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

Neuroadaptive Theories in Addiction/Craving

3 key drivers that underlie neurobiological changes associated with opioid dependence 

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

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 


Craving Assessment Tools 

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

Rutgers University

- Overwhelmingly strong desire or need to use a drug because of the memory of a pleasant rewarding effect in place of a negative emotional state 
- Strongly associated with patients having opioid misuse 
- Important treatment target to reduce the risk of relapse and
improve patients’ quality of life
- Essential component of dependence syndromes 

Craving

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

Neurobiology of Craving in Opioid Use Disorder 

- Slow overall changing of craving level that occurs in the absence of external cues
- May reflect negative effects associated with abstinence or
drug withdrawal and activate the anti-reward system 

Background (Tonic) Craving

- Episodes of fast-onset, short duration spikes of craving 
- Induced by specific drug cues or stressful life events 
- Craving intensity correlates with stress severity

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