Author(s)

Kenneth Blum^1*, Abdalla Bowirrat², David Baron¹, Rajendra D. Badgaiyan^3,4, Panayotis K. Thanos⁵, Igor Elman⁶, Eric R. Braverman⁷, Mark S. Gold⁸

¹Division of Addiction Research & Education, Center for Psychiatry, Medicine, & Primary Care (Office of the Provost), Western University Health Sciences, Pomona, USA.
²Department of Molecular Biology and Adelson School of Medicine, Ariel University, Ariel, Israel.
³Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital and Long School of Medicine, University of Texas Health Science Center, San Antonio, USA.
⁴Department of Psychiatry, MT. Sinai School of Medicine, New York, USA.
⁵Department of Psychology & Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Research Institute on Addictions, University at Buffalo, Buffalo, USA.
⁶Department of Psychiatry, Harvard School of Medicine, Cambridge, USA.
⁷Division of Personalized Medicine, The Kenneth Blum Behavioral & Neurogenetic Institute (Division of iVitalize, Inc.) Austin, USA.
⁸Department of Psychiatry, Washington University School of Medicine, St. Louis, USA.

We refute the controversial statement that addiction is not a brain disorder. Extensive peer-reviewed studies support the underlying neurobiological and neurogenetic basis of addiction’s “disease model”. In the 70s and 80s, a few clinical scientists suggested that it is possible to use behavioral training to teach controlled drinking. However, this controversial model failed drastically and increased labeling and stigmatization. Additionally, it was unhelpful in the search for treatment. Instead, we assert that addiction is a neuropsychiatric disorder characterized by a recurring desire to continue taking substances despite harmful physical and mental consequences. Work from our laboratory in 1995 supported the Reward Deficiency Syndrome (RDS) concept based on a common neurogenetic mechanism (hypodopaminergia) that underlies all substance and non-substance addictions. Non-substance addictions include behaviors like pathological gambling, internet addiction, and mobile phone addiction. Certain impulsive and compulsive behaviors or the acute intake of psychoactive substances result in heightened dopaminergic activity, while the opposite, hypodopaminergia, occurs following chronic abuse. Patients with Substance Use Disorder (SUD) can have a genetic predisposition compounded by stress or other epigenetic insults that can impact recovery. Relapse will occur post-short-term recovery if dopaminergic dysfunction remains untreated. Addiction, a brain disorder, requires treatment with DNA-directed pro-dopamine regulation and rehabilitation.

Reward Deficiency Syndrome, Abstinence, Controlled Drinking, Neurogenetic Brain Disorder

Blum, K. , Bowirrat, A. , Baron, D. , Badgaiyan, R. , Thanos, P. , Elman, I. , Braverman, E. and Gold, M. (2022) Understanding that Addiction Is a Brain Disorder Offers Help and Hope. Health, 14, 684-695. doi: 10.4236/health.2022.146050.