Genetic Predisposition
Happy couples vacationing on the USS Procreation visit this port city and plant the seeds of the next generation. They pass on polymorphic dopamine receptors, and the proportion and distribution of D1 and D2 receptors. They also determine the epigenetic enzymes which control gene expression in their offspring.
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Pre-Natal
Infants' developing brains enjoy ongoing exposure to a variety of substances due to their mothers' continued use of tobacco, alcohol, marijuana, and other drugs. Most of these gifts, which determine deeply-held personality traits, will persist indefinitely and continue to affect nearly every aspect of life.
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Peri-Natal
Early life stressors such as fetal distress, hypoxia, and premature birth cause early activation of the HPA (hypothalamic-pituitary-adrenal) axis. This "cranks up the volume" and "primes the pump" to be ready to respond aggressively to every potential stressor in life yet to come.
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Childhood
This is when environment, heredity, and personality combine to determine a long-lasting temperament that may be a help or a hindrance in facing all the challenges to come.
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The Badlands
Combined with the baggage of so many prior problems, exposure to conflict and instability lights the fire-in-the-hole for future addictive disorders.
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Adolescence Mall
Separation from parents gives freedom of choice for the first time, while the evolutionary imperatives of development drive behavior towards choices that are potentially irrational and dangerous. What was once a predisposition becomes a perfect storm.
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The Rotary
The development of addiction involves a progression of substance use from Experimentation, to Occasional Use, to Regular Use, to Abuse.
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Dependence (the point of no return) and The Canyon of Chronic Dysphoria
The eventual endpoint of Dependence with the development of chronic withdrawal symptoms. There is no joy here, only pain and suffering. The only effective way out is via the OMT Super-Highway.
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The Chronic Pain Train
The direct route into the Canyon of Chronic Dysphoria powered by prolonged exposure to high dose opioids with the development of chronic brain physiologic changes. No other influences needed.
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