Blackwood Christopher A, Cadet Jean Lud
Molecular Neuropsychiatry Research Branch, NIH/NIDA Intramural Research Program, 251 Bayview Boulevard, Baltimore, MD, 21224, USA.
Curr Res Neurobiol. 2021;2. doi: 10.1016/j.crneur.2021.100023. Epub 2021 Oct 14.
The number of people diagnosed with opioid use disorder has skyrocketed as a consequence of the opioid epidemic and the increased prescribing of opioid drugs for chronic pain relief. Opioid use disorder is characterized by loss of control of drug taking, continued drug use in the presence of adverse consequences, and repeated relapses to drug taking even after long periods of abstinence. Patients who suffer from opioid use disorder often present with cognitive deficits that are potentially secondary to structural brain abnormalities that vary according to the chemical composition of the abused opioid. This review details the neurobiological effects of oxycodone, morphine, heroin, methadone, and fentanyl on brain neurocircuitries by presenting the acute and chronic effects of these drugs on the human brain. In addition, we review results of neuroimaging in opioid use disorder patients and/or histological studies from brains of patients who had expired after acute intoxication following long-term use of these drugs. Moreover, we include relevant discussions of the neurobiological mechanisms involved in promoting abnormalities in the brains of opioid-exposed patients. Finally, we discuss how novel strategies could be used to provide pharmacological treatment against opioid use disorder.
由于阿片类药物流行以及为缓解慢性疼痛而增加阿片类药物的处方，被诊断患有阿片类药物使用障碍的人数急剧上升。阿片类药物使用障碍的特征是对药物使用失去控制、在出现不良后果的情况下继续使用药物，以及即使经过长时间戒断后仍反复复吸。患有阿片类药物使用障碍的患者通常存在认知缺陷，这可能继发于根据滥用阿片类药物的化学成分而有所不同的大脑结构异常。本综述通过介绍这些药物对人脑的急性和慢性影响，详细阐述了羟考酮、吗啡、海洛因、美沙酮和芬太尼对脑神经网络的神经生物学作用。此外，我们回顾了阿片类药物使用障碍患者的神经影像学结果和/或长期使用这些药物后急性中毒死亡患者大脑的组织学研究结果。此外，我们还对促进阿片类药物暴露患者大脑异常的神经生物学机制进行了相关讨论。最后，我们讨论了如何使用新策略来提供针对阿片类药物使用障碍的药物治疗。
