Scientific Evidence – Forest Tennant

New Life Detoxification Program

A national leader in the field of drug rehabilitation, Dr. Tennant is the author of more than 200 scientific papers, books and videos on the subjects of neurochemistry and drug dependence. He is the Executive Director of the Research Center for Chronic Pain and Dependency Disorders and the Executive Director of the Community Health Projects Medical Group. He has served as a Public Health Fellow for the U.S. Public Health Service, as an Associate Professor at the UCLA School of Public Health and is a member of the Drug Abuse Advisory Committee of the Food and Drug Administration. He is a Narcotics Training Consultant for the California Highway Patrol and the California Department of Justice. Dr. Tennant was the Keynote Speaker at the Conference on Human Detoxification, Los Angeles, 1995.

“I am indeed delighted to be here this afternoon and to share with you what I hope will be somewhat of a historical perspective, and to bring you up to where I believe we stand medically relative to what is known as detoxification.

I first heard the word “detoxification” in the year 1968. I was an Army surgeon in Europe. Even at that time the U.S. Army had to start doing something about its drug problems. Between the years 1966 and 1968, they had established in New York City what they called “detoxification centers.

I cannot tell you who coined that term. It referred primarily at that time to heroin addicts, who were put in hospitals and administered methadone to withdraw them from heroin.

Shortly after that time, the term detoxification came to mean “the substitution of a long-acting drug in the bloodstream for a short-acting drug that you are attempting to stop.” And that is a definition that to some extent continues until this day.

Needless to say, the terminology and activities of drug treatment have since taken quite an odyssey. What I would like to impress upon you is that, rather than getting caught up in semantics, it is critical today to understand that a huge amount of neurochemical and biochemical research has gone on in the last 10 or 12 years. Above all, we now know about metabolite formation.

This work goes back to 1961, when a man who won the Nobel Prize, by the name of Axelrod, took a rat brain and put it in a test tube. On it, he put cocaine and amphetamine and he saw that dopamine and noradrenaline, or norepinephrine, were displaced from the brain. A few hundred studies from that time up until now have shown very clearly that one of the fundamental effects of drugs, once they hit the bloodstream, is to go to biochemical reservoirs in the body and displace from those reservoirs such things as the endorphins, acetylcholine, cortisone and some other biochemicals. This is true with every drug of abuse that we know about-nicotine, anabolic steroids, marijuana and all other compounds.

The drug comes in through the bloodstream to reservoirs and biochemicals are displaced. What reservoirs are we talking about? The major one in the body is the pituitary gland. The second most important are the adrenal glands, probably the hypothalamus in the brain is number three. You have also huge reservoirs in the spinal column, the sciatic nerve and other big nerve endings in the body.

It is very critical for everyone who deals with drug dependence to understand that if, for example, you take heroin long enough your natural body levels of endorphin will deplete-your body will make less of it because the drug provides it. If you take drugs like cocaine long enough at a high enough dose, your body stores of dopamine will deplete. Once you get this depletion, the body sets up what we call a “craving cycle,” desiring more of the drug to make up for the chemical that you have depleted.

The second basic science principal that you need to know about is that these chemicals that I have just talked about work in the body by attaching to something that we call a “receptor site.” I’m sorry that we call it a receptor site, because it’s something of a misnomer. I wish that we called these things “electrical trigger points.”

The term “receptor site” comes from research with diabetes. Many years ago, endocrinologists knew that when the blood glucose went up after you ate a carbohydrate meal, the rise in blood glucose acted like a drug of abuse. It calls forward out of the pancreas reservoir something called insulin. The insulin and glucose then travel together and they are received on muscles like your biceps and your quadriceps. The little spots on the muscles that receive the insulin and the glucose were called “receptors.”

That wasn’t so bad, but then the cardiologists got into the act and they wanted to have cardiac “receptors.” And then the lung people wanted to have their receptors. And then disaster hit: The psychiatrists wanted their receptors.

Maybe they should have been called “trigger points.” It is body chemicals attaching to receptors in the brain, in the spinal cord, in the heart, in the kidney, in the intestine, that make the body work. And we now know that drugs of abuse go to those receptors and trigger those receptors. That’s why we all like our caffeine and our nicotine. And our carbohydrates, and our marijuana, our cocaine and all of these other compounds-because we can not only release certain chemicals, we can make those “trigger points” get triggered.

The third thing that you need to be aware of is a fairly recent discovery. In my way of thinking, I don’t think this conference would be being held today if we hadn’t discovered this. That is this: once a drug of abuse hits the bloodstream and makes its first pass through the liver, the drug is altered and something called a “by-product,” or a “metabolite,” is formed.

We now know that the component of a drug of abuse that we get addicted to is the metabolite of the drug, not the drug itself. This is a terribly important concept. In other words, heroin is converted to morphine in less than 120 seconds after it hits the bloodstream. We don’t really have heroin addicts, we have morphine addicts. We don’t really have cocaine addicts, we have benzoylecgonine addicts. Even alcohol has a metabolite. Nicotine has a metabolite called cotinine. Marijuana has two primary metabolites.

It is the metabolite that supports the addiction. It is the metabolite that gets stored in the body fat, and to some extent it is the metabolite that gives you some of the signs of drug influence. Certainly the long-term effects of the drugs derive from the metabolites.

Apparently, once a drug hits the bloodstream, the body says, “Gee, the body’s taken in a toxic substance. I’ve got to get rid of it.” It tries to rid itself of the drug of abuse by excreting it-through the breath, through the bile, through the urine. (It also has the mechanism to change the toxin to a metabolite.)

Here’s where the rub comes in. We don’t know much about these metabolites yet. We used to say they were inactive, they were inert. We now know different. We do know the body makes the metabolite and it will store it in the reservoirs, and in some cases it uses the metabolite. In other words, if you have a shortage of endorphins, fine. It will use the metabolites of heroin or morphine as a substitute.

If you’re short of your dopamine, it will use the metabolites of methamphetamine and cocaine as a substitute. If your nicotine, after several years, has driven out some of your serotonin, the cotinine and other metabolites of nicotine will be happy to substitute, at least for a while.

What we don’t know is how destructive those metabolites are. We really don’t have a good feel for that. We don’t like them when we find them in the body and, of course, we try to get them out of the body.