Addictive Substances and Neurological Disease

Addictive Substances and Neurological Disease

Alcohol, Tobacco, Caffeine, and Drugs of Abuse in Everyday Lifestyles
2017, Pages 281-291
Addictive Substances and Neurological Disease

Chapter 25 - Paradise Lost: A New Paradigm for Explaining the Interaction Between Neural and Psychological Changes in Nicotine Addiction Patients

https://doi.org/10.1016/B978-0-12-805373-7.00025-6Get rights and content

Abstract

We reviewed major hypotheses explaining the development of nicotine addiction, including the reward deficiency syndrome hypothesis, the sensitization theory of addiction, and the integrative neurodevelopmental model. We then describe and expand our own hypothesis, the Paradise Lost Theory (PLT) of Addiction. PLT hypothesizes that nicotine directly influences smokers' brain reward circuits and induces both hyperresponsivity to tobacco-related cues and hyporeactivity to nontobacco-related ones (such as food and money). The combination of nicotine-induced neural alterations and smokers' cognitive fallacies, caused by a lack of awareness regarding nicotine's influence on neural functioning, allows smokers to continue smoking, which leads to addiction. Additionally, self-reproductive rewards provided by smoking and high upward quantitative endurability of cigarette smoking are important factors in the development of addiction. These elements are influenced by trait variables; however, even individuals without any typical risk factors can acquire a nicotine addiction. Implications of PLT for intervention are discussed.

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