Outline

A disorder of reward learning, decision-making and self-awareness is called addiction.

• Definitions of Addiction
  • The American Society of Addiction Medicine’s Definition of Addiction
  • The DSM-5 Symptomology of Addiction (Substance Use Disorder)
• The Five Current, Leading Neuroscientific Explanations of Addiction
  • Genetic Vulnerability (Blum)
  • Incentive-Sensitization (Robinson and Berridge)
  • Pathology of Memory and Learning (Kalivas)
  • Stress-induced Allostasis (Koob and LeMoal)
  • Pathology of Motivation and Choice (Volkow, Goldstein)
• The Debate about Addiction’s Definition as a Disease

I. There have been recent advances in the pathophysiology of addiction.

• Epigenetics: a new understanding of heritability of addiction & recovery
  • The Overkalix Study and transgenerational trauma transmission
  • Nicotine primes cocaine use (Kandel and Kandel)
• Psychoneuroimmunology: the Gut-Brain-Immune Loop
  • Inflammation and Psychiatric Disorders
  • The Role of Microglia in brain disease and repair
• Implications for the Disease Argument

I. Recovery management is based on safety.

• Altering Health Disparities by Improving the Social Determinants of Health
• Professional Health Programs: What Makes a Good Aftercare Plan
  • Treatment and “Recovery Literacy”
  • Recovery Management Check-Ups
    • Active Linkage to Recovery-Oriented System of Care (ROSC)
  • Recovery Residences
  • Peer-based Sobriety Support (Kelly, Kaskutas)
  • Relapse Safety Planning
  • Urine Drug Testing (Monitoring)
  • Vocational Rehabilitation and The Collegiate Recovery Movement
  • Addiction Medicine Specialists
  • How Recovery Management informs Medication-Assisted Treatment
  • “Hedonic Rehabilitation”