Proposes that euphoria induced by a drug is opposed by a counteracting process that will eventually overtake initial euphoric effects 

Opponent Theory 

- Proposes that repeated use of illicit drugs induces neuroadaptations 
- Neuroadaptations lead to hyperreactivity in response to drug cues and incentives
- Ultimately leads to a disproportionate motivation to pursue the drug and a reduced sensitivity to normal, non-drug-related rewards

Incentive Sensitization Theory

This theory states that the neural basis for addiction is blunted reward circuitry. To compensate for low activation of reward circuitry, individuals seek pleasurable experiences or substances, such as drugs. 

Reward Deficiency Theory

- Neural basis for drug addiction is reduced inhibitory control. 
- The anterior cingulate cortex (ACC) and ventromedial prefrontal cortex (vmPC) in the frontal cortex of the brain primarily serves as inhibitory control for other brain regions. 
- People with substance use disorders seem to have decreased activity of these regions


Inhibitory Control Theory

- Theories include opponent, inhibitory control, reward deficiency, incentive sensitization, aberrant learning, and anti-reward theory 

University of Michigan - Ann Arbor

Rutgers University

- Craving/addiction neuroadaptive theories 
- Cycle of addiction 
- Reward and Anti-Reward pathways 
- Craving Assessment Tools

Neurobiology of Craving in Opioid Use Disorder 

It is a mental disorder that affects a person's brain and behavior, leading to their inability to control their use of substances such as legal or illegal drugs, alcohol, or medication. Symptoms can range from moderate to severe, with addiction being the most powerful form of SUDs.

Substance Use Disorder

Kakko J, Alho H, Baldacchino A, Molina R, Nava FA and Shaya G
 2019) Craving in Opioid Use Disorder: From Neurobiology to Clinical Practice.Front. Psychiatry 10:592. doi: 10.3389/fpsyt.2019.00592

Craving in Opioid Use Disorder: From Neurobiology to Clinical Practice

3 key drivers that underlie neurobiological changes associated with opioid dependence 

1. Drug liking
2. Withdrawal and negative affect
3. Craving and negative affect 

Cycle of Addiction

Reward and Anti-Reward Pathways 

- Measures of craving can be divided into observational and self-reported 
- Ecological momentary assessments (EMA) is a newer approach to assess cravings 


Craving Assessment Tools 

Addictions counseling, also called substance abuse counseling, is a specialization in counseling that focuses on treating individuals with a dependency on drugs or alcohol.

Addictions Counseling

Mindfulness has been studied for its usage in those suffering from addiction to substances. Mindfulness has been shown in some scenarios to be effective in decreasing addictive behaviors in people addicted to substances such as opioids, heroin, cocaine, drinking, and smoking. 

Mindfulness for those suffering from substance use disorder

Occurs after the body has adapted to the drug's presence after a period of time. When the drug is abruptly removed, it can cause a variety of physical symptoms. In some cases, this can be dangerous.

Substance Withdrawal Disorder

A chronic syndrome characterized by anterograde and retrograde amnesia due to alcoholism, along with other cognitive deficits. It is caused by a lack of thiamine (vitamin B1), which damages neurons. It can also involve deficits in executive functioning, apathy, and social impairments. 

Korsakoff's Syndrome

Alcohol abuse is responsible for one in eight deaths among older Americans. It is predicted that there will be an increase in illicit drug use and alcohol abuse among the baby boomer cohort as many have showcased addiction to prescription medication in the past.

Substance Abuse in Geriatric People 

AUDIT-C is a screener test for evaluating current alcohol consumption risk. 

Alcohol Use Disorder Identification Test (AUDIT-C)

Alcohol Use Disorder is characterized by symptoms such as alcohol craving, recurrent use of alcohol that interferes with the fulfillment of one’s daily responsibilities, alcohol-seeking behavior, inability to control one’s drinking, drinking despite potential hazards (e.g., drinking while driving), the need for increased amounts of alcohol to achieve its effects (tolerance), and withdrawal symptoms when one stops or reduces alcohol intake (e.g., hand tremors, nausea, agitation, hallucinations). The disorder is distinguished as mild, moderate, or severe depending on the number of these symptoms that an individual may have: Mild cases present with two to three symptoms; moderate cases four to five symptoms; and severe cases six or more symptoms.

Alcohol Use Disorder (AUD)

Health Psychology research studies relating to Substance Abuse include

- ICU Admissions and Alcohol Misuse
- Factors Associated with AUD (Alcohol Use Disorder)
- Alcohol Use and Gender



Health Psychology Research Relating to Substance Abuse

Central nervous system (CNS) stimulants are a category of drugs that increase nervous system activity. This group includes cocaine, amphetamines, cathinones, and MDMA, which act as dopamine agonists. Other stimulants like nicotine and caffeine function by affecting acetylcholine and adenosine neurotransmitter systems, respectively.

Central Nervous System Stimulants

Central nervous system depressants are drugs that affect GABA neurotransmission. Examples include alcohol, barbiturates, and benzodiazepines.

Central Nervous System Depressants

Opiate drugs are substances that serve as powerful analgesics through their effects on the endogenous opioid neurotransmitter system.

Opiate Drugs

Indicators of substance use disorder include behavioral and functional patterns such as using more of a substance than intended, difficulty controlling use, and continuing use despite significant adverse consequences. Dependence-related features may include tolerance, withdrawal, and psychological dependence or drug craving. Possible observable signs include changes in weight, appetite, sleep, pupil size, eye appearance, speech, coordination, tremors, nasal symptoms, or grooming; these signs should be considered within the broader pattern of substance use.

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