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      The neurobiology of addiction

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          Abstract

          Substance and alcohol use disorders impose large health and economic burdens on individuals, families, communities, and society. Neither prevention nor treatment efforts are effective in all individuals. Results are often modest. Advances in neuroscience and addiction research have helped to describe the neurobiological changes that occur when a person transitions from recreational substance use to a substance use disorder or addiction. Understanding both the drivers and consequences of substance use in vulnerable populations, including those whose brains are still maturing, has revealed behavioral and biological characteristics that can increase risks of addiction. These findings are particularly timely, as law‐ and policymakers are tasked to reverse the ongoing opioid epidemic, as more states legalize marijuana, as new products including electronic cigarettes and newly designed abused substances enter the legal and illegal markets, and as “deaths of despair” from alcohol and drug misuse continue.

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          Most cited references169

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          Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence

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            The conception of the ABCD study: From substance use to a broad NIH collaboration

            Adolescence is a time of dramatic changes in brain structure and function, and the adolescent brain is highly susceptible to being altered by experiences like substance use. However, there is much we have yet to learn about how these experiences influence brain development, how they promote or interfere with later health outcomes, or even what healthy brain development looks like. A large longitudinal study beginning in early adolescence could help us understand the normal variability in adolescent brain and cognitive development and tease apart the many factors that influence it. Recent advances in neuroimaging, informatics, and genetics technologies have made it feasible to conduct a study of sufficient size and scope to answer many outstanding questions. At the same time, several Institutes across the NIH recognized the value of collaborating in such a project because of its ability to address the role of biological, environmental, and behavioral factors like gender, pubertal hormones, sports participation, and social/economic disparities on brain development as well as their association with the emergence and progression of substance use and mental illness including suicide risk. Thus, the Adolescent Brain Cognitive Development study was created to answer the most pressing public health questions of our day.
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              Delayed reward discounting and addictive behavior: a meta-analysis.

              Delayed reward discounting (DRD) is a behavioral economic index of impulsivity and numerous studies have examined DRD in relation to addictive behavior. To synthesize the findings across the literature, the current review is a meta-analysis of studies comparing DRD between criterion groups exhibiting addictive behavior and control groups. The meta-analysis sought to characterize the overall patterns of findings, systematic variability by sample and study type, and possible small study (publication) bias. Literature reviews identified 310 candidate articles from which 46 studies reporting 64 comparisons were identified (total N=56,013). From the total comparisons identified, a small magnitude effect was evident (d= .15; p< .00001) with very high heterogeneity of effect size. Based on systematic observed differences, large studies assessing DRD with a small number of self-report items were removed and an analysis of 57 comparisons (n=3,329) using equivalent methods and exhibiting acceptable heterogeneity revealed a medium magnitude effect (d= .58; p< .00001). Further analyses revealed significantly larger effect sizes for studies using clinical samples (d= .61) compared with studies using nonclinical samples (d=.45). Indices of small study bias among the various comparisons suggested varying levels of influence by unpublished findings, ranging from minimal to moderate. These results provide strong evidence of greater DRD in individuals exhibiting addictive behavior in general and particularly in individuals who meet criteria for an addictive disorder. Implications for the assessment of DRD and research priorities are discussed.
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                Author and article information

                Contributors
                George.Uhl@va.gov
                jennlcable@gmail.com
                Journal
                Ann N Y Acad Sci
                Ann. N. Y. Acad. Sci
                10.1111/(ISSN)1749-6632
                NYAS
                Annals of the New York Academy of Sciences
                John Wiley and Sons Inc. (Hoboken )
                0077-8923
                1749-6632
                15 January 2019
                September 2019
                : 1451
                : 1 , Addiction Reviews ( doiID: 10.1111/nyas.v1451.1 )
                : 5-28
                Affiliations
                [ 1 ] New Mexico VA Healthcare System Albuquerque New Mexico
                [ 2 ] NIH/NIAAA Bethesda Maryland
                Author notes
                [*] [* ]Address for correspondence: George Uhl, New Mexico VA Healthcare System, Albuquerque, NM 87108. George.Uhl@ 123456va.gov
                Article
                NYAS13989
                10.1111/nyas.13989
                6767400
                30644552
                636743a7-c9ca-46cf-9f78-b8b8838daedf
                © 2019 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals, Inc. on behalf of The New York Academy of Sciences.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 26 September 2018
                : 22 October 2018
                Page count
                Figures: 2, Tables: 0, Pages: 24, Words: 16447
                Funding
                Funded by: National Institutes of Health
                Award ID: R13DA041813
                Categories
                Commentary
                Commentary
                Custom metadata
                2.0
                nyas13989
                September 2019
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.9 mode:remove_FC converted:30.09.2019

                Uncategorized
                addiction,substance abuse,neuroplasticity,alcohol,marijuana,nicotine,opioids
                Uncategorized
                addiction, substance abuse, neuroplasticity, alcohol, marijuana, nicotine, opioids

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