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Addiction to Medications: What Are the Risks and Who Is Vulnerable?

Nora D. Volkow, M.D.
National Institute on Drug Abuse

Tuesday, November 9, 2004 • 7 pm
Masur Auditorium • NIH Clinical Center
Photo of Nora D. Volkow

Nora D. Volkow, M.D., has been Director of the National Institute on Drug Abuse (NIDA) since May 1, 2003. Her main area of interest is the investigation of the mechanisms underlying the reinforcing, addictive, and toxic properties of drugs of abuse in the human brain.

At Brookhaven National Laboratory before coming to NIH, Dr. Volkow was Associate Director for Life Sciences, Director of Nuclear Medicine, and Director of the NIDA-Department of Energy Regional Neuroimaging Center. She was also Professor at the Department of Psychiatry, State University of New York at Stony Brook, and Associate Dean for that campus's medical school.

Dr. Volkow received her M.D. in 1981 from National University of Mexico in Mexico City and performed her residency in psychiatry at New York University. She was the first to use imaging to investigate the neurochemical changes in the human brain that occur during drug addiction. With imaging, Dr. Volkow showed that the function of the dopamine system decreases in addicted subjects; this decrease is associated with a disruption in function of frontal brain regions involved in motivation and drive.

Her work has also focused on (1) why subjects vary in their responses to drugs of abuse, and which of them are more vulnerable to drug abuse and alcoholism; (2) the rewarding and therapeutic effects of stimulant drugs; and (3) the effects and functional significance of changes in the dopamine system with aging.

By systematically comparing the pharmacological effects of cocaine (one of the most addictive drug of abuse) and of methylphenidate (a drug used to treat children with attention deficit hyperactivity disorder) in the human brain, Dr. Volkow demonstrated that drug pharmacokinetics [i.e., drug movement into, within, and out from a body] affects whether and how the reinforcing effects of stimulant drugs occur. Furthermore, stimulant drugs, when used therapeutically, amplify dopamine signals in the brain, enhancing the saliency of a stimulus and thus improving attention and performance.

When Dr. Volkow used imaging to investigate the changes in the dopamine system that occur with aging, she found that---despite no evidence of neurological dysfunction---healthy subjects do lose dopamine brain function with age, and that this loss is associated with motor slowing and with changes in performance of cognitive tasks that involve executive functions.

Her research now focuses on ways to minimize the age-related losses in dopamine brain activity to improve the quality of life of the elderly.

Dr. Volkow has authored or coauthored more than 280 peer-reviewed publications, three edited books, and more than 50 book chapters and other manuscripts. She is the recipient of multiple awards for her research, has been elected to membership in the Institute of Medicine of the National Academy of Sciences, and was named "Innovator of the Year" in 2000 by U.S. News and World Report.

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