Erickson - The science of addiction: from neurobiology to treatment

A.A. - Alcoholics Anonymous

ADH - Alcohol dehydrogenase

ADHD - Attention deficit hyperactivity disorder

ALDH - Aldehyde dehydrogenase

BAC - Blood alcohol concentration

BU - Beverage unit

CB - Cannabinoid receptor

CBT - Cognitive behavioral therapy

CNS - Central nervous system

COGA - Collaborative Study on the Genetics of Alcoholism

CRF - Corticotropin releasing factor

CT - Computerized tomography

DA - Dopamine

DAT - Dopamine transporter

DNA - Deoxyribonucleic acid

DRD2 - Dopamine receptor (type) D2

DSM-IV - Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition

DTs - Delirium tremens

DUDs - Drug-use disorders

DUI - Driving under the influence

DWI - Driving while intoxicated

ERP - Event-related potential

FAE - Fetal alcohol effects

FAS - Fetal alcohol syndrome

FASD - Fetal alcohol spectrum disorder

GABA - Gamma aminobutyric acid

GHB - Gamma hydroxybutyrate

GLU - Glutamate

5-HT - Serotonin

ICD-10 - International Classification of Diseases, Tenth Revision

LSD - Lysergic acid diethylamide

MAO - Monamine oxidase

MDMA- Methylenedioxy methamphetamine

MDS - Mesolimbic dopamine system

MET - Motivational enhancement therapy

MI - Motivational interviewing

M.M. - Moderation management

MRI - Magnetic resonance imaging (fMRI = functional MRI)

mRNA - Messenger ribonucleic acid

N.A. - Narcotics Anonymous

NAcc - Nucleus accumbens

NIAAA - National Institute on Alcohol Abuse and Alcoholism

NIDA - National Institute on Drug Abuse

NMDA - N-methyl-D-aspartate

OCD - Obsessive compulsive disorder

OPD - Other psychiatric disorders

PCM - Primary-care management

PET - positron emission tomography

PNS - Peripheral nervous system

PTSD - Posttraumatic stress disorder

QTL - Quantitative trait locus

RAS - Reticular activating system

RM - Recovery management

rRNA - Ribosomal ribonucleic acid

RVE - Research validity estimate

SERT - transporter

SIDS - Sudden infant death syndrome

SPECT - Single photon emission computerized tomography

SSRIs - Selective serotonin reuptake inhibitors

TBW - Total body water

TC - Therapeutic community

tRNA - Transfer ribonucleic acid

THC - Tetrahydrocannabinol

THIQs (TIQs) - Tetrahydroisoquinolines

TSF - facilitation

VTA - Ventral tegmental area

THE MOST EXCITING NEWS about the science of addiction is that neuroscience is playing a ground-breaking role in helping us clarify the exact causes of compulsive alcohol and other drug use. Neuroscience research on addiction involves an understanding of how drugs act on individual nerve cells as well as on large groups of nerve cells in the central nervous system. Research is also helping us clarify what addiction is, what it is not, and how it can be better treated. Unlike earlier alcoholism and addiction research, neurobiological research on addicting drugs is unique in that it interacts with so many other important areas: social work, psychology, sociology, medicine, pharmacology, physiology, genetics, brain imaging, epidemiology, and treatment research. Thus, this book covers, in order: (1) changes in the terminology and conceptualization of addiction that are emerging based on new neuroscience, genetic, and clinical findings, and that help us understand why one type of drug problem is a chronic medical brain disease; (2) the basics of neuroscience; (3) the neuroanatomy and function of brain reward sites; (4) the genetics of alcohol and other drug dependence; (5) the basic pharmacology of stimulants and depressants; (6) the basic pharmacology of alcohol; (7) the basic pharmacology of other drugs; (8) current and emerging treatments for chemical dependence and how neuroscience helps us understand the way they work; (9) how to evaluate the validity of science in this area and how to read and interpret new research findings; and (10) future research trends and important questions that addiction science should answer. The book closes with two appendices that provide supplemental information on alcohol (Appendix A) and other drugs (Appendix B).

The scientific conclusions that appear in this book are mine, and the story they tell is the result of over 30 years of addiction science research. Much of this research has substantiated the anecdotal reports told by those in recovery from the disease. When science agrees with real-life experience, and vice versa, the story is strengthened. Certainly, the story will change subtlety as the scientific evidence grows, and other scientists may draw somewhat different conclusions from those presented in this book. Some may suggest that I have misinterpreted the results of some scientific studies; others may say that I have missed key recent publications. Any omission of important research is unintentional: My goal is to accurately and articulately represent a cross-section of the scientific areas discussed in the text. The fact is that we have not yet solved the causes of drug problems, nor do we have all the answers to cure people. Thus, scientific conclusions are always open to challenge. The biggest challenge is for all of us to educate policy makers and to advocate for more alcohol and other drug research funding to find the final answers. No persons conclusions about the causes and best treatments for addictions are stronger than the weight of their scientific data, and more scientific data are urgently needed in this area!

Who This Book Can Help

Abuse of alcohol and illicit drugs affects millions of people on a daily basis (Hanson & Li, 2003). Over 8 million U.S. individuals meet the diagnostic criteria for alcohol dependence and another 5.6 million meet the criteria for alcohol abuse (Grant, Hasin, Chou, Stinson, & Dawson, 2004). In 2001, there were about 66.5 million tobacco smokers and 16 million illicit drug users (Grant et al., 2004). The U.S. economic cost of such abuse was estimated to be more than $484 billion per year, including $185 billion due to alcohol overuse, $138 billion due to smoking, and about $161 billion due to illicit drugs. Finally, of the more than 2 million U.S. deaths per year, around 1 in 4 is due to alcohol, tobacco, or illicit drug use.