Cited by 598Substance Abuse Treatment and OutcomesNeurotransmitter Receptor Influence on BehaviorPsychosomatic Disorders and Their Treatments

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The insula and drug addiction: an interoceptive view of pleasure, urges, and decision-making

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Naqvi, Nasir H., Bechara, Antoine·2010·Brain Structure and Function

DOI 10.1007/s00429-010-0268-7PMC PMC3698865

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Abstract

We have recently shown that damage to the insula leads to a profound disruption of addiction to cigarette smoking (Naqvi et al., Science 315:531-534, 2007). Yet, there is little understanding of why the insula should play such an important role in an addictive behavior. A broad literature (much of it reviewed in this issue) has addressed the role of the insula in processes related to conscious interoception, emotional experience, and decision-making. Here, we review evidence for the role of the insula in drug addiction, and propose a novel theoretical framework for addiction in which the insula represents the interoceptive effects of drug taking, making this information available to conscious awareness, memory and executive functions. A central theme of this framework is that a primary goal for the addicted individual is to obtain the effects of the drug use ritual upon the body, and representations of this goal in interoceptive terms by the insula contribute to how addicted individuals feel, remember, and decide about taking drugs. This makes drug addiction like naturally motivated behaviors, such as eating and sex, for which an embodied ritual is the primary goal.

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Authors: Naqvi, N. H., & Bechara, A.
Affiliations: New York State Psychiatric Institute (US)
University of Southern California (US)
Corresponding author: Naqvi, Nasir H.
ORCID: Bechara, Antoine
Venue: Brain Structure and Function
Publisher: Springer Science and Business Media LLC
Published: 2010-05-29
Volume: 214
Issue: 5-6
Pages: 435-450
ISSN: 1863-2653 (ISSN-L)
1863-2661
DOI: 10.1007/s00429-010-0268-7
PMC: PMC3698865
OpenAlex: W1976397511
Cited by: 598
References: 112
Citations by year: 2026: 23 · 2025: 28 · 2024: 29 · 2023: 32 · 2022: 30 · 2021: 41 · 2020: 98 · 2019: 46 · 2018: 44 · 2017: 38 · 2016: 38 · 2015: 36 · 2014: 28 · 2013: 46 · 2012: 22
FWCI: 3.17
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.springer.com/tdm (tdm)
Locations: Brain Structure and Function (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Mental Health (R25MH086466)
National Institute on Drug Abuse (R01DA023051)
National Institute of General Medical Sciences (T32GM007337)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Keywords: insula, drug addiction, interoception, decision-making, executive function, memory, embodied ritual, conscious awareness
MeSH terms: Animals, Awareness, Cerebral Cortex, Humans, Impulsive Behavior, Self Concept, Substance-Related Disorders, Pleasure

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The insula and drug addiction: an interoceptive view of pleasure, urges, and decision-making

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