Reichel Carmela M, Bevins Rick A
Department of Psychology, University of Nebraska-Lincoln, Lincoln NE 68588-0308, USA.
Curr Drug Abuse Rev. 2009 May;2(2):184-94. doi: 10.2174/1874473710902020184.
Understanding and preventing relapse to drug use is one of the most difficult challenges faced by clinicians and practitioners in the struggle to help people remain abstinent. In this paper, we review basic preclinical research on forced abstinence periods that identify the neural substrates involved and neural adaptations that occur after a drug-free period. Our attention focuses on forced abstinence after self-administration because of its promise for translational research in the development of candidate medications to reduce relapse. This model requires subjects (often rats) to initially acquire drug self-administration. However, rather than extinguishing behavior with daily drug-free sessions as in the reinstatement model of drug seeking, subjects are removed from the self-administration situation and do not receive any exposure to the drug. Notably, the integrity of the drug-taking behavior and the drug-associated cues in the drug-taking environment are preserved because they are not experienced in the absence of the drug. Research shows time dependent increases in drug-seeking following forced abstinence periods. More so, neural substrates and adaptations within the mesocorticolimbic system and the nigrostriatal system have been identified that contribute to increased drug seeking following abstinence. From a translational perspective, behavioral and pharmacological treatment of substance use disorder often starts during this initial abstinence period (either forced or voluntary). The forced abstinence model simulates some of the features of this treatment situation and thus allows for the study of potential treatments that alter relapse of drug-seeking behaviors along with the accompanying neurobiological changes.
理解并预防复吸是临床医生和从业者在帮助人们保持戒毒状态的斗争中所面临的最艰巨挑战之一。在本文中,我们回顾了关于强制戒毒期的基础临床前研究,这些研究确定了其中涉及的神经基质以及在戒毒期后发生的神经适应性变化。我们的注意力集中在自我给药后的强制戒毒上,因为它有望为开发减少复吸的候选药物的转化研究提供依据。该模型要求实验对象(通常是大鼠)首先学会自我给药。然而,与在药物寻求的恢复模型中通过每日的戒毒疗程来消除行为不同,实验对象被从自我给药环境中移除,且没有任何药物接触。值得注意的是,服药行为和服药环境中与药物相关的线索的完整性得以保留,因为在没有药物的情况下它们不会被体验到。研究表明,在强制戒毒期后,药物寻求行为会随时间增加。更重要的是,已经确定中脑边缘系统和黑质纹状体系统中的神经基质和适应性变化会导致戒毒后药物寻求行为增加。从转化的角度来看,物质使用障碍的行为和药物治疗通常在这个初始戒毒期(强制或自愿)开始。强制戒毒模型模拟了这种治疗情况的一些特征,因此允许研究改变药物寻求行为复吸以及伴随的神经生物学变化的潜在治疗方法。