Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, SC, United States.
Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, SC, United States.
Adv Pharmacol. 2022;93:403-441. doi: 10.1016/bs.apha.2021.10.007. Epub 2022 Jan 17.
The number of people who suffer from a substance abuse disorder has continued to rise over the last decade; particularly, the number of drug-related overdose deaths has sharply increased during the COVID-19 pandemic. Converging lines of clinical observations, supported by imaging and neuropsychological performance testing, have demonstrated that substance abuse-induced dysregulation of neurotransmissions in the brain is critical for development and expression of the addictive properties of abused substances. Recent scientific advances have allowed for better understanding of the neurobiological processes that mediates drugs of abuse and addiction. This chapter presents the past classic concepts and the recent advances in our knowledge about how cocaine, amphetamines, opioids, alcohol, and nicotine alter multiple neurotransmitter systems, which contribute to the behaviors associated with each drug. Additionally, we discuss the interactive effects of HIV-1 or COVID-19 and substance abuse on neurotransmission and neurobiological pathways. Finally, we introduce therapeutic strategies for development of pharmacotherapies for substance abuse disorders.
在过去的十年中，患有物质滥用障碍的人数持续上升；特别是在 COVID-19 大流行期间，与药物相关的过量死亡人数急剧增加。临床观察的交汇线，得到影像学和神经心理学表现测试的支持，表明物质滥用导致的大脑神经递质传递失调对于滥用物质成瘾特性的发展和表达至关重要。最近的科学进展使我们能够更好地理解介导滥用药物和成瘾的神经生物学过程。本章介绍了过去的经典概念和我们对可卡因、苯丙胺、阿片类药物、酒精和尼古丁如何改变多种神经递质系统的最新认识，这些系统有助于与每种药物相关的行为。此外，我们还讨论了 HIV-1 或 COVID-19 与物质滥用对神经传递和神经生物学途径的相互影响。最后，我们介绍了用于治疗物质滥用障碍的药理学治疗的开发的治疗策略。
