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The dopamine theory of addiction: 40 years of highs and lows

Abstract

For several decades, addiction has come to be viewed as a disorder of the dopamine neurotransmitter system; however, this view has not led to new treatments. In this Opinion article, we review the origins of the dopamine theory of addiction and discuss the ability of addictive drugs to elicit the release of dopamine in the human striatum. There is robust evidence that stimulants increase striatal dopamine levels and some evidence that alcohol may have such an effect, but little evidence, if any, that cannabis and opiates increase dopamine levels. Moreover, there is good evidence that striatal dopamine receptor availability and dopamine release are diminished in individuals with stimulant or alcohol dependence but not in individuals with opiate, nicotine or cannabis dependence. These observations have implications for understanding reward and treatment responses in various addictions.

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Figure 1: The effect of abused substances on human ventral striatal dopamine release.
Figure 2: Investigating diminished ventral striatal dopamine release in addictions.

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Correspondence to David J. Nutt.

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D.J.N. has received speaker's fees, or travel or grant support from companies with an interest in the treatment of addiction: RB pharmaceuticals, Lundbeck, GlaxoSmithKline, Pfizer, D&A Pharma and Nalpharm. A.L.-H. has received speaker's fees and grant support from Lundbeck and GlaxoSmithKline. D.E. has received grant support from GlaxoSmithKline. P.R.A.S. declares no competing interests.

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Nutt, D., Lingford-Hughes, A., Erritzoe, D. et al. The dopamine theory of addiction: 40 years of highs and lows. Nat Rev Neurosci 16, 305–312 (2015). https://doi.org/10.1038/nrn3939

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