Addiction

Addiction is a brain disorder characterized by compulsive engagement in rewarding stimuli despite adverse consequences.[8] Despite the involvement of a number of psychosocial factors, a biological process – one which is induced by repeated exposure to an addictive stimulus – is the core pathology that drives the development and maintenance of an addiction.[1][9] The two properties that characterize all addictive stimuli are that they are reinforcing (i.e., they increase the likelihood that a person will seek repeated exposure to them) and intrinsically rewarding (i.e., they are perceived as being inherently positive, desirable, and pleasurable).[1][3][7]

Addiction is a disorder of the brain’s reward system which arises through transcriptional and epigenetic mechanisms and occurs over time from chronically high levels of exposure to an addictive stimulus (e.g., eating food, the use of cocaine, engagement in sexual activity, participation in high-thrill cultural activities such as gambling, etc.).[1][10][11] ΔFosB, a gene transcription factor, is a critical component and common factor in the development of virtually all forms of behavioral and drug addictions.[10][11][12][13] Two decades of research into ΔFosB’s role in addiction have demonstrated that addiction arises, and the associated compulsive behavior intensifies or attenuates, along with the overexpression of ΔFosB in the D1-type medium spiny neurons of the nucleus accumbens.[1][10][11][12] Due to the causal relationship between ΔFosB expression and addictions, it is used preclinically as an addiction biomarker.[1][10][12] ΔFosB expression in these neurons directly and positively regulates drug self-administration and reward sensitization through positive reinforcement, while decreasing sensitivity to aversion.[note 1][1][10]

Addiction exacts an “astoundingly high financial and human toll” on individuals and society as a whole.[14][15][16] In the United States, the total economic cost to society is greater than that of all types of diabetes and all cancers combined.[16] These costs arise from the direct adverse effects of drugs and associated healthcare costs (e.g., emergency medical services and outpatient and inpatient care), long-term complications (e.g., lung cancer from smoking tobacco productsliver cirrhosis and dementia from chronic alcohol consumption, and meth mouth from methamphetamine use), the loss of productivity and associated welfare costs, fatal and non-fatal accidents (e.g., traffic collisions), suicides, homicides, and incarceration, among others.[14][15][16][17] Classic hallmarks of addiction include impaired control over substances or behavior, preoccupation with substance or behavior, and continued use despite consequences.[18] Habits and patterns associated with addiction are typically characterized by immediate gratification (short-term reward), coupled with delayed deleterious effects (long-term costs).[19]

Examples of drug and behavioral addictions include alcoholismamphetamine addictioncocaine addictionnicotine addictionopioid addictionfood addictiongambling addiction, and sexual addiction. The only behavioral addiction recognized by the DSM-5 and the ICD-10 is gambling addiction. The term addiction is misused frequently to refer to other compulsive behaviors or disorders, particularly dependence, in news media.[20] An important distinction between drug addiction and dependence is that drug dependence is a disorder in which cessation of drug use results in an unpleasant state of withdrawal, which can lead to further drug use.[21] Addiction is the compulsive use of a substance or performance of a behavior that is independent of withdrawal. Addiction can occur in the absence of dependence, and dependence can occur in the absence of addiction, although the two often co-occur.

Johnstown

Johnstown is a city and the county seat of Fulton County in the U.S. state of New York. As of the 2010 Census, the city had population of 8,743.[1] The city was named after its founder, Sir William Johnson.[2]

The city of Johnstown is mostly surrounded by the town of Johnstown, of which it was once a part when it was a village. Also adjacent to the city is the city of Gloversville. The two cities are together known as the “Glove Cities”. They are known for their history of specialty manufacturing. Johnstown is located approximately 45 miles (72 km) west of Albany, about one-third of the way between Albany and the Finger Lakes region to the west.

Johnstown, originally “John’s Town”, was founded in 1762 by Sir William Johnson, a Baronet who named it after his son John Johnson.[3] William Johnson came to the British colony of New York from Ireland in 1732.[4] He was a trader who learned American Indian languages and culture, forming close relationships with many Native American leaders. He was appointed as the Superintendent of Indian Affairs, as well as a major general in the British forces during the French and Indian War (Seven Years’ War). His alliances with the Iroquois were significant to the war.

As a reward for his services, Johnson received large tracts of land in what are now Hamilton and Fulton counties. He established Johnstown and became one of New York’s most prosperous and influential citizens. He was the largest landowner in the Mohawk Valley, with an estate of more than 400,000 acres (1,600 km2) before his death. Having begun as an Indian trader, he expanded his business interests to include a sawmill and lumber business, and a flour mill that served the area. Johnson, the largest slaveholder in the county and perhaps in the state of New York, had some 60 enslaved Africans working these businesses. He also recruited many Scots-Irish tenant farmers to work his lands.[5] Observing Johnson’s successful business endeavors, the local Native American inhabitants dubbed him Warragghivagey, or “he who does much business.”[6]