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ADDICTION NEUROETHICS
The Promises and Perils of Neuroscience Research on Addiction
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international research monographs in the addictions (irma)
Series Editor
Professor Griffith Edwards
National Addiction Centre
Institute of Pyschiatry, London
Volumes in this series present important research from major centres
around the world on the basic sciences, both biological and behavioural, that
have a bearing on the addictions. They also address the clinical and public
health applications of such research. The series will cover alcohol, illicit
drugs, psychotropics and tobacco. It is an important resource for clinicians,
researchers and policy makers.
Also in this series:
The Life of the Heroin User: Typical Beginnings, Trajectories and Outcomes
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Mortality amongst Illicit Drug Users: Epidemiology, Causes and Intervention
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Cannabis Dependence: Its Nature, Consequences and Treatment
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Gambling as an Addictive Behaviour: Impaired Control, Harm Minimisation,
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ISBN 9780521176378
A Community Reinforcement Approach to Addiction Treatment
Edited by Robert J. Meyers and William R. Miller
ISBN 9780521026345
Cannabis and Cognitive Functioning
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ISBN 9780521024808
Alcohol and the Community: A Systems Approach to Prevention
Harold D. Holder
ISBN 9780521035040
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ADD I C T I ON NEUROETH I C S
The Promises and Perils of NeuroscienceResearch on Addiction
ADRIAN CARTER AND WAYNE HALL
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# Adrian Carter and Wayne Hall 2012
This publication is in copyright. Subject to statutory exception
and to the provisions of relevant collective licensing agreements,
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First published 2012
Printed in the United Kingdom at the University Press, Cambridge
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Library of Congress Cataloging-in-Publication Data
Carter, Adrian.
Addiction neuroethics: the promises and perils of neuroscience research on addiction / Adrian
Carter and Wayne Hall.
p. cm. – (International research monographs in the addictions)
ISBN 978-1-107-00324-8 (Hardback)
1. Drug addiction. 2. Neurosciences–Moral and ethical aspects.
I. Hall, Wayne. II. Title. III. Series.
HV5801.C34 2012
174.208–dc232011026105
ISBN 978-1-107-00324-8 Hardback
Cambridge University Press has no responsibility for the persistence or
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Every effort has been made in preparing this book to provide accurate and up-to-date information
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To Donna and Pat
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Contents
Preface page xv
Acknowledgements xix
List of abbreviations xxi
Chapter 1. Introduction 1
1.1. Introduction 1
1.1.1. Neuroethics: the promises and perils
of neuroscience research 4
1.2. Addiction enters the neuroscientific era 7
1.3. Aims and overview 10
Part 1. The Science of Addiction
Chapter 2. What is addiction? 19
2.1. Introduction 19
2.2. The phenomenology of addiction 20
2.2.1. Folk understanding of addiction 21
2.2.2. Clinical understanding of addictive
behaviour 21
2.3. The social and economic costs of drug use
and addiction 23
2.3.1. Prevalence of drug use and addiction
in Australia 23
2.3.2. Drug use related harm 24
2.3.3. Burden of disease due to alcohol and drug use 25
2.4. Social response to drug abuse and addiction 26
2.5. Governing models of addiction 28
2.5.1. Moral vs. medical models of addiction 28
2.5.2. Neurobiological models of addiction 31
2.5.3. Potential consequences of neurobiological
explanations of addiction 32
2.6. Conclusion 34
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Chapter 3. The neurobiology of addiction 35
3.1. Introduction 35
3.2. The neuroanatomy of addiction 36
3.2.1. Reward and reinforcement: the ‘dopamine
hypothesis’ 38
3.2.2. The endogenous opioid system 45
3.3. Memory, learning and habits 46
3.4. Compulsion, craving and inhibitory control 47
3.5. Executive control and cognitive impairment 47
3.6. Representing bodily urges 50
3.7. Stress and drug use 50
3.8. Molecular and cellular changes in addiction 51
3.8.1. Synaptic plasticity in addiction 52
3.8.2. Epigenetic changes in addiction 53
3.9. Vulnerability to addiction: genetic and
neuropsychological factors 55
3.9.1. Genetic susceptibility to addiction 55
3.9.2. Vulnerabilities to addiction: a confluence
of the genetic and the social 57
3.10. Conclusion 59
Chapter 4. Neurobiological treatment of addiction 61
4.1. Introduction 61
4.2. Pharmacological treatments that block drug
binding 62
4.2.1. Agonists 62
4.2.2. Antagonists 66
4.2.3. Partial agonists 67
4.2.4. Duration of pharmacological treatment
of addiction 68
4.3. Pharmacological treatments of withdrawal 69
4.4. Pharmacological treatments of craving and relapse 70
4.4.1. Dopaminergic mesolimbic reward pathway 70
4.5. Pharmacological interventions in systems related
to the reward pathway 72
4.5.1. Opioids 72
4.5.2. The amino acid neurotransmitters:
glutamate and GABA 73
4.5.3. Cannabinoids 74
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4.5.4. Corticotropin-releasing factor and the stress
response 74
4.5.5. Memory manipulators and cognitive enhancers 75
4.6. Pharmacogenetic treatment of addiction 75
4.7. Novel approaches to drug treatment 76
4.7.1. Immunotherapies 76
4.7.2. Long-acting or sustained-release medications 77
4.7.3. Neurosurgery and deep brain stimulation 78
4.7.4. Transcranial magnetic stimulation 79
4.7.5. Applications of neuroimaging and
neurocognitive screening in addiction treatment 79
4.8. Psychosocial treatment of addiction 81
4.9. Conclusion 81
Part 2. The Ethical and Philosophical Implications
of Neuroscientific Knowledge of Addiction
Chapter 5. Autonomy, addiction and the public good 85
5.1. Introduction 85
5.2. Approaches to ethical analysis 87
5.2.1. Introduction to ethics 87
5.2.2. Principlism 90
5.2.3. Human rights 94
5.2.4. A pragmatic approach to neuroethics 95
5.3. Ethical principles in the treatment of addiction 97
5.3.1. Autonomy and addiction 99
5.3.2. Addiction and the public good 101
5.4. The minimum conditions for the ethical treatment
of addiction 102
5.5. Conclusion 103
Chapter 6. Autonomy and the capacity to consent to addiction
treatment 105
6.1. Introduction 105
6.2. The role of informed consent in addiction treatment 106
6.3. Can ‘addicts’ say ‘no’ to drugs? 108
6.3.1. Sceptical views of impaired autonomy
in addicted individuals 113
6.3.2. Capacity to consent to abstinence-oriented
treatment 114
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6.4. Implications for obtaining informed consent to enter
addiction treatment 115
6.5. Guidelines when admitting individuals into addiction
treatment 117
6.6. Conclusion 119
Chapter 7. The rights of individuals treated for addiction 121
7.1. Introduction 121
7.2. Addiction, drug policy and human rights 122
7.2.1. Basic human rights for addicted individuals 123
7.3. The right to access to effective treatment of addiction 124
7.3.1. The case for medical treatment of addiction 124
7.3.2. Effective treatment of addiction 125
7.3.3. The right to access harm reduction measures 126
7.3.4. The right to effective medical treatment 127
7.4. The use of unevaluated and risky treatments
of addiction 128
7.5. Respecting human rights when treating under
legal coercion 129
7.6. Human rights in the treatment of addicted prisoners 130
7.7. Human rights in the treatment of addicted pregnant
women 131
7.8. Future challenges for human rights practitioners 132
7.9. Conclusions 133
Chapter 8. Coerced treatment of addiction 134
8.1. Introduction 134
8.2. Approaches to coerced treatment 135
8.3. The case for legally coerced treatment 136
8.4. When is coerced treatment ethical? 138
8.5. Ethical issues in providing coerced addiction treatment 142
8.6. Is compulsory addiction treatment ethically
acceptable? 142
8.7. Conclusion 144
Chapter 9. Ethics of addiction research 146
9.1. Introduction 146
9.2. Informed consent to participate in addiction research 148
9.3. Paying addicted subjects 150
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9.4. Privacy, confidentiality and anonymity 152
9.5. Administering addictive drugs in research studies 153
9.5.1. Why do neuroscientists give drugs to ‘addicts’? 154
9.5.2. The risks of giving ‘addicts’ drugs in research
settings 156
9.5.3. Research participation by treated vs. untreated
‘addicts’ 157
9.5.4. Recruiting subjects and obtaining consent 158
9.6. Conclusion 160
Part 3. The Ethical and Public Policy Implications of Novel
Technologies for the Treatment of Addiction
Chapter 10. New developments in the treatment of addiction 165
10.1. Introduction 165
10.2. Novel pharmacological treatments of addiction 167
10.2.1. Ethical and policy issues in
pharmacological R&D in addiction 168
10.2.2. Anti-craving drugs 169
10.3. Novel relapse prevention treatments 170
10.3.1. Drug vaccines as a prophylaxis against
relapse 170
10.3.2. Sustained-release treatments: depot
medications and drug implants 173
10.3.3. The Australian naltrexone implant
experience 176
10.3.4. Coerced use of depot naltrexone to
‘restore autonomy’? 176
10.4. Conclusion 179
Chapter 11. The search for a neurological ‘cure’ of addiction? 180
11.1. Introduction 180
11.2. A brief history of addiction ‘cures’ 181
11.2.1. Quacks and nostrums: 1830–1900 181
11.2.2. Early medical treatments of drug
withdrawal: 1900–1970 183
11.3. The modern era: neurobiologically inspired
addiction ‘cures’ 185
11.3.1. Ibogaine therapy 186
11.3.2. Ultra-rapid opioid detoxification 187
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11.3.3. Neurosurgical ‘treatment’ of addiction 187
11.4. Deep brain stimulation for intractable addiction? 190
11.5. Avoiding future therapeutic enthusiasms 195
Chapter 12. Preventive medicine and personalised treatment
of addiction 197
12.1. Introduction 197
12.2. Bioprediction of addiction liability 197
12.2.1. Predictive genetic testing of addiction
liability 198
12.2.2. Using genetic information to increase
abstinence from drug use 200
12.2.3. Genetic discrimination and third party uses
of genetic information 202
12.2.4. Premature commercialisation of genetic
testing 204
12.2.5. Preventive interventions: ‘vaccinating’
against addiction 206
12.2.6. Predictive uses of neuroimaging technologies 207
12.3. Personalised treatment of addiction 208
12.3.1. Pharmacogenetic treatment of addiction 209
12.3.2. Neuroimaging and cognitive tests in the clinic 211
12.4. Conclusion 213
Chapter 13. Feeling better than well 214
13.1. Introduction 214
13.2. Memory modifiers, cognitive enhancers and
mood modulators 214
13.3. What’s wrong with neuroenhancement? 216
13.3.1. Concerns about safety and efficacy 217
13.3.2. Coerced neuroenhancement:
a psychopharmacological ‘arms race’ 218
13.3.3. Equity of access to neuroenhancement
technologies 219
13.3.4 Naturalistic objections to enhancement:
morality and personhood 220
13.4. Lessons from recreational drug use and drug policy 221
13.5. The future of drug regulation 223
13.6. Conclusion 225
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Part 4. The Future of Addiction Research and Policy
Chapter 14. The social and policy implications of addiction
neurobiology 229
14.1. Introduction 229
14.2. Implications for public health policies towards
drug addiction 229
14.3. Medicalisation of addiction 230
14.4. Neuroscience, addiction treatment and public
health policy 232
14.4.1. Competing population health strategies 233
14.4.2. Subversive uses of neuroscience research
on addiction 234
14.5. Drug policy and double standards 237
14.6. The prospects of novel pharmacological harm
reduction: engineering ‘safer’ recreational drugs? 240
14.7. Conclusions 242
Chapter 15. Concluding remarks and summary 244
15.1. Introduction 244
15.2. Summary and conclusion 244
15.2.1. Key findings 247
15.2.2. Specific implications for the treatment
of addiction 250
15.3. Neuroscience and the media: the role and
responsibility of neuroscientists 254
15.4. The tasks ahead for ethicists and policy makers 256
15.5. Future directions for addiction neuroethics 258
15.5.1. Private and public understanding of
addiction neuroscience 259
15.5.2. Capacity to consent in a research or
treatment setting 260
15.5.3. Epidemiological modelling of addiction
policy 261
15.5.4. Using incentives to reduce drug use and
achieve better health outcomes 262
15.6. Conclusion 262
Glossary 264
Bibliography 275
Index 331
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Preface
This book aims to provide a systematic analysis of the social and ethical
implications of neuroscience research on addiction that will be of interest to a
wide range of audiences. This includes those interested in, or working within,
the fields of addiction and mental health, such as clinicians and health care
professionals treating addiction and mental disorders, addiction researchers
from neuroscience, psychology and the social sciences, lawyers, policy
makers and public health educators. It should also be of interest to bioethi-
cists, neuroethicists and others working in applied philosophy, who want to
understand how neuroscience may affect society and public policy. Addiction
Neuroethics is designed to be accessible to advanced undergraduate and
post-graduate students in philosophy and ethics, medicine and psychiatry,
psychology, social work, nursing and law, and educated general readers who
want to learn more about the impact that drug use might have on the brain and
on our ability to control our behaviour.
In 1997, the then director of the National Institute on Drug Abuse, Alan
Leshner, famously proclaimed that ‘addiction is a brain disease, and it
matters’. Neuroscience research, Leshner promised, would revolutionise our
ability to treat addiction and lead to greater acceptance by society of addiction
as a psychiatric disorder, increasing access to medical treatment and decreasing
societal discrimination and stigma affecting those suffering from addiction.
Neuroscience research would put to an end claims that addiction was simply an
excuse for engaging in immoral or weak-willed behaviour, and produce more
humane and therapeutic approaches to addiction.
Unfortunately, these optimistic predictions have yet to be realised. Most
addicted individuals do not receive adequate medical or therapeutic assistance,
even in developed countries. There is some evidence that negative attitudes
toward ‘addicts’ have hardened with increasing acceptance of neurobiological
models of psychiatric disorders. Some commentators have also begun to point
out some potentially adverse consequences of the view that addiction is a brain
disease. For example, an unqualified acceptance of the brain disease model of
addiction carries substantial social policy risks:
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• It focuses on addiction to the exclusion of other adverse effects of drug use
(e.g. drug-related accidents, violence or drug-induced mental illness).
• It may unwittingly promote a policy preference for biological treatment of
addicted individuals over effective social policies to minimise drug use and
addiction (e.g. taxation, barriers to access).
• It may be seen as warranting experimentation with neurosurgical interven-
tions in brain function to ‘cure’ addiction, as has happened in the case of
neurosurgery and deep brain stimulation.
• It may also increase the use of coercive forms of treatment for addicted
persons whose capacity to make free and informed choices is said to be
seriously impaired by their ‘brain disease’.
These outcomes are already providing challenges to health care workers,
scientists and policy makers working in the field of addiction. They have
the potential to cause unanticipated harm to those who suffer from an addic-
tion and lead to misguided social policies that may paradoxically increase
drug-related harm. Such misuses of neuroscience research may also lead
to community scepticism or mistrust of neuroscience and neuroscientists,
impeding the timely translation of research into beneficial treatments and
policy.
According to many neuroscientists, addiction is a condition where repeated
use of addictive drugs produces changes in the brain that undermine an
addicted individual’s ability to control their drug use. According to prominent
psychiatrists Charles Dackis and O’Brien, the brains of addicted individuals
have been ‘hijacked’ by the drug. ‘Addicts’, they argue, are neurochemically
driven to repeatedly consume drugs, despite the harm that their use causes to
themselves and those around them. Such views question philosophical con-
cepts such as free will, agency and responsibility. The ethical, social and
public policy implications of addiction neuroscience will also provide
instructive case studies for examining the broader neuroethical implications
of neuroscience for society.
A detailed consideration of the ethical, social and policy challenges raised
by neuroscience research is essential if we are to realise some of Leshner’s
promises about addiction neuroscience, with minimal delay and without
causing harm. Our aim is to provide an accessible analysis of these challenges
raised by developments in neuroscience, and, when possible, to offer guide-
lines and recommendations to those treating addicted individuals, conducting
addiction research, seeking policy solutions, or simply affected by their own
or a family member’s addictive drug use.
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We have four major objectives that are reflected in the four parts of this book.
First, we critically review neuroscience research on addiction, from genes and
molecular and cellular biology through to neuropsychology and cognitive neuro-
science. We examine the impact that addictive drug use has on decision-making
and control over behaviour. We also include evidence from the social and
historical sciences to provide a social context to our analysis of the neuroscience.
This is both a synthetic and an analytical project: it aims to bring together
information and research from a range of disciplines in order to better understand
the potential social impacts of neuroscience research on addiction.
Second, based on this review, we provide clear practical recommendations
for treating addiction and dealing with addicted individuals, such as:
• Entering addicted individuals into treatment
• Providing treatments, including harm reduction programs, in a fair and
equitable manner
• The use of coercion in treating addiction
• Conducting neuroscience research with addicted individuals
Third, we examine the latest developments in neurobiological treatments of
addiction to identify the ethical, social and policy issues that their potential
future use may raise. These include:
• Novel psychopharmacological treatments
• Sustained-release medications (e.g. drug implants and depot injections)
• Drug vaccines to prevent relapse
• Neurosurgical treatments (e.g. deep brain stimulation)
• Genetic screening and neuroimaging to identify those vulnerable to
developing addiction
Based on this analysis, we provide ethical guidelines for conducting research
on these interventions and for their clinical use, should they prove safe and
effective.
Finally, we consider some unwelcome consequences of the misuse of
neuroscience research for social and public health policy. These include: a
focus on medical responses to addiction targeted at vulnerable individuals at
the expense of more broadly effective population approaches; and the poten-
tial misuse of neuroscience research by the alcohol, tobacco and gambling
industries to influence public policy in directions favourable to their interests.
This book is only a beginning; we raise many questions that will require much
more research and analysis. We therefore conclude the book with some
suggestions for future research in the field of Addiction Neuroethics.
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Acknowledgements
This book is an expanded and updated version of Adrian Carter’s Doctoral
Dissertation submitted to the Queensland Brain Institute, The University of
Queensland in 2009. It builds onWayneHall’s long-standing interests in the ethical,
social and policy issues raised by research on addiction, initially as the Director of
the National Drug and Alcohol Research Centre, University of New South Wales,
and more recently as NHMRC Australia Fellow and Director of the Addiction
Neuroethics Unit, The University of Queensland Centre for Clinical Research.
There are many researchers and colleagues who we are indebted to for their
kind support and insight during the research and preparation of this book. We
would like to sincerely thank Judy Illes and Eric Racine for their ongoing
support and encouragement for this project. They have been invaluable in
highlighting the importance of Addiction Neuroethics as well as providing
important reflections on our arguments. We would also like to offer our
appreciation to the following for comments and insights on earlier drafts of
the material in this book: Perry Bartlett, Director of the Queensland Brain
Institute for funding Adrian Carter’s post-graduate research and his support
throughout his thesis; Benjamin Capps, David Nutt and Richard Ashcroft who
we collaborated with on a project for EMCDDA and who made important
contributions on many parts of this research; Robert Hester, Craig Fry and
Murat Yucel at The University of Melbourne; Dan Lubman at Turning Point,
Melbourne; Mark Daglish of The University of Queensland; and Peter Miller at
Deakin University. We would like to thank the two anonymous reviewers for
their thoughtful comments on the proposal for this book, as well as the staff at
Cambridge University Press (particularly Joanna Chamberlin). We would also
like to thank colleagues at the Addiction Neuroethics Unit, UQ Centre for
Clinical Research for their ongoing support and editorial advice: Jayne Lucke,
Coral Gartner, Brad Partridge, Sarah Yeates, Rebecca Mathews and Stephanie
Bell. We would also like to thank both our friends and families. Last but not
least, we would offer our most sincere appreciation to Donna and Pat, without
whose unflinching support, this book would not be possible. Any errors or
omissions that remain, however, are solely the responsibility of the authors.
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Portions of Chapters 3 and 4 previously appeared in Carter, A., Capps, B.,
Nutt, D., ter Muelen, R., Ashcroft, R. and Hall, W. (2009) Addiction neuro-
biology: ethical and social implications, European Monitoring Centre for
Drugs and Drug Addiction, Lisbon.
Portions of Chapters 5 and 8 previously appeared in Carter, A. and Hall, W.
(2007) The ethical use of psychosocially assisted pharmacological treatment
of opioid dependence, World Health Organization, Geneva.
Portions of Chapters 6 and 9 previously appeared in Carter, A. and Hall, W.
(2008) The issue of consent to research that administers drugs of addiction
to addicted persons, Accountability in Research, 15, 209–225 and Carter, A.
and Hall, W. (2008) Informed consent to opioid agonist maintenance treat-
ment: recommended ethical guidelines, International Journal of Drug Policy,
19, 79–89.
Chapter 8 originally appeared in Mental health and human rights (Eds,
Dudley, D., Silvoe, D. and Gale, F.) Oxford University Press, London, (2012).
Portions of Chapter 10 previously appeared in Hall, W., Capps, B. and Carter, A.
(2008) The use of depot naltrexone under legal coercion: the case for caution,
Addiction, 103, 1922–1924.
Portions of Chapter 11 previously appeared in Carter, A. and Hall, W. (2011).
Proposals to trial deep brain stimulation to treat addiction are premature,
Addiction, 106, 235–237 and Carter, A., Bell, E., Racine, E., and Hall, W.
(2010) Ethical issues raised by proposals to treat addiction using deep brain
stimulation, Neuroethics, 1–14.
Portions of Chapter 12 previously appeared in Hall, W., Gartner, C. and
Carter, A. (2008) The genetics of nicotine addictions liability: ethical and
social policy implications, Addiction, 103, 350–359.
xx Acknowledgements
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Abbreviations
aCG Anterior cingulate gyrus
ADH Alcohol dehydrogenase
ADHD Attention deficit hyperactivity disorder
AIDS Acquired immune deficiency syndrome
ALDH Aldehyde dehydrogenase
AU$ Australian dollars
BBV Blood-borne virus
BOD Burden of disease
CB1 Cannabinoid receptor 1
CB2 Cannabinoid receptor 2
COMT Catechol-O-methyl transferase
CRF Corticotropin-releasing factor
D1, D2, D3, D4 Dopamine receptors 1, 2, 3 and 4
DA Dopamine
DALYs Disability adjusted life years
DAT Dopamine transporter
DBS Deep brain stimulation
DDS Dopamine dependence syndrome
DNA Deoxyribonucleic acid
DSM-III-R Diagnostic and Statistical Manual for Mental Disorders,
3rd Edition, Revised
DSM-IV-TR Diagnostic and Statistical Manual for Mental Disorders,
4th Edition, Text Revised
DSM-V Diagnostic and Statistical Manual for Mental Disorders,
5th Edition
EAP Employment assistance programs
ECT Electroconvulsive therapy
EEG Electroencephalograph
EMCDDA European Monitoring Centre for Drugs and Drug
Addiction
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Cambridge University Press978-1-107-00324-8 - Addiction Neuroethics: The Promises and Perils of Neuroscience Research on AddictionAdrian Carter and Wayne Hall FrontmatterMore information
FDA US Food and Drug Administration
fMRI Functional magnetic resonance imaging
GABA Gamma-aminobutyric acid
GHB Gamma-hydroxybutyric acid
HIV Human immunodeficiency virus
HCV Hepatitis C virus
HPA Axis Hypothalamic–pituitary–adrenal axis
HRT Hormone replacement therapy
ICD Impulse control disorder
ICD-10 International Classification of Disease, 10th Edition
IDU Injecting drug user
LSD Lysergic acid diethylamide
LTD Long-term depression
LTP Long-term potentiation
MDMA 3,4-Methylenedioxy-N-methylamphetamine
MEG Magnetoencephalograph
MOR Mu-opioid receptor
MMT Methadone maintenance treatment
NAC N-acetylcystein
NAcc Nucleus accumbens
NIAAA National Institute on Alcoholism and Alcohol Abuse
NIDA National Institute on Drug Abuse
NMDA N-methyl-D-aspartic acid
NRT Nicotine replacement therapy
OCD Obsessive compulsive disorder
OFC Orbitofrontal cortex
PCP Phencyclidine
PD Parkinson’s disease
PET Positron emission tomography
PFC Prefrontal cortex
PTSD Post-traumatic stress disorder
RNA Ribonucleic acid
SPECT Single photon emission computed tomography
SSRI Serotonin selective reuptake inhibitors
TMS Transcranial magnetic stimulation
UDHR Universal Declaration of Human Rights
UK United Kingdom
UN United Nations
UNAIDS United Nations Joint Program on HIV/AIDS
xxii List of abbreviations
www.cambridge.org© in this web service Cambridge University Press
Cambridge University Press978-1-107-00324-8 - Addiction Neuroethics: The Promises and Perils of Neuroscience Research on AddictionAdrian Carter and Wayne Hall FrontmatterMore information
UNODC United Nations Office on Drugs and Crime
UROD Ultra-rapid opioid detoxification
US United States
VTA Ventral tegmental area
WHO World Health Organisation
List of abbreviations xxiii
www.cambridge.org© in this web service Cambridge University Press
Cambridge University Press978-1-107-00324-8 - Addiction Neuroethics: The Promises and Perils of Neuroscience Research on AddictionAdrian Carter and Wayne Hall FrontmatterMore information