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"rom heroin and cocaine to sex and lies, Tetris and the ponies, the spectrum of human addictions is vast. But for Dr. Nora D. Volkow, the neuroscientist in charge of the National Institute on Drug Abuse, they all boil down to pretty much the same thing. She must say it a dozen times a day: Addiction is all about the dopamine. The pleasure, pain and devilish problem of control are simply the detritus left by waves of this little molecule surging and retreating deep in the brain. A driven worker with a colorful family history and a bad chocolate problem of her own, Dr. Volkow (pronounced VOHL-kuv), 55, has devoted her career to studying this chemical tide. And now, eight years into her tenure at the institute, the pace of addiction research is accelerating, propelled by a nationwide emergency that has sent her agency, with a $1.09 billion budget, into crisis mode. The toll from soaring rates of prescription drug abuse, including both psychiatric medications and drugs for pain, has begun to dwarf that of the usual illegal culprits. Hospitalizations related to prescription drugs are up fivefold in the last decade, and overdose deaths up fourfold. More high school seniors report recreational use of tranquilizers or prescription narcotics, like OxyContin and Vicodin, than heroin and cocaine combined. The numbers have alarmed drug policy experts, their foreboding heightened by the realization that the usual regulatory tools may be relatively unhelpful in this new crisis. As Dr. Volkow said to a group of drug experts convened by the surgeon general last month to discuss the problem, "In the past, when we have addressed the issue of controlled substances, illicit or licit, we have been addressing drugs that we could remove from the earth and no one would suffer." But prescription drugs, she continued, have a double life: They are lifesaving yet every bit as dangerous as banned substances. "The challenges we face are much more complex," Dr. Volkow said, "becau

"Recall a time you said or did something incorrect in front of peers or authority figures. Now think of all the details you can recall associated with that experience. Where you were, who was there, any other things you wouldn't ordinarily remember about distant events such as what you wore, saw, did earlier or later that day. If you have a minute, write down some of these ancillary sensory memories. What you recall now is the result of your dopamine-reward network and your flashbulb memory or event memory system. As the brain evolved for survival of the animal and the species, much of what we humans now do is directed by hard-wired neural networks and neurotransmitters not under conscious control. Actually only about 17% of your brain is capable of responding to your conscious will; the rest is pretty much like that of a lower mammal or newborn baby with reactions to input based on association with imminent danger, risk, or pleasure."