Chemical and Behavioral Addictions: New Perspectives and Challenges

Substance use and substance use disorders (SUD) are highly (and increasing) prevalent both as single disorders and within the context of complex psychiatric and somatic comorbidities. In parallel with the impact of these disorders, research on addictive processes has significantly expanded in recent decades. However, several challenges remain to be addressed on multiple levels. Within the context of continuing evolution of new (illicit and prescription) drugs of abuse and changes in the growing field of behavioral (nonchemical) addictions (gambling, gaming), the epidemiological situation is rapidly changing. On the level of disorder conceptualization and underlying pathogenetic mechanisms many challenges remain to be addressed, impacting a broad spectrum from legislation and public mental health issues to underlying neurobiological processes such as neuroimmune mechanisms and microbiome, and cognitive dimensions. These provide new targets of therapeutic approaches such as neuromodulation, personalized pharmacotherapy, and contingency management.