Understanding substance abuse addiction neurobiology

Understanding the Brain and Substance Use Disorders
• The human brain, with 86-100 billion neurons, is a complex living structure that regulates various bodily functions and cognitive processes.
• Neuroscience has revealed how specific neural networks become disrupted during addiction.
• A multi-center study by Dr. Michael D. Fox and Dr. Jacob L. Stubbs at the University of British Columbia found that addiction involves a unified circuit encompassing areas associated with craving, emotional regulation, and decision-making processes.

Three Interconnected Brain Regions in Substance Use Disorders
• The basal ganglia, the extended amygdala, and the prefrontal cortex are central players in the development and maintenance of addiction.
• The basal ganglia, particularly the nucleus accumbens (NAc), plays a decisive role in processing rewards and reinforces behaviors that “feel good.”
• The extended amygdala governs stress responses and the negative emotional states that accompany withdrawal from substances.
• The prefrontal cortex, responsible for executive functions such as decision-making, time management, and prioritisation, completes this triad.

Vulnerability of the Brain
• Adolescence is a critical “at-risk period” for substance use and addiction.
• The neuroadaptations that occur with ongoing substance use impair brain function and accelerate the transition from controlled to compulsive use.
• These alterations may persist long after substance use ceases, contributing to relapse vulnerability and periodic cravings even after prolonged periods of abstinence.

The Need for Nuanced Approaches to Prevention and Treatment
• Substance use can lead to addiction, but it does not inevitably do so on its own.
• A deeper understanding of the recovery process will influence the development of more effective treatment and support programs.

The Path Ahead
• Neurobiological research on addiction has reduced stigma by framing addiction as a chronic brain condition.
• As our understanding of the neurobiological basis of addiction evolves, so too will our treatment approaches.
• Neuroscientific insights can inform public policy, treatment approaches, and societal attitudes toward addiction.