David Nutt & Liam J. Nestor & Liam Nestor's Addiction PDF

Addiction Recovery

By David Nutt & Liam J. Nestor & Liam Nestor

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Fast) short-burst firing. VTA dopamine neurons also provide a predictive signal about rewards. Dopamine released from VTA neurons binds with dopamine 55 D1 and D2 receptors (D1/2R) in the VS. Binding to the D1R increases the excitability of neurons. Binding to DR2 decreases excitability. Dopamine binding to D2R is generally thought to encode information related to expected reward value and the reward itself. A number of other neurotransmitter systems influence VS reward circuitry. Inhibitory gamma-aminobutyric acid (GABA) neurons are located in the VS.

This suggests that the hard-wired circuitry essential for the processing of natural rewards can be unfavourably commandeered by substances of abuse. Importantly, the release of dopamine at the VS is not necessary for all forms of reward learning and ‘liking’. It may involve just the ‘wanting’ of a reward (see Chapter 3). ‘Wanting’ in the absence of ‘liking is a critical characteristic of addiction. Increased ‘wanting’ involves a disproportional change in the motivational value of substance rewards.

Reproduced with permission from the WHO Report on the Global Tobacco Epidemic, 2008. © World Health Organization, 2008. 6% of the total cause of burden in the European Union. These disorders are the largest contributor to all-cause morbidity burden, as measured by disability-adjusted life-years (DALYs). DALYs are defined as the sum of years of potential life lost due to premature mortality and the years of productive life lost due to disability. 3). Furthermore, drug use disorders are also amongst the most frequent.

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