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May 22/29, 2018

The Neurobiology of Opioid Addiction and the Potential for Prevention Strategies

Author Affiliations
  • 1Department of Anesthesia, Stanford University School of Medicine, Stanford, California
  • 2Department of Molecular & Cellular Physiology, Howard Hughes Medical Institute, Stanford, California
JAMA. 2018;319(20):2071-2072. doi:10.1001/jama.2018.3394

The health consequences of the opioid epidemic have led the United States to an inflection point at which its biomedical research–driven plan should be changed to effectively address this epidemic. To do so, 2 important changes in the focus for National Institutes of Health (NIH)–funded research are needed, which hopefully will develop actionable information and critically needed new treatments for opioid addiction. First, NIH-funded research currently focuses on the later stages of drug addiction1 that are associated with drug craving and relapse. However, because the opioid epidemic has a large iatrogenic component, prevention strategies that target the early stage of drug addiction should be developed. Second, a far deeper understanding of opioid neurobiology is required to change the focus. Instead of examining opiate-induced changes only at the neural circuit level or with brain imaging to identify involved brain regions, opiate-induced changes in synaptic signaling should be characterized.