Neural mechanisms linked to treatment outcomes and recovery in substance-related and addictive disorders

Abstract

The present review focuses on potential neural mechanisms underlying recovery from psychiatric conditions characterised by impaired impulse control, specifically substance use disorders, gambling disorder, and internet gaming disorder. Existing treatments (both pharmacological and psychological) for these addictions may impact brain processes, and these have been evaluated in neuroimaging studies. Medication challenge and short-term intervention administration will be considered with respect to treatment utility. Main models of addiction (e.g., dual process, reward deficiency syndrome) will be considered in the context of extant data. Additionally, advanced analytic approaches (e.g., machine-learning approaches) will be considered with respect to guiding treatment development efforts. Thus, this narrative review aims to provide directions for treatment development for addictive disorders.

Keywords:

• Neurobiology
• recovery
• substance-related disorders
• gambling disorder
• internet gaming disorder
• impulsivity
• addictive behaviours
• internet addiction

Disclosure statement

None of the authors have any conflicts of interest. Dr. Potenza has consulted for Opiant Pharmaceuticals, Idorsia Pharmaceuticals, AXA, Game Day Data, and the Addiction Policy Forum; has been involved in a patent application with Yale University and Novartis; has received research support (to Yale) from Mohegan Sun Casino and the National Centre for Responsible Gaming; has participated in surveys, mailings or telephone consultations related to drug addiction, impulse-control disorders or other health topics; has consulted for and/or advised gambling and legal entities on issues related to impulse-control/addictive disorders; has provided clinical care in a problem gambling services program; has performed grant reviews for research-funding agencies; has edited journals and journal sections; has given academic lectures in grand rounds, CME events and other clinical or scientific venues; and has generated books or book chapters for publishers of mental health texts.

Additional information

Funding

Dr. Potenza’s involvement was supported by the Connecticut Council on Problem Gambling, Children and Screens, and the National Institutes of Health (R01 DA039136, R01 DK121551, R01 AA029611, RF1 MH128614). This study was supported by the CITEI B22-001 project (Universidad Internacional de La Rioja) and by the Proyecto de Investigación concedido por la UNIR en la convocatoria 2021–2023.