Nora D. Volkow (born 27 March 1956) is a Mexican-American psychiatrist. She is currently the director of the National Institute on Drug Abuse (NIDA), which is part of the National Institutes of Health (NIH).
Early life and education Born in Mexico City to a Jewish family, Volkow is a daughter of Esteban Volkov, whose mother Zinaida Volkova was the eldest daughter of the Russian communist revolutionary Leon Trotsky. Volkow and her three sisters grew up in Coyoacán in the house where Trotsky was killed (now the Leon Trotsky Museum). Volkow was educated at the Modern American School, in Mexico City, and graduated M.D. from the National University of Mexico, before her postdoctoral training in Psychiatry at New York University. During psychiatry residency, she used Positron Emission Tomography (PET) scans in her research with psychiatrist Jonathan Brodie.
Career After finishing psychiatry residency, she joined the faculty at the University of Texas Medical School at Houston, working on PET scan research projects in addition to clinical duties. She conducted research work with Professor Alan Swann, now at Baylor, leaving to the Department of Energy’s Brookhaven National Laboratory (BNL) in Upton, New York in 1987. Volkow spent most of her professional career at Brookhaven, where she held several leadership positions. She was first a researcher, and then Director of Nuclear Medicine, Director of the NIDA-DOE Regional Neuroimaging Center at BNL, and finally Associate Director for Life Sciences at BNL. She was also appointed as a Professor in the Department of Psychiatry at Stony Brook University and as Associate Dean for its Medical School.
Disease model of addiction Volkow's imaging studies of the brains of people addicted to drugs have helped to clarify the mechanisms of drug addiction. At Brookhaven, PET scanning was being used to study the brain in people with schizophrenia. When Volkow moved to the University of Texas, studying patients with schizophrenia was not an option, but studying patients with cocaine addiction was possible. Volkow and colleagues studied the distribution of blood flow in the brain of chronic cocaine users and control patients who did not use cocaine. They found decreased blood flow to the prefrontal cortex of cocaine users, that continued after ten days of withdrawal from cocaine use. This research has played a part in changing the public's view of drug addiction, from that of a moral violation or character flaw to an understanding that pathological changes to brain structure make it very difficult for addicts to give up their addictions. Volkow concludes that abnormalities in the prefrontal cortex create a feeling of need or craving that people with addictions find difficult to prevent. She argues that this makes it difficult to override compulsions by exercising cognitive control. The main areas affected are the orbitofrontal cortex, which maintains attention to goals, and the anterior cingulate cortex, that mediates the capacity to monitor and select action plans. Both areas receive stimulation from dopamine neurons that originate in the ventral tegmental area. A steady influx of dopamine makes it difficult to shift attention away from the goal of attaining drugs. It also fastens attention to the motivational value of drugs, not pleasure. Volkow suggests that people with addictions are caught in a vicious circle of physical brain changes and the psychological consequences of those changes, leading to further changes.
National Institute on Drug Abuse
In 2003 Volkow became director of NIDA. As director, she has focused on enacting policies that address how stigma, socioeconomic status, health disparities and criminalization of drug use contribute to and exacerbate substance use disorders in the United States. Volkow is the first person from the NIH to visit the Dalai Lama at his residence in Dharamshala, Himachal Pradesh, India. During this 2013 visit, Volkow took part in a dialogue with the Dalai Lama about addiction science, as part of a five-day conference sponsored by the Mind and Life Institute.
Science communication and public advocacy In 2014, Volkow participated in an event organized by The Moth at a World Science Festival, where scientists, writers and artists told stories of their personal relationships with science. During this time, she discussed her family history and how it furthered her ambition to pursue science in order to positively influence others. In her 2015 TEDMED talk titled "Why do our brains get addicted?", Volkow explored how people with morbid obesity experience alterations to the dopamine reward system resulting in compulsive behavior similar to the mechanisms of addiction. She addressed how stigma around both conditions stems from their perception as personal moral failings, rather than medical disorders.
Awards and recognition
Volkow has been recognized for her contributions, both before and during her time at NIDA. The following are among the most significant:
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