Koob · Annual review of psychology 2008 · narrative review · n=?

Addiction and the brain antireward system.

Cited 1449 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review and theoretical framework based on mechanistic neurobiological reasoning without new empirical human data.

PubMed 18154498 · doi:10.1146/annurev.psych.59.103006.093548 · record verified 2026-08-31

What was done

The authors synthesized a neurobiological and opponent-process framework to conceptualize persistent motivational dysregulations and relapse vulnerability across the addiction cycle, incorporating reward pathways, antireward systems, and neuroendocrine stress responses.

What was found

The abstract describes a theoretical framework and provides no quantitative data. The model posits that addiction involves decreased reward system function (reduced dopamine and opioid peptide activity) and progressive recruitment of antireward systems (increased corticotropin-releasing factor activity), resulting in an allostatic state with a chronically altered reward set point that drives compulsive drug use.

Why it matters

This framework conceptualizes addiction beyond positive reinforcement, highlighting how recruitment of antireward and stress systems produces negative emotional states that fuel compulsive drug taking and relapse.

Limits

As a conceptual narrative review, no original human experimental data, sample sizes, controls, or quantitative effect estimates are reported.

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