Cue-elicited craving for cannabis activates the reward neurocircuitry associated with the neuropathology of addiction

Abstract

Craving or the intense desire for a rewarding object or experience is an important factor in the etiology of addiction. Based on the incentive sensitization theory, addiction stems from drug-induced sensitization in dopaminergic reward structures, which attribute incentive-related salience to drug-associated cues. In this way, after repeated coupling with the drug, the cue can trigger similar primary responses in the brain's reward neurocircuitry as the drug itself. There is growing evidence that cannabis exerts its addictive properties through effects of the endocannabinoid system on the brain reward neurocircuitry. Specifically, the ubiquitous cannabinoid 1 (CB1) receptors play a key role in modulating reward pathways. In the present chapter, we describe the evidence for cue-elicited craving for marijuana, and, more specifically, how in the absence of cannabis itself, cannabis-associated cues trigger activation in the reward pathway implicated in the neuropathology of addiction.