Vincent Dole - Approach To Therapy

Approach To Therapy

Dole & Nyswander's skeptical approach to the view that addicts of (certain) drugs were morally unfit, criminals in our midst helped to return the treatment of chemical dependency to doctors, from whom it had been usurped by the anti-narcotics constabulary.

Drug-seeking behavior, like theft, is observed after addiction is established and the narcotic drug has become euphorigenic. The question as to whether this abnormality in reaction stems from the basic weakness of character, or is a consequence of drug usage, is best studied when drug hunger is relieved. Patients on the methadone maintenance program, blockaded against the euphorigenic action of heroin, turn their energies to school work and jobs. It would be easy for them to became passive, to live indefinitely on public support and claim that they had done enough in winning the fight against heroin. Why they do not yield to this temptation is unclear, but in general they do not. Their struggles to become self-supporting members of the community should impress the critics who had considered them self-indulgent when drug-hungry addicts. When drug hunger is blocked without production of narcotic effects, the drug-seeking behavior ends.

Their achievement was made at a time before the discovery of stereo specific opioid receptor sites distributed throughout the central nervous system, brain and spinal cord, which were activated by naturally produced ligands called endorphins (for "endogenous morphine") & enkephalins to facilitate the body's own process of modulating painful stimuli from acute and/or chronic trauma. It was soon discovered these endogenously-produced agents had important molecular similarities to the plant-produced alkaloids morphine & codeine. The discovery allowed Pharmaceutical Companies to create new generations of semi-synthetic and synthetic opioid agonists (agents which mimic the effects of endorphins), antagonists (agents, such as naloxone (Narcan) which reverse the effects of agonists, essential in treating overdose), and even a separate category of "agonist-antagonists" which possess properties across a broad spectrum of different receptors (e.g. Mu, Kappa). Researchers continue to expand our understanding of how the human body regulates everything from reaction to noxious & pleasurable stimuli, temperature, pressure, emotions, learning, and many other physiological processes. The scientific leap also has doubled the choices available to opioid addicts with the availability in recent years of treatment from individual medical practitioners dispensing sub lingual buprenorphine HCl in the form of (Subetex & Suboxone), following the same principles discovered by Dole & Nyswander.