Peck Joshua A, Ranaldi Robert
Graduate Center, City University of New York, New York, NY, 10016, USA.
Psychopharmacology (Berl). 2014 May;231(10):2045-58. doi: 10.1007/s00213-014-3517-2. Epub 2014 Mar 16.
An enormous amount of resources has been devoted to the development of pharmacotherapies for drug addiction, with relatively little or no long-term success reported. The current review argues that a successful drug addiction treatment program will likely be one that focuses on both the neural mechanisms and the environmental contingencies that mediate drug use. Further, because the neural mechanisms and environmental factors that support abstinence in humans are similar in laboratory animals, several animal models of abstinence and relapse have been developed. Thus, this review also compares the similarities in the mechanisms that lead to abstinence between animals and humans.
We evaluate the construct and face validities of the behavioral strategies that help support human drug abstinence. Further, we crucially evaluate animal models by assessing their validity and utility in addressing human behavior that leads to long-term abstinence.
We found that the behavioral strategies with the greatest likelihood of supporting long-term abstinence are those that are carried out in drug addicts' natural setting(s) and while drug is readily available. Further, the behavioral strategies that may be most successful in supporting abstinence in humans are those that employ both positive consequences for abstinent related behavior and negative consequences for continued drug seeking or taking. Moreover, the animal models of abstinence and relapse that more closely represent the factors that support long-term abstinence in humans are those that limit their use of extinction or forced abstinence and present negative consequences for drug seeking and taking.
大量资源已投入到药物成瘾的药物治疗研发中,但报道的长期成功率相对较低或几乎没有。当前的综述认为,一个成功的药物成瘾治疗项目可能是一个既关注介导药物使用的神经机制又关注环境因素的项目。此外,由于支持人类戒断的神经机制和环境因素在实验动物中相似,因此已经开发了几种戒断和复发的动物模型。因此,本综述还比较了动物和人类在导致戒断的机制方面的相似性。
我们评估有助于支持人类药物戒断的行为策略的结构效度和表面效度。此外,我们通过评估动物模型在解决导致长期戒断的人类行为方面的有效性和实用性来进行关键评估。
我们发现,最有可能支持长期戒断的行为策略是那些在药物成瘾者的自然环境中且药物容易获得的情况下实施的策略。此外,在支持人类戒断方面可能最成功的行为策略是那些对与戒断相关的行为采用积极后果而对持续寻求或使用药物采用消极后果的策略。此外,更紧密代表支持人类长期戒断因素的戒断和复发动物模型是那些限制使用消退或强制戒断并对寻求和使用药物呈现消极后果的模型。