Heroin addiction hijacks the Nucleus Accumbens: craving and reactivity to naturalistic stimuli

Drug-related cues hijack attention away from alternative reinforcers in drug addiction, inducing craving and motivating drug-seeking. However, the neural correlates underlying this biased processing, its expression in the real-world, and its relationship to cue-induced craving are not fully established, especially in opioid addiction. Here we tracked inter-brain synchronization in the Nucleus Accumbens (NAc), a hub of motivational salience, while heroin-addicted individuals and healthy control subjects watched the same engaging heroin-related movie. Strikingly, the left NAc was synchronized during drug scenes in the addicted individuals and non-drug scenes in controls, predicting scene- and movie-induced heroin craving in the former. Our results open a window into the neurobiology underlying shared drug-biased processing of naturalistic stimuli and cue-induced craving in opiate addiction as they unfold in the real world.