The neurobiology of substance use and addiction: evidence from neuroimaging and relevance to treatment

Abstract

SUMMARY Addiction is a global health problem with a chronic relapsing nature for which there are few treatment options. In the past few decades, neuroimaging has allowed us to better understand the neurobiology of addiction. Functional neuroimaging paradigms have been developed to probe the neural circuits underlying addiction, including reward, inhibitory control, stress, emotional processing and learning/memory networks. Functional neuroimaging has also been used to provide biological support for the benefits of psychosocial and pharmacological interventions, although evidence remains limited and often inconclusive in this area, which may contribute to the variability in treatment efficacy. In this article, we discuss the changing definitions and clinical criteria that describe and classify addictive disorders. Using examples from functional neuroimaging studies we summarise the neurobiological mechanisms that underpin drug use, dependence, tolerance, withdrawal and relapse. We discuss the links between functional neuroimaging and treatment, outline clinical management in the UK and give an overview of future directions in research and addiction services.

Comparing healthy adolescent females with and without parental history of eating pathology on neural responsivity to food and thin models and other potential risk factors.

“…Although these studies advanced knowledge of ED risk factors, many of the risk factor findings have not been replicated by independent research teams and little research has focused on biological variables that might increase risk for ED onset. As neuroimaging studies have advanced understanding of the risk processes that give rise to and maintain mental health problems, such as schizophrenia and substance misuse (Hayes et al, 2020; Shapero et al, 2019), neuroimaging may likewise advance knowledge of risk processes for EDs. This exploratory study compared healthy female adolescents with and without parental history of eating pathology on several novel biological factors hypothesized to increase risk for future ED onset.…”

Opioid use disorder and the brain: a clinical perspective

“…Imaging research is now focusing upon identifying neural ‘biomarkers’, which may clarify under what circumstances treatments are effective as well as expose factors affecting individual vulnerability to relapse [108]. This will provide evidence to inform treatment (pharmacological and psychological) development, as well as informing how to use treatments more effectively (i.e.…”

“…This is of particular importance in countries with a growing ageing opioid-dependent population who are more likely to have significant health consequences as a result of chronic opioid use and who would probably benefit from detoxification and abstinence [3]. Imaging research is now focusing upon identifying neural 'biomarkers', which may clarify under what circumstances treatments are effective as well as expose factors affecting individual vulnerability to relapse [108]. This will provide evidence to inform treatment (pharmacological and psychological) development, as well as informing how to use treatments more effectively (i.e.…”

Neuroscience: the way forward

“…This special issue of BJPsych Advances illustrates some of the diversity of impact of modern neuroscience on psychiatry. Particularly thought-provoking contributions explore state-of-the-art knowledge of the complex biology behind substance misuse (Hayes 2020), some of the challenges associated with benzodiazepine pharmacotherapy in depression (Cates 2020) and the neuropsychiatric sequelae of Parkinson's disease (Jones 2020).…”

“…There is an opportunity to reflect on and update your knowledge of neuroscience by reading about the clinical relevance of evidence gained through imaging methods in addiction studies (Hayes 2020). You can also revisit your understanding of investigative laboratory techniques that are used to study single-gene psychiatric disorders (Mizen 2020).…”