Self Medication

Understanding the neurobiological mechanisms of addiction requires an integration of basic neuroscience with social psychology, experimental psychology, and psychiatry. Addiction is presented as a cycle of spiralling dysregulation of brain reward systems that progressively increases, resulting in compulsive drug use and a loss of control over drug-taking. Sensitization and counteradaptation are hypothesized to contribute to this hedonic homeostatic dysregulation, and the neurobiological mechanisms involved, such as the mesolimbic dopamine system, opioid peptidergic systems, and brain and hormonal stress systems, are beginning to be characterized. This framework provides a realistic approach to identifying the neurobiological factors that produce vulnerability to addiction and to relapse in individuals with a history of addiction.

A number of clinical findings have supported the hypothesis that the preference for a specific drug is not random, but rather, appears to be a process of "self selection."

MITOSIS is a unique cross-cultural research project investigating young people's drug consumption patterns.

The distinction between drug use and drug misuse is critical to the self-medication hypothesis. Dr. Duncan has long asserted that most of the people who take illegal drugs do not meet criteria for substance misuse, let alone for dependence.

This study cannot be seen as having disproved the amotivational syndrome hypothesis, but has cast serious doubt about its validity. There is no doubt that some people, including some marijuana users, appear to be poorly motivated. Whether this constitutes a syndrome or not is another question.

The self-medication hypothesis, which proposes that addicts are using their drug of choice to relieve symptoms of an underlying disorder or condition (such as stress), provides the clinician with a useful conceptual model to guide treatment.

To help understand addictive vulnerability, I have proposed a triad: the person, the pain, and the drug and how these three factors interact. I have adopted an overarching paradigm of substance abuse as a self-regulation disorder.

Every individual has needs, and we recognize that there are many differences among individuals. There are, however, many commonalities that make us very much alike. One of these sets of commonalities is probably a basic set of needs that we all have. What are these needs, and how do they relate to drugs?