The fundamental problem in addiction is the destructive nature of the substance abuse and the inability to stop. The frontal regions of brain control behaviors including planning and organization, motivation for goal directed activity, weighing consequences of future actions and impulse inhibition, known collectively as executive functions. The PFC projects to ACC and OFC, with all 3 projecting to the VS, a dopamine rich area important for expression of behaviors. Frontal cortical damage occurs with binge drinking intoxication. Dysfunction in specific regions of brain contributes to an imbalance between craving-limbic drive and frontal cortical attention and executive functions, particularly reflection and inhibitory control. PFC, ACC and OFC all contribute to executive functions and inhibition of impulses. Impulsive behaviors result from impaired executive functions since they include actions that are poorly conceived, prematurely expressed, unduly risky or inappropriate to the situation, which often result in undesirable consequences. Thus, addiction is likely due in part to increased impulsiveness from the loss of frontal cortical inhibition of impulses and increased limbic drive.
