One cannot get through a day (certainly not in the United States) without hearing about the devastation that substance abuse, addiction, and, in many cases, co-occurring disorders (ie, substance abuse or addiction in conjunction with a major psychiatric clinical syndrome and/or personality disorder) cast upon countless numbers of lives. For years, there has been a controversy as to whether addiction was simply a moral failing or a brain disease. Obviously, the latter is true.

As with any disease, addiction and co-occurring disorders are frequently considered to be primary, progressive, chronic, and, if untreated, fatal. With the advent of more sophisticated neurobiological and multivariate research, we can get beyond trivializing this serious disease entity by labeling it as a weakness or character defect, and get on with the significant work of focusing on those neurological pathways and their etiology that are responsible for addictive patterns of behavior.