Abstract
Volkow and colleagues review neurobiologic advances supporting addiction as a brain disease — reward circuitry, prefrontal control, and chronic relapse patterns.
Volkow, N. D., Koob, G. F., & McLellan, A. T. (2016). New England Journal of Medicine, 374(4), 363–371. DOI
Key findings
- Reward circuitry — Drugs hijack dopamine-related reward learning — wanting decouples from liking over time.
- Control erosion — Prefrontal regulation weakens with chronic use — impulse beats plan.
- Relapse biology — Cues trigger conditioned responses — abstinence is not a single decision.
- Treatment frame — Medical model supports medication and long-term care, not moral-only blame.
Limits
NEJM review — disease model debated socially; biology is one layer among behaviour and context.
Application
When relapse reads as weak will — consider cue-driven brain learning, not only character. See Dopamine baseline.