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Previous Volume 349:975-986 September 4, 2003 Number 10 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text PDF PDA Full Text Purchase this article Perspective by Clark, H. W. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

Drug addiction is a chronic, relapsing disorder in which compulsive drug-seeking and drug-taking behavior persists despite serious negative consequences. Addictive substances induce pleasant states (euphoria in the initiation phase) or relieve distress. Continued use induces adaptive changes in the central nervous system that lead to tolerance, physical dependence, sensitization, craving, and relapse (Table 1). The addictive drugs discussed here are opioids, cannabinoids, ethanol, cocaine, amphetamines, and nicotine.

View this table: [in this window] [in a new window]   Table 1. Definitions of Terms Used in Drug Addiction.

 
The World Health Organization¹ and the American Psychiatric Association² use the term "substance dependence" rather than "drug addiction." "Drug addiction," however, emphasizes the behavioral . . . [Full Text of this Article]

Factors Influencing Drug Abuse and Dependence

Pharmacologic and Physicochemical Properties of Drugs

Personality and Psychiatric Disorders

Genetic Factors

Drug Effects and Mechanisms of Action

Opioids

Cannabinoids

Ethanol

Cocaine and Amphetamines

Other Addictive Substances

Neurobiology

Animal Models

Neuroanatomical Substrates

The Leading Role of the Dopamine Pathway

            Dopamine and Opioids

            Dopamine and Cannabinoids

            Dopamine and Ethanol

            Dopamine and Cocaine and Amphetamines

            Dopamine and Nicotine

The Opioid Pathway

Long-Term Drug Use and Neuroadaptation

Tolerance and Withdrawal

            Opioid Tolerance

            Opioid Withdrawal

            Stress Systems

Molecular Mechanisms of Sensitization and Relapse

            Functional Changes

            Structural Changes

Comments

Source Information

From the Institut Municipal d'Investigació Mèdica (J.C., M.F.), Universitat Pompeu Fabra (J.C.), and Universitat Autònoma de Barcelona (M.F.) — all in Barcelona, Spain.

Address reprint requests to Dr. Camí at Institut Municipal d'Investigació Mèdica, Doctor Aiguader 80, E-08003 Barcelona, Spain, or at jcami@imim.es.

Related Letters:

Mechanisms of Drug Addiction
Munzar P., Camí J., Farré M.
Extract | Full Text | PDF  
N Engl J Med 2003; 349:2365, Dec 11, 2003. Correspondence

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