National Institute on Alcohol Abuse and Alcoholism (NIAAA)
George F. Koob, Ph.D., is an internationally-recognized expert on alcohol and stress, and the neurobiology of alcohol and drug addiction. He is the Director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), where he provides leadership in the national effort to reduce the public health burden associated with alcohol misuse. As NIAAA Director, Dr. Koob oversees a broad portfolio of alcohol research ranging from basic science to epidemiology, diagnostics, prevention, and treatment. He is a Senior Investigator at the National Institute on Drug Abuse where his laboratory is studying the neurobiology of drug and alcohol addiction.
Hyperkatifeia, negative reinforcement and the negative emotional side of addiction
Drug addiction is a chronically relapsing disorder of motivational dysregulation in three functional domains that reflect the three stages of the addiction cycle: incentive salience/pathological habits in the binge/intoxication stage, negative emotional states in the withdrawal/negative affect stage, and executive function deficits in the preoccupation/anticipation stage, all mediated by different neurocircuits. Compelling evidence suggests that the negative emotional state of drug withdrawal, termed hyperkatifeia, is triggered by acute excessive drug intake, is sensitized with repeated withdrawal, persists into protracted abstinence, and contributes to the development and persistence of compulsive drug seeking via negative reinforcement. Significant overlap in the engagement in addiction of circuits mediating brain emotional pain and brain physical pain may help explain the prominent role of drugs in “deaths of despair” and the effects of social isolation on alcohol and drug seeking in the COVID-19 pandemic.