This slide deck has been developed by Professor David Nutt,  Imperial College London, in collaboration with Cambridge Medical – A prime Global agency.

Substance use disorders (SUD), and addictions in general, are characterized by the compulsion to seek out or take a substance or engage in certain behaviours, with the associated loss of control. In this slide deck, basic concepts and definitions related to substance use disorders are explored. Theories of the underlying mechanisms are visualized, and a brief introduction to diagnostics based on DSM-5 and ICD-11 is given.

 

file_download Download slide

Index for
slide deck

History, definitions and diagnosis

Addiction slide deck 1 – slide 1
Substance use disorders and other addictions
file_download Download slide
Addiction 1 History Definitions And Diagnosis NT Slide2
The language of addiction

Whilst the origins of the word ‘addiction’ are complex, as outlined on the slide, the roots of the word lie in the concept of enslavement.[Rosenthal & Faris, 2019; Heilig et al., 2021] In modern use, the concept of addiction is…

file_download Download slide

Introduction

Addiction 1 History Definitions And Diagnosis NT Slide3
Introduction
file_download Download slide
Addiction 1 History Definitions And Diagnosis NT Slide4
What is addiction?

There are many possible reasons that an addiction can develop, but, once developed, an addiction can place considerable strain on an individual and on the people around them.[NHS website; APA, 2013] An addiction can impact a person’s work life, and…

file_download Download slide
Addiction 1 History Definitions And Diagnosis NT Slide5
Types of addiction

As shown on the slide, addiction can be conceptualized as encompassing substance-use disorders, and behavioural addictions.[APA, 2013; Sadock et al., 2017] Although categorised separately,[APA, 2013] substance-use disorders and behavioural addictions share many similarities, and are thought to share common neurological…

file_download Download slide
Addiction 1 History Definitions And Diagnosis NT Slide6
Definitions
file_download Download slide
Addiction 1 History Definitions And Diagnosis NT Slide7
Addiction versus dependence

The DSM-5 commentary recognizes that addiction is a term that is easily confused with dependence.[APA, 2013] The categories of substance abuse and substance dependence were eliminated in the DSM-5, and replaced with the overarching category of substance-use disorders.[APA, 2013] Within…

file_download Download slide
Addiction 1 History Definitions And Diagnosis NT Slide8
The historic use of psychoactive substances

The complex history of substance use, and addiction, is reflected in the pendulum swings of history where attitudes to addiction have changed over time.[Crocq, 2007] Such debates that have arisen include whether addiction is a sin or a disease, whether…

file_download Download slide
Addiction 1 History Definitions And Diagnosis NT Slide9
Pharmacology of drugs of abuse

As shown on the slide, drugs of abuse have a range of different targets and interact with different neurochemical pathways in the brain.

References used on slide:Purves D, Augustine GJ, Fitzpatrick D, et al. (eds). Neuroscience,…

file_download Download slide

The mechanics of addiction

Addiction 1 History Definitions And Diagnosis NT Slide10
The mechanics of addiction
file_download Download slide
Addiction 1 History Definitions And Diagnosis NT Slide11
Theories of addiction

Many theories attempt to explain the complex phenomenology of addiction, some of which are outlined on the slide. These various approaches to explaining addiction are not mutually exclusive, and it seems likely that different parts of separate theories might best…

file_download Download slide
Addiction 1 History Definitions And Diagnosis NT Slide12
Addiction – from choice to habit

The slide conceptualises how, though preoccupation, withdrawal, and habit formation, a choice can become a habit.[Nutt & Nestor, 2018] This process of addiction can be thought of as reflecting changes in brain homeostasis, and can ultimately lead to:[Nutt & Nestor,…

file_download Download slide
Addiction 1 History Definitions And Diagnosis NT Slide13
Dopamine as a driver of addiction

As shown on the slide, over time a person with addiction who starts taking stimulant drugs or alcohol for pleasure experiences brain changes that result in that person needing to taking drugs in order to relieve dysphoria.[Sadock et al., 2017;…

file_download Download slide
Addiction 1 History Definitions And Diagnosis NT Slide14
Stages of opioid addiction

As with addiction to stimulants or alcohol, over time a person with addiction who starts taking opioid drugs for pleasure experiences brain changes that result in that person needing to take drugs in order to relieve dysphoria.[Sadock et al., 2017;…

file_download Download slide
Neurocircuitry of the addiction cycle
Neurocircuitry of the addiction cycle

The diagram on the slide illustrates the interaction between neurocircuitry and behaviour of addiction, divided into binge/intoxication, withdrawal/negative affect, and preoccupation/anticipation, each of which is associated with the activation of certain neurological pathways.

References used on slide: Sadock BJ,…

file_download Download slide