- Due to drug intoxication
- Positive emotions, such as euphoria, are positively reinforcing and increasing drug use in the early stage of addiction 

Drug Liking 

- Associated with negative reinforcement
- Desire to consume a drug in order to improve the current emotional state and to offset the withdrawal symptoms 

Withdrawal and Negative Affect 

- Fixation of wanting to use a drug, which can also be associated with negative affect 

Craving and Negative Affect

3 key drivers that underlie neurobiological changes associated with opioid dependence 

1. Drug liking
2. Withdrawal and negative affect
3. Craving and negative affect 

Rutgers University

- Craving/addiction neuroadaptive theories 
- Cycle of addiction 
- Reward and Anti-Reward pathways 
- Craving Assessment Tools

Neurobiology of Craving in Opioid Use Disorder 

Kakko J, Alho H, Baldacchino A, Molina R, Nava FA and Shaya G
 2019) Craving in Opioid Use Disorder: From Neurobiology to Clinical Practice.Front. Psychiatry 10:592. doi: 10.3389/fpsyt.2019.00592

Craving in Opioid Use Disorder: From Neurobiology to Clinical Practice

- Theories include opponent, inhibitory control, reward deficiency, incentive sensitization, aberrant learning, and anti-reward theory 

Neuroadaptive Theories in Addiction/Craving

Cycle of Addiction

Reward and Anti-Reward Pathways 

- Measures of craving can be divided into observational and self-reported 
- Ecological momentary assessments (EMA) is a newer approach to assess cravings 


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