The Neuroscience of Addiction

Abstract

Effective public health approaches to addressing the opioid crisis require an understanding of addiction as a health condition primarily involving the brain, rather than an individual’s series of ongoing “bad choices” or inherent criminal tendencies that ultimately lead to poor health outcomes. Addiction has been defined as “the most severe, chronic stage of substance-use disorder, in which there is a substantial loss of self-control, as indicated by compulsive drug taking despite the desire to stop taking the drug.” Whether addiction is viewed primarily as a “disease” or the outcome of experiential and environmental influences, chronic changes that occur in the brain of the person with addiction form the scientific basis of an effective public health response. Understanding the behavioral changes driven by addiction is vital since they have a profound impact on public safety, the criminal justice system, and public health. This chapter provides an overview of the changes that occur in the brain during development of addiction and how understanding these changes can improve public health practice and policy. It complements more complete clinical and basic science reviews of the neuroscience of addiction that have been recently published.