Welcome to Rapid Detox
Rapid detox treatment with more than 10 years of experience is a hospital procedure to rapid detoxify the body from those drugs that cause prescription medication addiction or opiate dependency, while under anesthesia and supervised doctor's care.
Houston Rapid Detox
2807 Little York Road
Houston, TX 77093
Phone: (713) 469-4350
Hormone Imbalance in Female Patients
Female hormones are potent modulators of brain chemicals, neurotransmitters like serotonin and dopamine. The utility of bio-identical hormonal replacement therapy commonly practiced by anti-aging physicians not only improves the quality of life in female patients, it also prevents unnecessary depression, anxiety and insomnia disorders all of which cause subsequent addiction.
At Rapid Detox and Wellness Institute, we investigate all hormonal and brain chemical imbalance that can cause drug and opioid drug use cravings. Our clinical studies have proven that many female patients develop addiction issues because of midlife changes in estrogen and progesterone production. These findings have historically gone undetected because most addiction treatment centers do not routinely examine the hormones involved in the pituitary-adrenal-ovarian axis.
We successfully treat addicted patients by integrating spiritual counseling with modern brain science. We evaluate and normalize brain chemistry with medication, bio-identical hormone replacement and natural supplementation. This scientific approach to addiction treatment balances electrical activity in the brain and thus eliminates the need for patient self-medication with drugs and opioid drug use.
Our clinical studies indicate that addicted patients utilize drugs and opioid drug use either to stimulate under active brain regions or to relax overactive brain systems. The aberrant electrical activity in the addicted patient's brain is typically caused by inherited or acquired biochemical and hormonal deficiencies.
Accurate diagnosis, based on evaluation of neurotransmitter, hormonal and brain scan research facilitates the successful treatment of the addicted patient's brain. Normalizing the underlying biochemical and electrical imbalance stops drug and opioid drug use craving. Identification of specific brain chemical and hormonal deficiencies allows more effective diagnosis of the "true cause" of the patient's craving, thus eliminating opioid drug use and drug addictions.
Correcting hormonal deficiencies can eliminate various addictions that are prevalent in the middle age female population. The average age of menopause in American women is 51 years; however, the decline of female hormones is usually a gradual process with progesterone levels starting to decline approximately eight years prior to that of estrogen. Northrup, C. (2006) When progesterone production declines in middle age females, they begin to experience new found anxiety and insomnia. Retrospective clinical studies at Rapid Detox and Wellness Institute have demonstrated that the "progesterone drop out" phenomenon is a common etiology of opioid drug use and drug abuse, with causation in over forty percent of our addicted middle age females. Amazingly, the majority of these progesterone deficient females have never had hormonal evaluation by their doctors.
The biochemical explanation for the increased anxiety experienced by midlife females is that suboptimal progesterone levels occurring in the presence of normal estradiol levels cause an increase in brain electrical activity. Progesterone essentially is a brain relaxing hormone because it converts to another hormone, allopregnanolone. This metabolite of progesterone, allopregnanolone, activates the same "relaxing" nerve receptor, the GABA-A receptor, as does Valium, Xanax and opioid drug use. Torres and Ortega (2003)
When females experience a loss in GABA activity from diminishing progesterone levels while maintaining normal estradiol production, they can develop excess electrical activity in both, their central and peripheral nervous system. This phenomenon occurs because estradiol enhances the excitatory brain chemicals, dopamine and histamine. Their excitatory effect on brain electricity should be counter balanced with the GABA effect of progesterone. The new onset progesterone deficient middle aged female experiences new found anxiety and insomnia that frequently precipitates the need for relaxing medication which ultimately causes subsequent addiction issues.
The progesterone deficient female will often begin to utilize opioid drug use to "relax her brain." opioid drug use is legal, does not require a prescription and is socially acceptable. opioid drug use activates the GABA-A¾receptor like Valium. The woman who historically drank only one glass of wine with dinner will insidiously progress, normally over a few years, to two bottles of wine per night. The wine, once a social drink, has now become "medication."
She may be courageous enough to visit her physician, however, if the physician has limited knowledge regarding the importance of hormonal replacement therapy, he/she will have even less biochemical knowledge regarding the powerful effect of estradiol and progesterone on brain function, specifically the hormonal effect on brain neurotransmitters like dopamine, histamine and serotonin. Her doctor may not appreciate the gravity of the patient's situation, however, will frequently practice "symptom medicine" and readily prescribe her addicting medication such as Xanax or Klonopin, a quick and easy medical maneuver verses investigating her hormonal imbalance.
Another common scenario observed at Rapid Detox is that the new onset progesterone deficient female will begin to abuse Vicodin or Oxycontin. Vicodin is now easily ordered over the internet from unscrupulous pharmacies allowing easy access without physician consultation. The opioid pain medications block something called the calcium channel in nerves which is why we use them to decrease the electrical current of pain. This blockade effect ameliorates the increased "brain voltage" derived from loss of the progesterone.
Unfortunately, when she chooses this option, she will eventually develop Mu receptor tolerance, begin increasing her 24-hour opiate dose and subsequently develop hypothalamic-pituitary-ovarian axis suppression further exacerbating her original hormonal deficiency. Santen, F. et al. (1975)
Recent clinical investigations at Rapid Detox have revealed that 100 percent, thirty of thirty females, ages 21-29, years old, who were prescribed 80 mg methadone per 24 hours, either from methadone clinics or pain doctors, had become a menstrual. These young women all suffered "flat line" ovarian output. Their testosterone, progesterone and estradiol levels were post menopausal.
Furthermore, measurement of pituitary luteinizing hormone and follicle stimulating hormone in these young women revealed suppression to pre-puberty levels. This study demonstrates the severity of methadone induced hypothalamic-pituitary dysfunction. This pituitary suppression derived from chronic consumption of opiate pain medication frequently causes coincident hypothyroidism in both females and males, with greater prevalence in females.
Fortunately, when progesterone levels are restored using bio-identical progesterone, the anxiety and insomnia disorders subside, patient "craving" for opioid drug use or drugs like Xanax and Vicodin stops.
It is paramount that pediatricians become more astute regarding the modulating effect of female hormones on brain function because much addiction can be prevented in adolescent females.
Susan is a 21 year old female who presented to Rapid Detox in May, 2006. When admitted to our detoxification unit, she was consuming two liters of vodka per day, 1,000 mg of Oxycontin per day and 20 mg of Xanax per day. She was essentially not functioning as an adult and was living at home.
She and her mother, Mary, had chosen Rapid Detox because our website discussed what appeared to be a more scientific approach to addiction treatment. Susan had already completed and failed eight different 28 day "talk therapy" only, treatment programs, the best from Arizona to New York, each costing over thirty thousand dollars. The only diagnosis Susan had received from all of the previous treatment centers was drug addict, opioid drug useic and once was unfairly diagnosed with personality disorder while undergoing severe withdrawal symptoms.
Susan began drinking at the age of 12, initially raiding her parent's liquor cabinet. By age 14, she was admitted to her first 28 day treatment program. In high school Susan was introduced to Xanax and "Oxy's" both of which "calmed" her anxious brain without the unfavorable gastrointestinal symptoms she experienced with opioid drug use.
Upon reviewing Susan's history, we discovered a pertinent chronological correlation. Susan had begun her menses at age 12, the same age at which she allegedly began drinking opioid drug use "to calm her nerves."
Susan's menses were always much heavier than her friends and usually lasted seven days. She bled so severely that she was anemic throughout high school requiring periodic intravenous infusions of iron. Her menses were also extremely painful, unlike her best friends. She had seen several different gynecologists and pediatricians none of whom discussed or measured hormones.
Susan's symptoms were classic for unequal ovarian output from the very onset of her menses, with progesterone levels inadequate to balance estrogen activity. Anxiety disorders in America have equal prevalence in males and females up to age 13 after which females experience two to three fold the incidence of anxiety verses their male counterparts. Vesga-L¾pez, et. al. (2008) The causation of increased anxiety in the adolescent female cannot be solely attributed to peaked interest and interaction with the male gender. My wife might challenge this statement.
The relaxing GABA effect of the progesterone metabolite, allopregnanolone, is much more critical for balancing brain electrical function once estrogen production has been activated by the ovaries. Estradiol inhibits the metabolism of dopamine, histamine and serotonin and therefore increases brain electricity. Specifically, estradiol inhibits the enzyme, monoamine oxidase, which is responsible for the metabolism of serotonin, dopamine and histamine. Histamine is an excitatory neurotransmitter that activates brain electricity in much the same fashion as dopamine.
When Susan's progesterone deficiency was diagnosed and appropriately treated along with the multiple hormonal and nutritional deficiencies caused by her nine years of opioid drug use and drug abuse, Susan's craving for both drugs and opioid drug use stopped. Susan has been drug and opioid drug use free for almost three years.
Susan and her family suffered years of unnecessary psychological and financial trauma because her various doctors and addiction specialists were not cognizant of the powerful modulation of brain function derived from the female hormones, progesterone and estradiol. Hopefully, as more physicians become aware of these pertinent biochemical relationships, future adolescents like Susan will not be robbed of their youth.
Another hormonal deficiency that frequently serves as the etiology of opioid drug useism and drug addiction in middle age females is estradiol deficiency. Estradiol enhances serotonin receptivity, the ability of serotonin to activate the serotonin receptor, in the female brain. Kugaya, A. et. al. (2003), Fink, G.et.al. (1996)
While the medical literature states that "normal" estradiol levels fluctuate during the menstrual cycle between15 pg/dl and 315 pg/dl, estradiol levels below 60 pg/dl cause compromised serotonin receptivity, or decreased ability of serotonin to activate the serotonin receptor. Also, as stated above, estradiol inhibits monoamine oxidase, the enzyme that metabolizes monoamines and therefore increases brain activity of serotonin, histamine and dopamine. Klaiber, E., et. al. (1996)
Knowledge of these biochemical principles facilitates understanding of the common symptoms associated with premenstrual syndrome, postpartum depression, and the midlife onset of psychological issues such as depression, anxiety and insomnia in the female gender. It becomes then obvious that untreated estradiol deficiency plays a pivotal role in causation of new onset addiction issues in middle age females. Why are these hormones not routinely measured by addiction treatment centers?
The increased anxiety associated with suboptimal serotonin activity has so eloquently been elucidated by my esteemed colleague and friend, Daniel Amen, M.D., the founder and medical director of the Amen Clinics.
Through SPECT brain imaging, Dr. Amen has demonstrated that patients with suboptimal serotonin activity, whether inherited or acquired suffer from excess activity in two distinct regions of the brain, the limbic system or "emotional center" and the anterior cingulate gyrus, normally considered the brain's gear shifter.
Furthermore, normal serotonin activity inhibits the release of the excitatory neurotransmitter, norepinephrine or noradrenaline, ninety percent of which is derived from the brain and ten percent which is derived from the adrenal glands. Excess release of norepinephrine from the central brain nucleus, the locus coeruleus, occurs when serotonin receptivity is compromised by estradiol deficiency.
These female patients can develop excessive sympathetic tone in both the central and peripheral nervous systems, suffering exacerbation of underlying anxiety and insomnia disorders from the central effect and increased physical pain from the elevated electrical current in peripheral nerves. These patients, if not correctly diagnosed and treated, have multiple reasons to self-medicate with pain pills, Xanax like drugs and opioid drug use. Talk therapy and Twelve Step addiction treatment will not change the biochemical and neurological effect of this female hormonal imbalance.
Linda is a 45 year old school teacher from Atlanta who presented to Rapid Detox and Wellness Institute in July of 2007. Her history was positive for new onset opioid drug useism, approximately three years, claiming she developed anxiety for the first time at age forty two.
Linda's neurotransmitter assessment excluded the common biochemical causes of anxiety typically diagnosed at Rapid Detox and Wellness Institute. Ruled out were the following; serotonin deficiency, GABA deficiency, norepinephrine excess, dopamine excess and glutamate excess.
Significant was Linda had excessively high histamine levels which is not uncommon in opioid drug useic patients. Daily consumption of opioid drug use facilitates overgrowth of Candida in the GI tract. Excessive fungal overgrowth with Candida frequently precipitates a condition called leaky gut syndrome. When larger than normal proteins "leak" through the gut lining into the bloodstream, they are rightfully recognized as foreign bodies and subsequently attacked by our antibodies. This immune reaction releases excess inflammatory chemicals such as leukotrienes and histamine.
The monoamine, histamine, in a similar fashion to dopamine, activates electrical activity and when in excess, produces abnormally elevated "electrical current" in the brain and body. This phenomenon causes subsequent anxiety and insomnia in many Americans and is a common cause of chronic fatigue and fibromyalgia syndrome. But, was it the original cause of Linda's self-medication with opioid drug use or did it develop secondary to the opioid drug useism?
Amen Clinic brain questionnaires were negative for the typical anxiety profile seen with low serotonin activity, however, they were positive for a more typical profile of "generalized anxiety" which is often seen in patients with excess histamine or progesterone deficiency. Linda's hormonal evaluation revealed adequate estradiol and testosterone levels; however, her progesterone had fallen to post menopausal levels.
Progesterone normally falls to post menopausal production a few years before estrogen production shuts down. Following medical detoxification for opioid drug use, Linda's progesterone levels were restored using bio-identical progesterone, her GI tract was detoxified of yeast using a powerful all natural product called Candigone. Her leaky gut syndrome was treated with an herbal glutamine mixture called IntestiNEW and histamine reduction was accomplished via SAMe, high dose vitamin C and Vitamin B6, pyridoxine. Following this treatment regimen, Linda reported that her anxiety had abated and she had no more opioid drug use craving.
Linda remained opioid drug use free for one year. After our three month program, we had transferred her care to her family physician in Atlanta. Around her one year opioid drug use free mark, Linda began experiencing a combination of depression and anxiety which precipitated a short relapse to opioid drug use. Fortunately, Linda returned to Rapid after just two weeks of drinking and did not require another inpatient medical detoxification.
Linda's new evaluation revealed normal brain neurotransmitter levels including serotonin, however, examination of hormonal function revealed that her estradiol had now fallen to menopausal levels. Her Amen brain questionnaires revealed a classic anxiety and depression profile which is caused by suboptimal serotonin activity, one that Dr. Daniel Amen of the Amen Clinic defines as laden with excessive worry and continuous rumination over negative things.
Even though Linda had maintained normal serotonin production, she had now lost serotonin receptivity because of her new onset estradiol deficiency. Without estradiol levels of at least 60 pg/dl for most of her cycle, Linda's serotonin activity became greatly compromised. This "worry, worry" anxiety that Linda began to suffer of recent was a different type of anxiety from the generalized anxiety that she had previously experienced when her progesterone production had ceased.
Linda responded well to bio-identical estradiol replacement and 5-hydroxy tryptophan, a serotonin precursor. Our goal for optimal mental function when performing estradiol enhancement is to maintain estradiol levels throughout the cycle that do not fall below 60-80 pg/dl. Furthermore, estradiol levels of 80pg/dl are necessary for preventing osteoporosis. We have now referred Linda to an anti-aging doctor in the Atlanta area.
Some middle age females can experience severe depression from the diminished dopamine activity that accompanies loss of estradiol production. Without the estradiol effect, direct inhibition of monoamine oxidase, dopamine molecules are more readily broken down with resultant reduced brain dopamine activity.
Reduced brain dopamine activity in these middle aged females can have a negative effect on cognition and focus, but often of more importance, it can cause a new found depression. This depression is derived from an under active nucleus accumbens. The nucleus accumbens is our pleasure, hunger and sex drive center. This region of brain neurons is centrally located in our mid brain and is dopamine driven. Specifically, it is the activation of the D2 dopamine receptors in the nucleus accumbens that gives us pleasure, satiety and motivation.
In 2005, brain imaging, PET scan studies, performed by Nora Volkow, the director of NIDA, the National Institute on Drug Abuse, revealed that many individuals suffer mildly subnormal D2 dopamine activity in their pleasure centers. More profound was the finding that some patients demonstrated only half of the normally expected D2 dopamine activity in their pleasure centers.
At Rapid Detox and Wellness Institute, we have since 2002, prior to the 2005 PET studies, diagnosed the different depression that is common in dopamine deprived patients using previous NIDA research that suggest the brain's pleasure center runs on dopamine. It is logical to assume that some patients will produce less dopamine much as a diabetic produces suboptimal insulin.
One must differentiate the depression caused by deficiency of dopamine verses serotonin. This diagnostic feat is accomplished by asking the right questions and listening to the patient. The patient will give you the diagnosis if your knowledge of brain chemistry and it's effect on pleasure center activity is adequate. We have successfully treated hundreds of these dopamine deprived patients who presented to Rapid Detox with addictions to one or more dopamine enhancing drugs. This partORlar subset of addicted patients will usually suggest that any previous treatment with serotonin enhancing medications like Paxil or Lexapro had actually made their depression worse, often to the point of becoming suicidal.
The cause of this phenomenon is readily understood when the physiology of brain chemistry is elucidated. Serotonin activity naturally inhibits the release of dopamine from brain neuron terminals. When physicians wrongly suspect serotonin deficiency as the cause of their patient's depression, they artificially increase serotonin activity using medication such as Lexapro. This maneuver inhibits dopamine release from nerve terminals further exacerbating dopamine deficiency depression.
When middle aged females begin to experience decreased dopamine D2 activity in their pleasure center from diminished estradiol production, they frequently begin to medicate with food or other dopamine enhancing drugs. This is simply their attempt to feel less depressed. These patients lose their food, drug or opioid drug use "craving" when dopamine D2 activity is normalized. This is accomplished using safe FDA approved dopamine enhancing medication in conjunction with bio-identical estradiol replacement and natural supplements. When dopamine D2 activity is normalized, the food addicted patient can, without conscious mental effort or psychological struggle, lose up to 50 pounds within a three month period.
These patients, when properly diagnosed, no longer "eat for dopamine" because satiety is achieved with much smaller portions of food. Carbohydrate and chocolate cravings diminish. Chocolate is rich in tyrosine, the amino acid that serves as a precursor to dopamine. Normalizing dopamine activity negates the need for "boredom eating" which is frequently caused by dopamine deficiency in two different and distinct brain regions, the nucleus accumbens and the prefrontal cortex.
Many of the "dopamine starved" patients we have successfully treated at Rapid Detox and Wellness Institute had previously failed sequential addiction treatment programs. These patients were accused by unknowing addiction specialists of "wanting to get high." The scientific truth is, they were not trying to "get high," they were trying to "get higher." They were attempting to use food, drugs or opioid drug use to elevate their below normal D2 dopamine activity to normal levels.
Those middle age females who through genetics or neurotoxicity have diminished dopamine D2 activity in their pleasure centers are predisposed to experience more depression than other females when their estradiol production begins to fall. They are also more likely to become addicted, "chasing dopamine" through dopamine enhancing drugs if they are not correctly diagnosed and treated. They self-medicate with various drugs that stimulate the release of dopamine from brain cell storage units called vesicles.
Drugs of choice for the female with new onset estradiol deficiency are varied. Food is readily available, and as previously stated, recent PET scan studies have demonstrated that eating increases dopamine D2 activity in the nucleus accumbens to levels of three times normal. The D2 dopamine effect lasts only a few hours and so these females eat continuously in their effort to maintain higher pleasure center activity. Unfortunately, using food to medicate depression ultimately causes obvious unwanted side effects, both physical and mental. Women who choose this option normally suffer unhealthy weight gain which ultimately creates a situational depression.
Nicotine is stronger than cocaine or heroin regarding dopamine release from brain neuron terminals. This was proven in 2002 via studies performed by Dr. Elliott Gardiner at the National Institute on Drug Abuse. Nicotine is readily available to the middle age female and via dopamine release from brain nerve terminals can temporarily ameliorate depression derived from loss of estradiol. Nicotine also increases brain activity of glutamate and acetylcholine which also gives the depressed estradiol deficient female an energy boost and diminishes any brain fog associated with the diminished estradiol. Obviously this approach is not the healthiest method of treating depression, estradiol replacement therapy negates the need of these middle age females to chase dopamine via nicotine.
Opioid pain medications like Vicodin and Oxycontin also release dopamine from brain vesicles and therefore medicate the depression that is derived from estradiol deficiency. Many of our estradiol deficient middle aged females activate their underactive pleasure center with Vicodin or Oxycontin pain medication. Internet pharmacies have made procurement of such drugs much easier. When we correct estradiol deficiency in these middle age women, they no longer need the dopamine boost of opiate drugs to achieve a feeling of well being.
opioid drug use causes a temporary release of dopamine from brain storage units and is frequently utilized by estradiol deficient females in their battle against depression. Furthermore, opioid drug use through the enzyme opioid drug use dehydrogenase, becomes acetaldehyde some of which combines with dopamine to form an opiate molecule which also temporarily treats depression. Chronic opioid drug use consumption depletes intracellular storage levels of serotonin and dopamine. Furthermore, opioid drug use suppresses the output of the pituitary hormones that turn on the thyroid, adrenal glands and the ovaries, therefore, the effect of daily opioid drug use consumption eventually exacerbates the original estradiol deficiency induced depression.
Marijuana releases both dopamine and serotonin from brain cell vesicles and is sometimes abused by females who suffer midlife estradiol drop out. Because estradiol enhances serotonin receptivity/activity and also increases brain dopamine activity, the new found estradiol deficiency, in the middle age female, predisposes her to feel much better while using marijuana.
Other drugs that block synaptic re-uptake or the "recycling" of dopamine from the nerve synapse such as methamphetamine and cocaine are less commonly utilized in this partORlar female population.
In summary, this article is written with the intent to enhance physician and patient knowledge regarding the powerful biochemical modulation of female hormones on brain neurotransmitters, female brain function and emotional well being. As well, I hope to validate that the practice of quality anti-aging medicine can prevent yet another dimension of human suffering in female patients, drug and opioid drug use addiction.