1. Addiction is a brain disease that affects the limbic brain's reward system and results in drug use becoming equated with survival. 2. Genetic factors determine vulnerability to addiction by influencing how individuals respond to drugs and experience pleasure and stress. 3. Addictive drugs and behaviors hijack the brain's natural reward pathway by flooding it with dopamine and strengthening drug-related memories through glutamate. 4. Chronic stress, drug cues, and relapse are all mediated by the brain's stress systems and the neurotransmitter CRF, which opposes the brain's natural anti-reward systems.

1. Pleasure Unwoven: A Personal Journey about Addiction companion handouts to the DVD Adapted from the lecture “Is Addiction Really a Disease?” by Kevin McCauley and produced by the Institute for Addiction Study, Salt Lake City, UT

4. The Disease Model (a CAUSAL model)

6. If ever we could fit addiction into this model, then it would win admission into ”The Disease Club”. . .

9. The Key Parts of the Limbic Brain

19. But addiction does not begin in the Frontal Cortex … … addiction begins at a deeper (and older) part of the brain: the “Midbrain”

24. Olds experiments:

28. In addiction, the drug is equated with survival at the level of the unconscious (i.e. the drug IS survival)

30. Addiction is a disorder in the brain’s Reward (Hedonic) System It is a broken “pleasure sense” in the brain

39. Drugs cause Dopamine Surges in the midbrain reward system

47. STRESS : a major player in addiction & relapse

50. Stress change the brain’s ability to process Dopamine (pleasure)

51. The Brain has a Hedonic “Set Point”

52. Another “set point” in the brain . . .

53. The Dopamine System changes in conditions of severe, chronic stress

54. High stress hormone levels reset the brain’s pleasure “set point”

55. Change in Hedonic Set Point: Old pleasures don’t show up

57. Drugs cause Dopamine Surges in the midbrain reward system

61. HYPOFRONTALITY: during craving states the cortex actually shuts off

65. How do we restore the Frontal Cortex?

69. Then . . .

71. Addiction fits the “Disease Model!”