Sagrera Caroline E, Alderman Laura, Vest M Frances, Goeders Nicholas E, Murnane Kevin S
Louisiana Addiction Research Center, Louisiana State University Health Sciences Center-Shreveport, LA, USA.
Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, USA.
CNS Neurol Disord Drug Targets. 2023;22(7):946-949. doi: 10.2174/1871527321666220511145230.
The role of previous life stress and trauma in addiction has been understudied and underappreciated. To date, much previous research has emphasized other aspects of the disease of addiction, including the reward-based neural circuitry. While previous research has offered tremendous value and shaped human understanding of addiction, an increased emphasis on the role of stress and trauma in addiction may provide new targets for therapeutic development. Here, we review both clinical and preclinical literature in support of the hypothesis that addiction is largely initiated and driven by significant previous life stressors and traumas. We describe some of the available quantitative molecular in vitro studies, systematic literature reviews, case-control studies, and cross-sectional studies to summarize the neurobiology of the reward pathway, the influence of stress-related hormones on the brain, and the role of childhood trauma in the development of substance abuse. The current perspective highlights the importance of early intervention during stressful life events for the prevention of future addiction behavior and suggests that elucidating the neurobiology of these systems may provide new targets for medication development for addiction.
既往生活压力和创伤在成瘾中的作用一直未得到充分研究和重视。迄今为止，此前的许多研究都强调了成瘾疾病的其他方面，包括基于奖赏的神经回路。虽然此前的研究提供了巨大价值并塑造了人类对成瘾的理解，但更多地强调压力和创伤在成瘾中的作用可能为治疗发展提供新的靶点。在此，我们回顾临床和临床前文献，以支持成瘾在很大程度上由既往重大生活压力源和创伤引发及驱动这一假说。我们描述了一些现有的定量分子体外研究、系统文献综述、病例对照研究和横断面研究，以总结奖赏通路的神经生物学、应激相关激素对大脑的影响以及童年创伤在药物滥用发展中的作用。当前观点强调在压力性生活事件期间进行早期干预对预防未来成瘾行为的重要性，并表明阐明这些系统的神经生物学可能为成瘾药物开发提供新的靶点。
