Neurobiology of Addiction

Substance use disorders (SUDs) manifest as chronic relapsing disorders, characterized by compulsive drug taking despite serious adverse consequences, the loss of control over intake, and the emergence of negative emotional states during abstinence. Contrasting the traditional and stigmatizing view of addiction as a bad “choice” or moral failure, the collected evidence shows that frequent substance use changes the brain in ways that can engender the profound behavioral disruptions that are seen in individuals suffering from an SUD. Indeed, addictive drugs trigger a gradual and progressive wave of dysfunction that disrupts the very circuits involved in processing responses to rewarding stimuli and motivating behavioral actions, negative emotions, interoception, decision-making, and cognitive control. Our growing knowledge about the many individual and environmental factors that modulate SUD risk and about the effects of addictive substances in the brain is transforming our approaches to the prevention, diagnosis, and treatment of substance use disorders.