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By David Nutt & Liam J. Nestor & Liam Nestor

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Extra resources for Addiction

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56 All substances of addiction work by triggering transient, exaggerated increases in VS dopamine. g. g. food, water). e. the strengthening of connections between neurons) in this VS reward pathway. 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).

EMR=eastern Mediterranean region. EUR=European region. SEAR=South East Asian region. WPR=western Pacific region. , et al. Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders, 2223–2233. Copyright (2009), with permission from Elsevier. 5 Burden of disease attributable to alcohol is higher in men. Alcohol-attributable burden of disease in disability-adjusted life-years (DALYs) as a proportion of all DALYs by sex and WHO region in 2004. AFR=African region.

The VTA-NAcc dopamine pathway is thought to be part of a gating mechanism. This mechanism directs the translation of motive states into motor responses. The OFC is also involved in the processes of motivation and drive for rewards. The OFC is located on the ventral surface of the PFC. It is connected with brain regions involved in dopamine-dependent reinforcement. The NAcc projects to the OFC, and the OFC also receives direct dopamine projections from the VTA. OFC functioning appears to be particularly important for guiding goal-directed behaviour for rewards.

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