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The implications of this are larger than just alcohol.

From the above-cited Wikipedia entry:

Sex, exercise, eating, and risk taking generally result in the release of endorphins

So opoid receptor antagonists could conceivably be used not only in anti-obesity therapy, but also to curb dumbass risk-taking behavior, say, of financial traders.

Wouldn't it be interesting if a financial regulator were to require all persons involved financialization to take Nalmafene twice a day?

The fact is that what we're experiencing right now is a top-down disaster. -Paul Krugman

by dvx (dvx.clt št gmail dotcom) on Sun Jan 2nd, 2011 at 10:37:49 AM EST
That would be highly unethical. As in "we made these rules after the second world war for a reason" unethical.

'Sides, you can probably get the same magnitude of effect if you put 'em all though coke rehab.

- Jake

Friends come and go. Enemies accumulate.

by JakeS (JangoSierra 'at' gmail 'dot' com) on Sun Jan 2nd, 2011 at 10:57:00 AM EST
[ Parent ]
I don't see the ethical problem as all that dramatic, other things being equal (i.e. the side effects of the antagonists are negligible).

Traders who don't want to waive the rush would be free to go into useful work. And individuals who are currently working as traders could be offered backoffice jobs.

I'm not advocating compulsion. But there is a public interest in preventing financial traders from hotdogging.

Besides, Nalmafene would presumably constitute an effective coke rehab therapy in its own right.

The fact is that what we're experiencing right now is a top-down disaster. -Paul Krugman

by dvx (dvx.clt št gmail dotcom) on Sun Jan 2nd, 2011 at 03:52:54 PM EST
[ Parent ]
But isn't the whole point of gambling and trading not the "buzz"?

Index of Frank's Diaries
by Frank Schnittger (mail Frankschnittger at hot male dotty communists) on Sun Jan 2nd, 2011 at 04:14:59 PM EST
[ Parent ]
The bonuses are also part of the buzz.

If alcohol is a learned behaviour disorder, so is capitalism.

We're being run by monkeys pressing levers for a repeat hit.

And I mean that quite literally.

by ThatBritGuy (thatbritguy (at) googlemail.com) on Sun Jan 2nd, 2011 at 04:40:13 PM EST
[ Parent ]
And the monkeys are looked after by incompetent politicians who think their jobs depend on the number of levers pushed, who are in turn voted for by a majority of people with other levers called remote controls that allow them to almost instantly enter a hypnagogic state in which reality and fiction are impossibly entangled.

Mind you, we are all struggling to unravel.

You can't be me, I'm taken

by Sven Triloqvist on Sun Jan 2nd, 2011 at 05:01:17 PM EST
[ Parent ]
I don't see the ethical problem as all that dramatic, other things being equal (i.e. the side effects of the antagonists are negligible).

Negligible compared to what? Psychoactive drugs always have non-negligible side effects - at a bare minimum, they can cause their intended effect in people who don't need that effect. And a clinical trial that demonstrates that the side effects are less bad than addiction is far cry from demonstrating that it's harmless enough to be added to the general water supply on Manhatten.

I'm not advocating compulsion.

Because "take this drug or you lose your job" isn't compulsion? That is a very scary precedent to set.

But there is a public interest in preventing financial traders from hotdogging.

Of course. That is why we have financial regulators.

But enough public interest to justify violating the principle of informed consent? We don't even do that for the polio vaccine, and wiping out polio is a clear-cut case of public interest if I've ever seen one.

If you want traders to stop gambling with other people's money, you change the rules of operation of the stock exchange so they can't do it. You don't spike their lunch with psychopharmaca. We've been down that road before, and that's a really ugly neighbourhood.

- Jake

Friends come and go. Enemies accumulate.

by JakeS (JangoSierra 'at' gmail 'dot' com) on Sun Jan 2nd, 2011 at 05:10:20 PM EST
[ Parent ]
I'm not sure that nalmefene can be used in treating cocaine abuse. Coke has a dopaminergic effect which modulates neurotransmission, although it is also linked to the opioidergic system.

Nalmefene has a molecular shape that allows it 'block' neuronal endorphin receptors (like a fake key stuck in a lock that can't open the door). If endorphins enter the receptors of firing neurons, they promote new dendritic growth to neighbouring neurons that were also firing at the time of reception. That's how behaviour becomes hardwired - literally.

When neuronal receptors for endorphins are blocked, the process is 'reversed'. i.e. if the stimulation of a neuron by endorphin does not happen because of the blocking, then existing dendritic connections are weakened over time. That is essentially what the nalmefene treatment entails - 'forgetting' behaviour'. Although such behaviour can be quickly 'remembered' again by unblocked stimulation.

Whereas (if I understand it correctly) stimulated dopamine receptors modulate transmission across the synaptic gap. Which is a whole different kettle of students.

I don't know if dopaminergic antagonists have yet been discovered.

You can't be me, I'm taken

by Sven Triloqvist on Sun Jan 2nd, 2011 at 05:33:57 PM EST
[ Parent ]
It is a feature of the Sinclair Method treatment that any endorphin-related activity that you do NOT want to erase, has to be curtailed during treatment, or only allowed on special days; meaning chocs, pornography, gambling, jogging through the pain barrier, chilli, tattooing and piercing - among others.

Nalmefene is also known to work with heroin abuse. Providing, as with alcohol, the blocker is taken before the heroin. The FDA has not approved it for this use yet.

You can't be me, I'm taken

by Sven Triloqvist on Sun Jan 2nd, 2011 at 11:17:03 AM EST
[ Parent ]
heh, this reminds me of a friend, who every time he went on holiday, would religiously pack his 'how to give up smoking' tapes and books right next to his tobacco stash in his suitcase.

so if you're about to go out drinking with your buddies, and if you take the drug, you're going to get a subdued endorphin rush, whether it's from the booze or the company, entertainment etc.?

semi-numb to pleasure, basically?

excuse me if i have missed something, but aren't the only kind of alkies this might work with are the type who unplug the phone, shut the door and get sozzled in lugubrious oblivion, and yet are mature enough to know that they don't want this to be a pattern, so take the drug first too. i guess it will take a drug like this to see how many with this advanced stage of the 'disorder' show up to try it.

this drug sounds like a biochemical feedback machine, a 'lite' aversion therapy, it will be interesting to see how many lives this affects, and if there are long term side effects which are not revealed by the trials.

maybe a simpler way might be biofeedback training, without the chemical in the middle.

thanks for being the resident neurochemistry fan, sven, (and AT)!

there are plenty of teetotallers who already feel like a bishop at an orgy when they go out at a company bender, likewise the designated driver.

what fascinates me is how the drug regulates the drinking back to 'appropriate', ie after a couple of glasses of wine, all of a sudden the next glass doesn't appeal.

perhaps i misunderstood!

anything that helps with the hell that is alcoholism is worth trying.

the discussion about hardware and software modding each other was interesting. kc's point about the myths being the software rung a bell.

taking the analogy further, i suspect one day we will look at many cultural patrimonies as forms of malware installed on the citizen's hard drive before they are of an age to have their own password privileges.

which they then spend their adult lives trying to uninstall, or write macros to limit damage, and using up a lot of energy doing so. personally i feel many people use alcohol to absolve themselves of responsibility, as in 'i did that, really?' musta been the booze, hehe, and everyone hehe's right along because they feel an equal need to 'get out of their heads' too sometimes, so it becomes socially reinforced.

till we address those reasons for wanting to get hammered, removing the alcohol still leaves, as Frank infers also, a whole void to fill with different, less self-destructive activities.

like bungee jumping fr'example, lol.

people are bored, they'll do pretty much anything to change channel, get out of the rut. i have recently heard of the second acquaintance who has taken up hangliding, parasailing. the least likely people i would have ever imagined to fall for (!) something that darwinian, but they are head over heels, ouch, it's the holy grail.

nature has funny ways of thinning out the population, i guess. if they designed a unit that self-ignited spectacularly on its way down, there'd be some salivating consumers rapt in wide-eyed joy lining up to try it.

whatcha gonna do?

'The history of public debt is full of irony. It rarely follows our ideas of order and justice.' Thomas Piketty

by melo (melometa4(at)gmail.com) on Mon Jan 3rd, 2011 at 02:52:25 PM EST
[ Parent ]
There are 2 basic ways to treat Learned Behaviour Disorders: remove all the stimulii that trigger the behaviour (for a time), or prevent reinforcement of the behaviour.

In the case of alcohol, the stimulii are hard to remove because we have learned to drink so many different drinks in so many different places at different times of the day, in different company. It is a very complex behaviour.

But theoretically, if you had only ever drunk one cider a day at 6pm, alone in a red room, wearing a monkey suit, then the unavailability of those stimulii would, over time, erase the behaviour.

Being unable to remove the stimulii, the answer to alcoholism is to prevent reinforcement with, for instance, opioid blockers. For most of us, alcohol is a learned behaviour but not a disorder. It becomes a disorder when it becomes a dominant behaviour that is personally destructive. Before this point, other treatments can be beneficial (except punishment), while alternative behaviours should be encouraged before they are suppressed by the increasingly dominant behaviour of finding and drinking alcohol.

So I agree with Frank that counselling - encouraging and facilitating alternate behaviours - does work. The old behaviours, like an old romance, can sometimes be revived. But beyond a certain point, when the drinking behaviour has become dominant - to the exclusion of all else - the only intervention is the biochemical prevention of reinforcement.

You can't be me, I'm taken

by Sven Triloqvist on Mon Jan 3rd, 2011 at 05:33:24 PM EST
[ Parent ]

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