Mehr Samira Rostami, Nakhaei Babak, Soleimani Hossein, Madadlou Shaahriyar Kouhi, Abbasi Maleky Asghar, Abbasi-Maleki Saeid
Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Department of Pathobiology, Faculty of Veterinary Medicine, Urmia Branch, Islamic Azad University, Urmia, Iran.
Prog Brain Res. 2025;291:381-404. doi: 10.1016/bs.pbr.2025.01.012. Epub 2025 Jan 31.
This chapter delves into the complex interplay among addiction, stress, and the reward pathways in the brain, emphasizing the ways in which various drugs affect these systems and exacerbate SUD. Drugs have physiological effects that can be both pleasurable and unpleasant. These effects change behavior through both positive and negative reinforcement. A person's genetic predisposition to addiction is mostly determined by factors such as biological sex, age of first usage, and dopamine receptor density. Drug use behaviors are also greatly influenced by environmental stressors, media exposure, and substance accessibility; nevertheless, protective variables including social support, participation in healthy activities, and preventative programs serve to reduce the dangers associated with drug use. The reinforcement of addictive behaviors is mostly dependent on the brain's reward circuits, which include the nucleus accumbens, ventral tegmental region, and prefrontal cortex, in addition to neurotransmitters such as dopamine, serotonin, and endorphins. Stress makes addiction worse by intensifying cravings and raising the possibility of relapsing. Examined are the impacts of several drug types, such as opioids, stimulants, depressants, and hallucinogens, emphasizing the long-term consequences on brain function and susceptibility to addiction. In order to create individualized interventions that target the environmental and neurological components of addiction and eventually improve treatment results, a thorough understanding of these elements is important.
本章深入探讨成瘾、压力和大脑奖赏通路之间的复杂相互作用,强调各种药物影响这些系统并加剧物质使用障碍(SUD)的方式。药物具有既能带来愉悦又会产生不适的生理效应。这些效应通过正性和负性强化改变行为。一个人对成瘾的遗传易感性主要由生物性别、首次使用年龄和多巴胺受体密度等因素决定。药物使用行为也受到环境压力源、媒体曝光和物质可及性的极大影响;然而,包括社会支持、参与健康活动和预防项目在内的保护因素有助于降低与药物使用相关的风险。成瘾行为的强化主要依赖于大脑的奖赏回路,包括伏隔核、腹侧被盖区和前额叶皮质,以及多巴胺、血清素和内啡肽等神经递质。压力会通过加剧渴望和增加复发可能性而使成瘾情况恶化。研究了几种药物类型的影响,如阿片类药物、兴奋剂、抑制剂和致幻剂,强调了对大脑功能和成瘾易感性的长期影响。为了制定针对成瘾的环境和神经学因素的个性化干预措施并最终改善治疗效果,透彻理解这些因素很重要。