Molecules of Addiction

Drugs produce changes in the brain, and these changes are in the levels and activity of various molecules in certain neurons. For example, drugs seem to reduce the levels of D2 dopamine receptors, which have been discussed previously. These and other changes form the cellular and molecular bases of addictive behavior. Therefore, knowledge of these molecular events is critical for understanding drug addiction. Understanding a disease does not necessarily mean we can cure it, but it at least defines the problem. This understanding also sets the stage for a possible cure when new techniques and approaches develop over time.

The story of dopamine has been told to illustrate how brain chemicals mediate addiction. But dopamine is not the only important neurotransmitter. We have mentioned others including glutamate, GABA, serotonin, enkephalins, and anandamide. Addiction is complex and involves systems and circuits of neurons with many neurotransmitters. In the future, we hope to better specify the neurotransmitters and the specific neurons that are critical for addiction. We have made progress on this, but more remains to be done. In addition to neurotransmitters, a number of larger molecules such as proteins (transporters, receptors, and so on) are important for addiction. Again, we have learned much but much remains to be discovered.

As detailed in previous chapters, we know something about the genes involved in addiction, and we know something about the various molecules that are involved as well. We are learning about the important new science, epigenetics, and how drugs cause epigenetic changes in gene expression. As described in Chapter 5, "The Dark Side Develops!," epigenetic changes in neurons in the brain change the levels of various proteins in the nerve cells, such as the mesolim-bic neurons. We know a little bit about the drug-induced changes in gene expression and various molecules. But this knowledge needs to be extended and refined. Significant advances are likely in this area in the future. Someday, this knowledge will be translated into gains in new medications and treatments.

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