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The Reward Pathway And Addiction Based on a teaching presentation developed by the National Institute on Drug Abuse www.nida.nih.gov REWARDS • Natural – – – – Food Water Sex Nurturing • Artificial – – – – – Electronic games Shopping Texts and tweets Gambling Drugs (both natural and synthetic) Rewards reinforce and motivate behavior THE BRAIN’S REWARD PATHWAY Neurons of VTA release dopamine in the nucleus accumbens and prefrontal cortex Cellular Targets in the Brain SUBSTANCE USE and ABUSE Activation of the reward pathway by a substance that provides a “rewarding” stimulus “Positive reinforcement” results in repeated use of the substance ADAPTATION AND TOLERANCE Repeated activation of neuron by drug Neuron chemically adapts and alters intensity of cellular response to drug Desired effect of drug decreases DEPENDENCE Exogenous administration of drug replaces brain’s production of endogenous chemical Neurons now only function normally in presence of drug ADDICTIVE BEHAVIOR Use continues, even with negative consequences and in absence of pleasurable results (i.e. in order to maintain a “normal” brain environment) WITHDRAWAL AND CRAVINGS If drug is not available to the neuron, unpleasant emotional and physical effects occur, because the normal activating and inhibitory neurotransmitter levels have been altered See example, next slide Example: Addiction to stimulants causes lack of synaptic availability of DA and Serotonin 5-HT. When stimulants not available, the addicted person experiences associated cravings and withdrawal symptoms. Rothman, Blough, Baumann AAPS Journal, Vol. 1, 2007