Lesson 2: Understanding the Biology of Substance Use and Substance Use Disorders

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 This lesson, the first of three related to the etiology (cause) and development of substance use, focuses on its neurobiology and genetic basis. Lessons 3 and 4 focus on psychological and social factors.

Substance use and substance use disorders have devastating consequences. However, like many other chronic diseases, it is treatable, and emerging knowledge in neurobiology and brain imaging is providing important contributions to understanding the complexity of substance use disorders. This lesson is designed to provide you with an opportunity to develop general knowledge about the multi-factorial contributors (etiology) to substance use and subsequent substance use disorders. Through directed readings, you will consider the evidence that supports the biological factors currently believed to affect the onset of substance use disorders.

In this lesson, we consider how the concept of substance use has moved beyond the “disease” model and now is understood as a disease of the brain. Additionally, we examine how brain imaging technology has increased our knowledge about the role of neurobiology in the development and maintenance of substance use. Chapters 3–5 of your textbook, in combination with Dr. Nora Volkow’s videos and additional readings, provide a strong overview of the role of neurobiology.

You may find some of the terms/concepts presented in the readings for this lesson challenging. Try your best to work through the concepts, but don’t worry if you can’t work out all of the details; for the purposes of this course, the broad concepts are important. The aim is to develop a level of knowledge sufficient for explaining the concepts to a client/patient or co-worker.


Lesson 2 addresses the following three topics:

  • Neurobiology of Substance Use
  • Neurobiology of Adolescence and Vulnerability to Substance Use Disorders
  • Genetics and Substance Use Disorders

Learning Outcomes

After you complete this lesson, you should be able to:

  • Justify how current scientific evidence supports the hypothesis that substance use disorders are a disease of the brain.
  • Justify why substance use disorders are considered a developmental disorder.
  • Support the multi-factorial explanation for substance use disorders (i.e., a disease that results from the combined actions of genetic and environmental risk factors, and drug-induced effects).
  • Outline biological factors currently believed to be associated with the etiology (cause) of substance use disorders.
  • Evaluate, from a neurobiological perspective, the increased vulnerability that adolescents have for developing substance use disorders.
  • Describe the roles that specific gene variants play in determining a person’s level of susceptibility to substance use disorders (i.e., how genetic factors contribute to individual differences in vulnerability to initiating the use of addictive agents and in vulnerability to shifting from use to addiction).
  • Recognize how genetic testing may, one day, provide a tool for tailoring personalized treatments (i.e., by revealing genetic variations that predict how an individual might respond to a specific therapeutic intervention).


Following are the resources that you need for this lesson.

Required Readings/Videos

Koob, G. (2006). The neurobiology of addiction: A hedonic Calvinist view. In W. Miller & K. Carroll (Eds.), Rethinking substance abuse: What the science shows, and what we should do about it (pp. 25–45). New York, NY: Guildford Press.

Childress, A. (2006). What can human brain imaging tell us about vulnerability to addiction and to relapse? In W. Miller & K. Carroll (Eds.), Rethinking substance abuse: What the science shows, and what we should do about it (pp. 46–60). New York, NY: Guildford Press.

Hasin, D., Hatzenbuehler, M., & Waxman, R. (2006). Genetics of substance use disorders. In W. Miller & K. Carroll (Eds.), Rethinking substance abuse: What the science shows, and what we should do about it (pp. 61–80). New York, NY: Guildford Press.

VTC Research Institute. (2012). What Do We Know About Addiction? with Dr. Nora Volkow. Retrieved from http://vimeo.com/30015129.

Big Think. (2012, Apr 23). Big Think Interview With Nora Volkow (Director of the National Institute on Drug Abuse). Retrieved from http://www.youtube.com/watch?v=xoSARbXLjjo.

Canadian Center on Substance Abuse. (2007). Substance abuse in Canada: Youth in focus. Ottawa, ON. Canadian Center on Substance Abuse.

Available Through TRU library

Blum, K., Chen, A.L.C., Giordano, J., et al. (2012) The addictive brain: All roads lead to dopamine. Journal of Psychoactive Drugs, 44(2), 134–143.

Activity Checklist

Following is a checklist of the learning activities you will be completing in Lesson 2. You may find it useful for planning your work.

✔ Activity

☐ Activity 1: Neurobiology of the brain—An introduction

☐ Activity 2: Neurobiology of adolescence and vulnerability to substance use disorders

☐ Activity 3: Genetics and substance use disorders