Scientific advances over the past 20 years have shown that drug addiction is a chronic, relapsing disease that results from the prolonged effects of drugs on the brain. As with many other brain diseases, addiction has embedded behavioral and social-context aspects that are important parts of the disorder itself. Therefore, the most effective treatment approaches will include biological, behavioral, and social-context components. Recognizing addiction as a chronic, relapsing brain disorder characterized by compulsive drug seeking and use can impact society's overall health and social policy strategies and help diminish the health and social costs associated with drug abuse and addiction.

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New insights into our understanding of drug abuse and addiction have revealed that the desire to use drugs and the process of addiction depend on effects on brain function. Drugs of abuse have been hypothesized to produce their rewarding effects by neuropharmacological actions on a common brain reward circuit called the extended amygdala. The extended amygdala involves the mesolimbic dopamine system and specific subregions of the basal forebrain, such as the shell of the nucleus accumbens, the bed nucleus of the stria terminalis, and the central nucleus of the amygdala. The psychomotor stimulants cocaine and amphetamine activate the mesolimbic dopamine system; opiates activate opioid peptide receptors within and independent of the mesolimbic dopamine system. Sedative hypnotics alter multiple neurotransmitter systems in this circuitry, including: 1) gamma aminobutyric acid; 2) dopamine; 3) serotonin; 4) glutamate; and 5) opioid peptides. Nicotine and tetrahydrocannabinol both activate mesolimbic dopamine function and possibly opioid peptide systems in this circuitry. Repeated and prolonged drug abuse leads to compulsive use, and the mechanism for this transition involves, at the behavioral level, a progressive dysregulation of brain reward circuitry and a recruitment of brain stress systems such as corticotropin-releasing factor. The molecular mechanisms of signal transduction in these systems are a likely target for residual changes in that they convey allostatic changes in reward set point, which lead to vulnerability to relapse.

T he theme of this year's American Association for the Advancement of Science (AAAS) annual meeting-"Science As a Way of Life"-speaks to both the science and engineering communities and to the broader public. The AAAS meeting draws hundreds of speakers whose work emphasizes the multidisciplinary nature of modern science and the role of science in society. Few scientists (or their spouses) would contest the view that being a scientist pervades all aspects of their lives, professional and personal. But science is really a way of life not only for scientists but for all people, whether they choose it or not. Virtually every major issue facing global society today has science and technology components at its core: terrorism and other forms of violence, economic productivity, health status, global warming, and the need for sustainable development. History has shown that when individuals and nations lack infrastructure and access to science and technology, they are doomed to lag behind their better-equipped counterparts. Some people are not so happy about how central science and technology are to their lives. Although in the United States the relationship between science and society is basically positive, science and technology often encounter skepticism and wariness in other parts of the world. In a recent address at the AAAS, Sir David King, science advisor to the British prime minister, reported the results of attitude surveys that showed substantial differences in the way people in the United States and the United Kingdom view science in general and certain issues in particular. For example, whereas Americans are basically positive about genetically modified foods, people in Britain are extremely wary. The British are supportive of therapeutic cloning, whereas Americans are mixed at best in their views. Differences also exist in attitudes to global climate change and policies to combat it. One traditional response of the scientific community to what it views as a lack of appreciation or misinterpretations by the public has been to mount so-called public understanding or education campaigns designed to "enlighten" the populace, either about science in general or specific issues in particular. Some initiatives have been quite successful. Examples include campaigns about the dangers of air pollution and high blood pressure, and the negative health effects of smoking and lack of exercise. But simply trying to educate the public about specific science-based issues is not working. Many science skeptics are already quite well educated, but they relate more to the risks of science and technology advances than to their benefits. Moreover, given the uncertainties in science, the best science-based strategy is not always as clear as we would like and as many in our community might claim. And widely publicized examples of scientific dishonesty, like the Schön case, or unacceptable scientific practice, like the Lomborg affair or repeated unverified claims of human cloning, are not only misleading but seriously erode the public'...

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SCANNING THE RELATIONSHIP BETWEEN SCIENCE AND SOCIETY RECALLS CHARLES DICKENS' lead for A Tale of Two Cities: "It was the best of times, it was the worst of times. . ." Scientific advances are coming at an unprecedented pace, and they hold great promise for further improving the human condition. The public is clearly happy about this. At the same time, however, society is exhibiting increased disaffection, fostered by instances of scientific fraud and by scientists charged with financial conflicts of interest. Perhaps worse, public skepticism and concern are increasingly directed at scientific issues that appear to conflict with core human values and religious beliefs or that pose conflicts with political or economic expediency. These include embryonic stem cell research, the teaching of evolution in schools, evidence for global climate change, and controversies over genetically modified foods. The ensuing tension threatens to compromise the ability of the scientific enterprise to serve its broad societal mission and may weaken societal support for science. There is a growing consensus that to lessen this tension, scientists must engage more fully with the public about scientific issues and the concerns that society has about them. Efforts that focus simply on increasing public understanding of science are not enough, because the problem is not merely a lack of scientific comprehension. In some cases, the public generally does understand scientific content in a fundamental way but still doesn't like it. Thus, the notion of public engagement goes beyond public education. We must have a genuine dialogue with our fellow citizens about how we can approach their concerns and what specific scientific findings mean. This kind of outreach is being encouraged by government agencies and private sources in Europe, Canada, and the United States. Effective public engagement requires long-term commitment, because many issues are complex and tension is persistent. The creationism/evolution issue showed us this. It would be convenient to leave this task in the hands of a few representatives selected especially for their communication skills, but that won't work. Given the breadth of issues and the intensity of the effort required, we need as many ambassadors as we can muster. Engaging the public effectively is an acquired skill, and preparation for outreach strategies has seldom been part of scientific training programs. There are a few exceptions, including the Aldo Leopold Leadership Program and Research!America's Paul G. Rogers Society for Global Health Research. Many young colleagues are enthusiastic about discussing their work with the public, but they also are under tremendous pressure to stick to the bench, secure hard-to-get research grants, and publish rapidly and repeatedly in high-quality journals. Many even feel that the culture of science actively discourages them from becoming involved in public outreach, because it would somehow be bad for their careers. What can be done? First, the scientific reward system needs ...

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