A Psychopharmacologic

View Of Addiction
Neurobiological underpinnings of
dependence behavior
Agenda
The Beginning
Middle Ground
The Conclusion
The Beginning
Once upon a time
 Simply put, impulsivity and compulsivity are both symptoms
that result from the brain having a hard time saying no.

Impulsivity Compulsivity
Inability to stop the initiation of
Inability to terminate ongoing actions
actions
Circuitry of Impulsivity & Reward

ACC

VMPFC

striatum (Nucleus Accumbens)

thalamus
 Circuitry of Compulsivity and Motor
Response Inhibition

striatum

OFC

thalamus
forms of cognitive
inflexibility
Impulsivity and Compulsivity
Ventral Urge System

Liking

Wanting

Dorsal Habit System

Addictions (Substance and Behavioral)
Middle Ground
Meanwhile..
Abuse
Self-administration of any drug in a culturally disapproved
manner that causes adverse consequences
Addiction
(Psychological dependence)
A behavioral pattern of drug abuse characterized by
overwhelming involvement with the use of a drug (compulsive
use), the securing of its supply, and a high tendency to relapse
after discontinuation
Tolerance
Tolerance has developed when, after repeated administration, a
given dose of a drug produces a decreased effect, or, conversely,
when increasingly larger doses must be administered to obtain
the effects observed with the original use
Cross-tolerance
and Cross-dependence
The ability of one drug to suppress the manifestations of physical
dependence produced by another drug and to maintain the
physically dependent state
Withdrawal
The psychologic and physiologic reactions to abrupt cessation of
a dependence-producing drug
Dependence
The physiological state of adaptation produced by repeated administration of
certain drugs such as alcohol, heroin, and benzodiazepines when they are
abruptly discontinued, and are associated with physical drug withdrawal
distinct from the motivational changes of acute withdrawal and protracted
abstinence, which is part of addiction
Habit
Responses triggered by environmental stimuli regardless of the current
desirability of the consequences. This conditioned response to a
stimulus has been reinforced and strengthened either by past
experience with reward (positive reinforcement) or by the omission of
an aversive event (negative reinforcement).
Habits, Cues, Rewards, Craving
Habits can be seen as conditioned responses (such as drug
seeking, food seeking, gambling) to a conditioning stimulus
(such as being around people or places or items associated
with drugs, food, or gambling in the past).[Classical
Conditioning] (Cues)
Habits are reinforced and strengthened either by past
experience with reward (positive reinforcement) or with the
omission of an aversive event (loss of the negative
reinforcement that comes from withdrawal or
craving).[Operant Conditioning] (Reward Craving & Relief
Craving)
Dependence
Craving
Tolerance
Withdrawal
Loss of control
Loss of salience
Continued use despite harmful consequences
The Conclusion?
This is not the End.. Not even the beginning of the End.. But the
End of the Beginning
 Impulsive
Liking use

Wanting Addiction
Shifting from Impulsivity to Compulsivity
Chasing the Dragon
The first dose of
any drug will always
be the best one,
most reinforcing
and without penalty
Brains
own Morphine/Heroin:
Endorphins

Marijuana: Anandamide

Nicotine: Cocaine and

Amphetamine:
Acetyl Dopamine
Choline
Reference
Thank you