物质使用障碍

DeckerMed Medicine Pub Date : 2018-06-25 DOI:10.2310/im.1191
F. Moeller
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引用次数: 0

摘要

有一致的证据表明,药物滥用和依赖会使先前存在的医疗状况恶化,可能暂时模仿医疗和精神疾病,并且本身可能导致医疗问题,包括危及生命的过量服用。物质使用障碍在青年和中年人中很常见:包括酗酒在内的这些综合征的终生患病率在男性中超过20%,在女性中约为15%。本章讨论了依赖性、滥用、物质使用障碍和物质引起的障碍,包括抑制剂、兴奋剂、阿片类药物、大麻素、致幻剂、n -甲基- d -天冬氨酸(NMDA)受体通道阻滞剂和吸入剂。对流行病学、病因学、病理生理学、诊断(包括临床评估和实验室检查)和治疗进行了综述。治疗中毒,过量,戒断和康复讨论。这张图说明了成瘾的神经回路。表格描述了精神障碍诊断和统计手册,第四版(DSM-IV)滥用和依赖的诊断标准;经常滥用药物;常见滥用药物的神经效应;药物依赖的自然历史;影响尿药检结果的情况;以及药物过量治疗的药物选择。本章共有112处参考文献。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Substance Use Disorders
There is a consistent body of evidence showing that substance abuse and dependence can worsen preexisting medical conditions, can temporarily mimic medical and psychiatric disorders, and can themselves cause medical problems, including life-threatening overdose. Substance use disorders are common in young and middle-aged persons: the lifetime prevalence of these syndromes, including alcoholism, is over 20% for men and about 15% for women. This chapter discusses dependence, abuse, substance use disorder, and substance-induced disorders involving depressants, stimulants, opioids, cannabinoids, hallucinogens, N-methyl-D-aspartate (NMDA) receptor channel blockers, and inhalants. Epidemiology, etiology, pathophysiology, diagnosis (including clinical assessment and laboratory tests), and treatment are reviewed. Treatment of intoxication, overdose, withdrawal, and rehabilitation is discussed. A figure illustrates the neurocircuitry of addiction. Tables describe the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) diagnostic criteria for abuse and dependence; frequently misused drugs; neural effects of commonly abused drugs; the natural history of drug dependence; conditions affecting the outcome of urinary drug tests; and pharmacologic options for treatment of drug overdose. This chapter contains 112 references.
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