Worley Julie
J Psychosoc Nurs Ment Health Serv. 2017 Sep 1;55(9):17-21. doi: 10.3928/02793695-20170818-09.
Recent evidence and research has demonstrated that the pleasure response and associated neurotransmitters and brain circuits play a significant role in substance use disorders (SUDs). It was thought that negative behaviors associated with SUDs resulted from negative choices, but it is now known that chemical changes in the brain drive those behaviors. Several mental health disorders (e.g., eating disorders, non-suicidal self-injury, compulsive sex behaviors, internet gaming, gambling) are also thought to involve those same pleasure responses, neurotransmitters, and brain regions. Studies have shown that the use of naltrexone, a dopamine antagonist, can reduce symptoms of these disorders. It is important for nurses to understand the underlying physiology of mental health disorders that are thought to have an addictive or craving component. This understanding can help reduce stigma. Educating patients about likely neurobiological causes for their disorders can also help reduce guilt and shame. Nurses should educate patients about these disorders and evidence-based treatments, including off-label use of naltrexone. [Journal of Psychosocial Nursing and Mental Health Services, 55(9), 17-21.].
最近的证据和研究表明，愉悦反应以及相关的神经递质和脑回路在物质使用障碍（SUDs）中起着重要作用。过去认为与物质使用障碍相关的负面行为是由负面选择导致的，但现在已知大脑中的化学变化驱动了这些行为。几种心理健康障碍（如饮食失调、非自杀性自伤、强迫性行为、网络游戏、赌博）也被认为涉及相同的愉悦反应、神经递质和脑区。研究表明，使用多巴胺拮抗剂纳曲酮可以减轻这些障碍的症状。护士了解被认为具有成瘾或渴望成分的心理健康障碍的潜在生理机制非常重要。这种理解有助于减少污名化。向患者宣传其疾病可能的神经生物学原因也有助于减轻内疚和羞耻感。护士应向患者宣传这些障碍以及基于证据的治疗方法，包括纳曲酮的非标签使用。[《心理社会护理与心理健康服务杂志》，55(9)，17 - 21。]
