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Substance Abuse and Mental Health Services Administration (US); Office of the Surgeon General (US). Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health [Internet]. Washington (DC): US Department of Health and Human Services; 2016 Nov.

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Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health [Internet].

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Illustration shows the major neurotransmitter systems involved in the binge/intoxication stage of addiction. In this stage, the neurons in the basal ganglia contribute to the rewarding effects of addictive substances and to incentive salience through the release of dopamine and the brain's natural opioids (opioid peptides).

Figure 2.6Major Neurotransmitter Systems Implicated in the Neuroadaptations Associated with the Binge/Intoxication Stage of Addiction

Notes: Blue represents the basal ganglia involved in the Binge/Intoxication stage. Red represents the extended amygdala involved in the Negative Affect/Withdrawal stage. Green represents the prefrontal cortex involved in the Preoccupation/Anticipation stage.

Abbreviations: PFC - prefrontal cortex, DS - dorsal striatum, NAc - nucleus accumbens, BNST - bed nucleus of the stria terminalis, CeA - central nucleus of the amygdala, VTA - ventral tegmental area.

Source: Modified with permission from Koob & Volkow, (2010).14

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