Addiction - Knowledge

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bidirectional, as a history of amphetamine administration facilitates sexual behavior and enhances the associated increase in NAc DA ... As described for food reward, sexual experience can also lead to activation of plasticity-related signaling cascades. The transcription factor delta FosB is increased in the NAc, PFC, dorsal striatum, and VTA following repeated sexual behavior (Wallace et al., 2008; Pitchers et al., 2010b). This natural increase in delta FosB or viral overexpression of delta FosB within the NAc modulates sexual performance, and NAc blockade of delta FosB attenuates this behavior (Hedges et al, 2009; Pitchers et al., 2010b). Further, viral overexpression of delta FosB enhances the conditioned place preference for an environment paired with sexual experience (Hedges et al., 2009). ... In some people, there is a transition from "normal" to compulsive engagement in natural rewards (such as food or sex), a condition that some have termed behavioral or non-drug addictions (Holden, 2001; Grant et al., 2006a). ... In humans, the role of dopamine signaling in incentive-sensitization processes has recently been highlighted by the observation of a dopamine dysregulation syndrome in some people taking dopaminergic drugs. This syndrome is characterized by a medication-induced increase in (or compulsive) engagement in non-drug rewards such as gambling, shopping, or sex (Evans et al, 2006; Aiken, 2007; Lader, 2008)."

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and putamen, but not the medial preoptic nucleus. Next, the induction of c-Fos, a downstream (repressed) target of DeltaFosB, was measured in sexually experienced and naive animals. The number of mating-induced c-Fos-IR cells was significantly decreased in sexually experienced animals compared to sexually naive controls. Finally, DeltaFosB levels and its activity in the NAc were manipulated using viral-mediated gene transfer to study its potential role in mediating sexual experience and experience-induced facilitation of sexual performance. Animals with DeltaFosB overexpression displayed enhanced facilitation of sexual performance with sexual experience relative to controls. In contrast, the expression of DeltaJunD, a dominant-negative binding partner of DeltaFosB, attenuated sexual experience-induced facilitation of sexual performance, and stunted long-term maintenance of facilitation compared to DeltaFosB overexpressing group. Together, these findings support a critical role for DeltaFosB expression in the NAc in the reinforcing effects of sexual behavior and sexual experience-induced facilitation of sexual performance. ... both drug addiction and sexual addiction represent pathological forms of neuroplasticity along with the emergence of aberrant behaviors involving a cascade of neurochemical changes mainly in the brain's rewarding circuitry.

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of identity, enabled by interpersonal interactions and collective influences. Personal narratives of self-transition were connected to larger narratives of social transitions. The personal narratives of self-initiation and transition are contextualized and understood in terms of political (social) narratives within the core concept of the 'transitional society'. Another study examined the narratives of 'initiators': people who help people who inject drugs (PWID) with their first injection. Through their accounts, respondents described initiation events as meaningful transitions to a life characterized by predictable downfalls of homelessness, infections, and social stigma. Initiators used examples from their own personal experience to explain the process of initiation and assistance, attributing personal agency and predicting specific injection-related harms for initiates. They distinguished between two forms of harm: potentially avoidable proximal harm caused by risky injection practices (e.g. overdose, HIV) and perceived inevitable distal harm caused by long-term injection (e.g. socioeconomic decline). In this way, these narratives reflect a balance of individual agency, harm reduction intentions, and accepted notions of 'life after initiation' interact with the narrative experiences and intentions of PWIDs.

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cellular mechanisms of plasticity that control vulnerability to drug addiction, and that this increased vulnerability is mediated by ΔFosB and its downstream transcriptional targets. ... Sexual behavior is highly rewarding (Tenk et al., 2009), and sexual experience causes sensitized drug-related behaviors, including cross-sensitization to amphetamine (Amph)-induced locomotor activity (Bradley and Meisel, 2001; Pitchers et al., 2010a) and enhanced Amph reward (Pitchers et al., 2010a). Moreover, sexual experience induces neural plasticity in the NAc similar to that induced by psychostimulant exposure, including increased dendritic spine density (Meisel and Mullins, 2006; Pitchers et al., 2010a), altered glutamate receptor trafficking, and decreased synaptic strength in prefrontal cortex-responding NAc shell neurons (Pitchers et al., 2012). Finally, periods of abstinence from sexual experience were found to be critical for enhanced Amph reward, NAc spinogenesis (Pitchers et al., 2010a), and glutamate receptor trafficking (Pitchers et al., 2012). These findings suggest that natural and drug reward experiences share common mechanisms of neural plasticity

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rewarding or reinforcing effect of drugs of abuse. ... At present, no pharmacological therapy has been approved by the FDA to treat psychostimulant addiction. Many drugs have been tested, but none have shown conclusive efficacy with tolerable side effects in humans. ... A new emphasis on larger-scale biomarker, genetic, and epigenetic research focused on the molecular targets of mental disorders has been recently advocated. In addition, the integration of cognitive and behavioral modification of circuit-wide neuroplasticity (i.e., computer-based training to enhance executive function) may prove to be an effective adjunct-treatment approach for addiction, particularly when combined with cognitive enhancers. Furthermore, in order to be effective, all pharmacological or biologically based treatments for addiction need to be integrated into other established forms of addiction rehabilitation, such as CBT, individual and group psychotherapy, behavior-modification strategies, twelve-step programs, and residential treatment facilities.

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the Diagnostic and Statistical Manual of Mental Disorders. ... Existing prevalence rates of sexual addiction-related disorders range from 3% to 6%. Sexual addiction/hypersexual disorder is used as an umbrella construct to encompass various types of problematic behaviors, including excessive masturbation, cybersex, pornography use, sexual behavior with consenting adults, telephone sex, strip club visitation, and other behaviors. The adverse consequences of sexual addiction are similar to the consequences of other addictive disorders. Addictive, somatic and psychiatric disorders coexist with sexual addiction. In recent years, research on sexual addiction has proliferated, and screening instruments have increasingly been developed to diagnose or quantify sexual addiction disorders. In our systematic review of the existing measures, 22 questionnaires were identified. As with other behavioral addictions, the appropriate treatment of sexual addiction should combine pharmacological and psychological approaches.

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2009, Voss et al. 2011) ... Inhibitory control (one of the core EFs) involves being able to control one's attention, behavior, thoughts, and/or emotions to override a strong internal predisposition or external lure, and instead do what's more appropriate or needed. Without inhibitory control we would be at the mercy of impulses, old habits of thought or action (conditioned responses), and/or stimuli in the environment that pull us this way or that. Thus, inhibitory control makes it possible for us to change and for us to choose how we react and how we behave rather than being unthinking creatures of habit. It doesn't make it easy. Indeed, we usually are creatures of habit and our behavior is under the control of environmental stimuli far more than we usually realize, but having the ability to exercise inhibitory control creates the possibility of change and choice. ... The subthalamic nucleus appears to play a critical role in preventing such impulsive or premature responding (Frank 2006).

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conceptualized as a disorder of executive function; specifically, ADHD is characterized by reduced ability to exert and maintain cognitive control of behavior. Compared with healthy individuals, those with ADHD have diminished ability to suppress inappropriate prepotent responses to stimuli (impaired response inhibition) and diminished ability to inhibit responses to irrelevant stimuli (impaired interference suppression). ... Functional neuroimaging in humans demonstrates activation of the prefrontal cortex and caudate nucleus (part of the striatum) in tasks that demand inhibitory control of behavior. Subjects with ADHD exhibit less activation of the medial prefrontal cortex than healthy controls even when they succeed in such tasks and utilize different circuits. ... Early results with structural MRI show thinning of the cerebral cortex in ADHD subjects compared with age-matched controls in prefrontal cortex and posterior parietal cortex, areas involved in working memory and attention.

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physical or emotional neglect, witnessing violence in the household, or a parent being incarcerated or having a mental illness. As a result, the child's cognitive functioning or ability to cope with negative or disruptive emotions may be impaired. Over time, the child may adopt substance use as a coping mechanism or as a result of reduced impulse control, particularly during adolescence. Vast amounts of children who experienced abuse have gone on to have some form of addiction in their adolescence or adult life. This pathway towards addiction that is opened through stressful experiences during childhood can be avoided by a change in environmental factors throughout an individual's life and opportunities of professional help. If one has friends or peers who engage in drug use favorably, the chances of them developing an addiction increases. Family conflict and home management is a cause for one to become engaged in drug use.

3776:, conceptualizes diagnosis somewhat differently. ICD-11 first distinguishes between problems with psychoactive substance use ("Disorders due to substance use") and behavioral addictions ("Disorders due to addictive behaviours"). With regard to psychoactive substances, ICD-11 explains that the included substances initially produce "pleasant or appealing psychoactive effects that are rewarding and reinforcing with repeated use, with continued use, many of the included substances have the capacity to produce dependence. They have the potential to cause numerous forms of harm, both to mental and physical health." Instead of the DSM-5 approach of one diagnosis ("Substance Use Disorder") covering all types of problematic substance use, ICD-11 offers three diagnostic possibilities: 1) Episode of Harmful Psychoactive Substance Use, 2) Harmful Pattern of Psychoactive Substance Use, and 3) Substance Dependence. 10420:ΔFosB is an essential transcription factor implicated in the molecular and behavioral pathways of addiction following repeated drug exposure. The formation of ΔFosB in multiple brain regions, and the molecular pathway leading to the formation of AP-1 complexes is well understood. The establishment of a functional purpose for ΔFosB has allowed further determination as to some of the key aspects of its molecular cascadesAs a consequence of our improved understanding of ΔFosB in addiction, it is possible to evaluate the addictive potential of current medications (119), as well as use it as a biomarker for assessing the efficacy of therapeutic interventions (121,122,124). Some of these proposed interventions have limitations (125) or are in their infancy (75). However, it is hoped that some of these preliminary findings may lead to innovative treatments, which are much needed in addiction. 8902:

disproportionately, if something is not right in your life. They suffer first, and most, if you are stressed (Arnsten 1998, Liston et al. 2009, Oaten & Cheng 2005), sad (Hirt et al. 2008, von Hecker & Meiser 2005), lonely (Baumeister et al. 2002, Cacioppo & Patrick 2008, Campbell et al. 2006, Tun et al. 2012), sleep deprived (Barnes et al. 2012, Huang et al. 2007), or not physically fit (Best 2010, Chaddock et al. 2011, Hillman et al. 2008). Any of these can cause you to appear to have a disorder of EFs, such as ADHD, when you do not. You can see the deleterious effects of stress, sadness, loneliness, and lack of physical health or fitness at the physiological and neuroanatomical level in prefrontal cortex and at the behavioral level in worse EFs (poorer reasoning and problem solving, forgetting things, and impaired ability to exercise discipline and self-control). ...

638:(DSM or DSM-5) and is based on subjective experiences similar to substance use disorders. Food addiction may be found in those with eating disorders, though not all people with eating disorders have food addiction and not all of those with food addiction have a diagnosed eating disorder. Long-term frequent and excessive consumption of foods high in fat, salt, or sugar, such as chocolate, can produce an addiction similar to drugs since they trigger the brain's reward system, such that the individual may desire the same foods to an increasing degree over time. The signals sent when consuming highly palatable foods have the ability to counteract the body's signals for fullness and persistent cravings will result. Those who show signs of food addiction may develop food tolerances, in which they eat more, despite the food becoming less satisfactory. 4457:

found to be particularly effective at distinguishing the drawings of those with SUDs from those without: Person, Realism, and Developmental. The Person element assesses the degree to which a human features are depicted realistically, the Realism element assesses the overall complexity of the artwork, and the Developmental element assesses "developmental age" of the artwork in relation to standardized drawings from children and adolescents. By using the FEATS assessment tool, clinicians can gain valuable insight into the drawings of individuals with SUDs, and can compare them to those of the control group. Formal assessments such as FEATS provide healthcare providers with a means to quantify, standardize, and communicate abstract and visceral characteristics of SUDs to provide more accurate diagnoses and informed treatment decisions.

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can vary independently of learning. Neurobiological state changes can produce unlearned fluctuations or even reversals in the ability of a previously learned reward cue to trigger motivation. Such fluctuations in cue-triggered motivation can dramatically depart from all previously learned values about the associated reward outcome. ... Associative learning and prediction are important contributors to motivation for rewards. Learning gives incentive value to arbitrary cues such as a Pavlovian conditioned stimulus (CS) that is associated with a reward (unconditioned stimulus or UCS). Learned cues for reward are often potent triggers of desires. For example, learned cues can trigger normal appetites in everyone, and can sometimes trigger compulsive urges and relapse in individuals with addictions.

5055:. The male but not female offspring of these cocaine-exposed rats inherited both epigenetic marks (i.e., di-acetylation of lysine residues 9 and 14 on histone 3) within mPFC neurons, the corresponding increase in BDNF expression within mPFC neurons, and the behavioral phenotype associated with these effects (i.e., a reduction in cocaine reward, resulting in reduced cocaine-seeking by these male offspring). Consequently, the transmission of these two cocaine-induced epigenetic alterations (i.e., H3K9ac2 and H3K14ac2) in rats from male fathers to male offspring served to reduce the offspring's risk of developing an addiction to cocaine. As of 2018, neither the heritability of these epigenetic marks in humans nor the behavioral effects of the marks within human mPFC neurons has been established. 13148:

including stigma against treating people with addictions and institutional barriers to providing or funding addiction treatment. ... A major milestone was reached on March 14, 2016, when the American Board of Medical Specialties (ABMS) formally announced recognition of the field of Addiction Medicine as a medical subspecialty. ... In a statement issued to mark this milestone, ABAM President Robert J. Sokol summed up its significance: 'This landmark event, more than any other, recognizes addiction as a preventable and treatable disease, helping to shed the stigma that has long plagued it. It sends a strong message to the public that American medicine is committed to providing expert care for this disease and services designed to prevent the risky substance use that precedes it.'

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that define a state of addiction. ... A large body of literature has demonstrated that such ΔFosB induction in D1-type neurons increases an animal's sensitivity to drug as well as natural rewards and promotes drug self-administration, presumably through a process of positive reinforcement ... Another ΔFosB target is cFos: as ΔFosB accumulates with repeated drug exposure it represses c-Fos and contributes to the molecular switch whereby ΔFosB is selectively induced in the chronic drug-treated state. ... Moreover, there is increasing evidence that, despite a range of genetic risks for addiction across the population, exposure to sufficiently high doses of a drug for long periods of time can transform someone who has relatively lower genetic loading into an addict.

4560: 6815:ΔFosB has been linked directly to several addiction-related behaviors ... Importantly, genetic or viral overexpression of ΔJunD, a dominant negative mutant of JunD which antagonizes ΔFosB- and other AP-1-mediated transcriptional activity, in the NAc or OFC blocks these key effects of drug exposure. This indicates that ΔFosB is both necessary and sufficient for many of the changes wrought in the brain by chronic drug exposure. ΔFosB is induced in D1-type NAc MSNs by chronic consumption of several natural rewards, including sucrose, high fat food, sex, wheel running, where it promotes that consumption. This implicates ΔFosB in the regulation of natural rewards under normal conditions and perhaps during pathological addictive-like states. 11095:

expression (Maze et al., 2010; Sun et al., 2012a). ... Also, G9a is induced in NAc upon prolonged HDAC inhibition, which explains the paradoxical attenuation of cocaine's behavioral effects seen under these conditions, as noted above (Kennedy et al., 2013). GABAA receptor subunit genes are among those that are controlled by this feedback loop. Thus, chronic cocaine, or prolonged HDAC inhibition, induces several GABAA receptor subunits in NAc, which is associated with increased frequency of inhibitory postsynaptic currents (IPSCs). In striking contrast, combined exposure to cocaine and HDAC inhibition, which triggers the induction of G9a and increased global levels of H3K9me2, leads to blockade of GABAA receptor and IPSC regulation.

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Others argue that internet addiction should be considered a symptom of an underlying mental health condition and not a disorder in itself. Internet addiction has been described as "a psychological dependence on the Internet, regardless of the type of activity once logged on." Problematic internet use may include a preoccupation with the internet and/or digital media, excessive time spent using the internet despite resultant distress in the individual, increase in the amount of internet use required to achieve the same desired emotional response, loss of control over one's internet use habits, withdrawal symptoms, and continued problematic internet use despite negative consequences to one's work, social, academic, or personal life.

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motoric responses to stimuli that satisfy internal homeostatic needs. The shell of the NAc appears to be particularly important to initial drug actions within reward circuitry; addictive drugs appear to have a greater effect on dopamine release in the shell than in the core of the NAc. ... If motivational drive is described in terms of wanting, and hedonic evaluation in terms of liking, it appears that wanting can be dissociated from liking and that dopamine may influence these phenomena differently. Differences between wanting and liking are confirmed in reports by humans with addictions, who state that their desire for drugs (wanting) increases with continued use even when pleasure (liking) decreases because of tolerance.

558:, is a chronic and relapsing brain disorder that features drug seeking and drug abuse, despite their harmful effects. This form of addiction changes brain circuitry such that the brain's reward system is compromised, causing functional consequences for stress management and self-control. Damage to the functions of the organs involved can persist throughout a lifetime and cause death if untreated. Substances involved with drug addiction include alcohol, nicotine, marijuana, opioids, cocaine, amphetamines, and even foods with high fat and sugar content. Addictions can begin experimentally in social contexts and can arise from the use of prescribed medications or a variety of other measures. 4534:

addiction in an empowering manner, and thus serves as a viable therapeutic tool in applied gerontology. When treating substance abuse in older adults, it is essential to ensure that the client is respected and comfortable disclosing information. This should be done at the outset of treatment when the therapist and older adult are developing the therapeutic relationship. The social breakdown model is an important tool that can consider the compounded effects of ageism, physical changes, social changes, and substance abuse. The narrative approach integrates the social breakdown model with substance abuse challenges and can be an effective way to address addiction in this population.

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terminal fields, dopamine confers motivational salience ("wanting") on the reward itself or associated cues (nucleus accumbens shell region), updates the value placed on different goals in light of this new experience (orbital prefrontal cortex), helps consolidate multiple forms of memory (amygdala and hippocampus), and encodes new motor programs that will facilitate obtaining this reward in the future (nucleus accumbens core region and dorsal striatum). In this example, dopamine modulates the processing of sensorimotor information in diverse neural circuits to maximize the ability of the organism to obtain future rewards. ...

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demonstrated how dopamine modulates this integrative process. For example, high frequency stimulation potentiates hippocampal inputs to the NAc while simultaneously depressing PFC synapses (Goto and Grace, 2005). The converse was also shown to be true; stimulation at PFC potentiates PFC–NAc synapses but depresses hippocampal–NAc synapses. In light of the new functional evidence of midbrain dopamine/glutamate co-transmission (references above), new experiments of NAc function will have to test whether midbrain glutamatergic inputs bias or filter either limbic or cortical inputs to guide goal-directed behavior.

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healthy ways. The arts can be used as an assessment tool to identify underlying issues that may be contributing to a person's substance use disorder. Through art, individuals can gain insights into their own motivations and behaviors that can be helpful in determining a course of treatment. Finally, the arts can be used to advocate for those suffering from a substance use disorder by raising awareness of the issue and promoting understanding and compassion. Through art, individuals can share their stories, increase awareness, and offer support and hope to those struggling with substance use disorders.

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potentiates behavioral responses to cocaine and opiates, whereas increasing G9a function exerts the opposite effect (Maze et al., 2010; Sun et al., 2012a). Such drug-induced downregulation of G9a and H3K9me2 also sensitizes animals to the deleterious effects of subsequent chronic stress (Covington et al., 2011). Downregulation of G9a increases the dendritic arborization of NAc neurons, and is associated with increased expression of numerous proteins implicated in synaptic function, which directly connects altered G9a/H3K9me2 in the synaptic plasticity associated with addiction (Maze et al., 2010).

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analysis: optimistic, overly optimistic, pessimistic, overly pessimistic, "tough life," troubled/confused, and balanced. Narratives tended to express a basic level of emotionality in early stages of treatment ("optimistic", "pessimistic" narrative). Over time, as clients progressed through the program, their stories became more complex and detailed, including their drug abuse and recovery efforts, more skeptical positions towards treatment began to emerge. Clients began to distinguish between the positive and negative aspects of treatment, creating more "balanced" narratives in the process.

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of drugs. When looking at abuse liability there are a number of determining factors in whether the drug is abused. These factors are: the chemical makeup of the drug, the effects on the brain, and the age, vulnerability, and the health (mental and physical) of the population being studied. There are a few drugs with a specific chemical makeup that leads to a high abuse liability. These are: cocaine, heroin, inhalants, marijuana, MDMA (ecstasy), methamphetamine, PCP, synthetic cannabinoids, synthetic cathinones (bath salts), nicotine (e.g. tobacco), and alcohol.

1625:. Dopamine is responsible for producing pleasurable feelings, as well driving us to perform important life activities. Addictive drugs cause a significant increase in this reward system, causing a large increase in dopamine signaling as well as increase in reward-seeking behavior, in turn motivating drug use. This promotes the development of a maladaptive drug to stimulus relationship. Early drug use leads to these maladaptive associations, later affecting cognitive processes used for coping, which are needed to successfully abstain from them. 4440:

and comparing artwork created at different times, art therapists can be helpful in identifying and diagnosing issues, as well as charting the extent or direction of improvement as a person detoxifies. Where increasing adherence to treatment regimes and maintaining abstinence is the target; art therapists can aid by customizing treatment directives (encourage the client to create collages that compare pros and cons, pictures that compare past and present and future, and drawings that depict what happened when a client went off medication).

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based on the 12 step Minnesota Model endorsed by the Alcoholics Anonymous found that 66% of participants expressed the usefulness of art therapy as a part of treatment. Within the weekly art therapy session, clients were able to reflect and process the intense emotions and cognitions evoked by the programme. In turn, the art therapy component of the programme fostered stronger self-awareness, exploration, and externalization of repressed and unconscious emotions of clients, promoting the development of a more integrated 'authentic self'.

1688:. Knestler hypothesized in 1964 that a gene or group of genes might contribute to predisposition to addiction in several ways. For example, altered levels of a normal protein due to environmental factors may change the structure or functioning of specific brain neurons during development. These altered brain neurons could affect the susceptibility of an individual to an initial drug use experience. In support of this hypothesis, animal studies have shown that environmental factors such as stress can affect an animal's genetic expression. 1725:(NIDA) and studies cite lack of parental supervision, the prevalence of peer substance use, substance availability, and poverty as risk factors for substance use among children and adolescents. The brain disease model of addiction posits that an individual's exposure to an addictive drug is the most significant environmental risk factor for addiction. Many researchers, including neuroscientists, indicate that the brain disease model presents a misleading, incomplete, and potentially detrimental explanation of addiction. 12001:

specific case of drug addiction, cues and contexts that are intimately and repeatedly associated with drug use will themselves become reinforcing ... A fundamental piece of Robinson and Berridge's incentive-sensitization theory of addiction posits that the incentive value or attractive nature of such secondary reinforcement processes, in addition to the primary reinforcers themselves, may persist and even become sensitized over time in league with the development of drug addiction (Robinson and Berridge, 1993).

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communication difficulties, and a perceived lack of control. In a similar vein, people suffering from substance use disorders tend to be highly sensitive, creative, and as such, are likely able to express themselves meaningfully in creative arts such as dancing, painting, writing, music, and acting. Further evidenced by Waller and Mahony (2002) and Kaufman (1981), the creative arts therapies can be a suitable treatment option for this population especially when verbal communication is ineffective.

2387: 2143: 16608: 3721:– and therefore physical withdrawal symptoms occur on cessation of use. Tolerance is the process by which the body continually adapts to the substance and requires increasingly larger amounts to achieve the original effects. Withdrawal refers to physical and psychological symptoms experienced when reducing or discontinuing a substance that the body has become dependent on. Symptoms of withdrawal generally include but are not limited to body aches, 1684:) factors, have been established as significant contributors to addiction vulnerability. Studies done on 350 hospitalized drug-dependent patients showed that over half met the criteria for alcohol abuse, with a role of familial factors being prevalent. Genetic factors account for 40–60% of the risk factors for alcoholism. Similar rates of heritability for other types of drug addiction have been indicated, specifically in genes that encode the 1880:, certain addiction-induced epigenetic alterations in rats can be transmitted from parent to offspring and produce behavioral phenotypes that decrease the offspring's risk of developing an addiction. More generally, the heritable behavioral phenotypes that are derived from addiction-induced epigenetic alterations and transmitted from parent to offspring may serve to either increase or decrease the offspring's risk of developing an addiction. 19159: 1640:

individuals with a relatively low genetic risk, exposure to sufficiently high doses of an addictive drug for a long period of time (e.g., weeks–months) can result in an addiction. Adverse childhood events are associated with negative health outcomes, such as substance use disorder. Childhood abuse or exposure to violent crime is related to developing a mood or anxiety disorder, as well as a substance dependence risk.

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nurses with knowledge of mainstream systems, aesthetic knowing, feminism and substance use organized weekly gatherings, wherein women with histories of substance use and addiction worked alongside a nurse to create artistic expressions. Creations were presented at several venues, including an International Conference on Drug Related Harm, a Nursing Conference and a local gallery to positive community response.

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addictions among adolescents. This tool uses a set of questions for different scenarios. In the case of a specific combination of answers, different question sets can be used to yield a more accurate answer. After the questions, the DSM-5 criteria are used to identify the likelihood of the person having substance use disorder. After these tests are done, the clinician is to give the "5 RS" of brief counseling.

19147: 4691:, Heath proposed the 'cultural model', suggesting that 'problems' associated with heavy drinking, such as alcoholism – a recognised form addiction – were cultural: that is, that alcoholism is determined by cultural beliefs, and therefore varies among cultures. Heath's findings challenged the notion that 'continued use is inexorably addictive and damaging to the consumer's health'. 13108:

injuries, overdose deaths, suicides, homicides, domestic discord, the highest incarceration rate in the world and many other costly social consequences. The economic cost to society is greater than the cost of diabetes and all cancers combined. Despite these startling statistics on the prevalence and costs of addiction, few physicians have been trained to prevent or treat it.

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people in the United States needed treatment for addiction involving alcohol or drugs other than nicotine, but only 11.6 percent received any form of inpatient, residential, or outpatient treatment. Of those who do receive treatment, few receive evidence-based care. (There is no information available on how many individuals receive treatment for addiction involving nicotine.)

19135: 10529:) where it recruits HDAC1 as a corepressor. ... Chronic exposure to psychostimulants increases glutamatergic from the prefrontal cortex to the NAc. Glutamatergic signaling elevates Ca2+ levels in NAc postsynaptic elements where it activates CaMK (calcium/calmodulin protein kinases) signaling, which, in addition to phosphorylating CREB, also phosphorylates HDAC5. 1822:. The epigenetic state of chromatin may pose as a risk for the development of substance addictions. It has been found that emotional stressors, as well as social adversities may lead to an initial epigenetic response, which causes an alteration to the reward-signalling pathways. This change may predispose one to experience a positive response to drug use. 9129:

al., 1972). The environment plays a large role in the development of addiction as evidenced by great societal variability in drug use patterns between countries and across time (UNODC, 2012). Therefore, both genetics and the environment contribute to an individual's vulnerability to become addicted following an initial exposure to drugs of abuse. ...

961:, negatively affected relationships, increased risk of illegal behavior, and suicide attempts. Shopping addiction occurs worldwide and has shown a 5.8% prevalence in the United States. Similar to other behavioral addictions, CBD can be linked to mood disorders, substance use disorders, eating disorders, and other disorders involving a lack of control. 10463:ΔFosB is considered a primary and causative transcription factor in creating new neural connections in the reward centre, prefrontal cortex, and other regions of the limbic system. This is reflected in the increased, stable and long-lasting level of sensitivity to cocaine and other drugs, and tendency to relapse even after long periods of abstinence. 1770:

behavioral decision-making process. Therefore, adolescents are increasingly likely to act on their impulses and engage in risky, potentially addicting behavior before considering the consequences. Not only are adolescents more likely to initiate and maintain drug use, but once addicted they are more resistant to treatment and more liable to relapse.

1707:(GWAS) are used to examine genetic associations with dependence, addiction, and drug use. These studies rarely identify genes from proteins previously described via animal knockout models and candidate gene analysis. Instead, large percentages of genes involved in processes such as cell adhesion are commonly identified. The important effects of 4676:, the habitual heavy consumption of alcohol, was encouraged and valued, enforcing social bonds in the Camba community. Despite frequent intoxication, "even to the point of unconsciousness", the Camba held no concept of alcoholism (a form of addiction), and no visible social problems associated with drunkenness, or addiction, were apparent. 8849:

determined, and that many responses are relatively automatic, unattended, contention-scheduled, and habitual. Indeed, the cognitive flexibility, response inhibition, and self-regulation that appear to be hallmarks of cognitive control are noteworthy only in contrast to responses that are relatively rigid, associative, and involuntary.

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recorded to measure engagement, and the student artists were interviewed, which revealed a change in perspective and understanding, as well as greater appreciation of diverse experiences. Ultimately, the project found that art was an effective medium for empowering both the artist creating the work and the person interacting with it.

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universally accepted diagnostic criteria, a lack of diagnostic instruments demonstrating cross-cultural validity and reliability, and existing controversy surrounding the validity of labeling problematic internet use as an addictive disorder. The most common scale used to measure addiction is the Internet Addiction Test developed by

5115:" for a reward, is a "desire" or "want" attribute, which includes a motivational component, that the brain assigns to a rewarding stimulus. As a consequence, incentive salience acts as a motivational "magnet" for a rewarding stimulus that commands attention, induces approach, and causes the rewarding stimulus to be sought out. 11911:

incentive salience are often visible that can be used in neuroscience experiments: (i) UCS-directed 'wanting' – CS-triggered pulses of intensified 'wanting' for the UCS reward; and (ii) CS-directed 'wanting' – motivated attraction to the Pavlovian cue, which makes the arbitrary CS stimulus into a motivational magnet.

10726:ΔFosB serves as one of the master control proteins governing this structural plasticity. ... ΔFosB also represses G9a expression, leading to reduced repressive histone methylation at the cdk5 gene. The net result is gene activation and increased CDK5 expression. ... In contrast, ΔFosB binds to the 11831:

Recent evidence has shown that ΔFosB also represses the c-fos gene that helps create the molecular switch – from the induction of several short-lived Fos family proteins after acute drug exposure to the predominant accumulation of ΔFosB after chronic drug exposure – cited earlier (Renthal et al.

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Most addictive drugs increase extracellular concentrations of dopamine (DA) in nucleus accumbens (NAc) and medial prefrontal cortex (mPFC), projection areas of mesocorticolimbic DA neurons and key components of the "brain reward circuit". Amphetamine achieves this elevation in extracellular levels of

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et al, 2004), playing video games (Koepp et al, 1998; Hoeft et al, 2008) and the sight of appetizing food (Wang et al, 2004a) activate many of the same brain regions (i.e., the mesocorticolimbic system and extended amygdala) as drugs of abuse (Volkow et al, 2004). ... Cross-sensitization is also

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Artists who have personally lived with addiction and/or undergone recovery may use art to depict their experiences in a manner that uncovers the "human face of addiction". By bringing experiences of addiction and recovery to a personal level and breaking down the "us and them", the viewer may be more

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does not recognize sexual addiction as a clinical diagnosis. Hypersexuality disorder and internet addiction disorder were among proposed addictions to the DSM-5, but were later rejected due to the insufficient evidence available in support of the existence of these disorders as discrete mental health

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Only about 10 percent of the 21 million Americans who meet the need for care for an alcohol or drug use disorder receive any form of treatment, and much of the treatment available does not meet standards for evidence-based care. There are many attitudinal and systemic reasons for this treatment gap,

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An important dimension of reinforcement highly relevant to the addiction process (and particularly relapse) is secondary reinforcement (Stewart, 1992). Secondary reinforcers (in many cases also considered conditioned reinforcers) likely drive the majority of reinforcement processes in humans. In the

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Although the ΔFosB signal is relatively long-lived, it is not permanent. ΔFosB degrades gradually and can no longer be detected in brain after 1–2 months of drug withdrawal ... Indeed, ΔFosB is the longest-lived adaptation known to occur in adult brain, not only in response to drugs of abuse,

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The 35-37 kD ΔFosB isoforms accumulate with chronic drug exposure due to their extraordinarily long half-lives. ... As a result of its stability, the ΔFosB protein persists in neurons for at least several weeks after cessation of drug exposure. ... ΔFosB overexpression in nucleus accumbens

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increase cAMP levels in striatum, which activates protein kinase A (PKA) and leads to phosphorylation of its targets. This includes the cAMP response element binding protein (CREB), the phosphorylation of which induces its association with the histone acetyltransferase, CREB binding protein (CBP) to

6173:

Addiction: A term used to indicate the most severe, chronic stage of substance-use disorder, in which there is a substantial loss of self-control, as indicated by compulsive drug taking despite the desire to stop taking the drug. In the DSM-5, the term addiction is synonymous with the classification

6170:

Substance-use disorder: A diagnostic term in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) referring to recurrent use of alcohol or other drugs that causes clinically and functionally significant impairment, such as health problems, disability, and failure to

4905:

from methamphetamine use), the loss of productivity and associated welfare costs, fatal and non-fatal accidents (e.g., traffic collisions), suicides, homicides, and incarceration, among others. The US National Institute on Drug Abuse has found that overdose deaths in the US have almost tripled among

4888:

The transtheoretical model can be helpful in guiding development of tailored behavioral interventions that can promote lasting change. Progression through these stages may not always follow a linear path, as individuals may move back and forth between stages. Resistance to change is recognized as an

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and others, who felt anthropologists could "downgrade the severity of the problem". Merrill Singer found it notable that the ethnographers working within the prominence of the cultural model were part of the 'wet generation': while not blind to the 'disruptive, dysfunctional and debilitating effects

4508:

The Temple University College of Public Health department conducted a project to promote awareness around opioid use and reduce associated stigma by asking students to create art pieces that were displayed on a website they created and promoted via social media. Quantitative and qualitative data was

4503:

The use of visual arts can help bring attention to the lack of adequate substance use treatment, prevention, and education programs and services in a healthcare system. Messages can encourage policymakers to allocate more resources to addiction treatment and prevention from federal, state, and local

4106:

Estimates of lifetime prevalence rates in the US are 1–2% for compulsive gambling, 5% for sexual addiction, 2.8% for food addiction, and 5–6% for compulsive shopping. The time-invariant prevalence rate for sexual addiction and related compulsive sexual behavior (e.g., compulsive masturbation with or

4047:

In 2015, the estimated prevalence among the adult population was 18.4% for heavy episodic alcohol use (in the past 30 days); 15.2% for daily tobacco smoking; and 3.8% for cannabis use, 0.77% for amphetamine use, 0.37% for opioid use, and 0.35% for cocaine use in 2017. The mortality rates for alcohol

3799:

Abuse or addiction liability is the tendency to use drugs in a non-medical situation. This is typically for euphoria, mood changing, or sedation. Abuse liability is used when the person using the drugs wants something that they otherwise can not obtain. The only way to obtain this is through the use

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as a form of defense against feelings of hopelessness and helplessness as well as a symptom of failure to regulate powerful emotions related to adverse childhood experiences (ACEs), various forms of maltreatment and dysfunction experienced in childhood. In this case, the addictive substance provides

1695:

The data implicating specific genes in the development of drug addiction is mixed for most genes. Many addiction studies that aim to identify specific genes focus on common variants with an allele frequency of greater than 5% in the general population. When associated with disease, these only confer

1691:

In humans, twin studies into addiction have provided some of the highest-quality evidence of this link, with results finding that if one twin is affected by addiction, the other twin is likely to be as well, and to the same substance. Further evidence of a genetic component is research findings from

1179:

The Alcohol, Smoking, and Substance Involvement Test (ASSIST) is an interview-based questionnaire consisting of eight questions developed by the WHO. The questions ask about lifetime use; frequency of use; urge to use; frequency of health, financial, social, or legal problems related to use; failure

867:

Gambling addiction has been associated with some personality traits, including: harm avoidance, low self direction, decision making and planning insufficiencies, impulsivity, as well as sensation seeking individuals. Although some personality traits can be linked with gambling addiction, there is no

13104:

Sixteen percent of the non-institutionalized U.S. population age 12 and over – more than 40 million Americans – meets medical criteria for addiction involving nicotine, alcohol or other drugs. This is more than the number of Americans with cancer, diabetes or heart conditions. In 2014, 22.5 million

11901:

Here I discuss how mesocorticolimbic mechanisms generate the motivation component of incentive salience. Incentive salience takes Pavlovian learning and memory as one input and as an equally important input takes neurobiological state factors (e.g. drug states, appetite states, satiety states) that

11154:

It has been found that deltaFosB gene in the NAc is critical for reinforcing effects of sexual reward. Pitchers and colleagues (2010) reported that sexual experience was shown to cause DeltaFosB accumulation in several limbic brain regions including the NAc, medial pre-frontal cortex, VTA, caudate,

7151:

Drugs of abuse induce neuroplasticity in the natural reward pathway, specifically the nucleus accumbens (NAc), thereby causing development and expression of addictive behavior. ... Together, these findings demonstrate that drugs of abuse and natural reward behaviors act on common molecular and

7087:

Sexual addiction, which is also known as hypersexual disorder, has largely been ignored by psychiatrists, even though the condition causes serious psychosocial problems for many people. A lack of empirical evidence on sexual addiction is the result of the disease's complete absence from versions of

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In other words, a person cannot control the neurobiological processes that occur in the body in response to using an addictive drug. A person can make a voluntary choice to, for example, start using a drug (or not), or to seek help after becoming addicted, although resisting the urge to use drug(s)

4537:

A study conducted in 2009 in the Republic of Moldova looked into the social dynamics of initiating injection drug usage by examining 42 audio-recorded, semi-structured interviews with present and former injectors. A thematic analysis suggested that self-injection was viewed as a symbolic transition

4525:

The narrative medicine to addiction focuses on recognizing, absorbing, and interpreting the stories of those suffering from addiction, allowing for better understanding of their experiences with narrative analysis being used to study the discourse of those with addiction. This knowledge can be used

4460:

Other artistic assessment methods include the Bird's Nest Drawing: a useful tool for visualizing a client's attachment security. This assessment method looks at the amount of color used in the drawing, with a lack of color indicating an 'insecure attachment', a factor that the client's therapist or

4447:

Despite the large number of randomized control trials, clinical control trials, and anecdotal evidence supporting the effectiveness of art therapies for use in addiction treatment, a systematic review conducted in 2018 could not find enough evidence on visual art, drama, dance and movement therapy,

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report, although South America produced 3% of the world's morphine and heroin and 0.01% of its opium, prevalence of use is uneven. According to the Inter-American Commission on Drug Abuse Control, consumption of heroin is low in most Latin American countries, although Colombia is the area's largest

11945:

The brain reward circuitry that is targeted by addictive drugs normally mediates the pleasure and strengthening of behaviors associated with natural reinforcers, such as food, water, and sexual contact. Dopamine neurons in the VTA are activated by food and water, and dopamine release in the NAc is

8904:

EFs can be improved (Diamond & Lee 2011, Klingberg 2010). ... At any age across the life cycle EFs can be improved, including in the elderly and in infants. There has been much work with excellent results on improving EFs in the elderly by improving physical fitness (Erickson & Kramer

4811:

The three models developed here – the cultural model, the subcultural model, and the Critical Medical Anthropology Model – display how addiction is not an experience to be considered only biomedically. Through consideration of addiction alongside the biological, psychological, social, cultural and

4516:

A project known as "Voice" was a collection of art, poetry and narratives created by women living with a history of addiction to explore women's understanding of harm reduction, challenge the effects of stigma and give voice to those who have historically been silenced or devalued. In the project,

4439:

Art therapy is an effective method of dealing with substance abuse in comprehensive treatment models. When included in psychoeducational programs, art therapy in a group setting can help clients internalize taught concepts in a more personalized manner. During the course of treatment, by examining

713:

Addiction can exist in the absence of psychotropic drugs, which was popularized by Peele. These are termed behavioral addictions. Such addictions may be passive or active, but they commonly contain reinforcing features, which are found in most addictions. Sexual behavior, eating, gambling, playing

353:" is also a polyseme denoting either neuropsychological symptoms or mental disorders. In the DSM-5, dependences differ from addictions and can even normally happen without addictions; besides, substance-use dependences are severe stages of substance-use addictions (i.e. mental disorders) involving 9128:

However, the components that are responsible for the heritability of characteristics that make an individual more susceptible to drug addiction in humans remain largely unknown given that patterns of inheritance cannot be explained by simple genetic mechanisms (Cloninger et al., 1981; Schuckit et

8940:

These diverse inputs and back projections to both cortical and subcortical structures put the prefrontal cortex in a position to exert what is called "top-down" control or cognitive control of behavior. ... The prefrontal cortex receives inputs not only from other cortical regions, including

5339:

Despite the importance of numerous psychosocial factors, at its core, drug addiction involves a biological process: the ability of repeated exposure to a drug of abuse to induce changes in a vulnerable brain that drive the compulsive seeking and taking of drugs, and loss of control over drug use,

4512:

Another author critically examined works by contemporary Canadian artists that deal with addiction via the metaphor of a cultural landscape to "unmap" and "remap" ideologies related to Indigenous communities and addiction to demonstrate how colonial violence in Canada has drastically impacted the

4464:

Art therapists working with children of parents suffering from alcoholism can use the Kinetic Family Drawings assessment tool to shed light on family dynamics and help children express and understand their family experiences. The KFD can be used in family sessions to allow children to share their

4443:

Art therapy can function as a complementary therapy used in conjunction with more conventional therapies and can can integrate with harm reduction protocols to minimize the negative effects of drug use. An evaluation of art therapy incorporation within a pre-existing Addiction Treatment Programme

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at (or adjacent to) particular genes, and (3) epigenetic downregulation or upregulation of microRNAs which have particular target genes. As an example, while hundreds of genes in the cells of the nucleus accumbens (NAc) exhibit histone modifications following drug exposure – particularly, altered

1901:, is a critical component and common factor in the development of virtually all forms of behavioral and drug addictions. Two decades of research into ΔFosB's role in addiction have demonstrated that addiction arises, and the associated compulsive behavior intensifies or attenuates, along with the 1616:

Cognitive control is the intentional selection of thoughts, behaviors, and emotions, based on our environment. It has been shown that drugs alter the way our brains function, and its structure. Cognitive functions such as learning, memory, and impulse control, are affected by drugs. These effects

1141:

The CRAFFT (Car-Relax-Alone-Forget-Family and Friends-Trouble) is a screening tool that is used in medical centers. The CRAFFT is in version 2.1 and has a version for nicotine and tobacco use called the CRAFFT 2.1+N. This tool is used to identify substance use, substance related driving risk, and

1132:

This is a screening and assessment tool in one, assessing commonly used substances. This tool allows for a simple diagnosis, eliminating the need for several screening and assessment tools, as it includes both TAPS-1 and TAPS-2, screening and assessment tools respectively. The screening component

664:

on the hypothesis that foods high in fat, sugar, and salt have addictive-like effects which contribute to problematic eating habits. The YFAS is designed to address 11 substance-related and addictive disorders (SRADs) using a 25-item self-report questionnaire, based on the diagnostic criteria for

12219:

The official diagnosis of drug addiction by the Diagnostic and Statistic Manual of Mental Disorders (2013), which uses the term substance use disorder, is flawed. Criteria used to make the diagnosis of substance use disorders include tolerance and somatic dependence/withdrawal, even though these

11942:

VTA DA neurons play a critical role in motivation, reward-related behavior (Chapter 15), attention, and multiple forms of memory. This organization of the DA system, wide projection from a limited number of cell bodies, permits coordinated responses to potent new rewards. Thus, acting in diverse

11094:

G9a appears to be a critical control point for epigenetic regulation in NAc, as we know it functions in two negative feedback loops. It opposes the induction of ΔFosB, a long-lasting transcription factor important for drug addiction (Robison and Nestler, 2011), while ΔFosB in turn suppresses G9a

4884:

Recognizing that relapse is a common part of the change process, this stage focuses on identifying and addressing factors that may lead to a return to old behaviors. Relapse is viewed as an opportunity for learning and strategy adjustment, with the ultimate goal of eliminating or terminating the

4493:

A powerful educational tool for increasing awareness and understanding of addiction as a medical illness. Exhibitions featuring personal stories and images can help to create lasting impressions on diverse audiences (including addiction scientists/researchers, family/friends of those affected by

4456:

The Formal Elements Art Therapy Scale (FEATS) is an assessment tool used to evaluate drawings created by people suffering from substance use disorders by comparing them to drawings of a control group (consisting of individuals without SUDs). FEATS consists of twelve elements, three of which were

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conducted a national drug survey that quantified drug use for various types of drugs and demographics. The national found that in 2019, 11% of people over 14 years old smoke daily; that 9.9% of those who drink alcohol, which equates to 7.5% of the total population age 14 or older, may qualify as

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between ACEs and numerous health, social, and behavioral problems throughout a person's lifespan, including substance use disorder. Children's neurological development can be permanently disrupted when they are chronically exposed to stressful events such as physical, emotional, or sexual abuse,

1720:

Environmental risk factors for addiction are the experiences of an individual during their lifetime that interact with the individual's genetic composition to increase or decrease his or her vulnerability to addiction. For example, after the nationwide outbreak of COVID-19, more people quit (vs.

885:

does not have any standardized definition, yet there is widespread agreement that this problem exists. Debate over the classification of problematic internet use considers whether it should be thought of as a behavioral addiction, an impulse control disorder, or an obsessive-compulsive disorder.

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The NAc and VTA are central components of the circuitry underlying reward and memory of reward. As previously mentioned, the activity of dopaminergic neurons in the VTA appears to be linked to reward prediction. The NAc is involved in learning associated with reinforcement and the modulation of

4892:

Addiction causes an "astoundingly high financial and human toll" on individuals and society as a whole. In the United States, the total economic cost to society is greater than that of all types of diabetes and all cancers combined. These costs arise from the direct adverse effects of drugs and

4397:

The arts can be used in a variety of ways to address issues related to addiction. Art can be used as a form of therapy in the treatment of substance use disorders. Creative activities like painting, sculpting, music, and writing can help people express their feelings and experiences in safe and

4089:

As of 2021, 43.7 million people aged 12 or older surveyed by the National Survey on Drug Use and Health in the United States needed treatment for an addiction to alcohol, nicotine, or other drugs. The groups with the highest number of people were 18–25 years (25.1%) and "American Indian or

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Most individuals are exposed to and use addictive drugs for the first time during their teenage years. In the United States, there were just over 2.8 million new users of illicit drugs in 2013 (7,800 new users per day); among them, 54.1% were under 18 years of age. In 2011, there were

1769:

Adolescence represents a period of increased vulnerability for developing an addiction. In adolescence, the incentive-rewards systems in the brain mature well before the cognitive control center. This consequentially grants the incentive-rewards systems a disproportionate amount of power in the

11910:

When a Pavlovian CS+ is attributed with incentive salience it not only triggers 'wanting' for its UCS, but often the cue itself becomes highly attractive – even to an irrational degree. This cue attraction is another signature feature of incentive salience ... Two recognizable features of

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Core EFs are inhibition , working memory, and cognitive flexibility (including creatively thinking "outside the box," seeing anything from different perspectives, and quickly and flexibly adapting to changed circumstances). ... EFs and prefrontal cortex are the first to suffer, and suffer

4831:

Albert Bandura's 1977 social learning theory posits that individuals acquire addictive behaviors by observing and imitating models in their social environment. The likelihood of engaging in and sustaining similar addictive behaviors is influenced by the reinforcement and punishment observed in

4533:

Due to higher medication consumption, social isolation, financial worries, and other factors, older adults are particularly vulnerable to substance use problems. Incidence of addiction among this population is inaccurately reported. Narrative therapy can provide an avenue to unearth stories of

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of ΔFosB in the nucleus accumbens, and chronic acquisition of these rewards can result in a similar pathological addictive state through ΔFosB overexpression. Consequently, ΔFosB is the key transcription factor involved in addictions to natural rewards (i.e., behavioral addictions) as well; in

9131:

The evidence presented here demonstrates that rapid environmental adaptation occurs following exposure to a number of stimuli. Epigenetic mechanisms represent the key components by which the environment can influence genetics, and they provide the missing link between genetic heritability and

4529:

A narrative study demonstrated and studied cognitive and emotional tendencies among substance abusers during treatment periods to learn more about motivation and ambivalence inherent in recovery over the course of a residential treatment program. Seven narrative types emerged from the overall

4406:

Addiction treatment is complex and not always effective due to engagement and service availability concerns, so researchers prioritize efforts to improve treatment retention and decrease relapse rates. Characteristics of substance abuse may include feelings of isolation, a lack of confidence,

3011:

increases. Reward sensitization normally occurs following chronically high levels of exposure to the stimulus. ΔFosB expression in D1-type medium spiny neurons in the nucleus accumbens has been shown to directly and positively regulate reward sensitization involving drugs and natural rewards.

2809:

Dopamine is the primary neurotransmitter of the reward system in the brain. It plays a role in regulating movement, emotion, cognition, motivation, and feelings of pleasure. Natural rewards, like eating, as well as recreational drug use cause a release of dopamine, and are associated with the

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effects that are mediated through ΔFosB. This phenomenon is notable since, in humans, a dopamine dysregulation syndrome, characterized by drug-induced compulsive engagement in natural rewards (specifically, sexual activity, shopping, and gambling), has been observed in some individuals taking

13107:

Risky substance use and untreated addiction account for one-third of inpatient hospital costs and 20 percent of all deaths in the United States each year, and cause or contribute to more than 100 other conditions requiring medical care, as well as vehicular crashes, other fatal and non-fatal

12685:

Initial drug use can be attributed to the ability of the drug to act as a reward (ie, a pleasurable emotional state or positive reinforcer), which can lead to repeated drug use and dependence. A great deal of research has focused on the molecular and neuroanatomical mechanisms of the initial

11091:

Short-term increases in histone acetylation generally promote behavioral responses to the drugs, while sustained increases oppose cocaine's effects, based on the actions of systemic or intra-NAc administration of HDAC inhibitors. ... Genetic or pharmacological blockade of G9a in the NAc

8848:

Today, arguably more than at any time in history, the constructs of attention, executive functioning, and cognitive control seem to be pervasive and preeminent in research and theory. Even within the cognitive framework, however, there has long been an understanding that behavior is multiply

4729:

of 1960s and 1970s drug subcultures. The seminal publication "Taking care of business", by Edward Preble and John J. Casey, documented the daily lives of New York street-based intravenous heroin users in rich detail, providing unique insight into the dynamic social worlds and activities that

4158:

between 2009 and 2017, outpatient visits for mental health and addiction increased from 52.6 to 57.2 per 100 people, emergency department visits increased from 13.5 to 19.7 per 1000 people and the number of hospitalizations increased from 4.5 to 5.5 per 1000 people. Prevalence of care needed

1170:

The Drug Abuse Screening Test (DAST) is a self-reporting tool that measures problematic substance use. Responses to this test are recorded as yes or no answers, and scored as a number between zero and 28. Drug abuse or dependence, are indicated by a cut off score of 6. Three versions of this

10585:

Coincident and convergent input often induces plasticity on a postsynaptic neuron. The NAc integrates processed information about the environment from basolateral amygdala, hippocampus, and prefrontal cortex (PFC), as well as projections from midbrain dopamine neurons. Previous studies have

4807:

market politics. Social suffering, "the misery among those on the weaker end of power relations in terms of physical health, mental health and lived experience", is used by anthropologists to analyze how individuals may have personal problems caused by political and economic power. From the

4142:

Survey in 2012 found the lifetime prevalence and 12-month prevalence of substance use disorders were 21.6%, and 4.4% in those 15 and older. Alcohol abuse or dependence reported a lifetime prevalence of 18.1% and a 12-month prevalence of 3.2%. Cannabis abuse or dependence reported a lifetime

1639:

A number of genetic and environmental risk factors exist for developing an addiction. Genetic and environmental risk factors each account for roughly half of an individual's risk for developing an addiction; the contribution from epigenetic risk factors to the total risk is unknown. Even in

3015:"Cue-induced wanting" or "cue-triggered wanting", a form of craving that occurs in addiction, is responsible for most of the compulsive behavior that people with addictions exhibit. During the development of an addiction, the repeated association of otherwise neutral and even non-rewarding 889:

Studies conducted in India, United States, Asia, and Europe have identified Internet addiction prevalence rates ranging in value from 1% to 19%, with the adolescent population having high rates compared to other age groups. Prevalence rates have been difficult to establish due to a lack of

8943:

In conditions in which prepotent responses tend to dominate behavior, such as in drug addiction, where drug cues can elicit drug seeking (Chapter 15), or in attention deficit hyperactivity disorder (ADHD; described below), significant negative consequences can result. ... ADHD can be

3623:

Altered epigenetic regulation of gene expression within the brain's reward system plays a significant and complex role in the development of drug addiction. Addictive drugs are associated with three types of epigenetic modifications within neurons. These are (1) histone modifications, (2)

2779:

cortices, is another VTA output in the mesocorticolimbic pathway; it is important for the integration of information which helps determine whether a behavior will be elicited. It is critical for forming associations between the rewarding experience of drug use and cues in the environment.

920:

in the 11th edition of the International Classification of Diseases. Video game addiction has been shown to be more prevalent in males than females, higher by 2.9 times. It has been suggested that people of younger ages are more prone to become addicted to video games. People with certain

4489:

Addiction art exhibitions can come from a variety of sources, but the underlying message of these works is the same: to communicate through emotions without relying on intellectually demanding/gatekept facts and figures. These exhibitions can either stand alone, reinforce, or challenge

4763:

Emerging in the early 1980s, the critical medical anthropology model was introduced, and as Merrill Singer offers 'was applied quickly to the analysis of drug use'. Where the cultural model of the 1950s looked at the social body, the critical medical anthropology model revealed the

4667:

followed was typically undertaken socially, during festivals. Having returned in 1989, Heath observed that while much had changed, 'drinking parties' remained, as per his initial observations, and 'there appear to be no harmful consequences to anyone'. Heath's observations and

2571:

effects of sexual reward. Research on the interaction between natural and drug rewards suggests that dopaminergic psychostimulants (e.g., amphetamine) and sexual behavior act on similar biomolecular mechanisms to induce ΔFosB in the nucleus accumbens and possess bidirectional

4832:

others. The principle of reciprocal determinism suggests that the functional relationships between personal, environmental, and behavioral factors act as determinants of addictive behavior. Thus, effective treatment targets each dynamic facet of the biopsychosocial disorder.

4448:

or 'arts in health' methodologies to confirm their effectiveness as interventions for reducing substance misuse. Music therapy was identified to have potentially strong beneficial effects in aiding contemplation and preparing those diagnosed with substance use for treatment.

1124:. Executive functioning consists of processes that would be disrupted in addiction. In the context of addiction, incentive salience determines how one perceives the addictive substance. Increased negative emotional responses have been found with individuals with addictions. 4477:

Artists attempt to change the societal perception of addiction from a punishable moral offense to instead a chronic illness necessitating treatment. This form of advocacy can help to relocate the fight of addiction from a judicial perspective to the public health system.

2559:-mediated gene transfer) or G9a expression (via pharmacological means) reduces, or with a large increase can even block, many of the neural and behavioral alterations that result from chronic high-dose use of addictive drugs (i.e., the alterations mediated by ΔFosB). 4048:

and illicit drugs were highest in Eastern Europe. Data shows a downward trend of alcohol use among children 15 years old in most European countries between 2002 and 2014. First-time alcohol use before the age of 13 was recorded for 28% of European children in 2014.

1892:

and epigenetic mechanisms as a result of chronically high levels of exposure to an addictive stimulus (e.g., eating food, the use of cocaine, engagement in sexual activity, participation in high-thrill cultural activities such as gambling, etc.) over extended time.

897:

People with internet addiction are likely to have a comorbid psychiatric disorder. Comorbid diagnoses identified alongside internet addiction include affective mood disorders, anxiety disorders, substance use disorders, and attention deficit hyperactivity disorder.

4473:

Stigma can lead to feelings of shame that can prevent people with substance use disorders from seeking help and interfere with provision of harm reduction services. It can influence healthcare policy, making it difficult for these individuals to access treatment.

1218:

demonstrates that psychological profiles of drug users and non-users have significant differences and the psychological predisposition to using different drugs may be different. Models of addiction risk that have been proposed in psychology literature include: an

3819:

to attack and consume or otherwise disable the molecules of such substances that cause a reaction in the brain, thus preventing the addict from being able to realize the effect of the drug. Addictions that have been floated as targets for such treatment include

2813:

Excessive intake of many types of addictive drugs results in repeated release of high amounts of dopamine, which in turn affects the reward pathway directly through heightened dopamine receptor activation. Prolonged and abnormally high levels of dopamine in the

1593:

In operant conditioning, behavior is influenced by outside stimulus, such as a drug. The operant conditioning theory of learning is useful in understanding why the mood-altering or stimulating consequences of drug use can reinforce continued use (an example of

1760:

According to Travis Hirschi's social control theory, adolescents with stronger attachments to family, religious, academic, and other social institutions are less likely to engage in delinquent and maladaptive behavior such as drug use leading to addiction.

4029:

alcohol dependent; that 17.5% of the 2.4 million people who used cannabis in the last year may have hazardous use or a dependence problem; and that 63.5% of about 300000 recent users of meth and amphetamines were at risk for developing problem use.

12110:

Studies investigating general HDAC inhibition on behavioral outcomes have produced varying results but it seems that the effects are specific to the timing of exposure (either before, during or after exposure to drugs of abuse) as well as the length of

3038:

Research on the interaction between natural and drug rewards suggests that dopaminergic psychostimulants (e.g., amphetamine) and sexual behavior act on similar biomolecular mechanisms to induce ΔFosB in the nucleus accumbens and possess a bidirectional

15548:

Drug abuse and addiction exact an astoundingly high financial and human toll on society through direct adverse effects, such as lung cancer and hepatic cirrhosis, and indirect adverse effects –for example, accidents and AIDS – on health and

1721:

started) smoking; and smokers, on average, reduced the quantity of cigarettes they consumed. More generally, a number of different environmental factors have been implicated as risk factors for addiction, including various psychosocial stressors. The

1855:

which arise through chronic exposure to addictive stimuli during an addiction can be transmitted across generations, in turn affecting the behavior of one's children (e.g., the child's behavioral responses to addictive drugs and natural rewards).

744:

Sexual addiction involves an engagement in excessive, compulsive, or otherwise problematic sexual behavior that persists despite negative physiological, psychological, social, and occupational consequences. Sexual addiction may be referred to as

2825:

Drug seeking behavior is induced by glutamatergic projections from the prefrontal cortex to the nucleus accumbens. This idea is supported with data from experiments showing that drug seeking behavior can be prevented following the inhibition of

18096: 4906:

male and females from 2002 to 2017, with 72,306 overdose deaths reported in 2017 in the US. 2020 marked the year with highest number of overdose deaths over a 12-month period, with 81,000 overdose deaths, exceeding the records set in 2017.

4750:

meaning, and socially constructed purpose that they may feel is unattainable through conventional means. The subcultural model demonstrates the complexities of addiction, highlighting the need for an integrated approach. It contends that a

3031:). As conditioned positive reinforcers of drug use, these previously neutral stimuli are assigned incentive salience (which manifests as a craving) – sometimes at pathologically high levels due to reward sensitization – which can 3007:) that is assigned by the brain to a rewarding stimulus (e.g., a drug). In simple terms, when reward sensitization to a specific stimulus (e.g., a drug) occurs, an individual's "wanting" or desire for the stimulus itself and its associated 13183: 12220:

processes are not integral to addiction as noted. It is ironic and unfortunate that the manual still avoids use of the term addiction as an official diagnosis, even though addiction provides the best description of the clinical syndrome.

2799:

is involved in drug addiction, because of its role in learning and memory. Much of this evidence stems from investigations showing that manipulating cells in the hippocampus alters DA levels in NAcc and firing rates of VTA dopaminergic

1692:

family studies which suggest that if one family member has a history of addiction, the chances of a relative or close family developing those same habits are much higher than one who has not been introduced to addiction at a young age.

9688:

Addictive activities are determined neither solely by brain changes nor solely by social conditions ... the narrowing seen in addiction takes place within the behavioral repertoire, the social surround, and the brain — all at the same

1798:

found that there is a "definite connection between mental illness and the use of addictive substances" and a majority of mental health patients participate in the use of these substances: 38% alcohol, 44% cocaine, and 40% cigarettes.

9602: 1133:

asks about the frequency of use of the specific substance (tobacco, alcohol, prescription medication, and other). If an individual screens positive, the second component will begin. This dictates the risk level of the substance.

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Weicker NP, Whaley S, Urquhart G, Park JN, Sherman SG, Owczarzak J (October 2021). ""I Know It Is Going to Ruin Their Life:" Fortune-Telling, Agency, and Harm Reduction in Narratives Concerning Injection Initiation Assistance".

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of 1.1–1.3 percent; this has led to the development the rare variant hypothesis, which states that genes with low frequencies in the population (<1%) confer much greater additional risk in the development of the disease.

7173:

Beloate LN, Weems PW, Casey GR, Webb IC, Coolen LM (February 2016). "Nucleus accumbens NMDA receptor activation regulates amphetamine cross-sensitization and deltaFosB expression following sexual experience in male rats".

4877:

After successfully implementing a change, individuals enter the maintenance stage, where they work to sustain the new behavior and prevent relapse. This stage is characterized by ongoing effort and consolidation of gains.

4247:. This furthered the understanding of addiction being a medical condition. It was not until the 19th century that addiction was seen and acknowledged in the Western world as a disease, being both a physical condition and 1875:

epigenetic alterations that arise from various forms of addiction in humans and the corresponding behavioral phenotypes from these epigenetic alterations that occur in human offspring. Based on preclinical evidence from

8941:

association cortex, but also, via the thalamus, inputs from subcortical structures subserving emotion and motivation, such as the amygdala (Chapter 14) and ventral striatum (or nucleus accumbens; Chapter 15). ...

5080:

allows ΔFosB to more rapidly accumulate within the D1-type medium spiny neurons of the nucleus accumbens because it is selectively induced in this state. Before c-Fos repression, all Fos family proteins (e.g., c-Fos,

4225:. "Addiction" at the time meant "to attach" to something, giving it both positive and negative connotations. The object of this attachment could be characterized as "good or bad". The meaning of addiction during the 13678:

Appel PW, Ellison AA, Jansky HK, Oldak R (2004). "Barriers to enrollment in drug abuse treatment and suggestions for reducing them: opinions of drug injecting street outreach clients and other system stakeholders".

345:

defines addictions as the most severe degree of the addictive disorders, due to pervasive/excessive substance-use or behavioural compulsions/impulses. It is a definition that many scientific papers and reports use.

9957:

Catalano RF, Hawkins JD, Wells EA, Miller J, Brewer D (1990). "Evaluation of the effectiveness of adolescent drug abuse treatment, assessment of risks for relapse, and promising approaches for relapse prevention".

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hospital costs and 20% of all deaths in the US every year are the result of untreated addictions and risky substance use. In spite of the massive overall economic cost to society, which is greater than the cost of

10616:

DA by promoting efflux from synaptic terminals. ... Chronic exposure to amphetamine induces a unique transcription factor delta FosB, which plays an essential role in long-term adaptive changes in the brain.

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compulsive eating, shopping, gambling, and sex – so-called "natural addictions" – Indeed, addiction to both drugs and behavioral rewards may arise from similar dysregulation of the mesolimbic dopamine

1711:

are typically not capable of being captured by these methods. Genes identified in GWAS for drug addiction may be involved either in adjusting brain behavior before drug experiences, subsequent to them, or both.

5255:

pre-existing vulnerabilities and persistent drug use lead to a vicious circle of substantive disruptions in the brain that impair and undermine choice capacities for adaptive behavior, but do not annihilate

641:

Chocolate's sweet flavor and pharmacological ingredients are known to create a strong craving or feel 'addictive' by the consumer. A person who has a strong liking for chocolate may refer to themselves as a

4858:

is the stage in which individuals become aware of the problems caused by their addiction and are considering change. Although they may not fully commit, they weigh the costs and benefits of making a shift.

4546:

From a philosophy perspective, the behavior of many with addiction that is not explained by executive dysfunction or biological reasons can be explained by folk psychology – specifically the

4271:

that can be added to a subject to denote an addiction to it. It was extracted from the word alcoholism (one of the first addictions to be widely identified both medically and socially) (correctly the root

3832:. Vaccines have been identified as potentially being more effective than other anti-addiction treatments, due to "the long duration of action, the certainty of administration and a potential reduction of 2587:

The release of dopamine in the nucleus accumbens plays a role in the reinforcing qualities of many forms of stimuli, including naturally reinforcing stimuli like palatable food and sex. Altered dopamine

1774:

approximately 20.6 million people in the United States over the age of 12 with an addiction. Over 90% of those with an addiction began drinking, smoking or using illicit drugs before the age of 18.

3716:

and the associated withdrawal syndrome to identify an addictive state. Physical dependence occurs when the body has adjusted by incorporating the substance into its "normal" functioning – i.e., attains

10858:

gene that helps create the molecular switch—from the induction of several short-lived Fos family proteins after acute drug exposure to the predominant accumulation of ΔFosB after chronic drug exposure

916:(WHO) as excessive gaming behavior, potentially prioritized over other interests, despite the negative consequences that may arise, for a period of at least 12 months. In May 2019, the WHO introduced 14461: 8509:

Ali R, Meena S, Eastwood B, Richards I, Marsden J (September 2013). "Ultra-rapid screening for substance-use disorders: the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST-Lite)".

7775:

Tang J, Yu Y, Du Y, Ma Y, Zhang D, Wang J (March 2014). "Prevalence of internet addiction and its association with stressful life events and psychological symptoms among adolescent internet users".

4465:

experiences and needs with parents who may be in recovery from alcohol use disorder. Depiction of isolation of self and isolation of other family members may be an indicator of parental alcoholism.

714:

video games, and shopping are all associated with compulsive behaviors in humans and have been shown to activate the mesolimbic pathway and other parts of the reward system. Based on this evidence,

1269:, represent opposite processes (i.e., internal vs external or environmental, respectively) that compete over the control of an individual's elicited behaviors. Cognitive control, and particularly 9704: 2457: months, slowly accumulates following repeated high-dose exposure to stimulants through this process. ΔFosB functions as "one of the master control proteins" that produces addiction-related 702:– which is a behavior that is inherently rewarding (i.e., desirable or appealing) – despite adverse consequences. Preclinical evidence has demonstrated that marked increases in the expression of 7053:

Karila L, Wéry A, Weinstein A, Cottencin O, Petit A, Reynaud M, et al. (2014). "Sexual addiction or hypersexual disorder: different terms for the same problem? A review of the literature".

12123:

Petry NM, Rehbein F, Gentile DA, Lemmens JS, Rumpf HJ, Mößle T, et al. (September 2014). "An international consensus for assessing internet gaming disorder using the new DSM-5 approach".

4865:

Individuals in this stage are getting ready to change. They might have taken preliminary steps, like gathering information or making small commitments, in preparation for behavioral change.

12369: 10098: 5616: 5102:

According to two medical reviews, ΔFosB has been implicated in causing both increases and decreases in dynorphin expression in different studies; this table entry reflects only a decrease.

4497:

A way to destigmatize substance use disorders and shift public perception from viewing them as a moral failing to understanding them as a chronic medical condition which requires treatment.

3969:

can be used to determine when treatment can begin and which method will be most effective. If treatment begins too early, it can cause a person to become defensive and resistant to change.

1839:

genes and their products (e.g., proteins) are the key components through which environmental influences can affect the genes of an individual: they serve as the mechanism responsible for

10314:

Yuan TF, Li A, Sun X, Ouyang H, Campos C, Rocha NB, et al. (2015). "Transgenerational Inheritance of Paternal Neurobehavioral Phenotypes: Stress, Addiction, Ageing and Metabolism".

9606: 8938: • Working memory is a short-term, capacity-limited cognitive buffer that stores information and permits its manipulation to guide decision-making and behavior. ... 4123:

stated that "America's largest drug companies flooded the country with pain pills from 2006 through 2012, even when it became apparent that they were fueling addiction and overdoses."

4609:

considerations of addiction. A biopsychosocial–cultural–spiritual approach considers, for example, how physical environments influence experiences, habits, and patterns of addiction.

4852:

This initial stage precedes individuals considering a change in their behavior. They might be oblivious to or in denial of their addiction, failing to recognize the need for change.

5124:

In simplest terms, this means that when either amphetamine or sex is perceived as more alluring or desirable through reward sensitization, this effect occurs with the other as well.

10525:

in response to psychostimulant exposure. ΔFosB is also upregulated by chronic psychostimulant treatments, and is known to activate certain genes (eg, cdk5) and repress others (eg,

4078:

of addictions to alcohol and illicit drugs has been estimated to be approximately 8% and 2–3% respectively. Based on representative samples of the US adult population in 2011, the

3850:

intended to reduce or eliminate physical dependence on nicotine. This proprietary vaccine is being developed by Nabi Biopharmaceuticals of Rockville, MD. with the support from the

2756:(MSNs). The NAcc is associated with acquiring and eliciting conditioned behaviors, and is involved in the increased sensitivity to drugs as addiction progresses. Overexpression of 2695:

Understanding the pathways in which drugs act and how drugs can alter those pathways is key when examining the biological basis of drug addiction. The reward pathway, known as the

357:. In the ICD-11, "substance-use dependence" is a synonym of "substance-use addiction" (i.e. neuropsychological symptoms) that can but do not necessarily involve withdrawal issues. 14826:

Rhodes T, Bivol S, Scutelniciuc O, Hunt N, Bernays S, Busza J (November 2011). "Narrating the social relations of initiating injecting drug use: Transitions in self and society".

11906:

A brief CS encounter (or brief UCS encounter) often primes a pulse of elevated motivation to obtain and consume more reward UCS. This is a signature feature of incentive salience.

6045:

Additionally, the diagnosis of dependence caused much confusion. Most people link dependence with "addiction" when in fact dependence can be a normal body response to a substance.

4010:

Internet addiction disorder is highest in the Philippines, according to both the IAT (Internet Addiction Test) – 5% and the CIAS-R (Revised Chen Internet Addiction Scale) – 21%.

1790:

disorders such as depression, anxiety, attention-deficit/hyperactivity disorder (ADHD) or post-traumatic stress disorder are more likely to develop substance use disorders. The

12796:

Mak KK, Lai CM, Watanabe H, Kim DI, Bahar N, Ramos M, et al. (November 2014). "Epidemiology of internet behaviors and addiction among adolescents in six Asian countries".

64:

Addictive behaviour (e.g. substance-use addiction, sexual addiction), dependence, addictive disorder, addiction disorder (e.g. severe substance-use disorder, gambling disorder)

8936: • Executive function, the cognitive control of behavior, depends on the prefrontal cortex, which is highly developed in higher primates and especially humans. 13161: 4007:

The prevalence of alcohol dependence is not as high as is seen in other regions. In Asia, not only socioeconomic factors but biological factors influence drinking behavior.

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associated healthcare costs (e.g., emergency medical services and outpatient and inpatient care), long-term complications (e.g., lung cancer from smoking tobacco products,

4871:

involves actively modifying behavior by making specific, observable changes to address the addictive behavior. The action stage requires significant effort and commitment.

412:– psychoactive substances that with repeated use are associated with significantly higher rates of substance use disorders, due in large part to the drug's effect on brain 13126: 6948:"The Modified Yale Food Addiction Scale 2.0: Validation Among Non-Clinical and Clinical French-Speaking Samples and Comparison With the Full Yale Food Addiction Scale 2.0" 2179: 13320: 2491:). ΔFosB is the most significant biomolecular mechanism in addiction because the overexpression of ΔFosB in the D1-type medium spiny neurons in the nucleus accumbens is 4221:

throughout history has been misunderstood and has taken on various meanings associated with the word. An example is the usage of the word in the religious landscape of

831:

have been found in rat and human models, showing a correlation with the severity of the gambling behavior. This in turn was linked with greater dopamine release in the

665:

SRADs as per DSM-5. A potential food addiction diagnosis is predicted by the presence of at least two out of 11 SRADs and a significant impairment to daily activities.

5574: 758:

conditions. Reviews of both clinical research in humans and preclinical studies involving ΔFosB have identified compulsive sexual activity – specifically, any form of

14345:

Ashford RD, Brown AM, Curtis B (August 2018). "Systemic barriers in substance use disorder treatment: A prospective qualitative study of professionals in the field".

12609: 5511: 2562:ΔFosB plays an important role in regulating behavioral responses to natural rewards, such as palatable food, sex, and exercise. Natural rewards, like drugs of abuse, 18116: 10802:

gene occurs in concert with the recruitment of a histone deacetylase and presumably several other repressive proteins such as a repressive histone methyltransferase

3811:

for addiction have been investigated as a possibility since the early 2000s. The general theory of a vaccine intended to "immunize" against drug addiction or other

2734:). These cells respond when stimuli indicative of a reward are present. The VTA supports learning and sensitization development and releases dopamine (DA) into the 660:(YFAS), version 2.0, is the current standard measure for assessing whether an individual exhibits signs and symptoms of food addiction. It was developed in 2009 at 3760:

Medical researchers who actively study addiction have criticized the DSM classification of addiction for being flawed and involving arbitrary diagnostic criteria.

14264:

Ball SA, Legow NE (November 1996). "Attachment theory as a working model for the therapist transitioning from early to later recovery substance abuse treatment".

2453:

acts as a molecular switch that enables the accumulation of ΔFosB in the neuron. A highly stable (phosphorylated) form of ΔFosB, one that persists in neurons for

295:. A common use of "addiction" in medicine is for neuropsychological symptoms denoting pervasive/excessive and intense urges to engage in a category of behavioral 3705:

The DSM-5 introduced a new diagnostic category for behavioral addictions. Problem gambling is the only condition included in this category in the fifth edition.

2084: 2810:

reinforcing nature of these stimuli. Nearly all addictive drugs, directly or indirectly, act on the brain's reward system by heightening dopaminergic activity.

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to indicate the extent of disordered use. These specifiers are determined by the number of diagnostic criteria present in a given case. In the DSM-5, the term

2592:

is frequently observed following the development of an addictive state. In humans and lab animals that have developed an addiction, alterations in dopamine or

12468:, Rennard S, Jorenby D, Fiore M, Koopmeiners J, de Vos A, et al. (2005). "Safety and immunogenicity of a nicotine conjugate vaccine in current smokers". 4615:

engagements and developments in fields of knowledge have contributed to biopsychosocial–cultural–spiritual understandings of addiction, including the work of

3047:

transcriptional activity decreases user's sensitivity to the rewarding effects of the substance. CREB transcription in the nucleus accumbens is implicated in

957:(CBD), is the excessive urge to shop or spend, potentially resulting in unwanted consequences. These consequences can have serious impacts, such as increased 10124: 5656: 635: 14926:

Rau BL (September 2014). "The Oxford Handbook of Evidence-Based Management, Rousseau DM 2012. 432 pages, hardcover. New York, NY: Oxford University Press".

14463:

Implementation of the Provision of the Comprehensive Addiction and Recovery Act of 2016 Relating to the Dispensing of Narcotic Drugs for Opioid Use Disorder

4259:. The understanding of addiction has changed throughout history, which has impacted and continues to impact the ways it is medically treated and diagnosed. 16346: 8060:

Hyun GJ, Han DH, Lee YS, Kang KD, Yoo SK, Chung US, et al. (1 July 2015). "Risk factors associated with online game addiction: A hierarchical model".

2305: 4143:

prevalence of 6.8% and a 12-month prevalence of 3.2%. Other drug abuse or dependence has a lifetime prevalence of 4.0% and a 12-month prevalence of 0.7%.

1251:

of change (TTM) can point to how someone may be conceptualizing their addiction and the thoughts around it, including not being aware of their addiction.

812:

is involved in learning, motivation, as well as the reward system. The exact role of dopamine in gambling addiction has been debated. Suggested roles for

19074: 14089:

Matto H, Corcoran J, Fassler, A (January 2003). "Integrating solution-focused and art therapies for substance abuse treatment: guidelines for practice".

12465: 10630:"Transcriptional and epigenetic substrates of methamphetamine addiction and withdrawal: evidence from a long-access self-administration model in the rat" 9712: 6022: 2130: 14553:

Skelly J (2015). "Alternative Paths: Mapping Addiction in Contemporary Art by Landon Mackenzie, Rebecca Belmore, Manasie Akpaliapik, and Ron Noganosh".

18852: 2667:

Bottom: this illustrates the progressive increase in ΔFosB expression in the nucleus accumbens following repeated twice daily drug binges, where these

4718:

of their condition. As reports of drug use rapidly increased, the cultural model found application in anthropological research exploring western drug

18366: 16366: 4998: 1653: 13077: 7440:"Problem gambling, associations with comorbid health conditions, substance use, and behavioural addictions: Opportunities for pathways to treatment" 4500:

Provide those who are struggling with addiction assurance and encouragement of healing, and let them know that they are not alone in their struggle.

4090:

Alaska Native" (28.7%). Only about 10%, or a little over 2 million, receive any form of treatments, and those that do generally do not receive

864:

Risk factors for gambling addictions include antisocial behavior, impulsive personality, male sex, sensation seeking, substance use, and young age.

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Salamone JD (1992). "Complex motor and sensorimotor functions of striatal and accumbens dopamine: involvement in instrumental behavior processes".

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meet major responsibilities at work, school, or home. Depending on the level of severity, this disorder is classified as mild, moderate, or severe.

1617:

promote drug use, as well as hinder the ability to abstain from it. The increase in dopamine release is prominent in drug use, specifically in the

5067:

A decrease in aversion sensitivity, in simpler terms, means that an individual's behavior is less likely to be influenced by undesirable outcomes.

4742:. The prevailing culture can have a greater influence on drug taking behaviors than the physical and psychological effects of the drug itself. To 18106: 12629: 7368: 5133:

The lifetime prevalence of an addiction is the percentage of individuals in a population that developed an addiction at some point in their life.

4551:. According to this model, a person acquires and uses a substance or does an addictive activity in belief that it will help them achieve a goal. 126:

or engage in a behavior that produces natural reward, despite substantial harm and other negative consequences. Repetitive drug use often alters

4808:

perspective of critical medical anthropology heavy drug use and addiction is a consequence of such larger scale unequal distributions of power.

19099: 19079: 18857: 17664: 14669: 7268: 3991:

Due to cultural variations, the proportion of individuals who develop a drug or behavioral addiction within a specified time period (i.e., the

15561: 4485:

According to Santora the main purposes in using art as a form of advocacy in the education and prevention of substance use disorders include:

18677: 5975:

Ko C, Yen J, Yen C, Chen C, ChenC (2020). "The association between Internet addiction and psychiatric disorder: A review of the literature".

3953:

To be effective, treatment for addiction that is pharmacological or biologically based need to be accompanied by other interventions such as

1859:

The general classes of epigenetic alterations that have been implicated in transgenerational epigenetic inheritance include DNA methylation,

11448:

Eisch AJ, Harburg GC (2006). "Opiates, psychostimulants, and adult hippocampal neurogenesis: Insights for addiction and stem cell biology".

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in the United States. Prior models that have informed the prevailing biopsychosocial–cultural–spiritual consideration of addiction include:

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Flora, K. (July 2012). "Recovery From Substance Abuse: A Narrative Approach to Understanding the Motivation and Ambivalence About Change".

3106: 2760:

in the nucleus accumbens is a necessary common factor in essentially all known forms of addiction; ΔFosB is a strong positive modulator of

2298: 533: 8025:

Peters CS, Malesky LA (August 2008). "Problematic usage among highly-engaged players of massively multiplayer online role playing games".

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Examples of validated targets for ΔFosB in nucleus accumbens ... GluR2 ... dynorphin ... Cdk5 ... NFκB ... c-Fos

4482:

inclined to show compassion, forego stereotypes and stigma of addiction, and label addiction as a social rather than individual problem.

2326: 2077: 1847:

of their offspring (e.g., behavioral responses to environmental stimuli). In addiction, epigenetic mechanisms play a central role in the

14438: 12425: 4812:

spiritual (biopsychosocial–spiritual) elements which influence its experience, a holistic and comprehensive understanding can be built.

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Kimbrel NA, Nelson-Gray RO, Mitchell JT (April 2007). "Reinforcement sensitivity and maternal style as predictors of psychopathology".

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Importantly, these cues are strong mediators of drug-seeking behavior and can trigger relapse even after months or years of abstinence.

2511:. ΔFosB has been implicated in mediating addictions to many different drugs and drug classes, including alcohol, amphetamine and other 1738: 14167:

Rockwell P, Dunham M (January 2006). "The Utility of the Formal Elements Art Therapy Scale in Assessment for Substance Use Disorder".

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The transtheoretical model of change suggests that overcoming an addiction is a stepwise process that occurs through several stages.

4114:, almost half of US adults know a family member or close friend who has struggled with a drug addiction at some point in their life. 467:– dependence socially seen as being extremely mild compared to physical dependence (e.g., with enough willpower it could be overcome) 10730:

gene and recruits several co-repressors, including HDAC1 (histone deacetylase 1) and SIRT 1 (sirtuin 1). ... The net result is

2596:

neurotransmission in the nucleus accumbens and other parts of the striatum are evident. Use of certain drugs (e.g., cocaine) affect

2499:) seen in drug addiction. ΔFosB expression in nucleus accumbens D1-type medium spiny neurons directly and positively regulates drug 19104: 18283: 6085: 4172: 3769: 2584:ΔFosB inhibitors (drugs or treatments that oppose its action) may be an effective treatment for addiction and addictive disorders. 1840: 1831: 1274: 12582: 6728:

Functional neuroimaging studies in humans have shown that gambling (Breiter et al, 2001), shopping (Knutson et al, 2007), orgasm (

6194: 3999:(e.g., by age group, socioeconomic status, etc.). Where addiction is viewed as unacceptable, there will be fewer people addicted. 2555:, both oppose the function of ΔFosB and inhibit increases in its expression. Increases in nucleus accumbens ΔJunD expression (via 18862: 18402: 18081: 17654: 15804: 13045:

Key substance use and mental health indicators in the United States: Results from the 2021 National Survey on Drug Use and Health

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for many of the neural adaptations and behavioral effects (e.g., expression-dependent increases in drug self-administration and

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that are induced by chronic high-dose exposure to psychostimulants that increase the concentration of synaptic dopamine, like

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screening tool are in use: DAST-28, DAST-20, and DAST-10. Each of these instruments are copyrighted by Dr. Harvey A. Skinner.

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changes that do not involve alterations in the DNA sequence. Illicit drug use has been found to cause epigenetic changes in

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in press). The mechanism responsible for ΔFosB repression of c-fos expression is complex and is covered below. ...

5946: 2116: 78: 11116:"Sex, drugs, and rock 'n' roll: hypothesizing common mesolimbic activation as a function of reward gene polymorphisms" 8221: 7827:"Prevalence of internet addiction among college students in the Indian setting: a systematic review and meta-analysis" 4768:, considering drug use and addiction within the context of macro level structures including larger political systems, 4559: 1602:). Stimulus control is using the absence of the stimulus or presence of a reward to influence the resulting behavior. 969:

Signs and symptoms of addiction can vary depending on the type of addiction. Symptoms of drug addictions may include:

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and became intoxicated for several contiguous days at least twice a month'. This frequent, heavy drinking from which

4601:(biopsychosocial–cultural–spiritual) elements. A biopsychosocial–cultural–spiritual approach fosters the crossing of 1199: 1194: 232: 9628: 9146:"Adverse childhood events as risk factors for substance dependence: partial mediation by mood and anxiety disorders" 4683:, Heath's findings, when considered alongside subsequent cross-cultural experiences, challenged the perception that 4103:

and all forms of cancer combined, most doctors in the US lack the training to effectively address a drug addiction.

1180:

to perform duties; if anyone has raised concerns over use; attempts to limit or moderate use; and use by injection.

501:– a condition in which the use of substances leads to clinically and functionally significant impairment or distress 18802: 18707: 18622: 18567: 18376: 18208: 18196: 16484: 16351: 15793: 14390:"Stigma, discrimination, treatment effectiveness, and policy: public views about drug addiction and mental illness" 13514: 13345: 12264: 9542:"How the COVID-19 pandemic impacts tobacco addiction: Changes in smoking behavior and associations with well-being" 9267:

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The National Epidemiologic Survey on Alcohol and Related Conditions found that from 2012 to 2013 the prevalence of

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According to a review of experimental animal models that examined the transgenerational epigenetic inheritance of

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to develop better care plans with the potential to increase patient compliance and make treatment more effective.

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has led to a better understanding of the disease with research on the topic dating back to 1875, specifically on

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addiction etc.), highlighting the humanity of the problem and in turn encouraging compassion and understanding.

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of alcohol and illicit drug addictions were estimated at 12% and 2–3% respectively. The lifetime prevalence of

2480: 2275: 2266: 1843:, a phenomenon in which environmental influences on the genes of a parent can affect the associated traits and 1742: 15630: 14302:

Holt ES, Kaiser DH (January 2001). "Indicators of Familial Alcoholism in Children's Kinetic Family Drawings".

14212:"Representations of Attachment Security in the Bird's Nest Drawings of Clients with Substance Abuse Disorders" 12235: 6029: 770:

and sexual activity, meaning that exposure to one increases the desire for both, has been shown to occur as a

19184: 19021: 18970: 18742: 18737: 18732: 18657: 18652: 18647: 18587: 18298: 17143: 16187: 15797: 14732:

Gardner PJ, Poole JM (October 2009). "One Story at a Time: Narrative Therapy, Older Adults, and Addictions".

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Angres DH, Bettinardi-Angres K (October 2008). "The disease of addiction: origins, treatment, and recovery".

4019: 1912:

of the nucleus accumbens. Due to the causal relationship between ΔFosB expression and addictions, it is used

1704: 15138: 12996:"Prescription drug abuse: epidemiology, regulatory issues, chronic pain management with narcotic analgesics" 11568:

Kalivas PW, Volkow ND (August 2005). "The neural basis of addiction: a pathology of motivation and choice".

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Malenka RC, Nestler EJ, Hyman SE, Holtzman DM (2015). "Chapter 16: Reinforcement and Addictive Disorders".

10521:

acetylate histones and facilitate gene activation. This is known to occur on many genes including fosB and

4057: 3954: 3251: 2476: 676:

subscales of Negative Urgency and Lack of Perseverance have been shown to have relation to food addiction.

327:(i.e. limit subjects' social/family and occupational activities); the two categories of such disorders are 323:

are mental disorders involving high intensities of addictions (as neuropsychological symptoms) that induce

15948: 12387: 18943: 18879: 18822: 18697: 18692: 18687: 18672: 18662: 18612: 18607: 18597: 18577: 18557: 18516: 17967: 16014: 13660: 13609:

Bettinardi-Angres K, Angres DH (July 2010). Alexander M (ed.). "Understanding the Disease of Addiction".

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that negatively impacts those who are affected by it, most commonly associated with the use of drugs and

4229:

was mostly associated with positivity and goodness; during this early modern and highly religious era of

3649: 882: 877: 669: 519: 292: 224: 10910:"Addiction-related gene regulation: risks of exposure to cognitive enhancers vs. other psychostimulants" 9493:"Implications of genome wide association studies for addiction: are our a priori assumptions all wrong?" 7222:"Behavioral Addiction versus Substance Addiction: Correspondence of Psychiatric and Psychological Views" 4176:

opium producer. Mexico, because of its border with the United States, has the highest incidence of use.

19125: 19051: 19026: 18752: 18712: 18682: 18627: 17041: 16449: 15984: 13044: 12236:"International Classification of Diseases 11th revision – ICD-11. Disorders due to substance use" 8630:

Franken IH, Muris P (2006). "BIS/BAS personality characteristics and college students' substance use".

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di Giacomo E, Aliberti F, Pescatore F, Santorelli M, Pessina R, Placenti V, et al. (August 2022).

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Malenka R, Nestler E, Hyman S, Holtzman D (2015). "Chapter 16: Reinforcement and Addictive Disorders".

5171: 4659:

from June 1956 to August 1957. Heath observed that adult members of society drank 'large quantities of

4429:

Providing an alternative to verbal communication (via use of symbols) and conventional forms of therapy

1980: 954: 948: 778:

is required for this cross-sensitization effect, which intensifies with the level of ΔFosB expression.

673: 562: 555: 485:– stimuli that the brain interprets as intrinsically positive and desirable or as something to approach 376: 35: 31: 17: 11746: 4024:

The prevalence of substance use disorder among Australians was reported at 5.1% in 2009. In 2019 the

3637: 3538: 1277:. Stimulus-driven behavioral responses (i.e., stimulus control) that are associated with a particular 706:

through repetitive and excessive exposure to a natural reward induces the same behavioral effects and

19056: 18303: 18037: 17982: 17115: 16726: 16514: 16444: 16396: 16356: 16236: 16090: 14599:

Paivinen H, Bade S (June 2008). "Voice: challenging the stigma of addiction; a nursing perspective".

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stimulated by the presence of natural reinforcers, such as food, water, or a sexual partner. ...

6081: 5043:

of cocaine-addicted male rats. These epigenetic alterations in the rat mPFC result in increased BDNF

4548: 3986: 3913:. The vaccine does not affect the user's "desire" for cocaine—only the physical effects of the drug. 3910: 2700: 2552: 2419: 1976:– a protein that binds to DNA and regulates gene expression by promoting or suppressing transcription 1671: 913: 657: 15866: 12370:"To fight opioid crisis, UW researchers take new shot at developing vaccine against addictive drugs" 12172: 11620: 10641: 10047: 9877: 5475:

Marlatt GA, Baer JS, Donovan DM, Kivlahan DR (1988). "Addictive behaviors: etiology and treatment".

4117:

In 2019, opioid addiction was acknowledged as a national crisis in the United States. An article in

2142: 19189: 17674: 16197: 12290: 11838: 9417: 5365: 5032: 4916: 4898: 3706: 3113: 3048: 3024: 2512: 2492: 1953: 1920:. ΔFosB expression in these neurons directly and positively regulates drug self-administration and 463: 42: 12406: 10738: 10072: 7111:"Natural and drug rewards act on common neural plasticity mechanisms with ΔFosB as a key mediator" 5956:. US Department of Health and Human Services. November 2016. pp. 35–37, 45, 63, 155, 317, 338 5763: 5761: 5759: 4171:

in Latin America may be deceptive if observations are limited to epidemiological findings. In the

4107:

without pornography, compulsive cybersex, etc.) within the US ranges from 3–6% of the population.

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Moore RW, W (1 December 1983). "Art therapy with substance abusers: A review of the literature".

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of alcohol consumption', they were products 'socialized to view alcohol consumption as normal'.

1988:

the rate of gene transcription for example by helping or hindering RNA polymerase binding to DNA

18437: 17873: 17868: 17604: 17405: 17209: 17138: 16637: 16519: 16339: 16306: 16231: 16226: 16019: 12167: 11615: 9872: 6574:"Disentangling binge eating disorder and food addiction: a systematic review and meta-analysis" 5756: 4951: 4841: 4826: 4684: 4620: 3860: 3754: 3625: 2742:. Virtually all drugs causing drug addiction increase the DA release in the mesolimbic pathway. 2488: 2462: 2427: 2319: 2044: 2032: 1599: 1595: 1266: 1248: 570: 551: 497: 366: 228: 17765: 12645:"The neurocircuitry of illicit psychostimulant addiction: acute and chronic effects in humans" 9817: 9654:

Lewis M (October 2018). Longo DL (ed.). "Brain Change in Addiction as Learning, Not Disease".

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Narrative medicine : bridging the gap between evidence-based care and medical humanities

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Hasin DS, Saha TD, Kerridge BT, Goldstein RB, Chou SP, Zhang H, et al. (December 2015).

13078:"American Board of Medical Specialties recognizes the new subspecialty of addiction medicine" 12699: 12429: 11970:

Neuroscience for Addiction Medicine: From Prevention to Rehabilitation - Constructs and Drugs

11707:"Dopamine in drug abuse and addiction: results of imaging studies and treatment implications" 11284:

Witten IB, Lin SC, Brodsky M, Prakash R, Diester I, Anikeeva P, et al. (December 2010).

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Hill R, Harris J (2 November 2021). "Psychological Approaches to Addiction". In Day E (ed.).

8298:"Addictions Neuroclinical Assessment: A Neuroscience-Based Framework for Addictive Disorders" 7333:

American Psychiatric Association, American Psychiatric Association, DSM-5 Task Force (2013).

5650: 5112: 4941: 4926: 4190: 4127: 4071: 4038: 3958: 3789: 3653: 3074: 2761: 2749:(NAcc) is one output of the VTA projections. The nucleus accumbens itself consists mainly of 2438:

phosphorylation. Phosphorylated CREB increases levels of ΔFosB, which in turn represses the

2375: 2312: 1755: 1681: 1598:) and why the addicted person seeks to avoid withdrawal through continued use (an example of 858: 192: 188: 13502: 13212:"Prevalence of Marijuana Use Disorders in the United States Between 2001–2002 and 2012–2013" 13162:"Nearly half of Americans have a family member or close friend who's been addicted to drugs" 7976:

Wittek CT, Finserås TR, Pallesen S, Mentzoni RA, Hanss D, Griffiths MD, et al. (2016).

7599:

Musetti A, Cattivelli R, Giacobbi M, Zuglian P, Ceccarini M, Capelli F, et al. (2016).

1127: 19046: 18938: 18351: 18308: 18248: 18176: 18149: 17669: 17644: 17614: 17609: 17435: 17236: 16504: 16361: 16172: 16049: 16026: 15968: 15943: 15905: 15821: 15816: 15811: 15012:"Are We Ready for a True Biopsychosocial-Spiritual Model? The Many Meanings of "Spiritual"" 13438: 11357: 11297: 10996: 10958: 10886: 10599: 10441:

Biliński P, Wojtyła A, Kapka-Skrzypczak L, Chwedorowicz R, Cyranka M, Studziński T (2012).

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Douglas KR, Chan G, Gelernter J, Arias AJ, Anton RF, Weiss RD, et al. (January 2010).

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Menchon JM, Mestre-Bach G, Steward T, Fernández-Aranda F, Jiménez-Murcia S (9 April 2018).

7451: 5180: 5009: 4956: 4796: 4735: 4664: 4256: 4230: 4042: 3730: 3618: 3133: 3020: 2789: 2776: 2683: 2232: 2225: 2218: 2211: 2204: 1972: 1917: 1913: 1898: 1860: 1844: 1819: 1300: 1262: 1224: 1220: 907: 846: 821: 817: 813: 796:

Gambling provides a natural reward that is associated with compulsive behavior. Functional

723: 685: 566: 419: 236: 200: 131: 12321:. National Academies Press (US) – via National Center for Biotechnology Information. 11863:"From prediction error to incentive salience: mesolimbic computation of reward motivation" 9918:"Neurobiology of adolescent substance use and addictive behaviors: treatment implications" 9442:

Clarke TK, Crist RC, Kampman KM, Dackis CA, Pettinati HM, O'Brien CP, et al. (2013).

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Weinstein A, Lejoyeux M (September 2010). "Internet addiction or excessive internet use".

5209:"Addiction as a brain disease revised: why it still matters, and the need for consilience" 3757:

are common and may be profound. This phenomenon originated the idiom "kicking the habit".

3476: 3470: 3464: 3459: 3453: 2895: 8: 19016: 18953: 18521: 18457: 18191: 17893: 17815: 17262: 17246: 17192: 17076: 16428: 16311: 16261: 16256: 16246: 16241: 16192: 15958: 13554: 13188: 13042: 12879:

Peacock A, Leung J, Larney S, Colledge S, Hickman M, Rehm J, et al. (October 2018).

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environmental influences on the behavioral and physiological phenotypes of the offspring.

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Joseph J, Varghese A, Vr V, Dhandapani M, Grover S, Sharma S, et al. (August 2021).

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Table 1: Summary of plasticity observed following exposure to drug or natural reinforcers

6426: 5947:"Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health" 5052: 5002: 4769: 4602: 4410:

Primary advantages of art therapy in the treatment of addiction have been identified as:

4226: 4222: 4200: 4168: 4119: 4111: 4075: 3962: 3713: 3541: 3223: 3043:

effect that is mediated through ΔFosB. In contrast to ΔFosB's reward-sensitizing effect,

2753: 2500: 1909: 1663: 1659: 1113: 695: 509:– the diminishing effect of a drug resulting from repeated administration at a given dose 447: 296: 204: 161: 99: 17712: 11797:

Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences

11518:"Cocaine experience controls bidirectional synaptic plasticity in the nucleus accumbens" 11361: 11301: 11000: 9995:"Practitioner review: adolescent alcohol use disorders: assessment and treatment issues" 9863:

Spear LP (June 2000). "The adolescent brain and age-related behavioral manifestations".

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Heilig M, MacKillop J, Martinez D, Rehm J, Leggio L, Vanderschuren LJ (September 2021).

435:– the escalating effect of a drug resulting from repeated administration at a given dose 19179: 18960: 18547: 18166: 18022: 17977: 17957: 17916: 17034: 16902: 16854: 16704: 16611: 16574: 16549: 16539: 16334: 16271: 16251: 15953: 15874: 15774: 15737: 15718: 15693: 15422: 15397: 15336: 15143:. Structural Analysis in the Social Sciences (2 ed.). Cambridge University Press. 15084: 15038: 15011: 14987: 14962: 14908: 14803: 14757: 14711: 14663: 14578: 14414: 14389: 14370: 14327: 14239: 14192: 14071: 14028: 14003:

Chiang M, Reid-Varley WB, Fan X (May 2019). "Creative art therapy for mental illness".

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dopamine receptors can result in a decrease in the sensitivity to natural reinforcers.

2772: 2739: 2600:

that innervate the reward system, in turn affecting dopamine signaling in this region.

2597: 2392: 1667: 1278: 1270: 1207: 944: 805: 759: 727: 719: 280: 216: 212: 119: 107: 15709: 15319:. In Stein F, Diemberger H, Stasch R, Robbins J, Sanchez A, Lazar S, Candea M (eds.). 13630: 13374:

Pacurucu-Castillo SF, Ordóñez-Mancheno JM, Hernández-Cruz A, Alarcón RD (April 2019).

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The approach evolved from the ethnographic exploration into the lived experiences and

3927:

As of September 2023, it was further reported that a vaccine "has been tested against

70: 19139: 19031: 19011: 18602: 18407: 18278: 18139: 17936: 17903: 17878: 17390: 17123: 16796: 16630: 16569: 16411: 15938: 15744: 15723: 15680: 15581: 15537: 15513: 15493: 15449: 15427: 15375: 15340: 15316: 15297: 15262: 15220: 15216: 15152: 15119: 15088: 15074: 15043: 14992: 14943: 14912: 14900: 14892: 14851: 14843: 14807: 14795: 14749: 14715: 14703: 14651: 14641: 14616: 14582: 14570: 14535: 14505: 14495: 14419: 14362: 14358: 14331: 14319: 14281: 14243: 14231: 14184: 14144: 14106: 14063: 14020: 13989: 13975: 13937: 13887: 13856: 13819: 13774: 13770: 13739: 13696: 13646: 13634: 13580: 13568: 13518: 13470: 13452: 13447: 13407: 13354: 13241: 13227: 13025: 12976: 12912: 12813: 12770: 12727: 12719: 12676: 12528: 12485: 12316: 12208: 12185: 12181: 12140: 12101: 12047: 11991: 11981: 11931: 11892: 11878: 11822: 11764: 11728: 11682: 11633: 11585: 11547: 11496: 11465: 11427: 11385: 11380: 11345: 11323: 11258: 11209: 11172: 11145: 11082: 11068: 11024: 10939: 10890: 10845: 10788: 10717: 10663: 10576: 10511: 10454: 10403: 10341: 10291: 10235: 10024: 10010: 9975: 9939: 9890: 9849: 9837: 9768: 9683: 9671: 9585: 9573: 9522: 9508: 9473: 9371: 9333: 9284: 9280: 9253: 9241: 9175: 9119: 9050: 9039: 8990: 8925: 8892: 8839: 8808: 8794: 8744: 8686: 8674: 8612: 8581: 8567: 8526: 8522: 8491: 8442: 8327: 8275: 8263: 8173: 8129: 8077: 8042: 8007: 7894: 7856: 7802: 7757: 7722: 7673: 7632: 7573: 7535: 7479: 7420: 7350: 7340: 7315: 7243: 7220:

Alavi SS, Ferdosi M, Jannatifard F, Eslami M, Alaghemandan H, Setare M (April 2012).

7191: 7187: 7142: 7070: 7032: 7020: 6979: 6928: 6865: 6806: 6719: 6705: 6603: 6522: 6510: 6502: 6446: 6382: 6288: 6276: 6268: 6258: 6161: 6107: 6062: 5992: 5925: 5911: 5876: 5827: 5749: 5701: 5687: 5642: 5597: 5553: 5492: 5449: 5423: 5330: 5246: 5228: 4931: 4616: 4139: 4083: 4079: 3847: 3672:

to refer to a spectrum of drug use-related disorders. The DSM-5 eliminates the terms

3383: 3127: 2915: 2768: 2746: 2708: 2696: 2642: 2589: 2479:. The most important transcription factors that produce these alterations are ΔFosB, 2431: 2108: 2104: 1622: 1611: 1254: 1211: 824: 427: 196: 150: 90: 15766: 14761: 14374: 14075: 14032: 13708: 13482: 12924: 12782: 12739: 12540: 11477: 11270: 11221: 10925: 10415: 10353: 9902: 8756: 8740: 7906: 7203: 7082: 5419: 4795:

These three key points highlight how drugs may come to be used to self-medicate the

2637:

Top: this depicts the initial effects of high dose exposure to an addictive drug on

1121: 82: 18948: 18531: 18447: 18228: 18171: 18159: 17858: 17737: 17679: 17639: 17596: 17497: 17400: 17361: 17344: 17282: 17179: 16102: 15999: 15979: 15933: 15713: 15705: 15670: 15486: 15417: 15409: 15367: 15326: 15289: 15254: 15212: 15144: 15111: 15066: 15033: 15023: 14982: 14974: 14935: 14884: 14835: 14787: 14741: 14695: 14608: 14562: 14409: 14401: 14354: 14315: 14311: 14273: 14227: 14223: 14196: 14180: 14176: 14136: 14098: 14055: 14016: 14012: 13967: 13929: 13879: 13852: 13848: 13811: 13766: 13731: 13688: 13626: 13558: 13460: 13442: 13397: 13387: 13231: 13223: 13015: 13007: 12966: 12958: 12902: 12892: 12861: 12805: 12762: 12711: 12666: 12656: 12524: 12520: 12497: 12477: 12336: 12177: 12132: 12091: 12083: 12037: 12029: 11973: 11930:(second ed.). New York: McGraw-Hill Medical. pp. 147–48, 366–67, 375–76. 11882: 11874: 11812: 11804: 11718: 11672: 11664: 11625: 11577: 11537: 11533: 11529: 11457: 11419: 11375: 11365: 11313: 11305: 11248: 11201: 11135: 11127: 11072: 11064: 11014: 11004: 10929: 10921: 10882: 10835: 10827: 10778: 10770: 10707: 10699: 10653: 10645: 10566: 10558: 10501: 10493: 10395: 10331: 10323: 10281: 10273: 10225: 10217: 10014: 10006: 9967: 9929: 9882: 9829: 9758: 9750: 9663: 9563: 9553: 9512: 9504: 9463: 9455: 9363: 9323: 9315: 9276: 9231: 9221: 9165: 9157: 9109: 9101: 9029: 9021: 8980: 8882: 8874: 8831: 8786: 8736: 8709: 8666: 8639: 8604: 8559: 8518: 8481: 8473: 8434: 8317: 8313: 8309: 8259: 8255: 8163: 8119: 8111: 8069: 8034: 7997: 7989: 7886: 7846: 7838: 7792: 7784: 7753: 7749: 7712: 7704: 7663: 7622: 7612: 7585: 7565: 7525: 7520: 7515: 7469: 7459: 7410: 7402: 7305: 7297: 7233: 7183: 7132: 7128: 7124: 7062: 7010: 6969: 6959: 6920: 6796: 6788: 6709: 6701: 6593: 6585: 6494: 6438: 6372: 6364: 6302: 6250: 6151: 6143: 6004: 5984: 5915: 5907: 5866: 5858: 5817: 5807: 5735: 5691: 5683: 5628: 5589: 5484: 5415: 5358:"Drugs, Brains, and Behavior: The Science of Addiction – Drug Misuse and Addiction" 5320: 5236: 5220: 4752: 4743: 4569: 3614: 2461:, and upon sufficient accumulation, with the help of its downstream targets (e.g., 2423: 2284: 2259: 2249: 2239: 2165: 2056: 1618: 1588: 1258: 838: 828: 791: 739: 715: 456: 240: 15115: 14888: 13563: 13542: 12880: 11286:"Cholinergic interneurons control local circuit activity and cocaine conditioning" 11114:

Blum K, Werner T, Carnes S, Carnes P, Bowirrat A, Giordano J, et al. (2012).

9196:

Saunders GR, Wang X, Chen F, Jang SK, Liu M, Wang C, et al. (December 2022).

7168: 7166: 7164: 7162: 7160: 4977:

becomes increasingly difficult as addiction worsens. See for detailed discussion.

19151: 19036: 18985: 18923: 18422: 18397: 18243: 18027: 17941: 17863: 17853: 17624: 17619: 17502: 17440: 17417: 17061: 17051: 16593: 16477: 16202: 14839: 14791: 14699: 14612: 12855: 12033: 11131: 10399: 9558: 9459: 9209: 9161: 7890: 7788: 7464: 7406: 7066: 6729: 5988: 5077: 5044: 4894: 4779: 4673: 4644: 4586: 3982: 3812: 3577: 3445: 3316: 3069: 3056: 2926: 2854: 2638: 2536: 2524: 2458: 2450: 2400: 2172: 1938: 1889: 1877: 1848: 1815: 917: 850: 775: 707: 661: 439: 397: 372: 354: 300: 276: 180:(short-term reward), coupled with delayed deleterious effects (long-term costs). 139: 15853: 12881:"Global statistics on alcohol, tobacco and illicit drug use: 2017 status report" 12554: 12318:

Vaccines and Immunotherapies to Control Addiction in Minors: The Legal Framework

11723: 11706: 11581: 9833: 8349:"Tobacco, Alcohol, Prescription medication, and other Substance use (TAPS) Tool" 7104: 7102: 7100: 7098: 7096: 5633: 3897:, which destroy the molecule. This also prevents the cocaine from crossing the 2839:

Neural and behavioral effects of validated ΔFosB transcriptional targets in the

2719: 176:

and patterns associated with addiction are typically characterized by immediate

157:(and thus involuntary) factors that are implicated in addiction's development. 19163: 18933: 18899: 18874: 18464: 18181: 18007: 17997: 17911: 17820: 17760: 17704: 17457: 17412: 17312: 16699: 16689: 16459: 15991: 15928: 15355: 14978: 13933: 13392: 12715: 12481: 12087: 11977: 11423: 10442: 9390: 9226: 8713: 8670: 8643: 8477: 8438: 7842: 7708: 7157: 6589: 6242: 5224: 4921: 4680: 4648: 4337: 4252: 4248: 4095: 3785: 3742: 3492: 3008: 2815: 2738:. These neurons project and release DA into the nucleus accumbens, through the 2668: 2563: 2415: 2404: 2012: 1966: 1902: 1871:. With respect to addiction, more research is needed to determine the specific 891: 746: 699: 629: 574: 505: 476:– stimuli that increase the probability of repeating behaviors paired with them 401: 308: 208: 146: 15490: 15413: 15371: 15293: 15258: 14405: 14277: 14140: 14102: 14059: 13735: 13011: 12962: 12766: 10774: 10649: 10327: 9971: 9754: 9739:"The role of early life stress as a predictor for alcohol and drug dependence" 8790: 8608: 8563: 8073: 7993: 7569: 7391:"Gambling disorder and other behavioral addictions: recognition and treatment" 7339:(5th ed.). Arlington, VA: American Psychiatric Association. p. 481. 7015: 6998: 6964: 6368: 6272: 5894:

Koob G, Buck G, Cohen A, Edwards S, Park P, Schlosburg J, et al. (2014).

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with substances or behavior, and continued use despite negative consequences.

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Skylstad V, Babirye JN, Kiguli J, Solheim Skar AM, et al. (March 2022).

5812: 5232: 5048: 5028: 4711: 3902: 3816: 2955: 2609: 2573: 2197: 2190: 1958: 1787: 1708: 1379: 1232: 1215: 958: 801: 489: 480: 471: 413: 304: 284: 177: 165: 17750: 13456: 13427:"Historical and cultural aspects of man's relationship with addictive drugs" 13321:"Mental Health and Addictions System Performance in Ontario: 2021 Scorecard" 12809: 11856: 11854: 11852: 11850: 11848: 11846: 11629: 11309: 11009: 10180:"The Connection Between Mental Illness and Substance Abuse | Dual Diagnosis" 8115: 7601:"Challenges in Internet Addiction Disorder: Is a Diagnosis Feasible or Not?" 7301: 6254: 6249:. Wellcome Trust–Funded Monographs and Book Chapters. Oxon (UK): Routledge. 4775:

Highly relevant to addiction, the three issues emphasized in the model are:

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is a process that causes an increase in the amount of reward (specifically,

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can induce receptor downregulation in the neural pathway. Downregulation of

2508: 1174: 493:– an amplified response to a stimulus resulting from repeated exposure to it 18894: 18442: 18144: 17830: 17649: 17584: 17529: 17477: 17356: 17322: 17274: 17170: 16988: 16844: 16757: 15727: 15684: 15431: 15266: 15224: 15047: 14996: 14939: 14904: 14855: 14620: 14423: 14366: 14024: 13700: 13510: 13474: 13411: 13245: 13029: 12980: 12916: 12817: 12774: 12731: 12680: 12532: 12489: 12189: 12144: 12105: 12051: 11995: 11896: 11826: 11808: 11732: 11686: 11637: 11589: 11551: 11469: 11431: 11389: 11370: 11327: 11262: 11149: 11086: 11028: 10983:

Kim Y, Teylan MA, Baron M, Sands A, Nairn AC, Greengard P (February 2009).

10943: 10894: 10849: 10831: 10792: 10721: 10667: 10580: 10515: 10458: 10440: 10407: 10345: 10295: 10239: 10221: 10028: 9943: 9894: 9772: 9675: 9577: 9526: 9477: 9337: 9245: 9179: 9123: 9043: 8994: 8896: 8843: 8748: 8678: 8616: 8530: 8495: 8446: 8331: 8267: 8177: 8133: 8046: 8011: 7898: 7860: 7806: 7761: 7726: 7677: 7636: 7539: 7483: 7424: 7319: 7247: 7195: 7146: 7074: 7048: 7046: 7044: 7042: 7024: 6983: 6932: 6810: 6723: 6607: 6514: 6450: 6386: 6280: 6165: 5996: 5929: 5880: 5831: 5705: 5601: 5427: 5334: 5250: 4765: 4726: 4640: 4598: 4281: 4277: 3996: 3726: 2712: 2578: 2556: 2158: 2048:– a protein (or a small molecule) that works with transcription factors to 2036:– a protein (or a small molecule) that works with transcription factors to 1992: 797: 154: 135: 15675: 15658: 15070: 14635: 14489: 14285: 13883: 13860: 13815: 13692: 12837:"The Mental Health of Australians 2: Substance Use Disorders in Australia" 12404: 12158:

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Gowing L, Ali R, Allsop S, Marsden J, Turf E, West E, et al. (2015).

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surrounded their drug use. These findings challenge popular narratives of

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relationship between Indigenous peoples, their land, and substance abuse.

4273: 4262: 3035:(e.g., the use of an addictive drug) with which it was originally paired. 1924:

through positive reinforcement, while decreasing sensitivity to aversion.

452: 18341: 18288: 18134: 17972: 17840: 17795: 17717: 17694: 17427: 17385: 17093: 16956: 16882: 16837: 16684: 15789: 15331: 14566: 11843: 10538: 10336: 9090:"Mechanisms of transgenerational inheritance of addictive-like behaviors" 8785:(2nd ed.). Cambridge: Cambridge University Press. pp. 147–169. 8544:

Fehrman E, Egan V, Gorban AN, Levesley J, Mirkes EM, Muhammad AK (2019).

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Tobacco, Alcohol, Prescription Medication, and Other Substance Use (TAPS)

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induces NFκB ... In contrast, the ability of ΔFosB to repress the

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Chronic addictive drug use causes alterations in gene expression in the

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Addiction is a disorder of the brain's reward system developing through

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cites early aggressive behavior as a risk factor for substance use. The

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Philly Council bill to block supervised injection sites advances - WHYY

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approach is required to achieve a holistic understanding of addiction.

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understanding of the emergence of drug use and abuse, was developed by

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Heath DB (September 1958). "Drinking patterns of the Bolivian Camba".

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Philosophical Transactions of the Royal Society B: Biological Sciences

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of the disease; it has been noted that some of the alterations to the

127: 18884: 18432: 18427: 18002: 17987: 17962: 17810: 17805: 17790: 17785: 17745: 17722: 17659: 17516: 17489: 17373: 17231: 17214: 17187: 17103: 17066: 17056: 17029: 17000: 16961: 16948: 16926: 16897: 16694: 15896: 13184:"We were addicted to their pill, but they were addicted to the money" 11395:

but to any other perturbation (that doesn't involve lesions) as well.

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Addiction reimagined: challenging views of an enduring social problem

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Facilitating the expression of suppressed and/or complicated emotions

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developed by the Xenova Group which is used to negate the effects of

3753:, and seizures. During acute physical opioid withdrawal, symptoms of 3746: 3734: 3529: 3523: 3509: 3498: 3052: 3028: 2959: 2885: 2792:

projects into the NAcc and is thought to be important for motivation.

2735: 2723: 2703:, is characterized by the interaction of several areas of the brain. 2412: 2368: 1894: 1852: 1811: 577:

model. However, no one model completely illustrates substance abuse.

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only recognize gambling addictions as behavioral addictions, but the

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Nielsen DA, Utrankar A, Reyes JA, Simons DD, Kosten TR (July 2012).

9198:"Genetic diversity fuels gene discovery for tobacco and alcohol use" 6792: 5439: 5437: 3889:

toxin. It works in much the same way as a regular vaccine. A large

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glutamate receptors and glutamate release in the nucleus accumbens.

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