Jerome Lisa, Schuster Shira, Yazar-Klosinski B Berra
Multidisciplinary Association for Psychedelic Studies, 309 Cedar Street # 2323, Santa Cruz, CA 95060, USA.
Curr Drug Abuse Rev. 2013 Mar;6(1):54-62. doi: 10.2174/18744737112059990005.
A wider array of treatments are needed for people with substance abuse disorders. Some psychedelic compounds have been assessed as potential substance abuse treatments with promising results. MDMA may also help treat substance abuse based on shared features with psychedelic compounds and recent reports indicating that MDMAassisted psychotherapy can reduce symptoms of PTSD. Narrative reports and data from early investigations found that some people reduced or eliminated their substance use after receiving MDMA, especially in a therapeutic setting. MDMA is a potent monoamine releaser with sympathomimetic effects that may indirectly activate 5-HT2A receptors. It increases interpersonal closeness and prosocial feelings, potentially through oxytocin release. Findings suggest that ecstasy, material represented as containing MDMA, is associated with deleterious long-term effects after heavy lifetime use, including fewer serotonin transporter sites and impaired verbal memory. Animal and human studies demonstrate moderate abuse liability for MDMA, and this effect may be of most concern to those treating substance abuse disorders. However, subjects who received MDMA-assisted psychotherapy in two recent clinical studies were not motivated to seek out ecstasy, and tested negative in random drug tests during follow-up in one study. MDMA could either directly treat neuropharmacological abnormalities associated with addiction, or it could indirectly assist with the therapeutic process or reduce symptoms of comorbid psychiatric conditions, providing a greater opportunity to address problematic substance use. Studies directly testing MDMA-assisted psychotherapy in people with active substance abuse disorder may be warranted.
物质使用障碍患者需要更多种类的治疗方法。一些迷幻化合物已被评估为潜在的物质使用障碍治疗方法，结果令人鼓舞。基于与迷幻化合物的共同特征以及近期报告表明摇头丸辅助心理治疗可减轻创伤后应激障碍（PTSD）症状，摇头丸也可能有助于治疗物质使用障碍。早期调查的叙述性报告和数据发现，一些人在服用摇头丸后减少或戒除了物质使用，尤其是在治疗环境中。摇头丸是一种强效的单胺释放剂，具有拟交感神经作用，可能间接激活5-HT2A受体。它可能通过释放催产素增加人际亲密度和亲社会情感。研究结果表明，摇头丸（即被认为含有摇头丸的物质）在长期大量使用后会产生有害的长期影响，包括5-羟色胺转运体位点减少和言语记忆受损。动物和人体研究表明摇头丸具有中度滥用可能性，这种影响可能是治疗物质使用障碍的人最担心的。然而，在最近的两项临床研究中接受摇头丸辅助心理治疗的受试者没有寻求摇头丸的动机，并且在一项研究的随访期间随机药物检测呈阴性。摇头丸既可以直接治疗与成瘾相关的神经药理学异常情况，也可以间接辅助治疗过程或减轻共病精神疾病的症状，从而为解决有问题的物质使用提供更大的机会。可能有必要对有活跃物质使用障碍的人直接进行摇头丸辅助心理治疗的研究。
