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Kenneth Blum,1– 5 Bruce Steinberg,6 Marjorie C Gondre-Lewis,7 David Baron,1 Edward J Modestino,6 Rajendra D Badgaiyan,8– 10 B William Downs,11 Debasis Bagchi,11 Raymond Brewer,5 Thomas McLaughlin,12 Abdalla Bowirrat,13 Mark Gold14 1Center for Psychiatry, Medicine & Primary Care, Division of Addiction Research & Education, Graduate College, Western University Health Sciences, Pomona, CA, USA; 2Eötvös Loránd University, Institute of Psychology, Budapest, Hungary; 3Department of Psychiatry, Wright State University Boonshoft School of Medicine and Dayton VA Medical Center, Dayton, OH (IE), USA; 4Department of Psychiatry, University of Vermont, Burlington, VT, USA; 5Division of Nutrigenomics, The Kenneth Blum Behavioral & Neurogenetic Institute, Austin, TX, USA; 6Department of Psychology, Curry College, Milton, MA, USA; 7Developmental Neuropsychopharmacology Laboratory, Department of Anatomy, Howard University College of Medicine, Washington, DC, USA; 8Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; 9Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital, San Antonio, TX, USA; 10Long School of Medicine, University of Texas Medical Center, San Antonio, TX, USA; 11Division of Nutrigenomics, Victory Nutrition International, Inc., Harleysville, PA, USA; 12Department of Psychopharmacology, Center for Psychiatric Medicine, Lawrence, MA, USA; 13Adelson School of Medicine & Department of Molecular Biology, Ariel University, Ariel, Israel; 14Department of Psychiatry, Washington University, School of Medicine, St. Louis, MO, USACorrespondence: Bruce SteinbergDepartment of Psychology, Curry College, Milton, MA, USATel +1 617-333-2226Fax +1 617-333-2316Email Bsteinbe4@gmail.comAbstract: This is a review of research on “Precision Behavioral Management” of substance use disorder (SUD). America is experiencing a high prevalence of substance use disorder, primarily involving legal and illegal opioid use. A 3000% increase in treatment for substance abuse has occurred between 2000 and 2016. Unfortunately, present day treatment of opioid abuse involves providing replacement therapy with powerful opioids to, at best, induce harm reduction, not prophylaxis. These interventions do not enhance gene expression and restore the balance of the brain reward system’s neurotransmitters. We are proposing a generalized approach called “Precision Behavioral Management”. This approach includes 1) using the Genetic Addiction Risk Severity (GARS, a 10 candidate polymorphic gene panel shown to predict ASI-alcohol and drug severity) to assess early pre-disposition to substance use disorder; 2) using a validated reward deficiency syndrome (RDS) questionnaire; 3) utilization of the Comprehensive Analysis of Reported Drugs (CARD™) to assess treatment compliance and abstinence from illicit drugs during treatment, and, importantly; 4) utilization of a “Pro-dopamine regulator (KB220)” (via IV or oral [KB220Z] delivery systems) to optimize gene expression, restore the balance of the Brain Reward Cascade’s neurotransmitter systems and prevent relapse by induction of dopamine homeostasis, and; 5) utilization of targeted DNA polymorphic reward genes to direct mRNA genetic expression profiling during the treatment process. Incorporation of these events can be applied to not only the under-considered African-American RDS community, but all victims of RDS, as a demonstration of a paradigm shift that uniquely provides a novel putative “standard of care” based on DNA guided precision nutrition therapy to induce “dopamine homeostasis” and rebalance neurotransmitters in the Brain Reward Cascade. We are also developing a Reward Deficiency Syndrome Diagnostic Criteria (RDSDC) to assist in potential tertiary treatment.Keywords: substance use disorder, SUD, genomic disparity, dopamine, pro-dopamine regulation, KB220, GARS, homeostasis |
