Treating and preventing abuse, addiction and their medical consequences.
Nora D. Volkowa, b, , and Ting-Kai Lib
National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
Available online 10 August 2005.
Abstract
Recent advances in the fields of genetics, molecular biology,
behavioral neuropharmacology, and brain imaging have dramatically
changed our understanding of the addictive process and why relapse
occurs even in the face of catastrophic consequences. Addiction is now
recognized as a chronic brain disease that involves complex
interactions between repeated exposure to drugs, biological (i.e.,
genetic and developmental), and environmental (i.e., drug availability,
social, and economic variables) factors. Its treatment, therefore,
requires, in general, not only a long-term intervention but also a
multipronged approach that addresses the psychiatric, medical, legal,
and social consequences of addiction. Also, because addiction usually
starts in adolescence or early adulthood and is frequently comorbid
with mental illness, we need to expand our treatment interventions in
this age group both for substance abuse and psychiatric disorders.
Keywords: Addiction; Dopamine; Prevention; Treatment; Mental illness; Adolescence.
Abbreviations: ADHD, attention deficit/hyperactive disorder; CB,
cannabinoid; CM, contingency management; DA, dopamine; FAS, fetal
alcohol syndrome; GABA, gamma-amino butyric acid; GVG, gamma
vinyl-GABA; IDU, injection drug use; Meth, methamphetamine; MPH,
methylphenidate; MRI, magnetic resonance imaging; OFC, orbitofrontal
cortex; PET, positron emission tomography.
