Annu Rev Psychol. 2003:54:25-53. doi: 10.1146/annurev.psych.54.101601.145237. Epub 2002 Jun 10.


The development of addiction involves a transition from casual to compulsive patterns of drug use. This transition to addiction is accompanied by many drug-induced changes in the brain and associated changes in psychological functions. In this article we present a critical analysis of the major theoretical explanations of how drug-induced alterations in psychological function might cause a transition to addiction. These include: (a) the traditional hedonic view that drug pleasure and subsequent unpleasant withdrawal symptoms are the chief causes of addiction; (b) the view that addiction is due to aberrant learning, especially the development of strong stimulus-response habits; (c) our incentive-sensitization view, which suggests that sensitization of a neural system that attributes incentive salience causes compulsive motivation or "wanting" to take addictive drugs; and (d) the idea that dysfunction of frontal cortical systems, which normally regulate decision making and inhibitory control over behavior, leads to impaired judgment and impulsivity in addicts.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Animals
  • Brain / drug effects
  • Brain / physiopathology
  • Conditioning, Psychological / drug effects
  • Conditioning, Psychological / physiology
  • Decision Making / drug effects
  • Decision Making / physiology
  • Humans
  • Illicit Drugs* / toxicity
  • Motivation
  • Neuronal Plasticity / drug effects
  • Neuronal Plasticity / physiology
  • Pleasure-Pain Principle
  • Substance Withdrawal Syndrome / physiopathology
  • Substance Withdrawal Syndrome / psychology
  • Substance Withdrawal Syndrome / rehabilitation
  • Substance-Related Disorders / physiopathology
  • Substance-Related Disorders / psychology*
  • Substance-Related Disorders / rehabilitation


  • Illicit Drugs