#33 Dr. George Koob on the Neurobiology of Addiction

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Dr. George Koob is an internationally recognized expert on alcohol, stress, and the neurobiology of alcohol and drug addiction. He is the Director of the National Institute on Alcohol Abuse and Alcoholism, where he provides leadership in the national effort to reduce the public health burden associated with alcohol misuse. As NIAAA Director, Dr. Koob oversees a broad portfolio of alcohol research ranging from basic science to epidemiology, diagnostics, prevention, and treatment. Dr. Koob earned his doctorate in Behavioral Physiology from Johns Hopkins University in 1972. Prior to taking the helm at NIAAA, he served as Professor and Chair of the Scripps’ Committee on the Neurobiology of Addictive Disorders and Director of the Alcohol Research Center at the Scripps Research Institute. Dr. Koob is the recipient of many prestigious honors and awards for his research, mentorship, and international scientific collaboration. Dr. Koob has authored more than 650 peer-reviewed scientific papers and is a co-author of The Neurobiology of Addiction, a comprehensive textbook reviewing the most critical neurobiology of addiction research conducted over the past 50 years.

Neurobiology of Addiction refers to the of changes in the brain circuits of an individual after repeated use. In the most severe cases, there are changes in the reward system, decision making, and self-control become impaired. The specific changes in the brain will depend upon what addictive substance is used: alcohol, opioids, cocaine. These agents induce an increase in dopamine in the part of the brain called the basil ganglia which in turn produces an intense feeling of pleasure. The other part of the brain referred to as the prefrontal cortex becomes impaired after repeated substance use, which makes stopping more difficult. After repeated use, tolerance develops, and the brain needs more of the substance to create that experience of pleasure. This can make life without the substance feel less enjoyable. When a person experiences the pain of withdrawal symptoms, they will seek to use substances in order to reduce those distressing feelings associated with withdrawal.

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