IMR Press / FBL / Volume 22 / Issue 9 / DOI: 10.2741/4557

Frontiers in Bioscience-Landmark (FBL) is published by IMR Press from Volume 26 Issue 5 (2021). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on as a courtesy and upon agreement with Frontiers in Bioscience.


Substance use disorder a bio-directional subset of reward deficiency syndrome

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1 Department of Psychiatry and McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL, USA
2 Division of Addiction Services, Dominion Diagnostics, LLC, North Kingstown, RI, USA, Igene, Austin , Texas, USA
3 Departments of Psychiatry and Behavioral Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA
4 Division of Neuroscience Research and Addiction Therapy, Shores Treatment and Recovery Center, Port Saint Lucie, FL, USA
5 Human Integrated Services Unit, University of Vermont Centre for Clinical and Translational Science, College of Medicine, Burlington, VT, USA
6 Eotvos Loránd University, Institute of Psychology, Budapest, Hungary
7 Division of Clinical Neurology, PATH Foundation NY, New York, NY, USA
8 Division of Nutrigenomics, LaVita RDS, Draper, UT, USA
9 Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
10 Department of Psychology, University of Gothenburg, Gothenburg, Sweden
11 Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions, Research Institute on Addictions, University at Buffalo, Buffalo, NY, USA
12 Department of Psychiatry, University at Minnesota, Minneapolis, MN, USA
Front. Biosci. (Landmark Ed) 2017, 22(9), 1534–1548;
Published: 1 March 2017

This commentary is to inform clinicians challenged with an increase in people seeking treatment for Substance Use Disorder (SUD), that the ninety percent revolving door, is, in part, due to post–withdrawal, untreated neurotoxicity. This impairment attenuates neurotransmitter signaling and compromises resting state functional connectivity, leading to unwanted sequelae including depression, sleep disturbances, sensation seeking, lack of satisfaction and impulsivity. Neuroimaging studies indicate that neurobiological recovery can take years. Like a “double edge sword” SUD has a biological bi –directional (bio-directional) effect on the brain reward circuitry. The acute intake of psychoactive drugs results in heightened dopaminergic activity, while, the opposite, hypodopaminergia occurs following chronic abuse. Individuals with SUD can have a genetic predisposition, compounded by stress and neurotoxically induced, epigenetic insults that impact recovery from protracted abstinence. Follow-up post –short-term recovery usually includes supportive therapies and programs like 12 –steps and other fellowships. However, relapse will usually occur if post –short-term recovery hypodopaminergia is not treated with attempts at epigenetic manipulation of compromised brain neurochemistry using some manner of pro-dopamine regulation.

glutaminergic drive
resting state functional connectivity
Reward Deficiency Syndrome
DRD2 gene
bio-directional functional magnetic resonance imaging
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