[Addiction: a disease like no other?].
Addiction is undoubtedly a prototypical complex disorder owing to its multidimensional characteristics: socio-political, environmental, behavioral and cognitive, cellular-molecular, and perhaps genetic. At least four main questions are now open to debate: 1. the definition (what is drug dependence) posits that at the core of the syndrome three constructs must be considered: compulsive use, loss of control and a spiralling affective negative state, suggesting that complex neuropsychological-cognitive and emotional processes are involved; 2. there are huge individual differences concerning vulnerability to drugs and finally few subjects using drugs in a recreational way will succomb, a fact not reflected in the animal model; 3. at the neurospsychiatric level many brain regions, as well as hormonal systems, are functionally intricated, well beyond the classical dopamine-reward system; 4. the neurobiological adaptation that occurs in the course of dependence is often labelled as sensitization, which constitutes an oversimplification.
Le Moal
Michel
M
INSERM U. 588 Institut François Magendie 33077 Bordeaux. u588@bordeaux.inserm.fr
D003071:Cognition; D004703:Endocrine System; D006801:Humans; D009424:Nervous System Physiological Phenomena; D011619:Psychotropic Drugs / Q000009:adverse effects* / Q000494:pharmacology; D011954:Receptors, Dopamine / Q000502:physiology; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000503:physiopathology* / Q000628:therapy*
D011619:Psychotropic Drugs; D011954:Receptors, Dopamine