CNR National Research Council of Italy, Neuroscience Institute-Cagliari @ Department of Biomedical Sciences, University of Cagliari, Cittadella Universitaria di Monserrato, 09042 Monserrato, Cagliari, Italy.
Drug Test Anal. 2013 Jan;5(1):57-61. doi: 10.1002/dta.1401. Epub 2012 Aug 11.
Addiction is a complex disorder with interacting factors, including environmental factors, drug-induced neurobiological changes, comorbidity, personality traits and stress responsivity. Numerous genetic variants that affect these factors may work in concert to affect vulnerability and severity of addiction. Traditionally, abuse of illicit drugs, including cannabis, was considered to be primarily a problem specific to men but the recent focus on drug addiction in women has brought attention to numerous sex differences in the central effects of these drugs, epidemiology of abuse-related disorders, etiologic considerations and psychiatric comorbidity. Gender is now recognised as a major factor in the modulation of the pharmacological effects of drugs of abuse, and sex differences have been reported in various phases of the addiction cycle in both humans and animals. Recently, important gender-dependent differences have been detected in the rates of initiation of marijuana smoking and in the frequency of use. Several animal studies, and in particular self-administration studies, confirmed the crucial role played by sex and gonadal hormones in determining higher sensitivity to marijuana's rewarding properties and vulnerability to cannabis addiction in females than in males. In general, women also show higher rate of relapse to drug use than men, likely due to divergent withdrawal experiences and increased reactivity to internal (emotional) and external (drug-associated) cues. According with this, craving for marijuana smoking and propensity to re-use cannabis after abstinence may also develop differently between the sexes and require distinct treatment approaches, thus highlighting the urgent need for gender-tailored prevention strategies and detoxification treatments.
成瘾是一种复杂的疾病，涉及多种相互作用的因素，包括环境因素、药物引起的神经生物学变化、共病、个性特征和应激反应性。许多影响这些因素的遗传变异可能协同作用，影响成瘾的易感性和严重程度。传统上，包括大麻在内的非法药物滥用被认为主要是男性特有的问题，但最近对女性药物成瘾的关注使人们注意到这些药物在中枢作用、滥用相关疾病的流行病学、病因学考虑因素和精神共病方面存在许多性别差异。性别现在被认为是调节滥用药物的药理学作用的一个主要因素，在人类和动物的成瘾周期的各个阶段都报道了性别差异。最近，在大麻吸烟的起始率和使用频率方面，已经检测到重要的性别依赖性差异。几项动物研究，特别是自我给药研究，证实了性别和性腺激素在确定女性对大麻奖赏特性的敏感性以及对大麻成瘾的易感性方面比男性更高方面发挥着关键作用。一般来说，女性的药物复吸率也高于男性，可能是由于不同的戒断体验和对内部（情绪）和外部（与药物相关）线索的反应性增加。因此，对大麻吸烟的渴望和在禁欲后重新使用大麻的倾向也可能在性别之间存在不同的发展，需要不同的治疗方法，因此强调了制定针对性别的预防策略和解毒治疗的迫切需要。
