Volkow: why pain and addiction will go personalized

Why NIDA director Nora Volkow thinks pain and addiction need personalized approaches

While addiction still carries a social stigma, neuroscience research not only supports the view that it is a disease, but is starting to paint a more nuanced picture of the variety of mechanistic pathways involved. Nora Volkow, director of NIH’s National Institute on Drug Abuse, thinks a personalized approach to the condition is warranted to address the different biological disease processes operating in different patients.

Volkow has headed up NIDA since 2003 and has championed a complex definition of addiction that neither reduces it solely to a behavioral problem nor to a biological one. She has also advocated for a multipronged approach to therapeutics development, as there is likely to be no one-size-fits-all solution (see “Addiction Camps”).

According to Volkow, the preponderance of evidence suggests that individuals have different susceptibilities to addiction, based on a constellation of biological, behavioral, social and economic factors. Moreover, the biological risks are diverse, involving genetics, epigenetics, and the wiring and fine-tuning of synaptic circuits throughout the brain, not just dopamine signaling.

That means engaging in drug taking is riskier for some people than for others, and that not everyone

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