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Substance use disorder a bio-directional subset of reward deficiency syndrome

Journal article
Authors K. Blum
M. Gold
Z. Demetrovics
Trevor Archer
P. K. Thanos
D. Baron
R. D. Badgaiyan
Published in Frontiers in Bioscience-Landmark
Volume 22
Pages 1534-1548
ISSN 1093-9946
Publication year 2017
Published at Department of Psychology
Pages 1534-1548
Language en
Keywords Hypodopaminergia, glutaminergic drive, resting state functional connectivity, Reward Deficiency, dopamine-receptor gene, state functional connectivity, d2r dna transfer, nucleus-accumbens, brain reward, allelic association, alcohol, dependence, prefrontal cortex, heroin-addicts, syndrome rds, Biochemistry & Molecular Biology, Cell Biology
Subject categories Biochemistry and Molecular Biology, Cell biology


This commentary is to inform clinicians challenged with an increase in people seeking treatment for Substance Use Disorder (SUD), that the ninety percent revolving door, is, in part, due to post-withdrawal, untreated neurotoxicity. This impairment attenuates neurotransmitter signaling and compromises resting state functional connectivity, leading to unwanted sequelae including depression, sleep disturbances, sensation seeking, lack of satisfaction and impulsivity. Neuroimaging studies indicate that neurobiological recovery can take years. Like a "double edge sword" SUD has a biological bi-directional (bio-directional) effect on the brain reward circuitry. The acute intake of psychoactive drugs results in heightened dopaminergic activity, while, the opposite, hypodopaminergia occurs following chronic abuse. Individuals with SUD can have a genetic predisposition, compounded by stress and neurotoxically induced, epigenetic insults that impact recovery from protracted abstinence. Follow-up post -short-term recovery usually includes supportive therapies and programs like 12 -steps and other fellowships. However, relapse will usually occur if post -short-term recovery hypodopaminergia is not treated with attempts at epigenetic manipulation of compromised brain neurochemistry using some manner of pro-dopamine regulation.

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