STEPHEN HOLT, M.D.
Addictions and Dependence
The word addiction has its roots in the Latin term, addictus. This term implies “great devotion”. Socio-behavioral experts prefer to use the term “dependence”. In essence, the addict devotes him or herself to an act in a habitual manner. A large proportion of the American population has become devoted to, prone to use, accustomed to, attached, inclined or habituated to a variety of substances. 1, 2 Individuals with addictive personalities are usually dependent on more than one substance of abuse. For example, heavy smokers are often heavy drinkers and vice versa. 1, 2
Addictions to substances have extremely damaging effects on society. America’s love affair with simple sugars has contributed to the promotion of obesity, the metabolic Syndrome X and type-2 diabetes mellitus. Alcohol and drug dependence are so common that they may pass unrecognized in society. 1, 2 Many people may be surprised that excessive alcohol consumption requires early identification with prompt behavioral intervention. About 45% percent of all men, between the ages of 18 and 45 years, have a history of problem drinking. Excessive drinking among college students is an epidemic form of this behavior that threatens health and wellness.
Dependence is wide-ranging in society. The nation has a huge problem with a dependence on simple sugars and the wrong kind of fats in their diet. While conventional medicine has triumphed in some areas of management of dependence addictions, it has failed to curtail problems. This article reviews some natural ways to curb dependence, with a focus on alcohol consumption.
Herbs and Dependence: Kudzu
There are five key studies on the value of Kudzu in the reduction of alcohol intake.3- 7 The idea that herbs can reduce substance abuse is well described in traditional Chinese medicine. Studies at Shinn-Yang University in China, in the early 1990s, demonstrated that drunken rats consumed less alcohol and had reduced signs of intoxication as a consequence of the use of Chinese herbs, including Kudzu.
Kudzu is an annoying weed that was introduced from Japan into the United States in 1876, at the Centennial Exposition in Philadelphia. Kudzu became a popular plant because it was used in the early 20th century for soil erosion control. Kudzu has been featured in recent research for its ability to help people reduce their alcohol consumption; and it has been referred to as “the weed that whacks binge drinking.” (WJ Cromie, Harvard News Office).
Studies on Kudzu
Ground-breaking studies by members of the Department of Psychiatry at Harvard Medical School report that Kudzu in extracted forms can reduce total alcohol intake, slow down the speed of drinking of alcohol and result in fewer hangovers, without any significant side effects. In this study, fourteen human volunteers were placed into an apartment and allowed to drink as many beers as they wanted, up to a maximum intake of six bottles of beer. This resulted in a baseline observation concerning how many bottles of beer each individual could drink under “normal” circumstances. Many young Americans “think” that six beers represent modest alcohol intake, but young “Brits” often consider this level of intake quite homeopathic. After this initial observation, half of the volunteers were given a capsule containing Kudzu and half were given an inactive capsule (dummy pill or placebo). The results of these experiments were startling. Each individual that took Kudzu drank significantly less alcohol than those who took the placebo. Furthermore, the Kudzu-treated group was both slower and less likely to request a second or third bottle of beer. The individuals who took dummy pills (placebo) drank three or four bottles of beer, which was on average twice as much as the volunteers who took Kudzu.
The researchers noticed that the individuals who took Kudzu needed more gulps and swallows to finish a bottle of beer. This led to a suggestion that Kudzu may be acting on the brain and telling the body not to drink excessive amounts of alcohol. These researchers commented on an interesting observation that was made in a survey of Harvard University students where up to one half of all students admitted to binge drinking. These seem to be conservative estimates!
The research went further by the giving of low dosages of Kudzu over a period of one week. No side effects were noted. It was suggested that continuing use of Kudzu may cut down on the number and severity of hangovers, but no controlled studies have demonstrated that Kudzu will act in a way to eliminate established hangovers. The researchers criticized some commercially available forms of Kudzu and implied that they did not contain the putative active ingredient of Kudzu, which is called puerarin, a name taken from the family of plants called Pueriariae, of which Kudzu is a member.
How Does Kudzu Work?
There has been much speculation on how components within Kudzu may assist in helping people to reduce alcohol intake. Kudzu contains bioflavonoids, an example of which are isoflavones. Soy isoflavones have been shown to reduce alcohol intake in rats and the exact mechanism of action of isoflavones remain unknown. Isoflavones could inhibit the enzyme in the stomach wall called gastric alcohol dehydrogenase (gastric A.D.H.). 8 Inhibition of this stomach enzyme may act to increase blood alcohol levels following alcohol intake.8 It may be that isoflavones or other ingredients have other effects on alcohol metabolism, or they may have direct effects on the central nervous system.9
The researchers at Harvard suggested that puerarin in Kudzu may cause increased blood flow to the brain and heart. The postulated that increased blood flow may deliver more alcohol to the brain and result in the individual being satisfied with smaller amounts of alcohol intake. I believe that these postulates are incomplete because the distribution of alcohol is dependent on many factors other than blood flow.
Is Dependence a Disease?
One could argue strongly that addictions or circumstances of dependence are not necessarily diseases. Certainly, the use of a softer term “dependence” would not qualify as a disease. That said, alcoholism is a disease when chronic, excessive drinking occurs, but it is arguably a disease when it is in the form of binge drinking. The solution to any state of dependence, such as excessive alcohol intake, excessive eating, cigarette smoking or drug abuse, is intensive socio-behavioral interventions combined with positive lifestyle changes. However, natural substances that are safe and may assist in the nutritional support of anti-addictive behavior may be considered worthy of use.
Nutrition and Lifestyle for the Addicted
Natural substances to control drug dependence cannot be expected to work without many other interventions that are required to correct addictions. The addicted or dependent person often has a substandard diet and people who drink alcohol excessively invariably have nutrient depletion. All individuals dependent on substances of abuse will benefit from an optimal diet, together with multivitamin and mineral supplements.
Alcohol and cigarette smoke generate free radicals in the body and cause oxidative stress to tissues. This type of tissue damage results in many chronic diseases that are associated with substance abuse. Such diseases include, but are not limited to, heart disease, cancer, lung disease and premature aging. I believe that antioxidant intake is important nutritional support for many individuals who have addictions or dependence on substances.
Humans have a distinct desire for dependence on relationships, food and chemical substances. If one has the privilege of speaking to a drug addict, they will describe cigarette smoking as one of the most powerful “urges” that they possess. Using small amounts of alcohol to encourage an alcohol abuser into controlled drinking has been shown to be a waste of time. The recent scientific discoveries of natural substances that can assist in nutritional support of behavioral changes to combat dependence are very exciting.3-7 Medicine sometimes views dependence as a disease, but dependence may be best viewed as major deviations from acceptable lifestyles, especially in reference to alcohol intake. 1, 2
Dietary supplement products that claim to be a value in reducing hangover should be rejected on grounds of common logic. In the place of hangover remedies, one may substitute nutritional support that may have benefits in reducing the normal body function of the development of dependence. In fact, selling products to prevent or manage “hangovers” many encourage people to drink excessively. It is completely contrary to the philosophy of natural medicine to produce a natural product that could encourage people to persist with their drunkenness.
I emphasize that I am not recommending the treatment of addictions with dietary supplements and I believe strongly that all individuals with dependence on substances should be assessed by a healthcare practitioner.
1) Holt S, Stewart IC, Dixon JM, Elton RA, Taylor RV, Little K. Alcohol and the emergency service patient. British Medical Journal 281:638-40, 1980.
2) Holt S, Skinner HA, Israel Y. Identification of alcohol abuse. II. Clinical and laboratory indicators. Canadian Medical Association Journal 124(10):1279-94, 1981.
3) Lukas SE et al. An Extract of the Chinese Herbal Root Kudzu Reduces Alcohol Drinking by Heavy Drinkers in a Naturalistic Setting. Alcohol Clin Exp Res., 2005 May; 29(5): 756-762.
4) Benihabib E et al. Effects of Purified Puerarin on Voluntary Alcohol Intake and Alcohol Withdrawal Symptoms in P Rats Receiving Free Access to Water and Alcohol. J Med Food. 2004 Summer; 7(2): 180-6.
5) Carai MA et al. Potential Use of Medicinal Plants in the Treatment of Alcoholism. Fitoterapia. 2000 Aug.; 71 Suppl 1:S38-42.
6) Shebek J, Rindone JP. A Pilot Study Exploring the Effect of Kudzu Root on the Drinking Habits of Patients with Chronic Alcoholism. J Altern Complement Med. 2000 Feb.; 6(1): 45-8.
7) Keung WM, Vallee BL. Kudzu Root: an Ancient Chinese Source of Modern Antidipsotropic Agents. Phytochemistry. 1998 Feb.; 47(4): 499-506.
8) Holt S. Alcohol and H2 receptor antagonists. GI Report, News of Advances of Gastroenterology 5, 4, 1-7, 1990.
9) Holt S, “The Soy Revolution”, M. Evans, NY, NY, 1998 and Dell Publishing, Random House, 2000