4.5 Review

Why haven't we solved the addiction crisis?

期刊

出版社

ELSEVIER
DOI: 10.1016/j.jns.2022.120404

关键词

Addiction; Dopamine homeostasis; Genetic testing; Dopamine regulation; Neuroimaging

资金

  1. NIH HHS/United States [R01NS073884]
  2. NIH
  3. [R41 MD012318/MD/NIMHD]

向作者/读者索取更多资源

The current addiction crisis has caused devastation and governments' efforts to solve the problem have not been successful. In order to address addiction, a novel approach involving genetic risk testing and brain health checks for youth is proposed. Characterizing preaddiction could incentivize the development of interventions to prevent and treat early indications of addiction.
The current addiction crisis has destroyed a multitude of lives, leaving millions of fatalities worldwide in its wake. At the same time, various governmental agencies dedicated to solving this seemingly never-ending dilemma have not yet succeeded or delivered on their promises. We understand that addictive behavioral seeking is a multi-faceted neurobiological and spiritually complicated phenomenon. However, although the substitution replacement approach, especially to treat Opioid Use Disorder (OUD), has importance for harm reduction in the short term, it does not bring about a harm-free recovery or prevention. Instead, we propose a promising novel approach that uses genetic risk testing with induction of dopamine homeostasis and an objective Brain Health Check during youth. Our model involves a six-hit approach known as the Reward Dysregulation Syndrome Solution System, which can identify addiction risk and target the root cause of addiction, dopamine dysregulation. While we applaud all past sophisticated neurogenetic and neuropharmacological research, our opinion is that in the long term, addiction scientists and clinicians might characterize preaddiction using tests; for example, administering the validated RDSQuestionarre29, genetic risk assessment, a modified brain health check, or diagnostic framing of mild to moderate Substance Use Disorder (SUD). The preaddiction concept could incentivize the development of interventions to prevent addiction from developing in the first place and target and treat neurotransmitter imbalances and other early indications of addiction. WC 222.

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