The Amen Anti-Addiction Intervention (AAI) is an austere regimen intended to eradicate addictive impulses and behaviors. The theoretical and empirical foundations of this intervention are explicated herein. The AAI entails daily cyclic fasting, chronic caloric restriction, supplementation with specific neutraceutical agents, rigorous exercise, and minimalist meditation. The physiological focus of the AAI is twofold: the augmentation of neurogenesis in a manner analogous to the effect of psychotropic drugs and the activation of areas in the brain involved in the regulation of emotional arousal and reward. The psychological focus of the AAI is similarly twofold: the attenuation of anxiety and/or impulsivity and the cultivation of mental mastery and/or self-control. It shall be argued that the AAI, by virtue of its explicit integration of biological, psychological, and sociological elements—each of which evidently influences addiction—will plausibly be an improvement over existing interventions aimed at the treatment of addiction.
There is evidence extant in extensive scientific literature that addiction to various agents and behaviors shares common molecular mechanisms. Further, there is considerable scientific support for the supposition that biological, psychological, and sociological factors influence the propensity of individuals to succumb to addiction [
In the course of exploring the biological bases of drug addiction, it became clear to the Author that the same neurological systems involved in drug addiction are also altered by intermittent fasting, caloric restriction, and scheduled feeding. Additionally, the Author found evidence for the efficacy of exercise in the excitation of reward systems in the brain—systems acted upon by various drugs of abuse. The Author apprised himself of evidence that impulsivity and anxiety influence the propensity for addiction. This revealed the relevance of meditation as a means of attenuating impulsivity and anxiety, thereby supporting its suitability in the prevention and mitigation of addiction. Social support is crucial in the adoption of an intervention as rigorous as the AOHP. Adherents invariably find the support provided by fellow practitioners to be particularly valuable. Given the evidence that social environs influence addictive behaviors, it is plausible that the social support extant in the community of AOHP/AAI adherents could counterbalance the deleterious social signals which promote and sustain illicit substance use. This realization prompted the Author to consider other elements of the AOHP that are potentially conducive to the attenuation of addiction.
Arguments have been advanced that much substance abuse is intended to “self-medicate” symptoms of mental disorders, particularly depression and anxiety [
Complementing the evidence that fasting and caloric restriction may improve psychological well-being by mimicking the neurogenic effects of psychotropic drugs is evidence that exercise acts in a similar manner. This effect was established by Huang and colleagues [
Stress is known to induce neuronal loss in specific regions of the adult brain [
Certain natural substances are known to promote neurogenesis in particular regions of the brain, such as the hippocampus. Among such agents is the polar compound choline. Glenn [
It has been found that extracts of the South African herb, Aspalathus linearis (also known as Rooibos or red tea) inhibits the age related reduction in hippocampal thickness [
It is evident that each element of the AAI plausibly possesses the potential to attenuate addictive behavior via an empirically established ability to induce regionally specific neurogenesis in a manner similar to psychotropic drugs. Six separate components serve this salutary end—cyclic fasting, caloric restriction, exclusively vegetal nutriment, exercise, neutraceuticals, and meditation. The multifaceted nature of the AAI, combined with its manifest molecular mimicry of the psychotropic medication modality and its absence of artificiality (and presumably deleterious pharmacologic side-effects) may make it inherently more effective than alternative preventative/ therapeutic interventions.
Though there is no current consensus on the etiology of drug addiction, there is considerable support for the role of molecularly mediated motivation [
A major CNS dopaminergic pathway is the mesolimbic pathway. In this pathway, dopamine synthesized in the ventral tegmental area (VTA) of the mid brain is transported to the nucleus accumbens (NAc), amygdala, hippocampus, and prefrontal cortex (PFC) in the forebrain. The mesolimbic dopaminergic pathway is also referred to as the “reward pathway” because of its critical involvement in mediating rewarding effects of drugs such as cocaine (p. 439).
Additionally, impulsivity and impaired self-control are common, compelling, explanatory elements of theories and models of addictive behaviors [
It is herein hypothesized that cyclic fasting/caloric restriction (CF/CR) may be effective in the treatment of addiction insofar as it is operative in the two dimensions discussed above—that is, CF/CR may modulate molecularly mediated motivation and it may plausibly inhibit impulsivity. Evidence indicates that feeding restriction alters the chemistry of the brain such that pleasure centers (principally limbic structures) are activated [
Fasting entails self-imposed control over the impulse to eat. Foregoing feeding for 23 hours daily and partaking of a single evening meal of moderate energy density facilitates (and indeed constitutes) self-control. Appetitive impulses are suppressed during extended fasting and such suppression serves to strengthen one’s psyche thereby enabling the attenuation of addiction according to the hypothesis advanced herein. The feasibility of fasting for 23 hours daily is experientially established by the Author’s personal practice of the protocol for a period approaching a decade and his assistance in aiding patients in the successful adoption of the AOHP in the context of his private practice. The feasibility of fasting consistently for spans of 24+ hours has been empirically established by several clinical trials. In a review of caloric restriction studies in humans, Varady [
Anxiety is among the effects of drug withdrawal [
Preliminarily, the Author proposes to conduct a pilot study, the intent of which is to ascertain the effect of the AAI on the treatment of addiction among individuals in a drug treatment facility. It is hypothesized that the AAI will prove more effective in inducing abstinence than the standard treatment entailing psychological interventions (e.g. cognitive behavioral-based therapy (CBT)) solely or with the aid of prescribed pharmaceutical drugs (e.g. opioid antagonists). The Author endeavors to execute the investigation in an outpatient addiction clinic over a 3-month period. Participants will be recruited from incoming clients seeking treatment for alcohol and drug addiction. Self-selected individuals will be incorporated into an alternative treatment group. The alternative treatment group shall be instructed in the implementation of the AAI, asked to record their food intake, be provided with select neutraceutical agents included in the Amen Apothecary (specifically the two types of tea— traditional and red), asked to indicate the time and duration of fasting and exercise, and record the frequency and duration of meditation. The alternative treatment group shall be compared to a standard treatment group consisting of incoming clients assigned to conventional treatment—specifically, weekly individual and group psychotherapy sessions employing CBT as the primary treatment technique. The main outcome of interest (the dependent variable) shall be abstinence. Abstinence shall be defined as an absence of detectable drugs in random urinalyses over the study interval. The minor outcome of interest shall be a reduction in the intensity of addiction as assessed by an empirical index whose validity and reliability have been observationally established. The proportion of participants from the alternative and conventional groups who maintain drug abstinence (after the first month of the study’s commencement) shall be compared to ascertain the existence of a statistically significant difference. In addition, differences in the intensity of addiction attested by the two groups shall be quantified and compared. Subsequent studies shall be aimed at integrating all elements of the AAI over increasingly lengthy intervals of investigation.