Osteoreflectory Treatment of Alcohol Abstinence Syndrome and Craving for Alcohol in Patients with Alcoholism

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OSTEOREFLECTORY TREATMENT OF ALCOHOL ABSTINENCE SYNDROME AND CRAVING FOR ALCOHOL IN PATIENTS WITH ALCOHOLISM

ABSTRACT: Osteoreflexotherapy is used alone as a treatment used for alcohol abstinence syndrome and for alcohol craving by intraosseal stimulation of the processus styloideus ulnae of the patient's left and right hands as well as the processus spinosus of the seventh cervical vertebra and the manubrium sterni osteoreceptors. This is done by intraosseal injection of 0.5 to 1.0 ml of 0.9% NaC1 solution during a period of 3 to 5 seconds. Craving for alcohol and depressed mood, strongly manifested Alcohol Abstinence Syndrome (AAS) symptoms before osteoreflexotherapy, were reduced in a most convenient and fast manner under the influence of two sessions of osteoreceptive stimulation. The withdrawal symptoms caused by alcohol abstinence decreased markedly during the first two hours after the first osteoreflexotherapy treatment, continued to decrease in the next 24 hours and by the time the second osteoreflexotherapy session was given, the withdrawal symptoms completely disappeared in 7 2 hours. The most slowly and least reduced AAS symptoms were asthenia and disturbances of postular equilibrium. Based on clinical observations, it is speculated that osteoreceptive stimulations destroy ethanol dependent functional systems and restore the neurophysiological and neuromediatorial integration of the brain in alcoholism patients. Primarily because of these two cited factors, the patient can be freed of the craving for alcohol for several years, and he or she also does not suffer from depression.

KEY WORDS: Alcohol abstinence syndrome, Craving for alcohol, Ethanol dependent functional systems, Osteoreceptive stimulation, Osteoreceptive sensory system, Osteoreflexotherapy.

INTRODUCTION

Osteoreflexotherapy (Greek osteon -- bone, Latin reflexus -- reflection, Greek therapeia -- treatment) is one of the newest treatment methods for traditional reflectory alcohol abstinence syndrome and craving for alcohol. Osteoreflexotherapy is elaborated at the Latvian University Institute for Experimental and Clinical medicine and at its basis is the discovery of the scientists of the Institute that there exists the osteoreceptive sensory system (OSS) in the organism (the link of the bone nerves with the brain and other systems of the organism) (Fig. 1) [ 1, 2, 3].

The discovery of OSS made it possible to understand that the human brain without any interruption, receives signal flow from nerves from more than 200 different bones of the body, which form the skeleton. (Fig. 2) [ 1, 2, 3].

The brain in its turn directs the signals in different directions -- to the breathing and blood circulation systems, to the muscles, skin, endocrine glands and other systems, as well as to the bones, in such a way influencing the respective systems and the functional condition of the particular organ and vice versa (in their turn other systems are influencing the skeleton). In such a way, bone irritation to a certain extent participates in the regulation of the operation of these systems. Therefore osteoreflexotherapy is reasonably called a therapy of bone reflexes. On the basis of the previously mentioned it is a physiological treating method -- treating with bone reflexes and without any medical remedies.

The elaborated osteoreflexotherapy method for alcohol abstinence syndrome and craving for alcohol treatment is based on the researches of the scientists of Latvian University Institute for Experimental and Clinical Medicine into the representation of osteoreception (bone sensitivity) in those structures of the brain (for example, hypothalamus, hippocampus and others), which take part in the operation of the alcohol dependent functional systems [ 4, 5, 6]. The irritation of the osteoreceptors (nerve endings of the bone) provokes a modulation of the neurophysiological activity in the brain of the alcoholic, as well as neurochemical alterations in the representative osteoreceptive zones. This could be regarded as the basic factor of the collapse of the alcohol dependent functional systems and the rehabilitation of the physiologically functional systems.

The purpose of this article is to share the clinical experience which was obtained during the 7 years during which we used osteoreflectory methods to treat alcohol abstinence syndrome and craving for alcohol in patients suffering from alcoholism.

MATERIAL AND METHODS

For the treatment of alcohol abstinence syndrome and craving for alcohol with osteoreflexotherapy we made use of the knowledge about the functional asymmetry of the brain as well as researches regarding the mechanisms of the pathogenesis of alcoholism.

During one performance of osteoreflexotherapy the processus styloideus ulnae of the left and right arm was irritated (Fig. 3).

It was done in order to revive the intercollaboration of the right and the left cerebral hemispheres of the brain (the disturbance of which was caused by alcohol, suppressing the functioning of the right cerebral hemisphere, which is regarded as of great importance in the mechanism of the pathogenesis of alcoholism) [ 6] as well as the hindered interrelations of the cortex and subcortex (the hindrance was caused by alcohol firstly activating the neurons of the thirst centre and the agitation then spreading further to all the structures of the brain, and this factor is regarded as the most important mechanism of alcoholpathogenesis) [ 7].

In order to break the already tight functional bonds which have formed in the cortex between the sight, hearing, sense of smell, touch, taste and other cortical spheres (it is regarded as the main mechanism of the pathogenesis of alcoholism and one of the reasons by which some of the alcohol treatment methods do not achieve the desirable result), during the osteoreflexotherapy performance the osteoreceptors of manubrium sterni are irritated

In order to lessen the vegetative component the osteoreceptors of sharp protuberance of the seventh vertebra are irritated (Fig. 5).

Bone is a unitary system. It consists of periosteal, endosteal, compact and spongious bone tissues, osseous tissues, bone marrow. With osteoreflexotherapy the irritation of osteoreceptors (the nerve ends which are located in all consistuent parts) occurs, but during 3-5 seconds 0.5-1.0 ml 0.9% NaC1 (physiological solution) is administered in the bone marrow. This certain amount of the solution administered in a definite unit of time is determined on the basis of the researches carried out regarding the clinical, electrophysiological and EEG measurements of healthy and alcohol dependet people. They correspond to the irritation of the superthreshold. The physiological solution was used because of its adequacy to the solutions of the inner environment of the organism, and therefore it does not influence the osmotic cell pressure. Disposable needle (í 0.8 mm, length 40 mm) and syringe (2.0 x 5.0 ml) is used for injection of 0.9% NaC1 solution.

Osteoreflexotherapy is administered to a patient by piercing an ordinary injection needle in the left and right arm processus styloideus ulnae as well as the processus spinosus of the seventh cervical vertebra and the manubrium sterni and introducing intraossally into the bone marrow 0.5-1.0 ml of physiological solution during 3-5 seconds [ 1] (Fig. 6).

There exist two groups of patients, for whom the osteoreflexotherapy treatment is being used: the first group are patients for whom the alcohol abstinence syndrome is treated; the second group are patients who are undergoing treatment for the craving for alcohol.

Clinical observations for osteoreflectory treatment of alcohol abstinence syndrome were performed in 67 alcoholism patients (63 men and 4 woman) aged from 24 to 62. The duration of the disease varied from 2 to 15 years; the volume of ethanol solution consumed during 24 hours was from 0.2 to 1.5 litres; the duration of drinking periods varied from 3 days to 2 months. From 67 patients 42 had been treated for alcoholism by various methods, nevertheless the treatment had proven to be unsuccessful.

The osteoreflectory treatment of alcohol abstinence syndrome was applied in one to two sessions: 1) 1st session was given on the first day of abstinence from alcohol; 2) 2nd session is given after 24 hours.

The pronouncedness of the alcohol abstinence syndrome in the alcoholism patients before osteoreflexotherapy and the reduction of craving for alcohol, depressed mood, disturbances of postural equilibrium, asthenia, and other symptoms of alcohol abstinence syndrome under the influence of osteoreceptive irritation was estimated according to the 4 point (0-1-2-3) system internationally acknowlegded in narcological practice [ 8]. This system makes possible an estimation of the intensity of every alcohol abstinence syndrome clinical symptoms (features), for example, estimating the craving for alcohol: point 0 -- absence of the symptoms (features); point 1 -- the symptoms (features) are observed inconsistantly, they are not strongly expressed, the patient's attention is not focused on the symptom (feature) all the time; point 2 -- the symptom (feature) is outspoken and observed permanently, the patient's attention is focused on this symptom: it is possible to sidetrack the attention onl y with an execution of some intensively strenuous task; point 3 -- the symptom (feature) is heavily expressed, the attention is permanently focused on this symptom, and it is impossible to sidetrack attention as well as to perform any task.

The application of the osteoreflectory method to treat craving for alcohol was used with 49 patients suffering from alcoholism (47 men and 2 women), who were between 20 and 53 years of age. The patients indicated that the period of alcoholism ranged between 2 and 13 years in duration. The average amount of ethanol solution consumed during a 24-hour period ranged between 0.25 and 1.5 litres. The duration of the last alcohol consumption period had lasted between 5 and 60 24-hour periods. Over the course of the preceding year, all of the patients had used alcohol frequently, the number of days of sobriety had declined in favour of days of drinking.

Of the 49 patients, 37 had sought treatment for alcoholism through various methods. None of these had led to positive results.

In most cases, the osteoreflexotherapy treatment of craving for alcohol involved two or three sessions. The first treatment session was held on the first day of abstinence from alcohol, the second -- on the eighth day of abstinence from alcohol, and the third -- on the 15th day of abstinence from alcohol. If necessary, the fourth session was held on the 49th day of abstinence from alcohol, and the entire osteoreflexotherapy course could be repeated.

RESULTS

Tracing the pronouncedness of each alcohol abstinence syndrome symptom before osteoreflexotherapy and its reduction under the influence of osteoreceptive irritation, it was discovered that the following 2 alcohol abstinence syndrome symptoms reduced at the most rapid rate and most of all: craving for alcohol (Fig. 7) and depressed mood (Fig. 8).

The most slowly and less reduced alcohol abstinence syndrome symptoms were asthenia (Fig. 9) and disturbances of postural equilibrium (Fig. 10).

Osteoreflectory treatment of craving for alcohol in 49 patients suffering from alcoholism and observation of these patients for a period of 7 years led to the following clinical observations: 57% of the alcoholic patients who were treated with osteoreflexotherapy fully abstained from the use of alcohol during the period from 6 months to 7 years of observation.

A second osteoreflexotherapy treatment course was applied to 7 of the patients. Those patients who relapsed into the use of alcohol stated that upon the application of a second osteoreflexotherapy treatment course, the osteoreceptive irritation made alcohol abstinence syndrome considerably easier, bouts of drinking became less frequent, the length of time between bouts of drinking increased, etc.

To the fact that our observed patients did not use alcohol during the treatment with osteoreflexotherapy and the treatment certified first of all their appearance, the behaviour of the patient and other reactions. It was ascertained by the patient himself as well as by his reactions. The quantity of alcohol used by the patients during the osteoreflexotherapy treatment and after that we did not determine because the patients who had resumed to use alcohol after the 1st osteoreflexotherapy treatment or later were excluded from the our investigations. We continued to observe the patients who did not use alcohol.

DISCUSSION

One of the possible osteoreceptive irritation mechanisms in our opinion is that osteoreflexotherapy influences the thirst center of the hypothalamus and the patients lose the craving for alcohol [ 1, 2]. Under the osteoreflexotherapy influence on the hippocampus the depression and craving for alcohol vanishes [ 1, 2]. When the osteoreceptive irritation influences the nucleus amygdalae, agressivness disappears. When osteoreflexotherapy irritates the nuclei vestibulares, the cerebellum, the nucleus caudatus, the body posture is stabilized and ataxia, tremour and disturbances of body coordination are decreased and eliminated. Osteoreceptive irritation mainly influences the right brain hemisphere -- the mutual connection betweeen brain hemispheres and the connections between the cortex and subcortex formations are restored -- the feeling of discomfort, depression, and craving for alcohol disappears, the patient's orientation in space and time improves.

The restoration of the neurophysiological integration of the brain can be explained with the prolonged afferentation (up to a period of 60 days) from the locations of injection in two or three bones to the brain and its various structures changing their functional condition [ 1]. Of essential importance is the fact that by influencing the surface of the brain -- destroying the ethanol dependent functional systems, i.e., the diffuse and very strong activation of the alcoholic's brain -- the osteoreceptive irritation impacts the most important mechanism of the pathogenesis of alcoholism [ 7].

The restoration of the neuromediatorial integration of the brain can be explained by the fact that osteoreceptive irritation leads to prolonged and quantitative changes in the neuromediators of the osteoreceptive zones of the brain [ 9] as well as in the bone marrow [ 1].

The result of this is a prolonged elimination of ethanol dependent functional systems and a restoration of normal neurophysiological and neuromediatorial integration of the brain.

Primarily because of these two cited factors, the patient can be freed of the craving for alcohol for several years, and he or she also does not suffer from depression.

REFERENCES
(1.) Jankovskis G., Beldava I., Mertens A. Osteoreceptive Sensory System and Osteoreflexotherapy. "Zvaigzne" Publ. H., 222 p., Riga, Latvia, 1996.

(2.) Jankovskis G. Osteoreception. "Zinatne" Publ. H., 302 p., Riga, Latvia, 1982.

(3.) Jankovskis G. Osteoreceptive sensory system. Proceedings of Latvian Academy of Sciences, B, No. 4 (537), 52-54, Riga, Latvia, 1992.

(4.) Barabanchin V.G. Structural changes of hypotalamic regions in connection with chronic alcohol intoxication. J. Physician's proceeding, No. 6, 102-104, Russian Federation, 1988.

(5.) Paikova L.N. Significance of hippocampus and nucleus amygdalae in the mechanisms forming craving for alcohol. In book: New methods of diagnosis and treatment of the basic forms of nervous and psychical diseases, 300-302, Russian Federation, 1982.

(6.) Dvirsky A.Je., Kucer Ju.A., Motorny C.M., Vlasov G.V. Peculiarities of brain functional assymetry in cases of different types of the course of alcoholism and alcohol delirium. J. Narcology Issues, No. 3, 45-47, Moscow, Russian Federation, 1990.

(7.) Shostakovich G.S. About a nerve mechanism of subconscious craving for alcohol of chronical alcoholics. J. of Neuropathology and Psychiatry named after S.S.Korsakov, v. 87, No. 6, 898-900, Russian Federation, 1987.

(8.) Yatskov L.P. Scale of determination of the intensity of craving for alcohol. In book: Narcology Issues, 179-181, Moscow, Russian Federation, 1989.

(9.) Praulite G., Klusha V., Muceniece R., Liepa I. Influence of osteoreceptive signals on the contents of neuromediators in the structures of brain. Proceedings of Latvian Academy of Sciences, N1, 124-127, Riga, Latvia, 1989.

Cognizant Communication Corporation.

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By Georgs Yankovskis; Inta Balvada and Baiba Livina

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