Neurobiology of addiction: An integrative review

doi:10.1016/j.bcp.2007.07.030

Biochemical Pharmacology

Volume 75, Issue 1, 1 January 2008, Pages 266-322

https://doi.org/10.1016/j.bcp.2007.07.030 Get rights and content

Abstract

Evidence that psychoactive substance use disorders, bulimia nervosa, pathological gambling, and sexual addiction share an underlying biopsychological process is summarized. Definitions are offered for addiction and addictive process, the latter being the proposed designation for the underlying biopsychological process that addictive disorders are hypothesized to share. The addictive process is introduced as an interaction of impairments in three functional systems: motivation-reward, affect regulation, and behavioral inhibition. An integrative review of the literature that addresses the neurobiology of addiction is then presented, organized according to the three functional systems that constitute the addictive process. The review is directed toward identifying candidate neurochemical substrates for the impairments in motivation-reward, affect regulation, and behavioral inhibition that could contribute to an addictive process.

Section snippets

A shared underlying process

In the course of my work with individuals who suffered from psychoactive substance use disorders, bulimia, pathological gambling, or sexual addiction, I noticed that these conditions shared a number of characteristic clinical features. These included: (1) course of illness – the disorder typically begins in adolescence or early adulthood and follows a chronic course with remissions and exacerbations; (2) behavioral features – narrowing of behavioral repertoire, continuation of the behavior

The addictive process

In the course of reviewing evidence that psychoactive substance use disorders, bulimia, pathological gambling, and sexual addiction share an underlying biopsychological process, we noted that neuroscience research has demonstrated that a shared vulnerability underlies the abuse of psychoactive substances, has begun to delineate the neurobiological processes that constitute this vulnerability, and has expanded the realm of this shared vulnerability to include pathological gambling and

Conclusion

The present article represents the flowering of an idea that was planted in 1990:

A hypothesis may be submitted, the gist of which is that similar patterns in behavioral manifestations of the various addictive disorders…reflect similarities in some set of personality and/or biological variables, which may or may not be measurable by instruments currently available. In other words, addictive disorders would be most accurately described, not as a variety of addictions, but as a basic underlying

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Neurobiology of addiction: An integrative review

Abstract

Section snippets

A shared underlying process

The addictive process

Conclusion

Compr Psychiatry

Psychosom

Campr Psychiatry

Addict Behav

Psychiatry Res

Clin Psychol Rev

Eat Behav

Biol Psychiatry

Lancet

J Am Acad Child Adol Psychiatry

Addict Behav

Addict Behav

Drug Alcohol Depend

Compr Psychiatry

Drug Alcohol Depend

Addict Behav

Psychiatry Res

J Affect Disord

Psychiatry Res

Psychiatr Clin North Am

Addiction: definition and implications

Br J Addict

Psychopathology in hospitalized alcoholics

Arch Gen Psychiatry

The prevalence of psychiatric disorders in patients with alcohol and other drug problems

Arch Gen Psychiatry

Comorbidity of mental disorders with alcohol and other drug abuse: results from the epidemiological catchement area (ECA) study

J Am Med Assoc

From beer to crack: developmental patterns of drug involvement

Am J Public Health

Cannabis use, abuse, and dependence in a population-based sample of female twins

Am J Psychiatry

Alcohol, cannabis and tobacco use among Australians: a comparison of their associations with other drug use and use disorders, affective and anxiety disorders, and psychosis

Addiction

Into the world of illegal drug use: exposure opportunity and other mechanisms linking the use of alcohol, tobacco, marijuana, and cocaine

Am J Epidemiol

Anorexia nervosa, bulimia, and alcoholism: Association of eating disorder and alcohol

J Psychiatry Res

Characteristics of 275 patients with bulimia

Am J Psychiatry

Alcoholism and eating disorders in women of fertile age

Br J Addict

Bulimia nervosa in the male: a report of nine cases

Psychol Med

Drug and alcohol abuse by bulimic women and their families

Am J Psychiatry

A controlled family history study of bulimia

Psychol Med

A controlled study of lifetime prevalence of affective and other psychiatric disorders in bulimic outpatients

Am J Psychiatry

The etiology and treatment of bulimia nervosa: a biopsychosocial perspective

Bulimia in males: a matched comparison with females

Int J Eat Disord

Comorbidity and medical complications of bulimia nervosa

J Clin Psychiatry

Self-damaging and addictive behaviour in bulimia nervosa: a catchment area study

Br J Psychiatry

Psychiatric co-morbidity in patients with eating disorders

Psychol Med

Course of multi-impulsive bulimia

Psychol Med

Co-morbidity of eating disorders and substance abuse review of the literature

Int J Eating Disord

Bulimia in a male alcoholic: a symptom substitution in alcoholism

J Eat Disord

Psychiatric disorders in women with bulimia nervosa and their first-degree relatives: effects of comorbid substance dependence

Int J Eat Disord

Eating disorders and cocaine abuse: a survey of 259 cocaine abusers

J Clin Psychiatry

Eating disorders in women who abuse alcohol

Br J Addict

The incidence of bulimia in freshman college students

Int J Eat Disord

Drinking and other self-indulgences: Complements or counter-attractions?