Looking to Increase Your Chances of Overcoming Addiction? Discover How Holistic Psychiatry Can Help

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Less than 42% of the individuals who enter treatment for drug and alcohol use complete it.

Less than half.

Let’s look at how addiction is currently treated so we can see what’s partially working. Then let’s talk about other treatments that could increase that percentage and help more people, including you or your loved ones.

Addiction to any substance is treated in tiers.

The first tier is to ask your primary care doctor or psychiatrist to prescribe medications to make it easier to quit and stay sober. Even with several options, the outcomes are only mildly to moderately effective.

For nicotine:

• Varenicline/Chantix

• Bupropion SR

For alcohol:

• Naltrexone

• Gabapentin

• Acamprosate

• Disulfiram/Antabuse

For benzodiazepines:

• Gabapentin

For opiates:

• Methadone

• Buprenorphine/Suboxone

For cocaine and other stimulants:

• Gabapentin

• Bupropion

• Topiramate

There’s no method of stopping anything addictive that’s guaranteed to work. Some people come off gradually, for example, decreasing the number of cigarettes they smoke each week. Others stop cold turkey and get rid of their supply.

There is one rule though when deciding to stop using alcohol or benzodiazepines daily. You must go to a hospital or detox center for medical supervision while you come off these substances. They cannot be stopped cold turkey because doing so is life-threatening. There is a risk of seizures and death. At a hospital or detox center, you’ll be under medical supervision, and they will decrease the dose gradually to prevent seizures. All other substances can be stopped suddenly. The withdrawal will be bad, but it won’t kill you.

Aside from medications that make it easier to quit and help curb cravings, there are rehabs. These programs usually last a month, and you cannot leave while you’re there. The goal is to cut you off from all sources of the addictive substance and provide you with support while doing so. There are support groups, therapy sessions, and counseling.

There are also outpatient substance use clinics that provide support groups, therapy sessions, and counseling several times per week.

All the above are covered by insurance. Outside of the insurance realm, there are programs like AA (Alcoholics Anonymous), NA (Narcotics Anonymous), SMART Recovery, LifeRing, and more. These organizations have many meetings in person and online, as well as peer mentors. All of these are voluntary, as in nobody can make someone show up for them.

On the legal side, there are DUI’s, DWI’s, jail time, court-ordered drug rehab, parole, and more.

Most people in treatment for their substance use see a psychiatrist because they’re simultaneously depressed, anxious, or can’t sleep or concentrate. It’s common for people struggling with addiction to be on several psychiatric medications simultaneously, like an antidepressant to try to prevent low mood, a “mood stabilizer” to try to prevent outbursts, and a dopamine blocker to assist with sleep. All of these medications have side effects, especially when combined. The results are very mediocre.

That’s the current conventional medical model of addiction treatment.

Let’s go over different treatments that become available if we zoom out and take medical treatment models outside of conventional medicine into account.

A crucial part of treatment is a holistic health evaluation. Most people struggling with addiction are depleted of vitamins and minerals. Labs need to be drawn, and these imbalances addressed.

Common imbalances include:

• Low B6 and zinc

• Low B1 (thiamine), B12, B9 (folate)

• Low cholesterol

• Low Vitamin D

• Low Magnesium

• Inadequate protein breakdown

The overall goal is to support optimal bodily functioning, which is being prevented by a lack of the building blocks it needs to work well due to the stressor of substance use.

Then come the more targeted interventions, also aimed at supporting your body to help you feel better through a language it understands: nutrients, minerals, and vitamins.

The following interventions have been shown to be effective, in research and clinically:

• NAC (N-acetyl cysteine)

  • NAC restores levels of glutathione, which is the most powerful antioxidant in the body. Antioxidants are necessary to clean up, or reduce, the free radicals that are a result of energy production in the body. A byproduct of mitochondria producing our energy molecules, ATP, is free radicals, which wreak havoc if not cleaned up by antioxidants. They break down cell tissue and cause DNA damage, resulting in inflammation and other harmful effects.

  • Substance use leads to higher levels of free radicals, which makes glutathione production via NAC a crucial part of treatment.

• High protein intake

  • Proteins are made up of amino acids. There are 9 essential amino acids. They are called “essential” because our bodies can’t make them, so we need to eat them regularly. Amino acids are the crucial building blocks of body protein as well as creatine, peptide hormones, and neurotransmitters. Without essential amino acids, our bodies cannot carry out pivotal functions. Substance use is a stressor on the body, which means it depletes nutrients and minerals more quickly than normal, decreasing its ability to function well. High protein intake is one way to provide it with the nutrients it needs.

  • The recommendations vary amongst experts, but the following are good guidelines to aim for:

    • One gram of protein per pound of ideal body weight daily

    • At least 30g of protein, 3 times a day at each meal

    • 1.2 to 1.6 grams of protein per kilogram of your weight daily

• Low-dose Lithium

  • Recently, studies have shown that low-dose lithium, just 150mg a day, has the following results:

    • Average opiate medication dose was reduced by 50%

    • Benzodiazepine usage was reduced by 99%

    • Atypical antipsychotics down by 70%

    • Polypharmacy (the prescription of multiple psychiatric medications at once) lowered by 79%

    • Smoking cessation participation increased threefold

    • The rehab program completion rate almost doubled

  • Participants felt a difference about one week after starting it.

  • Lithium carbonate is typically prescribed in the treatment of bipolar disorder. Typical doses range from 600-1,200mg daily. At these doses, blood work to check how much is in your system needs to be done initially to make sure it’s not too high.

  • No blood work is needed when taking 150mg daily of lithium because it’s not a high enough dose to even show up in the blood.

  • The risks of side effects for lithium are dose-dependent, meaning they get worse as the doses go up. Since this is a low dose, the risk of side effects is very low.

• Increase Omega 3 fatty acids, decrease Omega 6 fatty acids

  • Adequate amounts of omega-3 fatty acids are required by our brain and body to keep us functioning. They are also essential nutrients because our bodies cannot make them, thus we must consume them regularly. They’re found in foods like fatty fish (salmon, mackerel, sardines, anchovies), flaxseeds, hemp seeds, chia seeds, and walnuts as well as extra virgin olive oil.

  • The omega 6 to omega 3 ratio is also important. A ratio of 4:1 is considered ideal; however, most commonly, the ratio in an average American diet is 16:1. Omega 6 fatty acids are found in high doses in sunflower, corn oil, soybean oil, and cottonseed oil, as well as margarine, and should be avoided for optimal omega 6 to 3 levels to help with healing.

• Vitamin B3/niacinamide - especially for those with alcohol addiction

  • It’s not well known that the founder of AA, Bill Wilson, was a huge proponent of niacinamide or vitamin B3 for the treatment of those with alcohol addiction. He was introduced to it by Dr. Hoffer, a prominent figure in Orthomolecular Medicine, which was founded by Linus Pauling, the Nobel prize in chemistry recipient. Orthomolecular medicine is based on the premise of biochemical individuality, meaning that there are person-to-person differences in the amount of nutrients and minerals needed for optimal functioning.

  • Bill Wilson himself took niacin and found it to be immensely helpful in “recovery from sometimes long-standing depression, exhaustion, and heavy tension” as well as in decreasing alcohol cravings. He ran experiments on others with alcohol addiction with good results, but the treatment never went mainstream.

If you’ve “tried everything” and still struggle with addiction, think again. More than likely, your doctor hasn’t recommended the above treatments to you. Why?

These treatments are not taught in medical school or residency training. Some are new, some are old, some aren’t prescriptions, and the ones that are are no longer under patent, so they don’t make much money. This means they aren’t advertised on TV or to doctors at conferences.

Basically, doctors have to go out of their way to find this information. The good news is that there are psychiatrists who have chosen to go beyond what was taught in medical school and residency. They saw how the conventional medicine treatment approach often fails patients and searched for other medical frameworks like functional, integrative, nutritional, lifestyle, orthomolecular, and mind-body medicine. They’ve sought out books, research, articles, lectures, and courses to learn from them so they can help their patients in ways outside of prescription medication. These are holistic psychiatrists.

Holistic psychiatrists take the best of their conventional medical training (4 years of medical school + 4 years of psychiatry residency) and combine it with non-conventional treatments like root cause analysis, individualized nutrient therapy, diet, movement, sleep, supplements, and wellness coaching. They do this to help you feel fully better, now and long term.

I created Brain-Body Psychiatry to bring you better mental health treatment through holistic psychiatry.

We all need support, guidance, and accountability in making and sustaining positive changes.

Brain-Body Psychiatry provides the tools and takes the time to guide you to your full potential.

If you’re interested in this approach, I am very excited to work on this together.

With care,

Dr. Luisa Cacciaguida

Disclaimer:

This blog post is intended to be informative and does not replace individual medical advice. Always consult with your healthcare provider or a professional for any personal medical decisions or concerns you may have. Everyone's health situation is unique and should be evaluated by a healthcare professional.

This blog post is designed as a general guide. This is not a substitute for personalized medical advice, nor is a patient-physician relationship established in this blog post.