Addiction: From brain research to new treatments?
Professor David Nutt
Professor of Neuropsychopharmacology
David Nutt, DM, FRCP, FRCPsych, FMedSci
David Nutt is a psychiatrist and the Edmund J. Safra Professor of Neuropsychopharmacology in the Division of Brain Science, Dept of Medicine, Hammersmith Hospital, Imperial College London. Here he uses a range of brain imaging techniques to explore the causes of addiction and other psychiatric disorders and to search for new treatments. He has published over 400 original research papers, a similar number of reviews and books chapters, eight government reports on drugs and 28 books, including one for the general public, Drugs: without the hot air, that won the Transmission Prize in 2014. He is currently the President of the European Brain Council and Founding Chair of DrugScience (formerly the Independent Scientific Committee on Drugs (ISCD). Previously he has been president of the British Association of Psychopharmacology the British Neuroscience Association and the European College of Neuropsychopharmacology.
He broadcasts widely to the general public both on radio and television. In 2010 The Times Eureka science magazine voted him one of the 100 most important figures in British Science, and the only psychiatrist in the list. In 2013 he was awarded the John Maddox Prize from Nature/Sense about Science for standing up for science.
Addiction is a major health problem that costs western societies the same as schizophrenia and depression, but has many fewer effective treatments. My talk will explore the brain mechanisms of addiction and the actions of current therapies to determine how to develop new interventions and to optimize selection of current treatments according to brain functions. The approach we have taken is to us multimodal imaging with PET and fMRI in people with heroin and alcohol addiction and also those with gambling disorder [to control for the effects of drug use].
Our research has revealed that dopamine appears not to be a major mediator of heroin addiction in humans, unlike cocaine and other stimulants. We have found evidence for both GABA and endorphin dysregulation in both alcohol and heroin addictions though not in gamblers. We have also developed a challenge test to measure endorphin capacity and found reduced release in gamblers and are now studying this in alcohol and heroin addiction. New relapse prevention treatments such as NK1 and selective dopamine receptor antagonists have been tested in fMRI models of the behaviours predictive of relapse in abstinence and show interesting profiles of activity.
Brain research offers a powerful way to study the mechanisms of addiction and hopefully will lead to the development of new treatments targeted to the underlying brain systems that underpin addiction.
Mick I,et al.  Amphetamine induced endogenous opioid release in the human brain detected with [(1)(1)C]carfentanil PET: replication in an independent cohort. The International Journal of Neuropsychopharmacology 17(12):2069-2074
Nutt DJ, Lingford-Hughes A, Erritzoe D, Stokes P (2015) Dopamine and addiction: 40 years of highs and lows Nature Reviews Neuroscience 16: 305-312 doi:10.1038/nrn3939
Paterson LM, et al (2015) The Imperial College Cambridge Manchester (ICCAM) platform study: An experimental medicine platform for evaluating new drugs for relapse prevention in addiction. Part A: Study description J Psychopharmacol. 2015 Sep;29(9):943-60. doi: 10.1177/0269881115596155. Epub 2015 Aug
Watson BJ, et al (2013) A critical test of the role of dopamine in human opioid addiction. Addiction Biology 19: 1032-1040dicdoi:10.1111/adb.12073