Laboratory of Neurophysiology, ULB Neuroscience Institute, Université Libre de Bruxelles (ULB), Brussels, B-1070, Belgium.
Transl Psychiatry. 2021 Aug 12;11(1):424. doi: 10.1038/s41398-021-01542-0.
Drug addiction is responsible for millions of deaths per year around the world. Still, its management as a chronic disease is shadowed by misconceptions from the general public. Indeed, drug consumers are often labelled as "weak", "immoral" or "depraved". Consequently, drug addiction is often perceived as an individual problem and not societal. In technical terms, drug addiction is defined as a chronic, relapsing disease resulting from sustained effects of drugs on the brain. Through a better characterisation of the cerebral circuits involved, and the long-term modifications of the brain induced by addictive drugs administrations, first, we might be able to change the way the general public see the patient who is suffering from drug addiction, and second, we might be able to find new treatments to normalise the altered brain homeostasis. In this review, we synthetise the contribution of fundamental research to the understanding drug addiction and its contribution to potential novel therapeutics. Mostly based on drug-induced modifications of synaptic plasticity and epigenetic mechanisms (and their behavioural correlates) and after demonstration of their reversibility, we tried to highlight promising therapeutics. We also underline the specific temporal dynamics and psychosocial aspects of this complex psychiatric disease adding parameters to be considered in clinical trials and paving the way to test new therapeutic venues.
药物成瘾每年在全球导致数百万人死亡。然而,由于公众的误解,它作为一种慢性疾病的管理仍然存在问题。事实上,吸毒者经常被贴上“软弱”、“不道德”或“堕落”的标签。因此,药物成瘾通常被视为个人问题,而不是社会问题。从技术上讲,药物成瘾被定义为一种慢性、复发性疾病,是药物对大脑持续作用的结果。通过更好地描述涉及的大脑回路,以及成瘾性药物给药引起的大脑的长期改变,我们首先可能能够改变公众对患有药物成瘾的患者的看法,其次我们可能能够找到新的治疗方法来使改变的大脑内稳态正常化。在这篇综述中,我们综合了基础研究对理解药物成瘾及其对潜在新疗法的贡献。主要基于药物诱导的突触可塑性和表观遗传机制的改变(及其行为相关性),并证明了它们的可逆性,我们试图强调有前途的治疗方法。我们还强调了这种复杂精神疾病的特定时间动态和心理社会方面,为临床试验增加了需要考虑的参数,并为测试新的治疗场所铺平了道路。