Substance Use and Addiction Research: Methodology, Mechanisms, and Therapeutics

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Book Chapter

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Alan David Kaye; Elyse M. Cornett


Addiction is a chronic illness caused by changes in the brain and repeated use or exposure to addictive substances. Addiction and substance use disorders are stigmatized even though over 60% of adults aged 12 and older reported using an addictive substance (tobacco, alcohol, or illegal substances) in the last month. Over 20 million of those persons have a substance use problem. Regardless of the addictive drug—alcohol, morphine, cocaine, cigarettes, food, etc.—the neurotransmitter dopamine is the primary driving force. Dopamine is the prinicple signaling molecule in the nigrostriatal pathway (responsible for initiating motor function and planning), tuberoinfundibular pathway (regulating pituitary gland prolactin release), mesocortical pathway (involved in cognition, working memory, and decision-making), and mesolimbic pathway (largely responsible for mediating pleasure, motivation, and reward). This last route is crucial in understanding addiction. Dopamine is now known to be required for motivation to seek out and reward normal food consumption and a factor linking all addictive substances, as they all boost dopamine levels in the striatum. Dopamine’s reward reactions contribute to the addictive cycle of intoxication, withdrawal, and desire, which leads to relapse and re-entry. Dspite increasing understanding of the neurobiology underlying addiction, treatment strategies continue to produce variable results among patients at best, and in some cases, remain limted to nonpharmacological options.

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Chapter Title

Chapter 18 - Types of addiction