Why haven't we solved the addiction crisis?

Kenneth Blum, Abdalla Bowirrat, Luis Llanos Gomez, B. William Downs, Debasis Bagchi, Debmalya Barh, Edward J. Modestino, David Baron, Thomas McLaughlin, Panayotis Thanos, Mauro Ceccanti, Igor Elman, Rajendra D. Badgaiyan, Catherine Dennen, Ashim Gupta, Eric R. Braverman, Mark S. Gold

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations


The current addiction crisis has destroyed a multitude of lives, leaving millions of fatalities worldwide in its wake. At the same time, various governmental agencies dedicated to solving this seemingly never-ending dilemma have not yet succeeded or delivered on their promises. We understand that addictive behavioral seeking is a multi-faceted neurobiological and spiritually complicated phenomenon. However, although the substitution replacement approach, especially to treat Opioid Use Disorder (OUD), has importance for harm reduction in the short term, it does not bring about a harm-free recovery or prevention. Instead, we propose a promising novel approach that uses genetic risk testing with induction of dopamine homeostasis and an objective Brain Health Check during youth. Our model involves a six-hit approach known as the “Reward Dysregulation Syndrome Solution System,” which can identify addiction risk and target the root cause of addiction, dopamine dysregulation. While we applaud all past sophisticated neurogenetic and neuropharmacological research, our opinion is that in the long term, addiction scientists and clinicians might characterize preaddiction using tests; for example, administering the validated RDSQuestionarre29, genetic risk assessment, a modified brain health check, or diagnostic framing of mild to moderate Substance Use Disorder (SUD). The preaddiction concept could incentivize the development of interventions to prevent addiction from developing in the first place and target and treat neurotransmitter imbalances and other early indications of addiction. WC 222.

Original languageEnglish
Article number120404
JournalJournal of the Neurological Sciences
StatePublished - 15 Nov 2022


  • Addiction
  • Dopamine homeostasis
  • Dopamine regulation
  • Genetic testing
  • Neuroimaging


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