FRANK HENRY GAWIN, M.D.
VICE-CHAIRMAN OF THE BOARD, THE BRIDGES OF HARMONY FOUNDATION
Internationally acclaimed, Dr. Gawin's work at Yale University and other top tier academic and medical institurions has been summarized for the popular media nationally and internationally in multiple network news and science broadcasts, long before the advent of the internet, on ABC, CBS, NBC, and CNN, as well as in articles appearing in national weekly periodicals including Time and Newsweek, and in The New York Times, Washington Post, The Readers Digest, and Science.
Dr. Gawin now lives with his beautiful wife Valerie Gawin on the island of Kauai, where he currently is creatng a seminal work on the scientific validity of spirituality, focussing on a scientific argument for people of all faiths to work in harmony. He works on spiritual insights gained from his experiences with spiritual recovery from addiction in AA, and conducts continuous study of all spiritual traditions to expand insights on concordances between all healing traditions of loving kindness with central sets of consensus principles; that he feels are present across all spiritual traditions and that are identical in accurately translated study of all comparative religion. Dr. Gawin unparalleled understanding of spirituality and science in order to affect a global paradigm shift in the manner in which members and institurions of faith shall relate.
Dr. Frank Gawin’s scientific research career was devoted to furthering the understanding of human desire or craving and brain neurophysiology. Dr. Gawin was the first clinician to suggest that all addictions, independent of withdrawal syndrome characteristics, were founded in neuroadaptations in brain reward (or pleasure) systems. This occurred shortly after such systems and their brain locations were first demonstrated in animals by scientists who used electrical brain stimulation studies and who used amphetamine’s single dose effects as a model of pleasure, but with a sole focus on basic mental functioning and psychiatric illness but not addiction. Understanding the importance of this very early research to addiction, and not only pleasure but desire and craving, Dr. Gawin extended this research domain to the first investigations of a then new perplexing drug being broadly used, but, at that time, seldom associated with treatment seeking and then a controversial area in which even the existence of cocaine abuse and dependance were denied by many serious scientists. He conducted the first systematic studies of cocaine addiction. He denied the plausibility of prevailing explanations that drugs lacking a dramatic withdrawal syndrome, like cocaine, were non-addictive, as well as the prevailing opinion then that multiple different brain systems mediated the effects of the multiple different classes of addictive agents, dismissing the prevailing focus on dissimilar "highs" and intoxication effects of different classes of intoxicants, and on their very dissimilar withdrawal syndromes. Instead, based on concordance he found between his observation that chronic cocaine-induced craving and associated anhedonia was fundamental to relapse in cocaine users, despite an absence of other major physiological withdrawal symptoms, and in his observation that anhedonia was the sole symptom common to disparate withdrawal syndromes of all other abused drugs, he concluded all drug addiction was focused in a single brain system - that mediating normal pleasure. He thus combined the dysregulation of pleasure in addiction presented by anhedonia in his studies with the early research indicating single dose amphetamine activated the brain pleasure mediating sites of euphoria that had been demonstrated by electrical stimulation studies in animals, and generated the first physiological explanation for cocaine addiction, which had previously been deemed non-existent or purely "psychological" (this was long before "crack"). He concluded that taken together, cocaine’s addiction, though lacking classic opiate or alcohol-like withdrawal syndromes, and addiction to all other abused drugs, was mediated by the same fundamental brain changes. Identified by animal studies of reward (pleasure) using electrical stimulation and localization of immediate reward effects of acute amphetamine, and fundamental to normal experience’s of human pleasure. His hypothesis that not only cocaine, but all addiction shared at least one property - that of activating the same brain regions that subserved the human experience of pleasure (principally the N. Accumbens via dopamine neurotransmission). He considered the commonality of pleasure induction by drugs of abuse paramount, and considered intoxication differences irrelevant distortions of fundamental similarity. This hypothesis was to be followed by years of subsequent acute studies of all classes of abused drugs and addictive agents - all confirming his prediction of a single cardinal brain reward system for all drugs of abuse, and by decades of still expanding research on chronic application of abused drugs in animals that not only confirmed his hypothesis of uniform reward dysregulation in the same areas after chronic drug reuse (or, addiction), but that ultimately far extended the hypotheses to other associated systems linked to physiological reward that explained distinctions in drug craving and created new targets for addiction treatment using medication.
Regarding specific research contributions, while still in training as a resident in Psychiatry, Dr. Gawin founded the first research clinic in the world devoted exclusively to the problems of cocaine abuse, while at Yale in 1982, with Herbert D. Kleber, M.D.. Observations in these patients combined with his anhedonia hypothesis to demonstrate a total inadequacy of prevailing explanations holding that cocaine caused only a mild, "psychological" addiction. His early publications included the first systematic studies of cocaine use patterns, the first systematic studies of interactions of cocaine addiction with other psychiatric disorders, the first systematic studies of neuroendocrine indices in cocaine abuse and craving, and the first systematic studies of of cocaine's complex clinical withdrawal phenomenon and the fundamental importance of classical conditioning of memory to relapse..
By 1984, Dr. Gawin presented the just described neurophysiologically based hypothesis of cocaine addiction which integrated clinical and brain science, focusing addiction science on clinical observations of dysphoric and anhedonic symptoms in cocaine withdrawal that paralleled existing pre-clinical (animal) data on brain reward systems. His hypotheses also immediately implied extension to all other addictions, as well as potential use of neuropharmacological treatments for cocaine and other drug withdrawal, which led to multiple open and double-blind clinical and human laboratory studies of new, pharmacological approaches to drug abuse treatment. These pharmacotherapy studies have resulted in the elimination of several candidate agents for cocaine withdrawal, and provided the first systematic, controlled, double-blind and multiply replicated trials suggesting that tricyclic and other anti-depressants (e.g. desipramine and, by others imipramine, selegeline and phenytoin) assist in abstinence initiation when used early in outpatient treatment. This work of Dr. Gawin’s provided the foundation for a major pharmaceutical firm to explore the anti-depressant bupropion in nicotine addiction treatment. This resulted in a new treatment arena for smoking that was to extend the lives of millions across the world.
These efforts are uniformly deemed to constitute major advances in medicine and to have pioneered a shift in conceptualization of addiction and withdrawal. They have helped open broad avenues for future advances, including university institutes devoted to medication treatments for stimulant and other addictions. The efforts have been recognized by invited publication of the only summating articles appearing in half a century in the pre-eminent journals in medicine and in science; the former on the neurophysiology, psychology, and clinical treatment of cocaine dependence in The New England Journal of Medicine (with E. Ellinwood) and, the latter by an invitation to review his contributions on the psychological and neurophysiological effects of cocaine, published in the journal Science in the early 1990’s.
Dr. Gawin’s research was interrupted by effects of Lyme Disease he contracted in his early 30’s. The research then underway included refining clinical precision in use of the abstinence facilitating medication desipramine, the first detailed and large scale investigation of the clinical phenomenology and natural history of cocaine withdrawal and addiction, the first double-blind assessment of a new class of agent, the antidepresive D-1 potent dopamine-blocking, depot thiothixene or, Flupenthixol, in "crack" abuse, as well as pioneering efforts to operationalize craving for abused drugs using neurophysiological indices (using facial EMG, CEEG, and other brain imaging techniques), as well as the first full scale investigation of the mechanisms and therapeutic maximization of spiritual treatments (such as Alcoholics Anonymous) in addiction and psychiatry.
Internationally acclaimed, Dr. Gawin's work has been summarized for the popular media nationally and internationally in multiple network news and science broadcasts, long before the advent of the internet, on ABC, CBS, NBC, and CNN, as well as in articles appearing in national weekly periodicals including Time and Newsweek, and in The New York Times, Washington Post, The Readers Digest, and Science.
Dr. Gawin has now endured decades of chronic illness, and now lives in on the island of Kauai, where he is works on spiritual insights gained from his experiences with spiritual recovery from addiction in AA, and conducts continuous study of all spiritual traditions to expand insights on concordances between all healing traditions of loving kindness with central sets of consensus principles; that he feels are present across all spiritual traditions and that are identical in accurately translated study of all comparative religion.