Effect of natural rewards on substance use disorder: an incentive sensitization perspective

In substance use disorder (SUD)/drug addiction, individuals often seek drug rewards at a large cost. Recent findings demonstrate that natural rewards may offer significant therapeutic potential against SUD. However, the mechanism by which natural rewards counteract SUD remains unclear. While the incentive sensitization theory provides valuable insights, a comprehensive understanding is still lacking. In this review, we first summarize the evidence and potential neurobiological mechanisms that support the protective effect of natural rewards against SUD, such as palatable food, social interaction, physical exercise, and environmental enrichment. We then propose an updated incentive sensitization framework to explain how natural rewards resist SUD by modulating “wanting” and “liking”. This review contributes to our understanding of the interaction between natural rewards and drug rewards, potentially facilitating the development of novel therapeutic strategies for SUD.