Maxwell Jane Carlisle
The University of Texas at Austin, Center for Social Work Research, Austin, Texas 78703, USA.
Curr Opin Psychiatry. 2005 May;18(3):235-42. doi: 10.1097/01.yco.0000165592.52811.84.
To describe and review the literature published on methamphetamine in 2003-2004, with a particular focus on patterns of use, its effects on the user and society, and progress being made towards effective treatment strategies.
The methamphetamine epidemic continues to grow, dominating drug use trends in many parts of the world, and signifying an increasing need for effective treatment. In addition to the already-documented physical effects of the drug, preliminary evidence suggests methamphetamine dependence may cause long-term neuronal damage. Recently abstinent users have been found to do poorly on neurocognitive tests of attention and motor skills, both factors that can adversely affect treatment outcomes. Methamphetamine use is also implicated in aggression and violence and there are increasing presentations to emergency rooms. It also affects the developing fetus, as well as children and adults who are exposed to toxic chemicals at laboratory sites. Outpatient programs, such as the Matrix Model, show improved in-treatment performance. Case management was found to be an effective intervention. Agonist-type pharmacotherapy in combination with quality behavioral therapy should produce benefit and a reduction in risks caused by stimulant abuse.
The increasing evidence that methamphetamine has adverse effects on the human brain indicates the pressing need for effective prevention and treatment approaches. There is a need to take these findings, particularly those that involve cognitive deficits, into consideration in current treatment programs and when developing new treatments.
描述并回顾2003 - 2004年发表的关于甲基苯丙胺的文献,特别关注其使用模式、对使用者和社会的影响以及在有效治疗策略方面取得的进展。
甲基苯丙胺的流行仍在继续,在世界许多地区主导着毒品使用趋势,这表明对有效治疗的需求日益增加。除了该药物已被记录的身体影响外,初步证据表明甲基苯丙胺依赖可能导致长期的神经元损伤。最近发现,刚戒毒的使用者在注意力和运动技能的神经认知测试中表现不佳,而这两个因素都会对治疗结果产生不利影响。甲基苯丙胺的使用还与攻击行为和暴力有关,并且急诊室的相关病例呈上升趋势。它还会影响发育中的胎儿,以及在实验室接触有毒化学物质的儿童和成年人。门诊项目,如矩阵模型,显示出治疗期间的表现有所改善。发现病例管理是一种有效的干预措施。激动剂型药物治疗与高质量行为疗法相结合应会产生益处,并降低兴奋剂滥用所带来的风险。
越来越多的证据表明甲基苯丙胺对人类大脑有不良影响,这表明迫切需要有效的预防和治疗方法。在当前的治疗项目以及开发新治疗方法时,需要考虑这些发现,特别是那些涉及认知缺陷的发现。