Positive Emotion Regulation in Addiction: A New Frontier for Recovery Science

Purpose of Review: Addiction has traditionally been framed as a disorder of negative affect and impaired downregulation of distress, yet disturbances in positive emotional experience and regulation are equally fundamental to the development and persistence of substance use disorders (SUDs). This review synthesizes clinical and psychophysiological evidence documenting the impact of addictive substances on positive emotion dysregulation, and highlights the role of positive emotion regulation on craving and drug relapse. Recent Findings: Individuals who engage in addictive use of opioids, nicotine, cannabis, and stimulants exhibit blunted positive affect, diminished responsiveness to natural rewards, and deficits in the volitional upregulation of positive emotion. These impairments reflect neuroplastic alterations in corticostriatal and corticolimbic circuits that weaken endogenous reward generation, and erode the capacity to derive pleasure from, and savor, everyday experiences. Summary: Addiction is underpinned by positive emotion dysregulation. Restoring positive affective functioning through positive emotion regulation interventions may revolutionize addiction recovery.