Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, Roanoke, Virginia.
R&D 12, VA Medical Center, Portland, Oregon.
Alcohol Clin Exp Res. 2019 Jan;43(1):6-21. doi: 10.1111/acer.13912. Epub 2018 Dec 3.
The current article highlights key issues in defining, studying, and treating addiction, a concept related to but distinct from substance use disorders. The discussion is based upon a roundtable discussion at the 2017 annual meeting of the Research Society on Alcoholism where Warren K. Bickel and John C. Crabbe were charged with answering a range of questions posed by Kenneth J. Sher. All the presenters highlighted a number of central concerns for those interested in assessing and treating addiction as well as those seeking to conduct basic preclinical research that is amenable to meaningful translation to the human condition. In addition, the discussion illustrated both the power and limitations of using any single theory to explain multiple phenomena subsumed under the rubric of addiction. Among the major issues examined were the important differences between traditional diagnostic approaches and current concepts of addiction, the difficulty of modeling key aspects of human addiction in nonhuman animals, key aspects of addiction that have, to date, received little empirical attention, and the importance of thinking of recovery as a phenomenon that possibly involves processes distinct from those undergirding the development and maintenance of addiction.
本文重点讨论了成瘾的定义、研究和治疗方面的关键问题,成瘾是一个与物质使用障碍相关但又不同的概念。讨论的依据是 2017 年酒精研究学会年会上的一次圆桌讨论,会上 Warren K. Bickel 和 John C. Crabbe 负责回答 Kenneth J. Sher 提出的一系列问题。所有演讲者都强调了那些对评估和治疗成瘾以及对开展适合于向人类状况进行有意义转化的基础临床前研究感兴趣的人所关注的一些核心问题。此外,讨论还说明了使用单一理论来解释包含在成瘾范畴下的多种现象的优缺点。所检查的主要问题包括传统诊断方法与当前成瘾概念之间的重要差异、在非人类动物中模拟人类成瘾关键方面的困难、迄今尚未受到多少实证关注的成瘾的关键方面,以及将康复视为可能涉及与成瘾的发展和维持所依赖的过程不同的过程的重要性。