My future is now

ByI was the City Addiction Commissioner. There were forty-one—shortly after the methadone system had been put in place. I was one of the early proponents of methadone and, because of my job in city government, for a couple of years I was a major spokesperson for methadone—which in subsequent years, I had mixed feelings about.

Bihari gives his background and credentials. Then I went to the National Institutes of Health for two years doing brain physiology—brain research. It works in My future is now addicts by blocking the receptors in cells, mostly in the brain in that situation. Then I became more broadly involved in drug addiction and alcoholism as a public health problem.

Inas I saw the AIDS epidemic expanding, I decided to shift my research energies from addiction to AIDS, and in particular, to look for something that might boost immune function.

Endorphins are the hormones that heroin works by mimicking.

They also play a major role during acute stress. It was while I was doing that that the mayor, Abe Beame, moved the addiction services agency into the health department, and I took over the management of all the addiction programs: So it was out on the market, and has remained so since, but has been relatively little used.

And when the drug came out, I was interested in trying it. None of them would stay on it. What we did was we measured the endorphin rises with different doses of Naltrexone. Those that are involved in pain relief, and relief of fear.

The blockade caused by naltrexone. We got the same rise with 50 mg, 10 mg, 5 mg, and 3 mg. I was the only deputy medical commissioner. They relieve the fright. They have a number of functions in the body.

Inthe National Institute on Drug Abuse finished the development of Naltrexone as an adjunct to treating heroin addicts. At the doses involved it caused anxiety, depression, irritability.

I ran all the programs that the city funded for addicts. I basically ran the city health department for about three years. The naltrexone itself is gone in about 3 hours, but the endorphins remain elevated all the next day.

They relieve pain; they relieve fear. It would take a very large amount of heroin to overcome the high. It was designed in the laboratory to block those receptors and prevent heroin from having access to them.

Heroin uses primarily the pain receptors. And I ran both for about four years. Can you talk about working with methadone? I did another residency training in Psychiatry in New York, at Columbia Presbyterian Medical Center and then, over the following five or six years, I got very involved in working in Drug Addiction.

Its purpose was to block the heroin high with the hope that it would become a very useful treatment for heroin addicts.

My colleagues and I worked to find some way of using that ability of naltrexone to raise endorphins, but without the downside of naltrexone blocking the endorphins, the purpose being to find a way to raise endorphins to boost immune function.

My medical training started at Harvard Medical School. One of the things I did know from its development, which I had followed closely because I was treating addicts, is that naltrexone, when taken in these high doses, would get the body to triple its production of endorphins.

I was seeing large numbers of the heroin addicts I was treating die. They also shift blood from the whole gastrointestinal tract where a lot of the blood flow is to the muscles and brain, which need it during a fight.

How did your connection with Naltrexone begin? So the hormones that people with AIDS need the most, to have the immune system fight the virus—those hormones are lacking. I knew that the immune system was regulated almost entirely by endorphins, and that also the endorphin production was markedly increased by naltrexone.

I graduated in I got very concerned about what I saw as a major epidemic—a worldwide epidemic—coming over time. I gave it to about two dozen heroin addicts who had recently stopped using heroin.Paul Greenberg is the author of the New York Times bestseller Four Fish: The Future of the Last Wild Food.

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My future is now
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