January 2017

Naltrexone is in fact not inactive in the absence of exogenous opioids. This is because the drug blocks the actions of the body’s endogenous opioid peptides (enkephalin, endorphin, and dynorphin); this can cause negative emotional effects (such as depressed mood), which reduce patient compliance (7). As a result, naltrexone is mostly effective for highly “motivated” addicted individuals whose employment can be used to coerce compliance. Based on animal studies showing that alcohol’s and nicotine’s addicting actions are mediated in part via activation of endogenous opioidergic neurons (Fig. 4-1), naltrexone has been used to treat addiction to these drugs as well. Some efficacy is observed clinically, but the effects of naltrexone are relatively small in magnitude and effective for a subset of patients only (9).

Аlcohol is an exception among them all. It’s a unique situation when a drug (according to neurobiological researches even more dangerous than illicit ones) has never been outlawed for really long. It isn’t appropriate now to discuss the reasons for this relatively favorable attitude of the society to alcohol, but the attitude doesn’t seem to be relevant to the alcohol abuse danger to humans. On the other hand, this unique situation gives rich and not only experimental material to study the implications and results of the use of alcohol as a psychoactive substance. The paradox of the situation has been stressed many times; there’re many examples of people starting to play a very dangerous and complex game with alcohol as well as attempts to break with the alcohol addiction (mostly in vain).

The personality system of psychoanalysis dealt with the driving forces or energies that have been called instincts or urges for self-preservation, and creative forces were called libido. The death instincts were energies directed either inward toward self-destruction, or outward in aggression or hatred. Freud divided psychic mental life of the personality into id, ego, and superego. The id included sexual and aggressive instincts, no value judgments, and energies directed toward immediate satisfaction and tension reduction; it obeyed the pleasure principle

We can endlessly complicate this picture involving new combinations, but apparently, in the analysis of the interaction of alcohol (such as tobacco or other drugs) with the human body and our mind we’ll never reach the full knowledge. However, remaining within the frameworks of behaviorism we breach its logic step by step. The more options and combinations, the more clearly the simplicity turns into complexity and verifiable things are replaced by hypothetical ones. On the other hand, understanding the complexity of any biological organism (not just human) we feel a priori it shall really be so. 9