Addiction Response Tactics: Tools for the Front Line-Neurobiology of Addiction; Stigma; Medications for for Substance Use Disorders

Neurobiology of Addiction; Stigma; Medications for for Substance Use Disorders

Video Transcription

Video Summary

Dr. Shalu, an OHSU addiction medicine physician, explains addiction as a brain-based condition that hijacks the dopamine reward system. Repeated substance use strengthens craving and stress pathways while impairing prefrontal functions such as impulse control and decision-making, making recovery difficult—not simply a matter of willpower.<br /><br />Stigma can delay care, reduce its quality, promote discrimination, and discourage people from seeking treatment. Providers and others in positions of authority should recognize and address their biases.<br /><br />For opioid use disorder, FDA-approved treatments are methadone, buprenorphine, and naltrexone. Methadone and buprenorphine reduce withdrawal and cravings; naltrexone blocks opioid receptors. These medications can reduce illicit use and overdose risk and improve treatment retention and quality of life. Alcohol use disorder medications include naltrexone and acamprosate. No medications are FDA-approved for methamphetamine use disorder; behavioral treatments, particularly contingency management, are supported by evidence.

Keywords

addiction medicine

dopamine reward system

stigma and discrimination

opioid use disorder

FDA-approved treatments

contingency management