Habit or addiction? And can Baclofen help with both

[mycall]

I'm a regular stopper and starter. Never got to any high dosage with Baclofen as I always have this stumbling block stopping me from really committing to the increase.

I feel like I'm driven by habits. I am compelled to run for around thirty minutes every day - and feel uncomfortable if I don't (good habit, really) I also like to have a hot chocolate at around 5pm - again, feel uncomfortable if I don't (neither good nor bad habit) I like to drink wine - a whole bottle - every evening, and feel uncomfortable if i don't (bad habit) There are more - just don't want to bore people too much!

Am I a person with the kind of brain that needs these routines and rituals, are they merely habits or could they be described as addictions? If they are addictions is there any hope or me or am I a total nut job who needs serious psychological help (because there are so many of them)?

Just trying to work out if Baclofen is the drug to sort out the difference between proper, craving type addictions and long held, ingrained habits, and whether it makes any difference to the eventual outcome anyway.

Would be so grateful if anyone could enlighten me as I'm at that stage (40mg per day) where I'm wondering whether to taper off or go up

Thanks in advance

[mycall]

Just to try and clarify what I mean - I had a habit/addiction of, on waking, taking two codeine tablets and would feel that same discomfort if I couldn't have them. Been doing it for years.
Last week I decided to take my run immediately on rising, instead of making tea and taking the codeine. I have now gone a week without these tablets - so am wondering if changing behaviour is what is needed rather than embarking on a long, drawn out drug regime.....

http://www.thefix.com/content/habit-or-addiction

[YouKayBee]

I don't believe that a medication can change your habits and that there are two components making up addiction.

1. Physical and neurobiological cravings
2. Pure habit which we use for one reason or another

I think that with any medication the person still needs to put in some thought in to make changes in their routine.

[mycall]

I agree with you - behaviour has to be 'un-learned', but possible baclofen can take away the obsessive thought process that drives problematic behaviour....

[YouKayBee]

I agree with you - behaviour has to be 'un-learned', but possible baclofen can take away the obsessive thought process that drives problematic behaviour....

Yes, just as nal + alcohol removes similar cravings. The person may however still need to stop and think "Oh I don't actually want a bottle of wine tonight".

[Spiritfree]

Addictions and/or habits -if answers to resolving issues related to both of these were easy to solve, then we would not even be having this discussion now, nor would we be spending billions of dollars trying to find solutions. The human brain is fascinating -right?

Thanks for the thread.

http://www.huffingtonpost.com/patricia-l-gerbarg-md/addiction-treatment_b_1665684.html

"How do addicting substances, such as alcohol or nicotine, and addicting behaviors, such as gambling, shopping, porn, or voyeurism, compel us to keep coming back for more? Addicting substances and behaviors stimulate the release of neurotransmitters and neurohormones that act on networks of nerves that produce subjective experiences of pleasure. Prominent among these are the neurotransmitter dopamine and the prosocial hormones (called so because they foster love, empathy, bonding, and caretaking) oxytocin and vasopressin. Intense pleasurable stimulation can lead to the release of hoards of dopamine molecules that grab our pleasure neurons by their dopamine receptors and VA VA VOOM!"

[Spiritfree]

Addictions and habits are two separate, but interlinked things. Nothing makes this clearer than eliminating one of them and seeing the other one have to be dealt with separately.

The best way to break the cycle is not to trust yourself to do it.

This, in my opinion, is a truism. If you trust the same brain cells that got you into the mess that you are in now, why would you think of trusting those same brain cells to get you out. It takes other people and other things to 'break' it out of its cycle.

The brain will keep doing whatever it "thinks" is necessary for the survival and well-being of the being. Typically, it takes an extraordinary negative event or medication intervention to cause the brain to go into "a change must occur" mode or a surrender mode in order to survive.

The brain (for most) is just a human organ that does not like to change once that it has established a consistent pattern.
Just a thought.

[neophyte]

There is a big difference between a habit and an addiction, when it comes to alcohol. Having some wine after a day of work at first is a habit but then becomes an addiction and a disease because continued use of alcohol damages the reward center in the brain.

Pharaphrasing from an article I read recently about KOR agonists below. Here is the basic theory which also applies to alcoholism (correct me if im wrong). in the brain there is an endogeonous kor agonist dynorphin which regulates the bodies natural addiction control mechanism. The area in the brian most strongly associated with addiction is the nucleus accumbens (NAcc). Addiction and continued use of the drug. In the case of alcohol, reduces dopamine receptors in the NAcc.

When consuming alcohol dopamine released in the NAcc. More alcohol more down regulation i.e. the more you drink the body adjusts to how much dopamine alcohol releases by accepting less of it. Take away the alcohol, there is no more dopamine, this is where the cravings come from. Now you no longer have a habit, you have an addiction. The brian can right itself after long time abstienence, however deep down you will always remember the high alcohol can induce. So alcoholism becomes a life long battle.

Now comes in baclofen, baclofen suppresses alcohol-stimulated dopamine release in the NAcc. I suppose when the dose is sufficient (switch dose) the level of dopamine released just doesnt give us the benefits over the side effects alcohol gives us, and we are no longer motivated to drink. Cravings go away because our brain has made the connection that alcohol doesn't give us the same dopamine release anymore

sources:

Baclofen hypothetical mechanism of action

KOR receptor - role in drug addiction

Recently this has lead me to think that baclofen is an excellent treatment, prolonged use, the brain repairs the damaged NAcc. Perhaps this is why overtime we can successfully reduce our baclofen dose and still gain an anti craving "switch dose" effect.

[Ga.peach]

Neophyte is right. My cravings did go away after I started taking Baclofen.But it did take about 3 months to stop drinking.

[neophyte]

Did some more reading on Dynorphin as in the original wiki i posted it just said it regulated the bodies natural addiction control mechanism.

Reading from the wiki on it http://en.wikipedia.org/wiki/Dynorphin#Addiction

One proposed molecular mechanism for increased dynorphin levels involves transcriptional regulation by CREB (3’, 5’-monophosphate response element binding protein). According to the model proposed by Carlezon et al., use of cocaine increases the expression of cAMP and cAMP-dependent protein kinase (PKA).[18] PKA leads to the activation of CREB, which increases the expression of dynorphin in the nucleus accumbens and dorsal striatum, brain areas important in addiction.[18] Dynorphin decreases dopamine release by binding to KORs on dopamine nerve terminals,[19] which leads to drug tolerance and withdrawal symptoms

and interestingly, perhaps a genetic component to addiction is explained with low levels of dynorphin levels

There is also evidence suggesting that increased amounts of dynorphin can protect humans from cocaine addiction. According to research at Rockefeller University, the gene for dynorphin is present in two versions: a “high output” and a “low output” functional variation.[21] The high output functional variation of the gene contains polymorphisms in the promoter regions that are speculated to cause it to produce more copies of dynorphin mRNA, which would give people carrying this variation a “built-in defense system” against drug addiction

It's cocaine being discussed which directly works on dopamine, so one might dismiss it in regards to alcoholism, but at the end of the day it comes back to dopamine as alcohol plays a role here too.

Cocaine addiction results from complex molecular changes in the brain following multiple exposures to cocaine.[16] Dynorphins have been shown to be an important part of this process. Although a single exposure to cocaine does not affect brain dynorphin levels, repeated exposures to the drug increases dynorphin concentrations in the striatum and substantia nigra in rats.[17]

Perhaps this gives a model of habit turning to addiction. If you keep drinking, for long enough, depending on your genetic make up. You are going to disrupt your dynorphin levels -> dopamine levels in the NAcc, and now you have relentless cravings.

[neophyte]

Neophyte is right. My cravings did go away after I started taking Baclofen.But it did take about 3 months to stop drinking.

my experience when i readched 295mg of baclofen was a sudden, i dont want to drink anymore, that lasted a while, but the ingrained behaviours associated with addiction were still there e.g. cravings after work, get a bottle of wine. I would still get some euphoria but generally it sucked. There was a period where I was slipping, drinking almost every day again, though in amounts much lower. I eventually added antabuse and got some solid sobriety, I found baclofen helping again and I have since come down in dose to 250mg. I plan on going to 200mg soon.

I think even if youre taking baclofen, then the mechanism mentioned in my prior posts can still pose a problem. My hunch is that baclofen blocks dopamine release on a dose bases depending on how damaged your reward system is. The worse you drink, the longer you have been drinking, the harder the higher the dose. The prescribing guide does infact provide a link between drinks consumed and the switch dose. However throw in a genetic component and we can see that its not so cut and dry a relationship.

Based on what I've found today, i think its important to try and not drink when on high dose baclofen, or you can end up still ruining your reward system.

[kronkcarr]

I'm not sure about habit versus addiction but baclofen works for me. I drank 3/4 to 1 or more bottles of wine a night and now I don't. From almost the start of taking bac my mind relaxed. I stopped being so driven or so full speed ahead.

When I was drinking every night I mostly wanted to stop and I'm not sure I realized how dull alcohol made me. Every day was just to be gotten through. When I was married I drank before I went home some nights, kept alcohol in my car and used it to numb emotionally.

Initially I had 1-2 drinks every few weeks with friends. I didn't keep alcohol in my home.
Only once (at 80 mgs) did I fight a desire or fierce habit to buy wine. Other than that I was amazed at how easy it was to pass on alcohol. If I had 3 drinks I had to nap and I didn't get that alcohol buzz.