What Is Addiction?

Biological/Medicinal Perspective of Addiction

What Is Addiction? Graphics courtesy of University at BuffaloOpens in new window

Addiction is an involuntary neuropsychological disorder characterized by persistent use of a drug, despite substantial harm and other negative consequences.

American Society of Addiction MedicineOpens in new window defines addiction as a primary, chronic disease of brain reward, motivation, memory and related circuitry.

Addiction is thus characterized by inability to constantly abstain, diminished behavioral control, craving, diminished recognition of significant problems with one’s behavior and dysfunctional emotional response.

Addiction affects neurotransmission and exchanges within reward structures of the brain, including the nucleus accumbens, anterior cingulated cortex, basal forebrain and amygdale, such that motivational structures are altered.

Addictive behaviors supersede healthy and self-care related behaviors. Addiction also affects neurotransmission and interactions between cortical and hippocampal circuits and brain reward structures, such that the memory of previous exposures to rewards (such as food, sex, alcohol, drugs and the internet) leads to a biological and behavioral response to external cues, in turn triggering craving and/or engagement in addictive behaviors.

It is widely accepted that the initial reinforcing effects of most addictive substances and behavior rely heavily upon the induction of large and rapid increases in the level of DA in the nucleus accumbens.

DA, a multifaceted neurotransmitter, is involved in the fine-tuning of motor and cognitive function, modulation of salience attribution and attention, and regulation of reward and motivation. For instance, imaging studies have shown that in drug-addicted individuals, supra physiological levels of DA in the nucleus accumbens are followed by marked decreases in dopamine function.

Further, in trying to understand and treat addiction, the biological/medical perspective relies on the view of addiction as being driven by reward.

Reward is generally identified with pleasure, which reinforces the addictive behavior. “The mesolimbic dopamine circuit is a hard-wired system in the brain … that provides pleasure in the process of rewarding certain behavior”.

In addicted individuals, natural rewards as well as the entire reward system are compromised.

Addictive substance and behaviors are simply effective at temporarily blocking the negative reinforcement that addicted individuals experience during abstinence, resulting in conditioned learning towards the substance or behavior and previously neutral stimuli associated with it expounds. This increases the risk for relapse when an addicted person is exposed to the addictive substance or behavior or their cues.

In this view, both seeking and use or engagement in behavior are motivated by innate pleasures caused by the addictive substance/behavior. When the substance/behavior no longer produces the same positive effect, people tend to increase use or engagement thereby leading to abuse. Addicts enter into withdrawal, taking or engaging more and more of the substance or the behavior to produce pleasurable effects to counter the negative experiences of withdrawal.

Some neurological studies have proposed a different approach on the role of brain systems in addiction that emphasizes how addictive substances and behaviors affect motivations and incentives that individuals experience. The emphasis of these theories is on seeking over using or engagement, proposing that “wanting” and seeking are central components of addictive behavior.

Based totally on analysis with animal models, Robinson and Berridge developed a psychological model of brain performance and abuse. Rather than reinforcement, Robinson and Berridge projected that the central brain system concerned in substance abuse — the mesolimbic Dopastat system mediates incentive saliency.

They “suggested that it’s the method of incentive saliency attribution that transforms ... the neural and psychological representations of stimuli, in order that they become particularly salient stimuli, stimuli that attract attention and become particularly engaging and wished, thereby eliciting approach and guiding behavior to a particular goal”.

Robinson and Berridge highlight ‘wanting’ as the individual feeling of incentive saliency, providing the need to pursue and use a substance or have interaction during an explicit behavior. In addition, Robinson and Berridge’s theory emphasized the importance of associative learning and context in shaping the attribution of saliency, instead of substances/behavior making an interior feeling of enjoyment. This view, wherever saliency is an element of larger activity interactions with the surroundings, helps open the door for biopsychosocial analysis through the thought of psychological and cognitive content processes.

Robinson and Berridge did not deny the importance of positive reactions to addictive behavior and substances, positing that “liking” plays a central role within the initiation of substance use and engagement in additive behavior. However, they projected that association in nursing individual’s sensitization to wanting drives problematic use.

Through sensitization or associated accumulated reaction to substance/behavior, “substance cues trigger excessive incentive motivation for substances, resulting in compulsive seeking”.

Thus, Robinson and Berridge’s theory projected that with increasing levels of use, the affected brain cells manufacture a greater-than-normal saliency signal. Supported, this increase within the quantity of saliency signalled the drug-addicted individual experiences a strong need for substance/behavior.

In clinical terms, this heightened prominence of substance and activity cues and connected behaviors corresponds to the compulsive seeking seen in drug abuse. In different words, the excessive prominence drives the compulsion to use, from seeking out medicine that now do not offer an equivalent enjoyable result to issues with relapse once addicts are trying to keep up abstinence.

Thus, as compared to the classic reward approach, this theory helps make a case for sure problematic aspect of substance abuse. However, the analysis that led to the creation of this theory was primarily based totally on work with rats and needed some remodeling to be utilized in a social science project.

Robinson and Berridge have conjointly emphasized wanting because of the subjective expertise associated with incentive attribution. This wanting an acutely awareness need for substance/behavior drives each seeking and relapse.

Thus, the excessive wanting of incentive prominence is seen because of the proximate mechanism driving cravings, the compulsive urge and/or need to use substance or interact in habit-forming behavior.

Anthropology analysis has confirmed that “wanting” is a typical means that drug abusers represented the expertise of desire. Thus, wanting received support as a relevant domain for exploration.

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