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A Public Health Guide to Ending the Opioid Epidemic$
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Jay C. Butler and Michael R. Fraser

Print publication date: 2019

Print ISBN-13: 9780190056810

Published to Oxford Scholarship Online: October 2019

DOI: 10.1093/oso/9780190056810.001.0001

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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (www.oxfordscholarship.com). (c) Copyright Oxford University Press, 2020. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use. date: 08 April 2020

The Neuroscience of Addiction

The Neuroscience of Addiction

A Primer for Public Health Professionals

(p.45) 6 The Neuroscience of Addiction
A Public Health Guide to Ending the Opioid Epidemic

Jay C. Butler

Oxford University Press

Effective public health approaches to addressing the opioid crisis require an understanding of addiction as a health condition primarily involving the brain, rather than an individual’s series of ongoing “bad choices” or inherent criminal tendencies that ultimately lead to poor health outcomes. Addiction has been defined as “the most severe, chronic stage of substance-use disorder, in which there is a substantial loss of self-control, as indicated by compulsive drug taking despite the desire to stop taking the drug.” Whether addiction is viewed primarily as a “disease” or the outcome of experiential and environmental influences, chronic changes that occur in the brain of the person with addiction form the scientific basis of an effective public health response. Understanding the behavioral changes driven by addiction is vital since they have a profound impact on public safety, the criminal justice system, and public health. This chapter provides an overview of the changes that occur in the brain during development of addiction and how understanding these changes can improve public health practice and policy. It complements more complete clinical and basic science reviews of the neuroscience of addiction that have been recently published.

Keywords:   neuroscience of addiction, chronic disease of the brain, addiction, treatment, prevention, three stages of addiction, primary prevention of addiction, adverse childhood events, ACEs

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