Hypoism



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Role of Dopamine in Addiction Causation


Theory of Addiction - Hypoism Hypothesis


Why drug use is unconscious and against one's willfulness - not volitional


Misuse of the word choice in addictions


THE INESCAPABLE LOGIC OF ANY VALID ADDICTION ETIOLOGICAL PARADIGM


WHAT OTHER DISEASE....?


What Am I Angry About? - Don't Ask Me This Again


Disease Concept - A Perspective


HYPOISM IN A NUT SHELL


Page Directory of this Site with Explanations and Links


The History of the Proof of Hypoism in the Wake of the P/R Paradigm page 1.


History page 2


Why Addiction Experts and Other People Are Ignoring Hypoism


Strange Brew


AIMING AT AN UNDERSTANDING OF ADDICTIONS


The Paradigm Vacuum in Addictions Today


THE ADDICTION PROBLEM AND THE SOLUTION


What Does An Addiction Expert Know?


The Hypoism Addiction Hypothesis - An Evolutionary Psychology Perspective


Addiction Questionnaire


Misconceptions of addictions and addicts


What's Hypoism? What's an Addiction?


WHY WE DON'T NEED HYPOISM.


Why We Need Hypoism: A Comparison of the Principles and Consequences between the two Paradigms


Entitled to Your Opinion? Not Anymore.


HYPOICMAN: A non-recovering, unimpressed Hypoic


The Field of Addictionology: A Golfing Analogy


NEW YEAR PREDICTIONS


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Hypoism Treatment Research



The Addiction Treatment Fraud Finally Exposed


Hypoism Treatment Research Proposal

N4A



I KEPT QUIET


The National Association for the Advancement and Advocacy of Addicts


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Addict Discrimination Documentation


Social Innovations Award 2000 for The N4A


Third Millennium N4A Conference Keynote Address on Hypoism - Pathophysiology in Addictions vs. Superstition


N4A Goes on the Offensive - Suggesting Real Action


The Verdict


Blind Faith?

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Chapter 1


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Addiction Genetics



Recent Genetic Studies on Various Addictions from a Large Twin Registry


Genetic Studies page 2.


Gateway theory finally disproven


Celera Discovers Millions of Tiny Genetic Differences in People

Interesting Addiction Science



Clinically Important Neurotransmitter Deficiencies

Hypoism Magazine-Articles by and for Hypoics



EMBRYONIC HYPOISM CIRCA 1968


#1 Hatred, #2 The Words: Opinion, Belief, and Knowledge, #3 Hate Addiction


#4 The Drug War War, #5 Evolution vs. Creationism Revisited for Addictions


#6 American Society for Addiction Medicine Statement for Recovering Physicians


#7 Issues Peculiar to the Disease of Addictions


#8 Critique of Alan Lechner's (NIH), "The Hijacked Brain Hypothesis."


#8a. Update!! Dr. Leshner recently makes a change


#9 MY STORY - The Doctor Drug War - Wrong and Wasteful p.1, 1/6/00


The Doctor Drug War p.2


Doctor Drug War p.3


Doctor Drug War p.4


Doctor Drug War p.5


Affidavit for judicial review of NYS Dept. of Ed.


#10 The Superstition Instinct 3/1/00


#11-Conflict of Interest in Addiction Research


#12 - Controlled Drinking Lands On Its Ass


#13 - The Kennedy Curse or Kennedy Hypoism?


#14 - The Lord's Prayer for Hypoics


#15 - Replacing Alan Leshner is the only way to end the Drug War


#16 - The Brain Addiction Mechanism and the COGA Study


#17 - Letter to the director of the National Academy of Medicine's Board on Neurobiology and Behavior Health on Addictions


#18 - Is Addiction Voluntary, A Choice, as Leshner and NIDA Insist?


#19 - Bush's Alcoholism and Lies


#20 - A P/R Paradigm Addict - "Cured?"


#21 - Congress Misled and Lied to by NIAAA


#22 - Special Letter to the Times on Addiction Genetics


#23 - JAMA Editor Publishes According to His Beliefs, Not Science


#24 - Smoking as Gateway Drug. I Don't Think So!


#24B - IS COCAINE ADDICTION CAUSED BY COCAINE?


#25 - One Less Heroin Addict. But At What Cost?


#26 - An Open Letter to the Judge who Sentences Robert Downey, Jr.


#27 - Letter To Schools About The Pride Program Against Drugs


#28 - A Letter To Bill Moyers, Close To Home, and PBS


#29 - HYPOISM IS ACTUALLY A DISEASE OF THE "WILL"


#30 - Brookhaven Labs Provide More Evidence For Hypoism


#31 - Addiction Prevention Revisited


#32 - DRUG WAR EVALUATION BY THE NATIONAL ACADEMY OF SCIENCE


#33 - NIDA Is Close But No Cigar


#34 - Bush's Addict Discrimination and Hypocricy Begins


#35 - Maya Angelou's, "Still I Rise."


#36 - Leshner Lies To Congress


#37 - Addiction Combos


#38 Brain tumor proves Hypoism hypothesis


#39: So-called Availability Debunked as Contributor of Addictions


#40 - Hypoism Reproduced By A Pill


PIMMPAL Complex


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The Hypoism Blog - The Addiction Blog



The Addiction Blog 4/17/11 -


The Addiction Blog 9/14/10 - 4/16/11


The Addiction Blog 11/12/09 - 9/14/10


The Addiction Blog 7/23/09 - 11/09/09


The Addiction Blog 5/16/09 - 7/22/09


The Addiction Blog 3/3/09 - 5/13/09


The Addiction Blog 8/3/08 - 3/3/09


The Addiction Blog 4/1/07 - 8/3/08

old letters



My NY Times Letters to the Editor page 1.


My NY Times Letters to the Editor page 2.


My NY Times Letters to the Editor page 3.


My NY Times Letters to the Editor page 4.


My NY Times Letters to the Editor page 5.


My New York Times Letters to the Editor page 6.


My Letters to the editor of the NY Times page 7.


My Letters to the Editor of the NY Times page 8.


NY Times Letters Page 9.


New York Times Letters Page 10


My NYT Letters page 11


NY Times Letters page 12.


NY Times letters p. 13


Letters to the NY Times page 14.


Letters to Newsday


Letters To The Los Angeles Times


Creationism/Evolution Letter to BAM 11-25-05

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Committee for Physician Health Speech
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The Future of Addictions

Addict Discrimination in the News



Mandated Treatment for Welfare Recipients


Anorectic Murdered by Doctors out of Ignorance and "Desperation"(10/20/99)


Six Dead Heroin Addicts-Enough? 10/31/99


American Society of Addiction Medicine Discrimination


Darryl Strawberry Punished Again


South Carolina Forces Pregnant Women to Take Drug Tests


When it comes to drugs, the constitution doesn't apply


Parents of Overweight Girl Will Sue New Mexico


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Hypoics are born, not made.

Hypoism  
Dan F. Umanoff, M.D.  
941-926-5209  
8779 Misty Creek Dr.  
Sarasota, Florida 34241  

dan.umanoff.md@gmail.com  




The whole business with addictions centers around this system

AIMING AT AN UNDERSTANDING OF ADDICTIONS

Here's your quote for the day:

"Most human misery comes from either the misinterpretation of reality or from the misunderstanding of reality."---Umanoff

Misery from misinterpretation and misunderstanding of addiction is included. The human brain works in such a way as to make this misery practically inevitable. Hopefully, my understanding of the brain and addiction as outlined below can help others to allay this inevitability.

[CRITICAL CONCEPTS, CONCEPTS YOU MUST UNDERSTAND TO COMPREHEND THIS ARTICLE, ARE IN RED OR BLUE. If you don't understand these statements, please let me know and I will help you with them.]

The whole business with addictions starts with and centers around the system diagrammed below. It begins here, with the reward cascade, and grows in concentric circles, each larger, each heading towards the ultimate behavior, addiction or no addiction. All explanations of and treatments for addiction must take this system and its workings into account. Moreover, the disease we envision and utilize to explain the cause of addictions, must take into account the entire system, not merely the reward system or just the behavior. Here are the circles. The FOKS is defined in: http://www.nvo.com/hypoism/whatshypoismwhatsanaddiction/

The Behavior System
(In the case of addictions, the addiction is the behavior)

As you can see from this diagram, there are many physiological steps between the reward cascade neurobiology and the ultimate behavior, addiction. One cannot simply explain addictive behaviors by the mere outlining of the physiology of the reward system. Likewise, one is in deep trouble in dealing with addictions if one expects interventions solely at the level of the reward system to "cure" addictive behaviors. Similarly, because of these many steps, we wouldn't expect a single gene to be responsible for addictions. There are many places in this system where genetic alterations can cause addictions, and, thus, we would expect many possibilities of where altered genes programming for functional changes in this system would be capable of causing addictions.

How do we know this is the system where the pathophysiology of addiction resides? Look at the prototypical experimental addiction paradigm, the animal who has had a fine electrode placed in certain positions of the brain under MRI or surgical guidance. This animal will perform practically any task endlessly to receive small electrical shocks into only these parts of the brain. The animal will prefer these tiny shocks over sex, food, and water, and put up with painful aversive stimuli even to the point of death. Practically any animal will respond with addiction this way in the presence of the electrode. When the brains of these animals are dissected, it is found that this behavior can be elicited only along a specific neural tract in the mesolimbic region of the brain, the so-called pleasure center, reward system or reward cascade: from VTA to Acc (DA) and the ICSS in the diagram below.

Schematic diagram of the brain-reward circuitry of the mammalian (laboratory rat) brain, with sites at which various abusable substances appear to act to enhance brain-reward and thus to induce drug-taking behavior and possibly drug-craving, ICSS, descending, myelinated, moderately-fast-conducting component of the brain-reward circuitry that is preferentially activated by electrical intracranial self-stimulation; DA, subcomponent of the ascending mesolimbic dopaminergic system that appears preferentially activated by abusable substances; Raphe, brain stem serotonergic raphe nuclei; LC, locus coeruleus; VTA, ventral tegmental area; Acc, nucleus accumbens; VP, ventral pallidum; ABN, anterior bed nuclei of the medial forebrain bundle; AMYG, amygdala; FCX, frontal cortex; 5HT, serotonergic (5-Hydroxytryptomine) fibers, which originate in the anterior raphe nuclei and project to both the cell body region (ventral tegmental area) and terminal projection field (nucleus accumbens) of the DA reward neurons; NE, noradrenergic fibers, which originate in the locus coeruleus and synapse into the general vicinity of the ventral mesencephalic DA cell fields of the ventral tegmental area; GABA, GABAergic inhibitory fiber systems synapsing upon the locus coeruleus noradrenergic fibers, the ventral tegmental area, and the nucleus accumbens, as well as the GABAergic outflow from the nucleus accumbens; Opioid, endogenous opioid peptide neural systems synapsing into both the ventral tegmental DA cell fields and the nucleus accumbens DA terminal projection loci; ENK, enkephalinergic outflow from the nucleus accumbens; DYN, dynorphinergic outflow from the nucleus accumbens; GLU, glutamatergic neural systems originating in frontal cortex and synapsing in both the ventral tegmental area and the nucleus accumbens.

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For perspective, it needs to be known that the reward system as pictured above in a mouse, first developed several hundreds of millions of years ago in reptiles, our evolutionary predecessors, to reward instinctive behavior. In fact, earth worm's brains contain a neurotransmitter chemical, octopamine, very similar to dopamine, which was probably used for the same rewarding purposes in even these more primitive organisms. Thus, the concept of neurotransmitter reward of instinctive behavior is very very old one evolutionarily. Today we have fifty or more neurotransmitters acting in or on or around this system, but the end result is still the same, release of dopamine in the nucleus accumbens. As you will discover on reading further, the human reward system has evolved over these hundreds of millions of years to reinforce and evaluate instinctive behaviors of all animals from primitive reptiles up the evolutionary ladder. Every instinct is neurobiologically hard-wired and is wired to the reward system. All addictive chemicals, drugs, act on the same receptors designed for these neurotransmitter that have evolved to regulate and modulate decision-making and survival behavior. I discuss this more completely in another article at: http://www.nvo.com/hypoism/thehypoismaddictionhypothesis/

To complete the evolutionary perspective I briefly introduce below the basics of the modern human brain set up:

At a basic evolutionary level, the brain is organized in three parts (the tripartite brain): 1) The reptilian brain brainstem (BODY): controls automatic life support and basic motor functions, and the basic instincts of territorial acquisition and defense, dominance striving, agonistic threat displays, and mating. 2) The limbic (early mammalian) system (HEART or SOUL): assigns emotional context (emotional evaluation) to real situations and memory for decision-making purposes, and allows for and programs mammalian instincts. 3) The cortex (HEAD): does the rational thinking, analyzing, coordinating, calculating, and the associating of real and imaginary information, assigning meaning as well as use of language, speech and complex motor function. The key to the anatomy diagram below: Reptilian is black, Limbic (early mammalian) is shaded, and Cortex (late mammalian) is white. Words in parentheses are mine. For comparison, I place the circle diagram next to the tripart brain diagram of MacLean.
On the left is MacLean's Tripartite Brain
(from MacLean, P. D. (1973)
A Triune Concept of the
Brain and Behavior,
University of Toronto Press, Toronto)

The structural parts of the reptilian brain are NUCLEUS ACCUMBENS, basal ganglia, olfactory tubercle, and the corpus striatum. The limbic parts of the brain are cingulate cortex, fornix, HIPPOCAMPUS, , amygdala, prefrontal cortex, hypothalamus, and parts of the thalamus, and the pituitary gland delineated in the picture of the brain cut sideways below. You can see from this comparison just how ancient are the unconscious parts of the brain that affect behavior.

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To continue, the same kind of behavioral response can be elicited from these animals when, instead of electric shocks, certain drugs are placed in these same brain areas and never in others via micropipettes. All known addicting chemicals have been shown to interact somewhere along this neurological system, somewhere along this neurological system, somewhere along the length of the system, but not all at the same place (as seen in the diagram). All addictive chemicals, though, do ultimately cause release of dopamine at the nucleus accumbens as an end result. This release of dopamine is the conscious experience of pleasure, the felt reward or high, to use the vernacular. (Similarly, all instincts cause stimulation and activation of this system.) There may be other brain drug effects when these same drugs are ingested systemically, but it is the dopamine release at the nucleus accumbens that is the ultimate neurobiological change, recognized consciously in a person as a change in feeling, that accompanies addiction in those who eventually become addicted. This is exactly the same phenomenon as occurs in animals with electrical stimulation of the reward cascade, although not as intense, not to the same degree. Simultaneously, many unconscious neurobiological processes are occurring that also ensure addiction in those susceptible to addiction and its perpetuation (neurophysiological adaptation). The reward system is, however, the proximate end point resulting in addiction.

Unlike with electrical stimulation, not all animals get addicted to drugs when administered systemically. Some pure bred strains of animals do get addicted this way, though, some to one chemical and others to other chemicals. Many of these strains do so "voluntarily," as a sign of preference, genetically determined. This is quite similar to our experiences with humans. Some humans get addicted and others, exposed to the same drugs and behaviors, don't get addicted. Some of those who do get addicted, get addicted to one chemical and others to other chemicals, and still others to behaviors, not chemicals. The key issue, though, is that all addiction, chemical or behavioral, occur via the reward pathway.

There are two other issues related to this system and the overall organization and function of the brain that must be included here to fill the void of misunderstanding of addictions. 1) Modularity of the brain, and 2) Delusion of control.

1. Brain modularity: If one gazes at the human body, or any animal or plant body for that matter, it becomes immediately apparent that organisms are made up of many machines working in conjunction to produce a functional whole. This is true at the macroscopic level as well as at the microscopic and submicroscopic level. If you aren't aware of this, please take a course in biology. Most people would agree to this when it comes to the body, but balk when confronted with this reality when it comes to the brain. We currently misconceive our brains as vague black boxes out of which mysteriously come thoughts, feelings, decisions, and behaviors. Much to our lament and chagrin, however, is the fact that neurology and neurobiology have progressed to the point that even the brain is known to be a collection of machines, modules, that have evolved to perform specific functions to produce a functional whole. As in all known diseases of the body, when portions of these modules are either genetically altered or altered by outside forces such as microorganisms, trauma, toxic chemicals, or environmental physical forces, these machines can break in a variety of ways and instead of performing their "healthy" functions, produce outcomes that are damaging to the organism. Diseases don't arise out of vacuums. All of nature, human and otherwise, works this way. Lack of this understanding, or more realistically, this misunderstanding, frequently to the point of superstitious belief, has forever been responsible for human misery. I want to state emphatically here that there is a brain module whose job it is to make decisions, The Decision-Making Apparatus, in which the reward system has a central role. Disorders of this module produce diseases we currently view in a perverted light. One of these diseases is Hypoism whose symptoms are addictions. To understand addictions we must understand the functional module out of which they arise, its "normal" function, and ultimately, how alterations in its machinery cause the disease from which addictions arise. This material is fully discussed in my book, Hypoic's Handbook.

2. Delusion of control: When brain machines are working "normally" we have the illusion that we are in control of our brain and its functions. In fact, we are not. "Normal" brains don't require control. This truth is accepted in bodily machines, but not in brain machines. The only time we recognize we (our consciousness) are not in control is when a disease strikes. A peculiar dichotomy in evaluation of these events usually arises at this point. If we can pin point an outside cause for the malady such as a bacterium, poison, or gene, we accept being out of control especially if this outside cause is perceived as overpowering our will. We didn't choose to get sick, so we are personally not responsible for the illness. We can accept that. When this occurs to our brain for some recognizable and diagnosable reason, we also accept it. But, when we expect ourselves or others to be in control of our/their brains and the brain begins to act in ways that we don't like and we have no recognizable cause for this, we blame ourselves or the person who is out of control. The fact is, when the brain is functioning "normally" we think (misinterpret) that we're in control of it when we aren't, and similarly, when it is functioning "abnormally" in certain people we think they are willfully and consciously misbehaving, "out of control." The entire concept of "control" is a delusion. No one is in control. Currently, addiction fits into this kind of misinterpretation of reality due to ignorance and lack of understanding of the biology of addictions. Addicts are no more in control of their disease, Hypoism, and addictions than are nonaddicts in control of their not being addicts. Until this misconception is clear and related to the neurobiology of the disease causing addictions which I hypothesize is Hypoism, but may well be something else, we will maintain the human misery we currently call addiction. Let me be perfectly clear, however, whatever the disease turns out to be, it will and must involve some machine or module in the brain that is functionally broken for one valid reason or another. In addictions, it is clear that the module is broken because of genetic reasons, due to low activity genetic alleles in place of normal activity alleles, not reasons involving immorality, willful misbehavior, lack of religion or role models, poor upbringing, pseudopsychological psychobabble, spiritual or metaphysical maladies.

Many questions concerning the role this system plays in producing addictions have to be answered by any paradigm claiming to explain human addictions which are to drugs (chemical addictors - exogenous neurotransmitter substitutes) and behaviors (instinct stimulated endogenous neurotransmitter addictors). These questions are:

  • What is the brain module that is genetically broken that causes addictions?
  • How does the reward system fit into and participate in the normal and abnormal function of this module?
  • What is an addiction?
  • What is an addictor?
  • What is the difference between electric stimuli and addictors which explains why every animal or person experiencing addictors as opposed to direct electrical stimulation doesn't get addicted?
  • What is the biological difference between different addictors?
  • What is the difference between the people (and animals) who get addicted and those who do not, never, even on experiencing the same addictors? Or, asked in a different way, why can most people use addictors without ever getting addicted while others do get addicted?
  • What role does genetics, the predominant etiological factor in addictions, have in this system and in the differences between addicts and non-addicts?
  • Why do different people get addicted to different specific addictors rather than to all of them, and moreover, not the same one(s), even in the same families?
  • How do behavioral addictors relate to chemical addictors, and why are they both similarly addicting and their addictions identical to one another?
  • How well does the paradigm fit the science and empiricisms of addictions, all addictions.
  • How do current and even future attempts to control this system as a way to "treat" addictions (fail to) deal with the underlying entity that cause addictions?
  • How do we aim valid scientific experimentation toward delineating the cause of addictions.

There probably are many other questions needed to be answered by any paradigm devised to deal with addictions, but those above are a good start to altering our misconception of addictions. If you believe in a particular paradigm of addictions, ask yourself in all honesty, "Does my paradigm answer these questions?"

NO CURRENT ADDICTION PARADIGM ANSWERS THEM. Despite this, they are used willy nilly because people believe them. This must be changed.

Hypoism answers them all. Hypoism is amenable to experimental validation. Hypoism results in healthy and realistic recovery and policy.

For more information on these ideas please read Hypoic's Handbook and its bibliography present at: http://www.nvo.com/hypoism/bibliography/ Absent the understanding of the science and concepts discussed therein you will continue the misintepreting and misunderstanding of an issue you believe you understand. Not good.









You can take the addiction out of the hypoic, but you can't take the Hypoism out of the addict.




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