In the midst, of the COVID 19 pandemic, there is also an addiction crisis worldwide [1]. The devastation and deaths due to drug overdose, while highest in the United States is indeed a global issue requiring “out of the box” thinking [2]. The use of opioids to treat the same problem with powerful opioids seems inane and locks people in unwanted addiction [3]. Our group has been cognizant that one primary benefit is to reduce harm without addressing the root cause [4]. An additional approach is to utilize the narcotic antagonist (e.g. naltrexone) to induce “psychological extinction” via blocking D2 receptors [5]. The latter approach seems to be more acceptable, but compliance is a major issue [6]. The approved drug acamprosate, a NMDA receptor antagonist and a positive allosteric modulator of GABAA receptors also disturbs dopaminergic signaling. Understanding the above premise and the further emerging acceptance of the umbrella term Reward Deficiency Syndrome (RDS) first coined by Blum in 1995, facilitates the common mechanism hypothesis for drug and non -addictive behaviors [7]. Understanding the common neuro modulating aspects of neurotransmission and its disruption via chronic exposure of drugs and behavioral addictions, requires a known Osteopathic approach involving “dopamine homeostasis [8].”

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