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Chapter 1. Neurobiology of Addiction

George F. Koob, Ph.D.
DOI: 10.1176/appi.books.9781585623440.344000

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Drug addiction, also known as substance dependence, is a chronic, relapsing disorder characterized by 1) compulsion to seek and take the drug, 2) loss of control in limiting intake, and 3) emergence of a negative emotional state (e.g., dysphoria, anxiety, irritability) when access to the drug is prevented (defined here as dependence) (Koob and Le Moal 1997). Addiction and substance dependence, as currently defined in DSM-IV-TR (American Psychiatric Association 2000), will be used interchangeably throughout this chapter and refer to a final stage of a usage process that moves from drug use to addiction. Clinically, the occasional but limited use of a drug with the potential for abuse or dependence is distinct from escalated drug use and the emergence of a chronic drug-dependent state. An important goal of current neurobiological research is to understand the neuropharmacological and neuroadaptive mechanisms within specific neurocircuits that mediate the transition from occasional, controlled drug use to the loss of behavioral control over drug seeking and drug taking that defines chronic addiction.

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Sample questions:
1.
Which of the following animal models is associated with the preoccupation/anticipation stage of addiction to explain the behavioral aspects of drug dependence in patients?
2.
Drug dependence has been modeled as both impulse control disorder and as compulsive disorder, two models that feature different drug-related behaviors. Which of the following behaviors is associated with impulse control disorder as opposed to compulsive disorder?
3.
Several neurobiological substrates have been identified to explain the acute reinforcing effects of abused drugs. These models include both specific neurotransmitters and anatomical foci. Which drug of abuse is associated with the neurotransmitters dopamine, -aminobutyric acid (GABA), and opioid peptides and the anatomic loci of the nucleus accumbens, ventral tegmental area, and amygdala?
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