Neurology (ECronicon). 2025 May;17(5):01219. Epub 2025 Apr 4.
ABSTRACT
Addictive behaviors-including the misuse of tobacco, alcohol, illicit substances, and compulsive activities such as gambling, overeating, and sexual excess-remain widespread and profoundly burdensome on both individuals and societies. Their impact is multifaceted, encompassing adverse health outcomes, increased criminal activity, and significant economic costs due to lost productivity. Addiction is a highly complex condition shaped by genetic predispositions, environmental influences, and behavioral factors, all of which contribute to disruptions in neural regulation and compulsive decision-making. While advances have been made in identifying the genetic and biochemical underpinnings of addiction and related psychiatric disorders, progress in developing broadly effective therapies has been limited. Addiction is often characterized by feelings of fragmentation, helplessness, and existential despair-phenomena that may reflect a deeper, unmet need for personal integration, purpose, and transformation. This perspective supports the notion that spiritual yearning can be an integral part of the recovery process. Efforts to address addiction have frequently overlooked the potential therapeutic value of spirituality in fostering healing. If one accepts the premise that the brain governs both conscious and unconscious experience-including religious and spiritual phenomena-it follows that addiction, and mental illness may involve disrupted neural systems that regulate reward and suffering. We propose that individuals may have differing capacities for spiritual resilience or growth based on a dynamic interplay between their genetic architecture and epigenetic factors (e.g. life experiences, trauma, social environment). This expert opinion presents current evidence supporting this hypothesis and highlights the relevance of the Hierarchical Neuro-Spiritual Model (HNSM) as a novel framework for understanding the spiritual dimension in the pathophysiology and treatment of addiction.
PMID:41835103 | PMC:PMC12981603
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