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Drug addiction co-morbidity with alcohol: Neurobiological insights.

Authors
  • McGinn, M Adrienne1
  • Pantazis, Caroline B2
  • Tunstall, Brendan J3
  • Marchette, Renata C N3
  • Carlson, Erika R3
  • Said, Nadia3
  • Koob, George F3
  • Vendruscolo, Leandro F3
  • 1 Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, United States. Electronic address: [email protected] , (United States)
  • 2 Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, United States. Electronic address: [email protected] , (United States)
  • 3 Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, United States. , (United States)
Type
Published Article
Journal
International review of neurobiology
Publication Date
Jan 01, 2021
Volume
157
Pages
409–472
Identifiers
DOI: 10.1016/bs.irn.2020.11.002
PMID: 33648675
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Addiction is a chronic disorder that consists of a three-stage cycle of binge/intoxication, withdrawal/negative affect, and preoccupation/anticipation. These stages involve, respectively, neuroadaptations in brain circuits involved in incentive salience and habit formation, stress surfeit and reward deficit, and executive function. Much research on addiction focuses on the neurobiology underlying single drug use. However, alcohol use disorder (AUD) can be co-morbid with substance use disorder (SUD), called dual dependence. The limited epidemiological data on dual dependence indicates that there is a large population of individuals suffering from addiction who are dependent on more than one drug and/or alcohol, yet dual dependence remains understudied in addiction research. Here, we review neurobiological data on neurotransmitter and neuropeptide systems that are known to contribute to addiction pathology and how the involvement of these systems is consistent or divergent across drug classes. In particular, we highlight the dopamine, opioid, corticotropin-releasing factor, norepinephrine, hypocretin/orexin, glucocorticoid, neuroimmune signaling, endocannabinoid, glutamate, and GABA systems. We also discuss the limited research on these systems in dual dependence. Collectively, these studies demonstrate that the use of multiple drugs can produce neuroadaptations that are distinct from single drug use. Further investigation into the neurobiology of dual dependence is necessary to develop effective treatments for addiction to multiple drugs. Copyright © 2021 Elsevier Inc. All rights reserved.

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