Introducing precision addiction management of reward deficiency syndrome, the construct that underpins all addictive behaviors

Worldwide daily, millions of people are unable to combat their frustrating and even fatal romance with getting high; for some, “high” may be just experiencing feelings of well-being. The neuroscience community conducts and funds, outstanding research using sophisticated neuroimaging and molecular-genetic applied technology to improve understanding of the complex functions of brain reward circuitry that has a key role in addiction symptomatology. While it is widely accepted that dopamine is a major neurotransmitter implicated in behavioral and substance addictions, there remains controversy about how to modulate dopamine clinically to treat and prevent various types of addictive disorders. A prudent approach may be biphasic; a short-term blockade followed by long-term dopaminergic upregulation. The goal of treatment would be to enhance brain reward functional connectivity volume, and target reward deficiency and the stress-like anti reward symptomatology of addiction. Such phenotypes can be characterized using the Genetic Addiction Risk Score (GARS)^R . Dopamine homeostasis may thus be achieved via “Precision Addiction Management” (PAM)^R , the customization of neuronutrient supplementation based on the GARS test result, along with a behavioral intervention.