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The transition to compulsion in addiction

Publié dansNature Reviews Neuroscience, vol. 21, no. 5, p. 247-263
Date de publication2020
Résumé

Compulsion is a cardinal symptom of drug addiction (severe substance use disorder). However, compulsion is observed in only a small proportion of individuals who repeatedly seek and use addictive substances. Here, we integrate accounts of the neuropharmacological mechanisms that underlie the transition to compulsion with overarching learning theories, to outline how compulsion develops in addiction. Importantly, we emphasize the conceptual distinctions between compulsive drug-seeking behaviour and compulsive drug-taking behaviour (that is, use). In the latter, an individual cannot stop using a drug despite major negative consequences, possibly reflecting an imbalance in frontostriatal circuits that encode reward and aversion. By contrast, an individual may compulsively seek drugs (that is, persist in seeking drugs despite the negative consequences of doing so) when the neural systems that underlie habitual behaviour dominate goal-directed behavioural systems, and when executive control over this maladaptive behaviour is diminished. This distinction between different aspects of addiction may help to identify its neural substrates and new treatment strategies.

Citation (format ISO)
LUSCHER, Christian, ROBBINS, Trevor W, EVERITT, Barry J. The transition to compulsion in addiction. In: Nature Reviews Neuroscience, 2020, vol. 21, n° 5, p. 247–263. doi: 10.1038/s41583-020-0289-z
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ISSN du journal1471-003X
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Création30/04/2020 10:26:00
Première validation30/04/2020 10:26:00
Heure de mise à jour15/03/2023 21:56:20
Changement de statut15/03/2023 21:56:20
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