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Common Factors Across Highly Addictive Substances Research from ISSUP, Colombo Plan, and international agencies identifies common characteristics of highly addictive substances: Rapid Brain Reward Activation: All produce quick, intense dopamine release Tolerance Development: Require increasing doses over time Withdrawal Symptoms: Physical and psychological discomfort drives continued use Neuroplastic Changes: Lasting alterations in brain structure and function Cue Reactivity: Environmental triggers produce powerful cravings Impaired Control: Difficulty limiting use despite negative consequences High Relapse Risk: Return to use is common even after extended abstinence Treatment Principles for Highly Addictive Substances Understanding addiction potential is just the first stepsuccessful recovery also requires addressing relapse risk

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O'Rourke, an East Cambridge native with gray hair and dark eyebrows that climb toward the center of his forehead, suggested to Remy that they create a website and sell autographed photocopies of the score cards the RemDawg used during each telecast