Neurobiology of adolescent substance use and addictive behaviors: treatment implications

Adolesc Med State Art Rev. 2014 Apr;25(1):15-32.


Psychoactive substance and nonsubstance/behavioral addictions are major public health concerns associated with significant societal cost. Adolescence is a period of dynamic biologic, psychological, and behavioral changes. Adolescence is also associated with an increased risk for substance use and addictive disorders. During adolescence, developmental changes in neural circuitry of reward processing, motivation, cognitive control, and stress may contribute to vulnerability for increased levels of engagement in substance use and nonsubstance addictive behaviors. Current biologic models of adolescent vulnerability for addictions incorporate existing data on allostatic changes in function and structure of the midbrain dopaminergic system, stress-associated neuroplasticity, and maturational imbalances between cognitive control and reward reactivity. When characterizing adolescent vulnerability, identifying subgroups of adolescents at high risk for addictive behaviors is a major goal of the addiction field. Genetics, epigenetics, and intermediate phenotypes/endophenotypes may assist in characterizing children and adolescents at risk. Improved understanding of the neurobiology of adolescence and addiction vulnerability has the potential to refine screening, enhance prevention and intervention strategies, and inform public policy.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adolescent
  • Adolescent Behavior / physiology*
  • Adolescent Development / drug effects*
  • Adolescent Medicine
  • Behavior, Addictive / physiopathology*
  • Environment
  • Genetic Predisposition to Disease
  • Humans
  • Models, Biological
  • Neurobiology*
  • Policy
  • Risk Factors
  • Substance-Related Disorders / physiopathology*
  • Substance-Related Disorders / prevention & control
  • Substance-Related Disorders / therapy