Neurobiology and Management of Drug Addiction and Dependence: A Multidisciplinary Review

Abstract

Drug addiction and dependence are chronic, relapsing disorders influenced by a complex interplay of neurobiological, psychological, environmental, and social factors. Central to the addictive process is the dysregulation of the brain’s reward system, particularly the mesolimbic dopamine pathway, which reinforces compulsive drug-seeking behavior and contributes to craving, tolerance, and withdrawal. This article provides a comprehensive overview of drug addiction, exploring definitions, pharmacology, prevalence, and societal impact. It outlines the neurobiological basis of addiction, including neurotransmitter systems, neuroadaptations, and affected brain circuits, with emphasis on the binge/intoxication, withdrawal/negative effect, and preoccupation/anticipation stages of the addiction cycle. Commonly abused drug classes such as opioids, stimulants, depressants, cannabinoids, and hallucinogens are discussed in terms of their mechanisms of action and physiological and psychological effects. Risk factors for addiction include genetic predisposition, psychiatric comorbidities, peer and family influences, low socioeconomic status, and environmental exposures. The article also reviews validated screening tools and diagnostic criteria for substance use disorders (SUDs). Management strategies include pharmacological treatments like methadone and buprenorphine-naloxone, and non-pharmacological interventions such as cognitive behavioral therapy (CBT) and cue exposure therapy (CET). Prevention efforts are categorized into universal, selective, and indicated approaches, targeting families, schools, communities, and healthcare settings. Despite advances, challenges such as stigma, relapse, limited resources, and lack of trained professionals persist. Future directions in research focus on personalized treatments, translational models, neurocircuitry mapping, and innovative techniques like optogenetics and single-cell profiling. A multidisciplinary and evidence-based approach remains vital to effectively address the complexities of addiction and mitigate its public health burden.