Popescu Alexandra, Marian Maria, Drăgoi Ana Miruna, Costea Radu-Virgil
Department of Psychiatry, 'Prof. Dr. Alex. Obregia' Clinical Hospital of Psychiatry, 041914 Bucharest, Romania.
Department of General Surgery, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Exp Ther Med. 2021 May;21(5):544. doi: 10.3892/etm.2021.9976. Epub 2021 Mar 23.
The hypothesis issued by modern medicine states that many diseases known to humans are genetically determined, influenced or not by environmental factors, which is applicable to most psychiatric disorders as well. This article focuses on two pending questions regarding addiction: Why do some individuals become addicted while others do not? along with Is it a learned behavior or is it genetically predefined? Recent data suggest that addiction is more than repeated exposure, it is the synchronicity between intrinsic factors (genotype, sex, age, preexisting addictive disorder, or other mental illness), extrinsic factors (childhood, level of education, socioeconomic status, social support, entourage, drug availability) and the nature of the addictive agent (pharmacokinetics, path of administration, psychoactive properties). The dopamine-mesolimbic motivation-reward-reinforcement cycle remains the most coherent physiological theory in addiction. While the common property of addictive substances is that they are dopamine-agonists, each class has individual mechanisms, pharmacokinetics and psychoactive potentials.
现代医学提出的假说认为，人类已知的许多疾病都是由基因决定的，受环境因素影响或不受其影响，这一观点也适用于大多数精神疾病。本文聚焦于成瘾方面两个悬而未决的问题：为什么有些人会成瘾而有些人不会？以及成瘾是一种习得行为还是由基因预先决定的？最近的数据表明，成瘾不仅仅是反复接触，而是内在因素（基因型、性别、年龄、既往成瘾障碍或其他精神疾病）、外在因素（童年经历、教育水平、社会经济地位、社会支持、周围环境、毒品可得性）与成瘾物质性质（药代动力学、给药途径、精神活性特性）之间的同步性。多巴胺 - 中脑边缘动机 - 奖赏 - 强化循环仍然是成瘾领域最具连贯性的生理学理论。虽然成瘾物质的共同特性是它们都是多巴胺激动剂，但每一类都有各自的机制、药代动力学和精神活性潜力。
