Foltin R W, Fischman M W
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205.
Drug Alcohol Depend. 1991 Jun;28(1):3-48. doi: 10.1016/0376-8716(91)90052-z.
Stimulant drugs have been illicitly consumed for non-medical purposes for centuries. Within the past several decades procedures for assessing the abuse liability of a compound prior to marketing have been developed, which should limit the introduction of new stimulants with high abuse liability to the public. Drugs with high abuse liability are positive reinforcers in that they maintain behavior leading to their consumption. Assessment of abuse liability has traditionally involved a comparison of the profile of effects of a known drug of abuse to that of a drug with unknown abuse liability. With respect to stimulant drugs, amphetamine and cocaine may be considered prototypic stimulants with high abuse liability. Various procedures have been used to study abuse liability including the measuring of (1) subjective effects, (2) drug 'liking', (3) estimates of value, (4) the accuracy of drug identification, (5) the ability of trained subjects to discriminate one drug from another and (6) drug self-administration. In this paper the behavioral effects of a number of stimulant drugs will be compared along these dimensions and the effects along each dimension will be related to each drugs' known abuse liability. Dissociations among the various measures will also be described, and the implications of these dissociations discussed. We conclude that the best single assessment of abuse liability is obtained from drug self-administration studies, but that the most accurate assessment of abuse liability is obtained when the effects of a drug are evaluated along as many of these dimensions as possible.
几个世纪以来，兴奋剂类药物一直被非法用于非医疗目的。在过去几十年里，已开发出在药物上市前评估其滥用可能性的程序，这应能限制具有高滥用可能性的新型兴奋剂流入公众手中。具有高滥用可能性的药物是阳性强化剂，因为它们会维持导致其被使用的行为。传统上，滥用可能性的评估涉及将一种已知滥用药物的效应特征与一种滥用可能性未知的药物的效应特征进行比较。就兴奋剂类药物而言，苯丙胺和可卡因可被视为具有高滥用可能性的典型兴奋剂。已采用各种程序来研究滥用可能性，包括测量：（1）主观效应；（2）对药物的“喜好”；（3）价值估计；（4）药物识别的准确性；（5）经过训练的受试者区分一种药物与另一种药物的能力；以及（6）药物自我给药。在本文中，将沿着这些维度比较多种兴奋剂类药物的行为效应，并将每个维度的效应与每种药物已知的滥用可能性联系起来。还将描述各种测量方法之间的分离情况，并讨论这些分离情况的含义。我们得出结论，滥用可能性的最佳单一评估来自药物自我给药研究，但当沿着尽可能多的这些维度评估一种药物的效应时，能获得对滥用可能性最准确的评估。
