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Cleveland Clinic Journal of Medicine Dec 2019Vaping devices, introduced to the US market in 2007 as aids for smoking cessation, have become popular among youth and young adults because of their enticing flavors and... (Review)
Review
Vaping devices, introduced to the US market in 2007 as aids for smoking cessation, have become popular among youth and young adults because of their enticing flavors and perceived lack of negative health effects. However, evidence is emerging that vaping may introduce high levels of dangerous chemicals into the body and cause severe lung injury and death. This article reviews the history and prevalence of vaping and available research on its health effects and efficacy in smoking cessation, and proposes recommendations for clinicians and legislators to reduce harms associated with vaping.
Topics: Adolescent; Adolescent Behavior; Behavior, Addictive; Electronic Nicotine Delivery Systems; Humans; United States; Vaping
PubMed: 31821136
DOI: 10.3949/ccjm.86a.19118 -
Advances in Psychosomatic Medicine 2011Addictive drugs have in common that they are voluntarily self-administered by laboratory animals (usually avidly), and that they enhance the functioning of the reward... (Review)
Review
Addictive drugs have in common that they are voluntarily self-administered by laboratory animals (usually avidly), and that they enhance the functioning of the reward circuitry of the brain (producing the 'high' that the drug user seeks). The core reward circuitry consists of an 'in-series' circuit linking the ventral tegmental area, nucleus accumbens and ventral pallidum via the medial forebrain bundle. Although originally believed to simply encode the set point of hedonic tone, these circuits are now believed to be functionally far more complex, also encoding attention, expectancy of reward, disconfirmation of reward expectancy, and incentive motivation. 'Hedonic dysregulation' within these circuits may lead to addiction. The 'second-stage' dopaminergic component in this reward circuitry is the crucial addictive-drug-sensitive component. All addictive drugs have in common that they enhance (directly or indirectly or even transsynaptically) dop-aminergic reward synaptic function in the nucleus accumbens. Drug self-administration is regulated by nucleus accumbens dopamine levels, and is done to keep nucleus accumbens dopamine within a specific elevated range (to maintain a desired hedonic level). For some classes of addictive drugs (e.g. opiates), tolerance to the euphoric effects develops with chronic use. Postuse dysphoria then comes to dominate reward circuit hedonic tone, and addicts no longer use drugs to get high, but simply to get back to normal ('get straight'). The brain circuits mediating the pleasurable effects of addictive drugs are anatomically, neurophysiologically and neurochemically different from those mediating physical dependence, and from those mediating craving and relapse. There are important genetic variations in vulnerability to drug addiction, yet environmental factors such as stress and social defeat also alter brain-reward mechanisms in such a manner as to impart vulnerability to addiction. In short, the 'bio-psycho-social' model of etiology holds very well for addiction. Addiction appears to correlate with a hypodopaminergic dysfunctional state within the reward circuitry of the brain. Neuroimaging studies in humans add credence to this hypothesis. Credible evidence also implicates serotonergic, opioid, endocannabinoid, GABAergic and glutamatergic mechanisms in addiction. Critically, drug addiction progresses from occasional recreational use to impulsive use to habitual compulsive use. This correlates with a progression from reward-driven to habit-driven drug-seeking behavior. This behavioral progression correlates with a neuroanatomical progression from ventral striatal (nucleus accumbens) to dorsal striatal control over drug-seeking behavior. The three classical sets of craving and relapse triggers are (a) reexposure to addictive drugs, (b) stress, and (c) reexposure to environmental cues (people, places, things) previously associated with drug-taking behavior. Drug-triggered relapse involves the nucleus accumbens and the neurotransmitter dopamine. Stress-triggered relapse involves (a) the central nucleus of the amygdala, the bed nucleus of the stria terminalis, and the neurotransmitter corticotrophin-releasing factor, and (b) the lateral tegmental noradrenergic nuclei of the brain stem and the neurotransmitter norepinephrine. Cue-triggered relapse involves the basolateral nucleus of the amygdala, the hippocampus and the neurotransmitter glutamate. Knowledge of the neuroanatomy, neurophysiology, neurochemistry and neuropharmacology of addictive drug action in the brain is currently producing a variety of strategies for pharmacotherapeutic treatment of drug addiction, some of which appear promising.
Topics: Behavior, Addictive; Brain; Humans; Narcotic Antagonists; Neural Pathways; Reward; Substance-Related Disorders
PubMed: 21508625
DOI: 10.1159/000324065 -
Cold Spring Harbor Perspectives in... Apr 2021Drug addiction is a chronic relapsing disorder, and a significant amount of research has been devoted to understand the factors that contribute to the development, loss... (Review)
Review
Drug addiction is a chronic relapsing disorder, and a significant amount of research has been devoted to understand the factors that contribute to the development, loss of control, and persistence of compulsive addictive behaviors. In this review, we provide an overview of various theories of addiction to drugs of abuse and the neurobiology involved in elements of the addiction cycle. Specific focus is devoted to the role of the mesolimbic pathway in acute drug reinforcement and occasional drug use, the role of the mesocortical pathway and associated areas (e.g., the dorsal striatum) in escalation/dependence, and the contribution of these pathways and associated circuits to conditioned responses, drug craving, and loss of behavioral control that may underlie drug relapse. By enhancing the understanding of the neurobiological factors that mediate drug addiction, continued preclinical and clinical research will aid in the development of novel therapeutic interventions that can serve as effective long-term treatment strategies for drug-dependent individuals.
Topics: Behavior, Addictive; Disease Progression; Humans; Neurobiology; Recurrence; Substance-Related Disorders
PubMed: 32205414
DOI: 10.1101/cshperspect.a039628 -
Nature Reviews. Neuroscience May 2015For several decades, addiction has come to be viewed as a disorder of the dopamine neurotransmitter system; however, this view has not led to new treatments. In this... (Review)
Review
For several decades, addiction has come to be viewed as a disorder of the dopamine neurotransmitter system; however, this view has not led to new treatments. In this Opinion article, we review the origins of the dopamine theory of addiction and discuss the ability of addictive drugs to elicit the release of dopamine in the human striatum. There is robust evidence that stimulants increase striatal dopamine levels and some evidence that alcohol may have such an effect, but little evidence, if any, that cannabis and opiates increase dopamine levels. Moreover, there is good evidence that striatal dopamine receptor availability and dopamine release are diminished in individuals with stimulant or alcohol dependence but not in individuals with opiate, nicotine or cannabis dependence. These observations have implications for understanding reward and treatment responses in various addictions.
Topics: Animals; Behavior, Addictive; Dopamine; Humans; Receptors, Dopamine; Reward
PubMed: 25873042
DOI: 10.1038/nrn3939 -
Dialogues in Clinical Neuroscience Sep 2019In this targeted review, we summarize current knowledge on substance-use disorder (SUD)-related cognitive deficits, the link between these deficits and clinical... (Review)
Review
In this targeted review, we summarize current knowledge on substance-use disorder (SUD)-related cognitive deficits, the link between these deficits and clinical outcomes, and the cognitive training, remediation, and pharmacological approaches that have the potential to rescue cognition. We conclude that: (i) people with SUDs have moderate deficits in memory, attention, executive functions, and decision-making (including reward expectancy, valuation, and learning); (ii) deficits in higher-order executive functions and decision-making are significant predictors of relapse; (iii) cognitive training programs targeting reward-related appetitive biases, cognitive remediation strategies targeting goal-based decision-making, and pharmacotherapies targeting memory, attention, and impulsivity have potential to rescue SUD-related cognitive deficits. We suggest avenues for future research, including developing brief, clinically oriented harmonized cognitive testing suites to improve individualized prediction of treatment outcomes; computational modeling that can achieve deep phenotyping of cognitive subtypes likely to respond to different interventions; and phenotype-targeted cognitive, pharmacological, and combined interventions. We conclude with a tentative model of neuroscience-informed precision medicine. .
Topics: Behavior, Addictive; Central Nervous System Stimulants; Cognition; Cognition Disorders; Cognitive Behavioral Therapy; Humans; Substance-Related Disorders
PubMed: 31749652
DOI: 10.31887/DCNS.2019.21.3/gdom -
Neuropsychopharmacology : Official... Dec 2018Can food be addictive? What does it mean to be a food addict? Do common underlying neurobiological mechanisms contribute to drug and food addiction? These vexing... (Review)
Review
Can food be addictive? What does it mean to be a food addict? Do common underlying neurobiological mechanisms contribute to drug and food addiction? These vexing questions have been the subject of considerable interest and debate in recent years, driven in large part by the major health concerns associated with dramatically increasing body weights and rates of obesity in the United States, Europe, and other regions with developed economies. No clear consensus has yet emerged on the validity of the concept of food addiction and whether some individuals who struggle to control their food intake can be considered food addicts. Some, including Fletcher, have argued that the concept of food addiction is unsupported, as many of the defining features of drug addiction are not seen in the context of feeding behaviors. Others, Kenny included, have argued that food and drug addiction share similar features that may reflect common underlying neural mechanisms. Here, Fletcher and Kenny argue the merits of these opposing positions on the concept of food addiction.
Topics: Animals; Behavior, Addictive; Eating; Feeding Behavior; Food Addiction; Humans; Obesity; Reward
PubMed: 30188514
DOI: 10.1038/s41386-018-0203-9 -
Annual Review of Clinical Psychology May 2018Should excessive and problematic engagement in nonsubstance use behaviors be mental disorders? The fifth edition of the Diagnostic and Statistical Manual of Mental... (Review)
Review
Should excessive and problematic engagement in nonsubstance use behaviors be mental disorders? The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) repositioned gambling disorder in the substance use disorders section and introduced Internet gaming disorder in the research appendix; the International Classification of Diseases (ICD-11) is also considering it. This article outlines pros and cons of considering behavioral addictions as mental disorders and also reviews the DSM-5 decision-making processes. It focuses on three conditions: gambling disorder, Internet gaming disorder (IGD), and Internet addiction (IA). We detail assessment methods and prevalence rates for these conditions and outline psychiatric comorbidities, demographic and biological risk factors, and promising treatment approaches. We also briefly discuss other putative behavioral addictions: eating/food, sex, exercise, shopping, and tanning "addictions." Overall, data are inconclusive, and consistent terminology and methodology are needed to define and evaluate these conditions more fully prior to considering them mental disorders.
Topics: Behavior, Addictive; Disruptive, Impulse Control, and Conduct Disorders; Gambling; Humans; Internet; Video Games
PubMed: 29734827
DOI: 10.1146/annurev-clinpsy-032816-045120 -
Prilozi (Makedonska Akademija Na... Dec 2021Problematic smartphone use and or addiction is defined as a form of behaviour characterized by the compulsive use of a smartphone that results in various forms of... (Review)
Review
Problematic smartphone use and or addiction is defined as a form of behaviour characterized by the compulsive use of a smartphone that results in various forms of physical, psychological, or social harm. Global popularity in the area of the use of smartphones has raised concerns about the negative effects associated with problematic smartphone use, especially in the younger population. Having no consensual definition of smartphone addiction (SA), this behavioural addiction is based on the classic addiction symptomology that was included in DSM-5 criteria for compulsive gambling and substance abuse (APA 2013) This article provides a review of current research related to SA. Articles were found in the PUBMED database using related key words. Statistics confirm the exponential rise of this problem globally, especially in children and adolescents. Therefore, one must make this a high priority among public health issues.
Topics: Adolescent; Behavior, Addictive; Child; Humans; Internet Addiction Disorder; Public Health; Smartphone
PubMed: 35032372
DOI: 10.2478/prilozi-2021-0032 -
Dialogues in Clinical Neuroscience Sep 2020The last decades have seen a major gain in understanding the action of cannabinoids and the endocannabinoid system in reward processing and the development of addictive... (Review)
Review
The last decades have seen a major gain in understanding the action of cannabinoids and the endocannabinoid system in reward processing and the development of addictive behavior. Cannabis-derived psychoactive compounds such as Δ-tetrahydrocannabinol and synthetic cannabinoids directly interact with the reward system and thereby have addictive properties. Cannabinoids induce their reinforcing properties by an increase in tonic dopamine levels through a cannabinoid type 1 (CB) receptor-dependent mechanism within the ventral tegmental area. Cues that are conditioned to cannabis smoking can induce drug-seeking responses (ie, craving) by eliciting phasic dopamine events. A dopamine-independent mechanism involved in drug-seeking responses involves an endocannabinoid/glutamate interaction within the corticostriatal part of the reward system. In conclusion, pharmacological blockade of endocannabinoid signaling should lead to a reduction in drug craving and subsequently should reduce relapse behavior in addicted individuals. Indeed, there is increasing preclinical evidence that targeting the endocannabinoid system reduces craving and relapse, and allosteric modulators at CB receptors and fatty acid amide hydrolase inhibitors are in clinical development for cannabis use disorder. Cannabidiol, which mainly acts on CB and CB receptors, is currently being tested in patients with alcohol use disorder and opioid use disorder. .
Topics: Animals; Behavior, Addictive; Cannabinoids; Drug-Seeking Behavior; Endocannabinoids; Humans; Marijuana Abuse; Receptors, Cannabinoid; Reward
PubMed: 33162767
DOI: 10.31887/DCNS.2020.22.3/rspanagel -
Psychiatria Danubina 2021Addiction does not mean "addiction to substances" only. At the core of the definition of substance dependence is the loss of control. Gambling addiction belongs to... (Review)
Review
Addiction does not mean "addiction to substances" only. At the core of the definition of substance dependence is the loss of control. Gambling addiction belongs to non-substance / non-chemical addictions or behavioral/behavioral addictions. The concept of behavioral addictions is new and revolutionary in psychiatry. Gambling addiction, formerly pathological or problematic gambling occurs due to loss of control over gambling. There is growing evidence to suggest that behavioral addictions resemble substance addictions in many domains, including phenomenology, tolerance, comorbidity, overlapping genetic contribution, neurobiological mechanisms, and response to treatment. Behavioral addiction has been proposed as a new class in the Diagnostic Statistical Manual Fifth Revision (DSM-5), but the only category included is gambling addiction. The prevalence of gambling disorders in adolescence is very high and for certain disorders (especially related to the use of the Internet) it becomes more pronounced over time. In this paper, we presented a comprehensive overview of gambling disorders from definition, epidemiology, manifestations, comorbidities, assessment, treatment options, and existing forms of treatment. Given the complexity of the approach to the treatment of gamblers, a creative individualized integrative approach is necessary, which is the basis of creative psychopharmacotherapy. Due to the possibility of the emergence of problem gambling and other impulse-control deficits we need to be very careful when commencing a patient on dopamine replacement therapy or therapy with aripiprazole.
Topics: Adolescent; Behavior, Addictive; Comorbidity; Diagnostic and Statistical Manual of Mental Disorders; Gambling; Humans; Substance-Related Disorders
PubMed: 35354178
DOI: No ID Found