Addiction research has long been centered around vulnerability understanding why some individuals are more susceptible to substance use disorders (SUDs). However, a recent critical literature review by Dr. Alexandra Rogers and Professor Frances Leslie from the University of California, Irvine, suggests a paradigm shift is necessary. Instead of focusing solely on why people become addicted, the researchers argue that the field should also explore why many do not, even when exposed to the same addictive substances. Their work, published in Addiction Neuroscience, advocates for a deeper investigation into resilience mechanisms that could pave the way for more effective addiction therapies.
Substance use disorders have plagued societies for centuries, yet the majority of drug users do not develop full-blown addictions. In fact, studies indicate that only 5-30% of regular drug users meet the criteria for SUDs. This discrepancy highlights the need to study the neurobiological and psychological factors that protect against addiction. Rogers and Leslie point out that while the neurobiology of vulnerability has been extensively studied, resilience the ability to maintain normal functioning despite exposure to addictive substances remains underexplored.
The researchers suggest that the mechanisms of resilience are distinct from those of vulnerability. “Resilience is not just the absence of vulnerability. It involves active compensatory brain changes that allow individuals to cope with the challenges posed by drug use,” explains Dr. Rogers. This perspective shifts the focus from trying to reverse the brain changes associated with addiction to identifying and enhancing the brain’s natural resilience mechanisms.
Their research draws on evidence from stress models, where the concept of resilience has been more thoroughly investigated. In these models, certain individuals display remarkable resilience to stress, avoiding the negative outcomes typically associated with it. Similar protective mechanisms could be at play in addiction resilience. For example, studies have shown that resilient individuals may exhibit enhanced neurogenesis in certain brain regions or possess specific genetic variants that confer protection against addiction.
Dr. Rogers and Professor Leslie also emphasize the potential for identifying new therapeutic targets by studying resilience. Traditional addiction treatments often focus on reducing cravings or withdrawal symptoms, but they do not address the underlying resilience that keeps most users from becoming addicted in the first place. By understanding how resilience works, researchers could develop therapies that bolster these protective factors, potentially offering more robust and long-lasting treatment options.
The critical literature review underscores the importance of looking beyond addiction as a “brain disease” and considering it within a broader framework that includes both vulnerability and resilience. This dual approach could lead to a more comprehensive understanding of addiction and, ultimately, more effective treatments. “Future research should aim to uncover the full spectrum of responses to addictive substances, not just the pathological ones,” says Professor Leslie. “By doing so, we can better support those at risk and help more people recover from addiction.”
Dr. Rogers and Professor Leslie’s call for a renewed focus on resilience in addiction research is timely, given the ongoing opioid crisis and rising addiction rates worldwide. Their work suggests that a more balanced approach one that considers both vulnerability and resilience could lead to breakthroughs in how we treat and prevent addiction.
Journal Reference
Rogers, A., & Leslie, F. (2024). “Addiction neurobiologists should study resilience.” Addiction Neuroscience, 11, 100152. DOI: https://doi.org/10.1016/j.addicn.2024.100152
About the Author
Alexandra Rogers is a medical writer and neurobiologist with experience in pharmacology and neurobiology. She completed her PhD in Pharmacological Sciences at the University of California, Irvine, where she was an NIH T32 and Vertex Pharmaceuticals Fellow. Her professional journey has taken her from cognitive science, studying the impact of music on memory recall, through retinal degeneration and glial roles in recovery from spinal cord injury to the identification and characterization of neuronal substrates of addiction resilience. Currently, Alexandra is a freelance medical writer, collaborating with academic institutions and industrial pharmaceutical enterprises. She excels in developing and refining scientific documents, including peer-reviewed publications and grant applications for national agencies such as NIH and HHMI.
A passionate advocate for mentorship and professional development, Alexandra co-founded a peer mentoring program at UC Irvine and multiple programs to support undergraduate excellence in her graduate research group. Alexandra resides in San Francisco with her partner and their cats. She enjoys hiking, gardening, and reading, finding inspiration in the endless possibilities of both science and imagination.
