restaurant industries etc….

The economic impact will be incomprehensible and beyond any frame of reference. There is nothing to compare this to in terms of modeling an economic recovery.

The Ripple Effect

The “ripple effect” will be profound.

Consumer behavior will be forever altered. If you own a business Adapt and transition and do all you can to survive. Pivot like Shaq back in his Orlando Magic days….

But I believe things are starting to turn in a better direction (relatively speaking). We will be seeing movement toward a “re-opening” sooner than later.

SIDE NOTE: The media is starting to prepare for a full out politicalization of the COVID-19 issue ahead of the presidential election.

They will get even more sensationalistic. Each side digging in for trench warfare. The erosion of journalistic integrity is somewhat comical. If it weren’t so sad and scary.

All Hands On Deck

The co-occurring mental health and substance misuse epidemic concerns me. Suicides climbing. SUD escalating. Overdoses are happening all day, everyday.

Public health interventions for behavioral health issues need to be aggressively rolled out. Community health workers out in the neighborhoods.

And the workers do not have to be “recovery coaches only”.

We need to get over this idea that only recovering people can help. All hands on deck.

Be Compassionate

I never liked the whole “only an addict can help an addict” vibe.

I think recovering people bring vital knowledge and unique skills to the fight. However, I know many recovering people who are mean and punishing and do more harm than good.

I reject the “recovery” only vibe. How about this: “only nice people are allowed to help. Only compassionate people….”.

Everyone will need to contribute to containing the behavioral health pandemic. Just as everyone needs to contribute to containing the COVID-19 pandemic.

The post Letters From The Pandemic: “The Ripple Effect” appeared first on The Recovery Cartel.