Ridenour Ty A
Prevention Research Center, Pennsylvania State University, State College, Pennsylvania 16801, USA.
Curr Opin Psychiatry. 2005 May;18(3):243-7. doi: 10.1097/01.yco.0000165593.52811.cd.
Until recently, inhalant abuse and dependence have been overlooked as serious problems, perhaps because of their relatively low prevalence. The purpose of this review is to summarize recent advances in our understanding of the consequences, pharmacology, and etiology of inhalant use, and how we might develop preventive and management strategies to combat abuse and dependence on these drugs.
Animal models have cast light on how reinforcement of inhalant use occurs, and on mechanisms of development of tolerance and dependence. The reinforcing effects occur principally through GABA and dopamine-mediated mechanisms (rather than NMDA-mediated mechanisms). Assays for inhalants provide greater opportunities for accurate diagnosis. In addition to known medical consequences of inhalant use (including death), other risks associated with inhalant use and addiction include addiction to other substances, major depression, suicide, and impaired learning and memory.
The extensive medical, psychiatric, and psychological damage that can be caused by inhalant use argues for much greater attention to be paid to developing prevention and treatment programmes for inhalant abuse and dependence. These are currently nonexistent, but are badly needed.
直到最近,吸入剂滥用和依赖一直被视为严重问题而被忽视,这可能是因为它们的患病率相对较低。本综述的目的是总结我们在理解吸入剂使用的后果、药理学和病因学方面的最新进展,以及我们如何制定预防和管理策略来对抗这些药物的滥用和依赖。
动物模型揭示了吸入剂使用强化的发生方式以及耐受性和依赖性发展的机制。强化作用主要通过γ-氨基丁酸(GABA)和多巴胺介导的机制(而非N-甲基-D-天冬氨酸(NMDA)介导的机制)产生。吸入剂检测为准确诊断提供了更多机会。除了吸入剂使用已知的医学后果(包括死亡)外,与吸入剂使用和成瘾相关的其他风险还包括对其他物质成瘾、重度抑郁症、自杀以及学习和记忆受损。
吸入剂使用可能造成广泛的医学、精神和心理损害,这表明应更加重视制定针对吸入剂滥用和依赖的预防和治疗方案。目前这些方案并不存在,但却迫切需要。