Drug abuse: hedonic homeostatic dysregulation.
Understanding the neurobiological mechanisms of addiction requires an integration of basic neuroscience with social psychology, experimental psychology, and psychiatry. Addiction is presented as a cycle of spiralling dysregulation of brain reward systems that progressively increases, resulting in compulsive drug use and a loss of control over drug-taking. Sensitization and counteradaptation are hypothesized to contribute to this hedonic homeostatic dysregulation, and the neurobiological mechanisms involved, such as the mesolimbic dopamine system, opioid peptidergic systems, and brain and hormonal stress systems, are beginning to be characterized. This framework provides a realistic approach to identifying the neurobiological factors that produce vulnerability to addiction and to relapse in individuals with a history of addiction.
Koob
G F
GF
The Scripps Research Institute, Department of Neuropharmacology CVN-7, 10550 North Torrey Pines Road, La Jolla, CA 92037, USA.
Le Moal
M
M
D000222:Adaptation, Physiological; D000679:Amygdala / Q000502:physiology; D000818:Animals; D016739:Behavior, Addictive; D001921:Brain / Q000187:drug effects / Q000503:physiopathology; D004298:Dopamine / Q000502:physiology; D006706:Homeostasis; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects*; D018377:Neurotransmitter Agents / Q000502:physiology; D012008:Recurrence; D012054:Reinforcement, Psychology; D012201:Reward; D013375:Substance Withdrawal Syndrome / Q000503:physiopathology; D019966:Substance-Related Disorders / Q000503:physiopathology / Q000523:psychology / Q000628:therapy
D013287:Illicit Drugs; D018377:Neurotransmitter Agents; D004298:Dopamine