Marino A, Costa R
Istituto di Farmacologia Sperimentale e Clinica, II Facoltà di Medicina, Università, Napoli.
Recenti Prog Med. 1993 Oct;84(10):709-21.
In every age and culture, people have had to distinguish between positive and negative consequences of the use of psychoactive substances. Since the ancient times it was known that alcohol, easily available in wide quantities, could facilitate social contacts. The abuse and the addiction represent, on the other hand, a complicated social phenomenon and are the expression of physiological adaptive mechanisms brought to the extreme point. The high level of diffusion and the complexity of these problems made it necessary to create diagnostic classifications to classify illnesses on the basis of definite and reliable principles, with the main goal of obtaining therapeutic progress. The consequences of alcohol abuse are both physical and psychic, thus therapeutic approaches must take into account these two points. Some pharmacological agents may lead to cross-tolerance with alcohol and, besides, they are not necessary in case of a slight abstinence where brief psychotherapies are sufficient. Recent advances in the knowledge of the mechanisms which underlie alcohol addition suggest approaches particularly aimed to correct imbalances of neurotransmitters that can determine addiction. Among these, GHB acid seems to be particularly important. At the end, on the basis of the latest progress in psycho-immunopharmacology, the relationships between alcohol and disease are considered.
在每个时代和文化中，人们都必须区分使用精神活性物质的积极和消极后果。自古以来就知道，大量可得的酒精能够促进社交。另一方面，滥用和成瘾是一种复杂的社会现象，是生理适应性机制走向极端的表现。这些问题的高度普遍性和复杂性使得有必要创建诊断分类，以便根据明确可靠的原则对疾病进行分类，主要目的是取得治疗进展。酒精滥用的后果既有身体上的，也有心理上的，因此治疗方法必须考虑到这两点。一些药物可能会导致对酒精的交叉耐受性，此外，在轻度戒酒且简短心理治疗就足够的情况下，这些药物并非必需。对酒精成瘾背后机制的认识的最新进展表明了一些特别旨在纠正可能导致成瘾的神经递质失衡的方法。其中，γ-羟基丁酸似乎尤为重要。最后，根据精神免疫药理学的最新进展，探讨了酒精与疾病之间的关系。
