Two major questions about addictive behaviors need to be explained by any worthwhile neurobiological theory. First, why do people seek drugs in the first place? Second, why do some people who use drugs seem to eventually become unable to resist drug temptation and so become "addicted"? We will review the theories of addiction that address negative-reinforcement views of drug use (i.e., taking opioids to alleviate distress or withdrawal), positive-reinforcement views (i.e., taking drugs for euphoria), habit views (i.e., growth of automatic drug-use routines), incentive-sensitization views (i.e., growth of excessive "wanting" to take drugs as a result of dopamine-related sensitization), and cognitive-dysfunction views (i.e., impaired prefrontal top-down control), including those involving competing neurobehavioral decision systems (CNDS), and the role of the insula in modulating addictive drug craving. In the special case of opioids, particular attention is paid to whether their analgesic effects overlap with their reinforcing effects and whether the perceived low risk of taking legal medicinal opioids, which are often prescribed by a health professional, could play a role in the decision to use. Specifically, we will address the issue of predisposition or vulnerability to becoming addicted to drugs (i.e., the question of why some people who experiment with drugs develop an addiction, while others do not). Finally, we review attempts to develop novel therapeutic strategies and policy ideas that could help prevent opioid and other substance abuse.

中文翻译：

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成瘾的神经行为方法：对阿片类药物流行和成瘾心理学的影响。


任何有价值的神经生物学理论都需要解释关于成瘾行为的两个主要问题。首先，人们为什么首先寻求毒品？其次，为什么一些吸毒的人似乎最终无法抗拒药物的诱惑，从而变得“上瘾”？我们将回顾成瘾理论，这些理论涉及药物使用的负强化观点（即服用阿片类药物以减轻痛苦或戒断）、正强化观点（即服用药物以获得欣快感）、习惯观点（即自动药物使用习惯的增长）、激励敏化观点（即，由于多巴胺相关的致敏导致过度“想要”服用药物的增长）和认知功能障碍观点（即 受损的前额叶自上而下控制），包括涉及竞争神经行为决策系统 （CNDS） 的那些，以及岛叶在调节成瘾性药物渴望中的作用。在阿片类药物的特殊情况下，要特别注意它们的镇痛作用是否与它们的增强作用重叠，以及服用通常由卫生专业人员开具的合法药物阿片类药物的感知低风险是否会在决定使用中发挥作用。具体来说，我们将解决对药物成瘾的易感性或脆弱性问题（即，为什么一些尝试药物的人会上瘾，而另一些人则不会）。最后，我们回顾了开发有助于防止阿片类药物和其他物质滥用的新型治疗策略和政策理念的尝试。