Drug addictions plague about 22.5 million Americans, according to recent statistics. But promising scientific research may one day begin to whittle away at that number, say scientists writing in a special issue of the journal Neuron published Wednesday.
The issue is devoted to addiction and details many of the latest theories about substance abuse prevention and treatment. Included in the journal (online access is free for this issue) are papers on opioid prescriptions for chronic pain and the risks involved; how drugs might be used for cognitive enhancement and how obesity is linked to other addictions.
Don't miss the essay by Dr. Nora Volkow, director of the National Institute on Drug Abuse. There's also a podcast of her speaking on the subject. Volkow describes how addiction rewires the human brain's reward systems to impair normal thinking and behavior.
"People's ability to successfully identify, seek, and obtain what is important to them (but also avoid what's undesirable) at a particular point in time is crucial for their well-being. That which motivates us toward obtaining certain goals plays a key role in how successfully we navigate complex social environments. The sinister nature of addiction is that the very neurobiological systems underpinning this process become dysfunctional, hijacked by a user's drug (or drugs) of choice," she writes.
More recent research, however, indicates that addiction targets more than the reward system of the brain. Imaging studies show that the brain's cognitive systems in the prefrontal cortex area are disrupted by drug addiction.
"For example, damage to ventral areas of this brain region can interfere with the ability of a person to accurately distinguish right from wrong in a socially acceptable manner, which can lead to socially inappropriate behaviors. . . Because the functions of these brain regions are also impaired in addicted individuals, this could explain an addict's inability to accurately steer their behaviors in appropriate directions despite having access to the required knowledge," she writes.
Finally, the stigma of addiction reflected in the inability to get treatment, find a job after jail time and rejection by friends and family further reduces an addict's prospects for recovery, she says. Only about 10% of people with substance abuse problems get treatment, Volkow says. With a big push from science, perhaps we can do better.
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