酒精使用障碍治疗:问题与解决方案。

IF 11.2 1区 医学 Q1 PHARMACOLOGY & PHARMACY
George F Koob
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引用次数: 0

摘要

在美国,酒精使用障碍(AUD)困扰着 2900 多万人,每年导致超过 14 万人死亡。AUD 的启发式框架包括三个阶段的循环--酗酒/中毒、戒断/负性情绪和妄想/期待--这为探索 AUD 在治疗方面的异质性提供了一个起点。有效的行为健康治疗方法和美国食品和药物管理局批准的药物虽已上市,但使用率却很低,这就造成了治疗上的巨大差距。本综述概述了酒精领域在缩小治疗差距方面所面临的挑战,并提出了解决方案,包括扩大批准治疗 AUD 药物的终点;增加筛查、简单干预和转诊治疗的使用率;解决污名化问题;实施启发式康复定义;参与早期治疗;教育医疗保健专业人员和公众了解与酒精滥用相关的挑战。此外,本综述还重点探讨了如何利用成瘾三阶段启发式模型(该模型概述了 AUD 的功能障碍领域和 AUD 的中介神经生物学)拓宽 AUD 药物开发的潜在目标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Alcohol Use Disorder Treatment: Problems and Solutions.

Alcohol use disorder (AUD) afflicts over 29 million individuals and causes more than 140,000 deaths annually in the United States. A heuristic framework for AUD includes a three-stage cycle-binge/intoxication, withdrawal/negative affect, and preoccupation/anticipation-that provides a starting point for exploring the heterogeneity of AUD with regard to treatment. Effective behavioral health treatments and US Food and Drug Administration-approved medications are available but greatly underutilized, creating a major treatment gap. This review outlines challenges that face the alcohol field in closing this treatment gap and offers solutions, including broadening end points for the approval of medications for the treatment of AUD; increasing the uptake of screening, brief intervention, and referral to treatment; addressing stigma; implementing a heuristic definition of recovery; engaging early treatment; and educating health-care professionals and the public about challenges that are associated with alcohol misuse. Additionally, this review focuses on broadening potential targets for the development of medications for AUD by utilizing the three-stage heuristic model of addiction that outlines domains of dysfunction in AUD and the mediating neurobiology of AUD.

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来源期刊
CiteScore
27.80
自引率
0.00%
发文量
53
期刊介绍: Since 1961, the Annual Review of Pharmacology and Toxicology has been a comprehensive resource covering significant developments in pharmacology and toxicology. The journal encompasses various aspects, including receptors, transporters, enzymes, chemical agents, drug development science, and systems like the immune, nervous, gastrointestinal, cardiovascular, endocrine, and pulmonary systems. Special topics are also featured in this annual review.
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