Addiction: Decreased reward sensitivity and increased expectation sensitivity conspire to overwhelm the brain's control circuit
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Based on brain imaging findings, we present a model according to which addiction emerges as an imbalance in the information processing and integration among various brain circuits and functions. The dysfunctions reflect (a) decreased sensitivity of reward circuits, (b) enhanced sensitivity of memory circuits to conditioned expectations to drugs and drug cues, stress reactivity, and (c) negative mood, and a weakened control circuit. Although initial experimentation with a drug of abuse is largely a voluntary behavior, continued drug use can eventually impair neuronal circuits in the brain that are involved in free will, turning drug use into an automatic compulsive behavior. The ability of addictive drugs to co‐opt neurotransmitter signals between neurons (including dopamine, glutamate, and GABA) modifies the function of different neuronal circuits, which begin to falter at different stages of an addiction trajectory. Upon exposure to the drug, drug cues or stress this results in unrestrained hyperactivation of the motivation/drive circuit that results in the compulsive drug intake that characterizes addiction.
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Addiction involves impairments in circuits involved with self-control, decision-making, interoception, and mood and stress regulation.
“there are impairments in circuits involved with self-control and decision-making, interoception and mood and stress regulation (8).”
From Obesity and addiction: Neurobiological overlaps (2013) · cites this paper as [8]
The urge to seek and consume drugs in addiction involves disruption of reward circuitry and other circuits including interoception, inhibitory control, mood/stress regulation, and memory.
“The overwhelming urge to seek and consume the drug in addiction involves disruption not only of the reward circuitry but also of other circuits, including interoception, inhibitory control, mood and stress regulation, and memory (39).”
From The Addictive Dimensionality of Obesity (2013) · cites this paper as [39]
Allostatic theory asserts reward insensitivity and negative reinforcement underlie the later and more severe stages of addiction.
“but reward insensitivity and negative reinforcement underlie the later and more severe stages(18–20).”
From A Prospective 5-Year Re-examination of Alcohol Response in Heavy Drinkers Progressing in Alcohol Use Disorder (2016) · cites this paper as [19]
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- Authors
- Volkow, N. D., Wang, G., Fowler, J. S., Tomasi, D., Telang, F., & Baler, R.
- Affiliations
- National Institutes of Health (US)
- Brookhaven National Laboratory (US)
- Corresponding author
- Volkow, Nora D.
- Venue
- BioEssays
- Publisher
- Wiley
- Published
- 2010-08-17
- Volume
- 32
- Issue
- 9
- Pages
- 748-755
- ISSN
- 0265-9247 (ISSN-L)
- 1521-1878
- PMC
- PMC2948245
- OpenAlex
- W2109565047
- Cited by
- 532
- References
- 54
- Citations by year
- 2026: 32 · 2025: 36 · 2024: 36 · 2023: 38 · 2022: 30 · 2021: 43 · 2020: 32 · 2019: 39 · 2018: 33 · 2017: 40 · 2016: 35 · 2015: 34 · 2014: 31 · 2013: 25 · 2012: 25
- FWCI
- 2.08
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- BioEssays (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute on Alcohol Abuse and Alcoholism (ZIAAA000550)
- Topics
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- addiction, reward sensitivity, stress reactivity, negative mood, free will, dopamine, glutamate, GABA
- MeSH terms
- Brain, Dopamine, Humans, Impulsive Behavior, Memory, Models, Neurological, Models, Psychological, Neuropharmacology, Reward, Behavior, Addictive
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