查看Addiction的源代码

==  Key elements of addiction ==

* Addictive substances are highly reinforcing.
* They are reinforcing because they induce pleasure.
* Pleasure leads to ‘liking’ the effects of addictive substances.
* ‘Liking’ a substance can become conditioned to substance-related cues.
* ‘Wanting’ a substance can occur at the expense of ‘liking’ the substance.
* Excessive ‘wanting’ can lead to a loss of control of substance use.
* Substance use habits are unconscious—they are automatic.
* Craving for substances may occur following prolonged abstinence.
* Craving may trigger substance relapse

 • 成瘾物质具有高度强化作用。
 • 它们正在强化，因为它们会引起快乐。
 • 快乐导致“喜欢”成瘾物质的效果。
 • “喜欢”一种物质可能会受到与物质相关的线索的影响。
 • “想要”某种物质的发生可能会以牺牲“喜欢”该物质为代价。
 • 过度的“想要”会导致对物质使用的失控。
 • 物质使用习惯是无意识的——它们是自动的。
 • 戒断滥用物质会导致重复使用。
 • 长期戒酒后可能会出现对物质的渴望。
 • 渴望可能会引发物质复发

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== Neurobiological processes in addiction ==

成瘾中的神经生物学过程

* The brain controls necessary motivational and cognitiv  processes.
* These processes involve a network of independent and overlapping brain circuits.
* These processes involve reward, motivation, learning/memory, and cognition.
* Reward involves dopamine in the ventral striatum.
* Learning involves dopamine in the ventral tegmental area and ventral striatum.
* Memory involves glutamate in the amygdala and hippocampus.
* Motivation and drive involve GABA and dopamine in the orbitofrontal cortex.
* Cognition involves dopamine and glutamate in the prefrontal cortex.
* These processes are disrupted by substances of addiction

 • 大脑控制必要的动机和认知过程。
 • 这些过程涉及一个由独立和重叠的大脑回路组成的网络。
 • 这些过程涉及奖励、动机、学习/记忆和认知。
 • 奖励涉及腹侧纹状体中的多巴胺。
 • 学习涉及腹侧被盖区和腹侧纹状体的多巴胺。
 • 记忆涉及杏仁核和海马体中的谷氨酸。
 • 动机和驱动力涉及眶额叶皮层中的 GABA 和多巴胺。
 • 认知涉及前额叶皮层中的多巴胺和谷氨酸。
 • 这些过程被成瘾物质打乱

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==  Pharmacodynamics of addictive substances ==

成瘾物质的药效学

* Pharmacodynamics refers to the effect of substances on the body.
* The pharmacodynamic effects of substances take place at receptors.
* Agonists mimic the effects of neurotransmitters at receptors.
* Antagonists block the effects of neurotransmitters at receptors.
* Addictive substances can alter brain pharmacodynamics.
* Brain pharmacodynamics can be influenced by genetics.

 • 药效学是指物质对身体的影响。
 • 物质的药效学作用发生在受体处。
 • 激动剂模拟神经递质对受体的作用。
 • 拮抗剂阻断神经递质对受体的作用。
 • 成瘾物质可以改变大脑药效学。
 • 大脑药效学会受到遗传学的影响。

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== The dopamine system and addiction ==

多巴胺系统和成瘾

* Dopamine release is involved in the reinforcing effects of addictive substances.
* Dopamine release can be blunted by substance abuse.
* Dopamine release is involved in drug craving.
* Dopamine receptors are reduced during substance addiction withdrawal.
* Medications that boost dopamine functioning may be useful in substance addiction.
* Reductions in dopamine functioning may predispose people to substance addiction

 • 多巴胺的释放与成瘾物质的强化作用有关。
 • 药物滥用会减慢多巴胺的释放。
 • 多巴胺释放与药物渴望有关。
 • 物质成瘾戒断期间多巴胺受体减少。
 • 促进多巴胺功能的药物可能对物质成瘾有用。
 • 多巴胺功能降低可能使人易患物质成瘾

药物：
* Cocaine（苯甲酰甲基芽子碱、古柯碱，是一种从古柯树叶中提取出来的生物碱）
* Amphetamine（又名：苯丙胺）
* Methamphetamine（又名：甲基苯丙胺、去氧麻黄碱、甲基安非他明）
* Morphine（吗啡碱，从鸦片中直接提取的生物碱）

* Ketamine（氯胺酮）
* MDMA（3,4－亚甲二氧基甲基苯丙胺），误服后主要表现为活动过度、摇头扭腰、嗜舞、妄想、不知羞耻、性冲动及幻觉和暴力倾向，俗称“摇头丸”。
* GHB（gamma－hydroxybutyrate，γ－羟丁酸，神仙水）

* Heroin（二乙酰吗啡，海洛因），具有镇痛、镇静、镇咳、平喘、缩瞳、催吐、抑制呼吸、精神欣快、影响内分泌等作用。使用后有短暂的欣快感，疼痛消失，迅速出现头昏、乏力、眼花、心慌、呼吸困难、肢体湿冷、紫绀、昏迷、瞳孔缩小，对光反射消失等症状。海洛因的致死量为0.12克至0.15克。

参考：[https://qnzs.youth.cn/zt/2019jd/jdbk/201906/t20190628_11994824.htm 毒品基础知识]

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== The GABA system and addiction ==

GABA 系统和成瘾

* GABA is the major inhibitory neurotransmitter in the brain.
* GABA binds with GABA-a and GABA-b receptors to inhibit neuronal activity.
* Substances of abuse can downregulate or upregulate the GABA system.
* GABA-b receptors modulate substance reward and reinforcement behaviours.
* Disturbances to the GABA system may pre-date substance addiction.
* Compounds that target the GABA system may help in the  treatment of addiction

 • GABA 是大脑中主要的抑制性神经递质。
 • GABA 与 GABA-a 和 GABA-b 受体结合以抑制神经元活动。
 • 滥用物质可以下调或上调 GABA 系统。
 • GABA-b 受体调节物质奖励和强化行为。
 • 对 GABA 系统的干扰可能早于物质成瘾。
 • 靶向 GABA 系统的化合物可能有助于治疗成瘾

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== The glutamate system and addiction ==

谷氨酸系统和成瘾

* Addiction involves enduring neuroplasticity in the reward  circuitry of the brain.
* Neuroplasticity is a result of glutamate-dependent long-term potentiation.
* Glutamate is an excitatory neurotransmitter.
* Glutamate release is involved in alcohol and drug relapse in response to drug cues.
* There are changes in glutamate receptor functioning in  substance addiction.
* Medications that reduce glutamate tone may prevent alcohol and drug relapse

 • 成瘾涉及大脑奖励回路中持久的神经可塑性。
 • 神经可塑性是谷氨酸依赖长期增强的结果。
 • 谷氨酸是一种兴奋性神经递质。
 • 谷氨酸的释放与酒精和药物复发有关。
 • 物质成瘾中谷氨酸受体功能发生变化。
 • 降低谷氨酸调理的药物可以防止酒精和药物复发

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==  The opioid system and addiction ==

阿片类药物系统和成瘾

* 大脑包含一个复杂的内源性阿片肽系统。
* 这些肽称为内啡肽、脑肽和强啡肽。
* 内啡肽优先与 mu 阿片受体 （mOR） 结合。
* 脑蛋白优先与 δ 受体 （dOR） 结合。
* 强啡肽优先与 κ 受体 （kOR） 结合。
* 阿片类药物，如海洛因和吗啡，也会刺激 mOR。
* mOR 在物质成瘾中上调
* mOR 的遗传多态性会影响对酒精的主观反应。

 • The brain contains a complex system of endogenous opioid peptides.
 • These peptides are called endorphins, encephalins, and dynorphin.
 • Endorphins preferentially bind to the mu opioid receptor (mOR).
 • Encephalins preferentially bind to the delta receptor (dOR).
 • Dynorphin preferentially binds to the kappa receptor (kOR).
 • Opiates, such as heroin and morphine, also stimulate the mOR.
 • The mOR is upregulated in substance addiction
 • Genetic polymorphisms at the mOR influence subjective responses to alcohol.

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== Nicotine addiction ==

* Nicotine is a stimulant that is the main psychoactive element of cigarettes.
* Nicotine is an agonist at nicotinic acetylcholine receptors in the brain.
* Nicotine in smoked tobacco is addictive.
* Nicotine causes disturbances to reward and cognitive processing.
* Cigarette smoking presents considerable health risks.
* Cigarette smoking induces high costs on healthcare resources.
* Smoking cessation medications and safer nicotine products (e.g. e-cigs) are now available to treat nicotine addiction

 • 尼古丁是一种兴奋剂，是香烟的主要精神活性成分。
 • 尼古丁是大脑中烟碱乙酰胆碱受体的激动剂。
 • 烟熏烟草中的尼古丁会让人上瘾。
 • 尼古丁会干扰奖励和认知处理。
 • 吸烟会带来相当大的健康风险。
 • 吸烟会导致医疗保健资源的高成本。
 • 戒烟药物和更安全的尼古丁产品（例如电子烟）现在可用于治疗尼古丁成瘾

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==  Appetite hormones and addiction ==

食欲、荷尔蒙和成瘾

* Appetite and feeding are regulated by hormones that affect the brain.
* These hormones signal the present energy state of the body.
* These hormones can regulate reward and motivational processes.
* Ghrelin is an orexigenic gut hormone that activates reward circuitry.
* Ghrelin increase the consumption of food, but also drugs of addiction.
* Glucagon-like peptide-1 (GLP-1) is an anorexigenic hormone.
* GLP-1 reduces the consumption of food and drugs of addiction.

 • 食欲和进食受影响大脑的激素调节。
 • 这些激素是身体当前能量状态的信号。
 • 这些激素可以调节奖励和激励过程。
 • 生长素释放肽是一种产食欲的肠道激素，可激活奖励回路。
 • 生长素释放肽增加了食物的消费，但也增加了成瘾药物的消费。
 • 胰高血糖素样肽-1 （GLP-1） 是一种厌食激素。
 • GLP-1 减少食物和成瘾药物的消费。

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==  Conclusion and overview ==

* Substances of addiction are highly reinforcing because they induce pleasure.
* Cocaine and amphetamines trigger exaggerated increases in dopamine.
* GABA is the major inhibitory neurotransmitter in the brain.
* Compounds that target the GABA system may help in the treatment of addiction.
* Addiction involves glutamate-dependent neuroplasticity in the brain.
* Medications that target glutamate may be efficacious in preventing drug relapse

* The brain contains a complex system of endogenous opioid peptides.
* The mu opioid receptor appears to be involved in substance abuse and addiction.
* Compounds that target the mu opioid receptor system may help treat addiction.
* Nicotine causes disturbances in reward and cognitive processing.
* Smoking cessation medications are available to treat nicotine addiction.
* Appetite and feeding are regulated by hormones that affect the brain.
* These hormones can regulate reward and motivational processes.


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 • 成瘾物质具有高度强化作用，因为它们会引起快乐。
 • 可卡因和安非他明会引发多巴胺的过度增加。
 • GABA 是大脑中主要的抑制性神经递质。
 • 靶向 GABA 系统的化合物可能有助于治疗成瘾。
 • 成瘾涉及大脑中谷氨酸依赖性的神经可塑性。
 • 靶向谷氨酸的药物可能有效预防药物复发

 • 大脑包含一个复杂的内源性阿片肽系统。
 • mu 阿片受体似乎与药物滥用和成瘾有关。
 • 靶向 μ 阿片受体系统的化合物可能有助于治疗成瘾。
 • 尼古丁会干扰奖励和认知处理。
 • 戒烟药物可用于治疗尼古丁成瘾。
 • 食欲和进食受影响大脑的激素调节。
 • 这些激素可以调节奖励和激励过程。
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