Hornick Mary G, Stefanski Ashley
College of Science, Health and Pharmacy, Roosevelt University, Schaumburg, IL, United States.
Front Pharmacol. 2023 Aug 22;14:1221719. doi: 10.3389/fphar.2023.1221719. eCollection 2023.
The United States is entering its fourth decade of the opioid epidemic with no clear end in sight. At the center of the epidemic is an increase in opioid use disorder (OUD), a complex condition encompassing physical addiction, psychological comorbidities, and socioeconomic and legal travails associated with the misuse and abuse of opioids. Existing behavioral and medication-assisted therapies show limited efficacy as they are hampered by lack of access, strict regimens, and failure to fully address the non-pharmacological aspects of the disease. A growing body of research has indicated the potential of hallucinogens to efficaciously and expeditiously treat addictions, including OUD, by a novel combination of pharmacology, neuroplasticity, and psychological mechanisms. Nonetheless, research into these compounds has been hindered due to legal, social, and safety concerns. This review will examine the preclinical and clinical evidence that psychoplastogens, such as ibogaine, ketamine, and classic psychedelics, may offer a unique, holistic alternative for the treatment of OUD while acknowledging that further research is needed to establish long-term efficacy along with proper safety and ethical guidelines.
美国正进入阿片类药物流行的第四个十年，且看不到明确的结束迹象。这场流行病的核心是阿片类药物使用障碍（OUD）的增加，这是一种复杂的病症，包括身体成瘾、心理合并症以及与阿片类药物滥用和误用相关的社会经济和法律困境。现有的行为疗法和药物辅助疗法疗效有限，因为它们受到难以获得治疗、严格治疗方案以及未能充分解决该疾病非药理学方面问题的阻碍。越来越多的研究表明，致幻剂有可能通过药理学、神经可塑性和心理机制的新颖组合，有效且迅速地治疗成瘾，包括阿片类药物使用障碍。尽管如此，由于法律、社会和安全方面的担忧，对这些化合物的研究受到了阻碍。本综述将审视临床前和临床证据，即诸如伊博格碱、氯胺酮和经典迷幻剂等精神塑造剂可能为治疗阿片类药物使用障碍提供一种独特的、整体的替代方案，同时承认需要进一步研究以确定长期疗效以及适当的安全和伦理准则。
