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Implications of Food Addiction for Understanding and Treating Binge Eating Disorder

Introduction There has been considerable debate in the field about whether applying an addiction model could advance our understanding and treatment of compulsive overeating (e.g., Wilson ). Although we agree that an addiction model does not adequately address all of the core clinical features of eating disorders, we believe that this perspective may be useful in furthering our understanding of binge eating disorder (BED), in particular,…

The Biology and Treatment of Gambling Disorder

Introduction Gambling has become increasingly accessible and socially acceptable over the past two decades, with an increasing number of venues and opportunities through casinos, video lottery terminals, sports betting venues, and online poker and other gambling sites. Although most people participate in gambling activities recreationally, some experience gambling problems, including the most severe form, gambling disorder. Gambling disorder has been associated with significant financial debt, family…

Ketamine and Phencyclidine

Introduction Ketamine and phencyclidine are chemically related to each other and have psychotropic effects similar to those of other prototypical hallucinogens such as lysergic acid diethylamide. Phencyclidine was developed first as a dissociative anesthetic for animals and humans, but seizures, recreational abuse, and unpredictable effects have prevented its therapeutic use. Ketamine was developed after phencyclidine and has similar properties, although it is still used therapeutically as…

Serotonergic Hallucinogens

Introduction This chapter focuses on hallucinogens with psychoactive properties mediated through the serotonin system. Although commonly referred to as “hallucinogens,” a lexigraphic disclaimer is warranted, as the experience elicited by these drugs commonly centers on distortion of perception, not true hallucinations. The most apt term is probably “psychedelic” from the Greek psukhē , meaning “mind” and dēloun, meaning “reveal” or “make visible.” Although the enlightenment sought…

Caffeine

Introduction Caffeine is the most widely consumed drug in history. Indeed, caffeine is unusual among psychoactive compounds in being part of the daily diet of most people. With more than 80% of people worldwide consuming caffeine daily, current usage transcends almost every social barrier, including age, gender, geography, and culture. No other psychoactive substance—including nicotine, alcohol, and the many illicit drugs—comes close to caffeine in popularity.…

Anabolic-Androgenic Steroids

Introduction Anabolic-androgenic steroids (AASs) refer to the male hormone, testosterone, and many of its natural and synthetic derivatives. All AASs have androgenic (masculinizing) and muscle-specific (anabolic) effects, but some are relatively more anabolic or androgenic than others. Oxandrolone, for example, has greater anabolic activity and less androgenic activity than testosterone. All AASs share a cholesterol-like and -derived chemical structure in common with other classes of steroid…

Clinical Aspects of Inhalant Addiction

Types of Inhalants Being Abused Inhalants encompass a wide range of pharmacologically diverse substances that readily vaporize. Unlike most other substances of abuse, which are classified into groups that share a specific central nervous system (CNS) action or perceived psychoactive effect, inhalants are grouped by their common route of administration. Inhalants are classified into three groups on the basis of their currently known pharmacologic actions (…

Sedative-Hypnotics and Anxiolytics

Introduction The sedative-hypnotics and anxiolytics are central nervous system depressants that also have muscle relaxant and anticonvulsant effects and are widely used in psychiatry, neurology, anesthesiology, and general medicine. The most common of these are the benzodiazepines and the new-generation nonbenzodiazepine hypnotics (i.e., zaleplon, zolpidem, and eszopiclone), which due to their better safety profiles have largely replaced the barbiturates and other older agents, particularly in the…

Clinical Aspects of Methamphetamine

Introduction Methamphetamine, developed in 1893, is a synthetic stimulant that affects the central nervous system and other major organ systems. Until the 1950s, no prescription was necessary to obtain methamphetamine or other amphetamine-containing products. Prescriptions for variants of these drugs were freely dispensed in the 1960s. Different versions of methamphetamine became popular in the 1960s, and “ice,” a smokable derivative, emerged in the late 1980s in…

Opiates and Prescription Drugs

Classification Medications derived from Papaver somniferum , the opium poppy, have played a central role in medical practice for well over 3500 years. Sumerian clay tablets, which include our oldest known medical texts, called the opium poppy “Hul Gil,” the “Joy Plant.” In the Greco-Roman era, poppies were cultivated for their pain-relieving, antidiarrheal, and sedative properties. Today, medications in this class are divided into two groups.…

Cannabis: An Overview of the Empirical Literature

Introduction Marijuana (also referred to as cannabis) is a drug that is derived from the flowers, stems, leaves, and seeds of the hemp plant ( Cannabis sativa ). Cannabis is the generic term that refers to the psychoactive substances derived from the plant, including cannabis-like substances (e.g., synthetic cannabinoid compounds). In this chapter, we utilize the term cannabis, but it should be noted marijuana is used…

Nicotine

Epidemiology Cigarette smoking is the principal cause of premature death and disability in the United States. In 2016 about 480,000 deaths in the United States were caused by cigarette smoking. According to the International Agency for Research on Cancer, tobacco smoking is causally linked to at least 13 different types of neoplastic disease. However, despite education about the health hazards of smoking and other tobacco control…

Cocaine

Introduction The effects of cocaine on the nervous system have been studied for more than a hundred years. Early observers noted that among the symptoms produced by frequent cocaine use, one of the most prominent was cocaine craving. In time, this craving for cocaine develops into a disorder termed cocaine dependence or addiction. Cocaine addiction is a chronic disorder characterized by compulsive drug seeking, frequent relapses,…

Alcohol: Clinical Aspects

Acknowledgments We thank Catharine Helms and Robert H. Cormier, Jr., for their assistance with manuscript preparation. Introduction Alcohol is one of the oldest and the most widely used psychoactive substances in the world, second only to caffeine. The use of alcohol is a part of most cultures worldwide, and it is recognized that there are both positive and negative aspects of alcohol consumption. Positive aspects might…

Neuroinflammatory Processes in Drug Addiction

Acknowledgments We thank the National Institute on Alcohol Abuse and Alcoholism for its support through the Neurobiology of Adolescent Drinking in Adulthood (NADIA) consortium (AA020024, AA020023), the Bowles Center for Alcohol Studies (AA011605), and the U54 collaborative partnership among NCCU, and UNC (AA019767), and K08-AA024829. Innate Immune Signaling in the Brain Immune Cells of the Brain Historically the brain has been considered an “immune privileged” organ,…

Novel Methodologies: Proteomic Approaches in Substance Abuse Research

Acknowledgment The writing of this chapter was supported in part by funding of the following NIH grants: DA012498, DA003628, and DA06634 (SEH). Introduction The comprehensive sequencing of human and other important genomes has enhanced our understanding of the cellular organization and function in higher organisms. This has been largely accomplished by the innovations in large-scale analysis of messenger RNA (mRNA) expression (microarrays, serial-analysis of gene expression…

Animal Models of Substance Use Disorders: Motivational Perspective

Acknowledgments The author would like to thank Michael Arends for his assistance with manuscript preparation. Definitions Relevant to Animal Models Drug addiction, also known as substance use disorder, is a chronically relapsing disorder that is characterized by (1) compulsion to seek and take the drug, (2) loss of control in limiting intake, and as defined by the present author and others, (3) emergence of a negative…

Neurobehavioral Toxicology of Substances of Abuse

Ethanol (Alcohol) History Ethanol is surely the oldest known substance of abuse. The details of the original discovery of fermented beverages have been lost to time because of the unavailability of the written word. Thus no one really knows exactly when humans started drinking fermented beverages. Animals such as birds, insects, and elephants have shown signs of drunkenness by purposefully eating ripened fruit in which yeast…

Neurobiological Basis of Drug Reward and Reinforcement

Introduction Drug use disorders involve a number of factors including genetic and environmentally influenced predispositions, the actions of the drugs themselves, the immediate environment, and the neurobiological mechanisms that promote and support drug actions and addiction. This chapter deals mostly with the latter aspect of drug use, abuse, and addiction, as we explore the ways in which the brain is built to adapt to environmental circumstances,…

Neuroimaging Findings in Substance Use Disorders

Introduction A comprehensive understanding of the underlying neurobiology of alcohol and other drug use will likely prove essential in developing more effective prevention, early intervention, and treatment strategies. Ethical limitations prevent the use of many of the techniques developed to study brains in animal models of addiction; however, technical advancements in neuroimaging are increasingly allowing for more in-depth brain assessments in humans. This chapter reviews findings…