N Engl J Med. 2010 Jan 14; 362(2):110-7: Morphine use after combat injury in Iraq and post-traumatic stress disorder

Subject:N Engl J Med. 2010 Jan 14; 362(2):110-7: Morphine use after combat injury in Iraq and post-traumatic stress disorder
Date:Thu, 21 Jan 2010 09:38:14 -0600
New England Journal of Medicine 2010 Jan 14;362(2):110-7: Morphine use after
combat injury in Iraq and post-traumatic stress disorder

It is my hypothesis that DHEA was selected by evolution because it optimizes
replication and transcription of DNA. Therefore, all tissues rely on
sufficient levels of DHEA for optimal function. This produces a competition
among tissues for available DHEA. Trauma triggers a reduction in available
DHEA for repair of injured tissues.

It is also my hypothesis that cortisol evolved to counteract the actions of
DHEA. (I think this ratio determines the "fight-or-flight" mechanism.)
Therefore, when DHEA is low, the effects of cortisol increase. It is well
known that excessive cortisol exposure for excessive time causes damage,
especially to the nervous system. I suggest this is why trauma causes mental
problems; prolonged cortisol exposure may actually damage neurons. That is,
the results of trauma switch available DHEA from the brain to repair and
healing processes. The brain is then subject to the negative effects of
cortisol and these cause post-traumatic stress disorder.

Well, again, it is also my hypothesis that all drugs of abuse first block
receptors in the brain which then stimulates DHEA production. Continued use
of these drugs ultimately starts a cycle of DHEA stimulation followed by
DHEA reduction which becomes a cycle and causes addiction. Ultimately, the
adrenal glands' ability to produce DHEA is exhausted and drug abusers crash,
either for the short run or long run. My point of importance to your report
is that initial use of morphine increases production of DHEA. This initial
impulse of DHEA increases available DHEA which provides DHEA for the trauma
and the brain. That is, the morphine reduces the effects of increased
cortisol by increasing the DHEA to cortisol ratio. I suggest the foregoing
may be the explanation of these findings.

James Michael Howard

Fayetteville, Arkansas

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• N Engl J Med. 2010 Jan 14; 362(2):110-7: Morphine use after combat injury in Iraq and post-traumatic stress disorder
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