Courtwright David T
Univ. of North Florida.
Soc Hist Alcohol Drugs. 2005 Fall;20(1):105-40.
All researchers agree that individuals can become intoxicated by and dependent on alcohol, tobacco, and other psychoactive drugs. But they have disagreed over whether, and to what extent, drug pathologies comprise a unitary medical problem. Most critically, does addiction have a biological common denominator? Consensus on this question has shifted back and forth. In the late nineteenth and early twentieth centuries, physicians often studied and treated various drug addictions together, working under the "inebriety" paradigm. By the mid-twentieth century the inebriety paradigm had collapsed. Tobacco and alcohol had split off, both in the medical research community and in western popular culture. This article argues that neuroscientific, genetic, epidemiological, and historical evidence helped to reunify the addiction field in the late twentieth century. A new unifying paradigm emerged, variously called chemical dependency, substance abuse, or simply ATOD -- alcohol, tobacco, and other drugs.
所有研究人员都认为,个体可能会因酒精、烟草和其他精神活性药物而中毒并对其产生依赖。但他们对于药物病理学是否构成一个统一的医学问题以及在何种程度上构成这一问题存在分歧。最关键的是,成瘾是否有生物学上的共同特征?关于这个问题的共识一直在反复变化。在19世纪末和20世纪初,医生们经常在“酗酒”范式下共同研究和治疗各种药物成瘾问题。到20世纪中叶,酗酒范式已经瓦解。在医学研究界和西方大众文化中,烟草和酒精都已分离开来。本文认为,神经科学、遗传学、流行病学和历史证据在20世纪后期帮助重新统一了成瘾领域。一种新的统一范式出现了,它有各种不同的叫法,如化学依赖、药物滥用,或者简单地称为ATOD——酒精、烟草和其他药物。