Iyalomhe G B S
Department of Pharmacology & Therapeutics, College of Medicine, Ambrose Alli University, Ekpoma, Nigeria.
Niger J Med. 2009 Apr-Jun;18(2):128-33. doi: 10.4314/njm.v18i2.45050.
Drug addiction, particularly among teenagers and young adults, has become a serious public health problem globally. Drugs with addictive potential include the non-therapeutic drugs that are licit/legal (caffeine, tobacco or nicotine, alcohol) and those that are illegal/illicit for common use such as benzodiazepines, amphetamines, cocaine and crack, heroin and cannabis. Worldwide, the challenge of cannabis abuse and addiction is particularly devastating, nay in Nigeria. Despite this ugly scenario, the use of cannabis continues unabated and its control remains enigmatic. The aim of the present review is to provide a contemporary comprehensible overview of exciting recent developments in the understanding of brain circuits related to the nature and effects of cannabis abuse and addiction as well as to highlight the current therapeutic approach to effective management.
A thorough manual literature and internet (Medline and HINARI databases) search were conducted.
It was found that recent advances in the neurobiology of drug abuse and addiction have led to the identification of neuronal substrates (eg dopamine, 5-hydroxyltrypytamine etc) as being responsible for the rewarding effects of cannabis and are also crucial to the addictive process/behaviour. There is increasing evidence that prolonged exposure to drugs of abuse including cannabis, produces long-lasting effects in cognitive and drug-rewarding brain circuits. Hence, addiction is now generally considered a chronic brain disease. Chronic use of cannabis impairs cognitive functions, perception, reaction time, learning, memory, concentration, social skills and control of emotions. There may also be panic reactions, hallucinations, paranoid states with fixed delusions and even acute psychosis. These impairments have obvious negative implications for the operation of a motor vehicle or machinery and performance at school or workplace as well as the development of a healthy family, a strong national economy and a secure society. Complications of use, including psychosis and withdrawal effects, can be treated. Psychosocial measures and rehabilitation, together with effective prevention initiatives are essential in the management of individuals with drug-related problems.
Cannabis abuse and addiction is destructive and may affect all of our lives and the fabric of the society. The development of long-term management strategies based on medication, psychosocial support and continued monitoring as well as preventive initiatives to reduce risk factors and strengthen protective factors against drug abuse is a challenging clinical goal.
药物成瘾,尤其是在青少年和年轻人中,已成为全球严重的公共卫生问题。具有成瘾潜力的药物包括合法的非治疗性药物(咖啡因、烟草或尼古丁、酒精)以及苯二氮䓬类、苯丙胺类、可卡因和快克、海洛因和大麻等常见的非法药物。在全球范围内,大麻滥用和成瘾的挑战尤为严峻,在尼日利亚更是如此。尽管情况如此糟糕,但大麻的使用仍有增无减,对其管控仍然难以捉摸。本综述的目的是提供一个当代可理解的概述,介绍在理解与大麻滥用和成瘾的性质及影响相关的脑回路方面令人兴奋的最新进展,并强调当前有效管理的治疗方法。
进行了全面的手动文献检索和互联网(Medline和HINARI数据库)检索。
发现药物滥用和成瘾神经生物学的最新进展已导致确定神经元底物(如多巴胺、5-羟色胺等)是大麻奖赏效应的原因,并且对成瘾过程/行为也至关重要。越来越多的证据表明,长期接触包括大麻在内的滥用药物会在认知和药物奖赏脑回路中产生持久影响。因此,成瘾现在通常被视为一种慢性脑病。长期使用大麻会损害认知功能、感知、反应时间、学习、记忆、注意力、社交技能和情绪控制。还可能出现惊恐反应、幻觉、伴有固定妄想的偏执状态甚至急性精神病。这些损害对驾驶机动车或操作机器以及在学校或工作场所的表现以及健康家庭、强大国民经济和安全社会的发展具有明显的负面影响。使用的并发症,包括精神病和戒断效应,可以得到治疗。心理社会措施和康复,以及有效的预防举措,对于管理有药物相关问题的个体至关重要。
大麻滥用和成瘾具有破坏性,可能会影响我们所有人的生活和社会结构。基于药物治疗、心理社会支持和持续监测制定长期管理策略以及采取预防举措以降低危险因素并加强预防药物滥用的保护因素,是一个具有挑战性的临床目标。