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Suggested Citation:"Color Plates." Institute of Medicine. 1996. Pathways of Addiction: Opportunities in Drug Abuse Research. Washington, DC: The National Academies Press. doi: 10.17226/5297.
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FIGURE 3.1 Sagittal rat brain section illustrating a drug (cocaine, amphetamine, opiate, and alcohol) neural reward circuit that includes a limbic-extrapyramidal motor interface. Yellow indicates limbic afferents to the nucleus accumbens (N Acc.), and orange represents efferents from the nucleus accumbens thought to be involved in psychomotor stimulant reward. Red indicates projection of the mesocorticolimbic dopamine system thought to be a critical substrate for psychomotor stimulant reward. This system originates in the A10 cell group of the ventral tegmental area (VTA) and projects to the N. Acc., olfactory tubercle, and ventral striatal domains of the caudate-putamen (C-P). Green indicates opioid peptidecontaining neurons, systems that may be involved in opiate and ethanol reward. These opioid peptide systems include the local enkephalin circuits (short segments) and the hypothalamic midbrain beta-endorphin circuit (long segment). Blue indicates the approximate distribution of GABA-A receptor complexes, some of which may mediate sedative/hypnotic (ethanol) reward, determined by both tritiated flumazenil binding and expression of the alpha, beta, and gamma subunits of the GABA-A receptor. Yellow refers to nicotinic receptors hypothesized to be localized on dopamine and opioid peptide systems. AC, anterior commissure; AMG, amygdala; Cer, cerebullum; DMT, dorsomedial thalamus; FC, frontal cortex; Hippo, hippocampus; LC, locus coeruleus; LH, lateral hypothalamus; OT, olfactory tract; PAG, periaqueductal gray; SNr, substantia nigra pars reticulata; VP, ventral pallidum. Modified with permission of Elsevier Science LTD., from Koob, 1992a.

Suggested Citation:"Color Plates." Institute of Medicine. 1996. Pathways of Addiction: Opportunities in Drug Abuse Research. Washington, DC: The National Academies Press. doi: 10.17226/5297.
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FIGURE 3.2 Metabolic images obtained with FDG in a normal control and in a cocaine abuser tested 3 months after cocaine discontinuation. Notice the reductions in metabolism in frontal brain regions when compared with the control. Reprinted with permission from N. Volkow, Brookhaven National Laboratory.

Suggested Citation:"Color Plates." Institute of Medicine. 1996. Pathways of Addiction: Opportunities in Drug Abuse Research. Washington, DC: The National Academies Press. doi: 10.17226/5297.
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FIGURE 3.3 [18F]N-methylspiroperidol images in a normal control and in a cocaine abuser tested 1 month and 4 months after last cocaine use. The images correspond to the four sequential planes where the basal ganglia are located. Notice the lower uptake of the tracer in the cocaine abuser when compared with the normal control. Notice the persistence of the decreased uptake even after 4 months of cocaine discontinuation (Reprinted by permission of John Wiley & Sons, Inc. from Volkow et al., 1993).

Suggested Citation:"Color Plates." Institute of Medicine. 1996. Pathways of Addiction: Opportunities in Drug Abuse Research. Washington, DC: The National Academies Press. doi: 10.17226/5297.
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Page 311
Suggested Citation:"Color Plates." Institute of Medicine. 1996. Pathways of Addiction: Opportunities in Drug Abuse Research. Washington, DC: The National Academies Press. doi: 10.17226/5297.
×
Page 312
Suggested Citation:"Color Plates." Institute of Medicine. 1996. Pathways of Addiction: Opportunities in Drug Abuse Research. Washington, DC: The National Academies Press. doi: 10.17226/5297.
×
Page 313
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Drug abuse persists as one of the most costly and contentious problems on the nation's agenda. Pathways of Addiction meets the need for a clear and thoughtful national research agenda that will yield the greatest benefit from today's limited resources.

The committee makes its recommendations within the public health framework and incorporates diverse fields of inquiry and a range of policy positions. It examines both the demand and supply aspects of drug abuse.

Pathways of Addiction offers a fact-filled, highly readable examination of drug abuse issues in the United States, describing findings and outlining research needs in the areas of behavioral and neurobiological foundations of drug abuse. The book covers the epidemiology and etiology of drug abuse and discusses several of its most troubling health and social consequences, including HIV, violence, and harm to children.

Pathways of Addiction looks at the efficacy of different prevention interventions and the many advances that have been made in treatment research in the past 20 years. The book also examines drug treatment in the criminal justice setting and the effectiveness of drug treatment under managed care.

The committee advocates systematic study of the laws by which the nation attempts to control drug use and identifies the research questions most germane to public policy. Pathways of Addiction provides a strategic outline for wise investment of the nation's research resources in drug abuse. This comprehensive and accessible volume will have widespread relevance--to policymakers, researchers, research administrators, foundation decisionmakers, healthcare professionals, faculty and students, and concerned individuals.

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