Addictive disorders are diseases of the brain. Addictions like chronic illness
may have remissions and relapses. These are caused by genetic, biological,
psychological, social and economic factors. Reward pathways for all substance and
non-substance related addictive behavior (gambling, sex and food addiction etc.) are
similar and are mediated through nucleus accumbens and associated circuits. Negative
preexisting emotional state or due to withdrawal from substance and self-medication to
seek relief may perpetuate addictive behavior. Substance or non-substance related
addictive behavior-pleasure-reinforcement-reuse paradigm perpetuates addictive
behavior. Environmental cues and memories associated with addiction related activities
contribute to craving and relapse. Dopamine neurotransmitter plays major role in
addictive behaviors. Treatment consideration should factor in all of these
biopsychosocial factors.
Keywords: Addiction reward pathways, Cues and craving, Dopamine, Nucleus
accumbens, Operant conditioning, Self-medication theory.
