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Vol. LVIII, No. 9
May 5, 2006
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NIDA Director Delivers Spirit Lecture

NIDA director Dr. Nora Volkow talks with NIEHS director Dr. David Schwartz before she delivered the fifth annual Spirit Lecture.
Drug addiction is a disease of the brain, according to Dr. Nora Volkow, director of the National Institute of Drug Abuse. Volkow delivered the fifth annual Spirit Lecture on Mar. 20 at NIEHS. The annual event honors "women sustaining the American spirit." Volkow's presentation aimed at changing the way people think about drug abuse, to ensure they understand that they are dealing with a medical disease, not a lack of will.

Chronic exposure to drugs creates changes in the brain that cause addiction, which, by definition, a person has no control over, she said. While vulnerability to drug addiction is partially genetically determined, exposure at certain stages — such as adolescence — is much more harmful than exposure at other stages. Drug abuse, Volkow said, is a developmental disease that often begins in adolescence, and sometimes in late childhood. In adolescents' developing brains, the target areas for drugs of abuse are significantly larger than in adults, while the areas that inhibit emotion or suppress impulses are not fully developed in youngsters, she said.

It is important to recognize that the earlier someone begins taking drugs, the more severe the resulting addiction will likely be, she explained. Volkow also said environmental factors such as the availability of drugs, family support, poverty and crime all play a role in either protecting people from or putting them at risk for drug abuse.

She said animal studies have shown that if you stress an animal, it is more likely to take drugs. Therefore, Volkow noted, applying stressors is akin to stimulating drug abuse. A primate study conducted by Wake Forest University researchers showed that dominant animals within the social structure had more dopamine receptors, are less likely to experience stress and are less susceptible to drug addiction. By contrast, subordinate animals had fewer receptors and were more vulnerable to addiction. While human social structures are more complex — individuals can be dominant in some areas of their life while being subordinate in others — the social environment and related stress clearly emerge as important factors in addiction, Volkow said.

She said addressing the problem of addiction requires an approach that considers social factors, behavioral factors, neuronal circuits, protein expression and the genome. Only then can targeted interventions be created to protect people at greater risk for drug addiction, she noted.

A physician and psychiatrist, Volkow was appointed director of NIDA in 2003. She pioneered the use of brain imaging to investigate toxic effects of drugs.

Before joining NIDA, Volkow was a professor in the department of psychiatry and was associate dean of the medical school at the State University of New York, Stony Brook. She is a member of the National Academy of Sciences' Institute of Medicine.

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