ADOLESCENT/YOUNG ADULT ADDICTION (T CHUNG, SECTION EDITOR) Neurobiology of Craving: Current Findings and New Directions Lara A. Ray 1,2 & Daniel J. O. Roche 2 # Springer International Publishing AG, part of Springer Nature 2018 Abstract Purpose of the Review This review seeks to provide an update on the current literature on craving and its underlying neurobi- ology, as it pertains to alcohol and drug addiction. Recent Findings Studies on craving neurobiology suggest that the brain networks activated by conditioned cues in alcohol- and drug-dependent populations extend far beyond the traditional mesolimbic dopamine system and suggest that the early neurobiolog- ical theories of addiction, which heavily relied on dopamine release into the nucleus accumbens as the primary mechanism driving cue-induced craving and drug-seeking behavior, are incomplete. Ongoing studies will advance our understanding of the neurobio- logical underpinnings of addiction and drug craving by identifying novel brain regions associated with responses to conditioned cues that may be specific to humans, or at least primates, due to these brain areas’ involvement in higher cognitive processes. Summary This review highlights recent advances and future directions in leveraging the neurobiology of craving as a transla- tional phenotype for understanding addiction etiology and informing treatment development. The complexity of craving and its underlying neurocircuitry is evident and divergent methods of eliciting craving (i.e., cues, stress, and alcohol administration) may produce divergent findings. Keywords Craving . Addiction . Neurobiology . fMRI . Cue reactivity . Alcohol . Drug Introduction The notion of craving and its association with addiction has been the purview of scientific study for the past 60 years [1]. Craving for a substance is defined as a strong desire to con- sume that substance, which in turn has been associated with the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criterion of loss of control over substance use, one of the seven criteria for substance dependence in DSM- IV [2]. As the diagnostic system evolved, craving itself repre- sents a criterion for substance disorder in the current version of the DSM-5 [3]. A longitudinal study of alcoholism course and chronicity found that craving was associated with the highest relative risk of all other diagnostic criteria for alcoholism [4]. Furthermore, recent studies have advanced our understanding of the neurobiological and genetic bases of craving. Many of these studies use one or a combination of the following: self- report data in family-based designs (e.g., [5]), experimental laboratory paradigms (e.g., [6]), and neuroimaging techniques (e.g., [7]). Pharmacological studies have also leveraged crav- ing paradigms to screen [8] and to establish the initial efficacy [9, 10] of promising medications for alcoholism. In short, the construct of craving has been successfully applied to the study of addiction etiology and treatment. This review of the scien- tific study of craving and substance use will begin with a discussion of the phenomenology and assessment of craving, followed by a review of studies on craving neurobiology. We will then conclude by providing directions for future inquiry in the field. Phenomenology and Assessment Although the operational definition of craving has been debat- ed over the years, craving is inherently a subjective experi- ence, best described as a state of desire or wanting [11]. Individuals trying to abstain from alcohol or drugs often This article is part of the Topical Collection on Adolescent/Young Adult Addiction * Lara A. Ray lararay@psych.ucla.edu 1 Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, USA 2 Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, USA Current Addiction Reports https://doi.org/10.1007/s40429-018-0202-2