Neuroscience.pdf

格式: pdf 页数: 286 文件大小: 1MB 侵权/举报
Neuroscience.pdf

Neuroscience.pdf

格式: pdf 页数: 286 文件大小: 1MB
Neuroscience.pdf Neuroscience of psychoactive substance use and dependence The Neuroscience of psychoactive substance use and dependence provides an authoritative summary of current knowledge of the biological basis of substance use and dependence, and discus- ses the relationship of these behaviours with environmental fac- tors. The book focuses on specific brain mechanisms governing craving, tolerance, withdrawal, and dependence on a wide range of psychoactive substances, including tobacco, alcohol and illicit drugs. The ethical implications of new developments for preven- tion and treatment are also discussed, and the public health implications of this knowledge are translated into recommenda- tions for policy and programmes at national and international levels. Relying on contributions from many international experts, the best available evidence is presented from the various schools of thought and areas of research in this rapidly growing field. Neuroscience of psychoactive substance use and dependence is written for individuals with more than a basic knowledge of the field, including scientists from a variety of disciplines. The book should be of interest to health care workers, clinicians, social workers, university students, science teachers and policy makers. ISBN 92 4 156235 8 N euroscience of psychoactive substance use and dependence WHO DepNeuroCoverFinal_CAG 19.1.2004 12:15 Page 1 Neuroscience of psychoactive substance use and dependence WORLD HEALTH ORGANIZATION GENEVA Pagetit 19.1.2004, 12:361 © World Health Organization 2004 All rights reserved. Publications of the World Health Organization can be obtained from Marketing and Dissemination, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel: +41 22 791 2476; fax: +41 22 791 4857; email: bookorders@who.int). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to Publications, at the above address (fax: +41 22 791 4806; email: permissions@who.int). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. Text design by minimum graphics Cover design by Tushita Graphic Vision Printed in Switzerland WHO Library Cataloguing-in-Publication Data Neuroscience of psychoactive substance use and dependence. 1. Psychotropic drugs - pharmacology 2. Substance-related disorders - physiopathology 3. Psychopharmacology 4. Brain - drug effects I. World Health Organization. ISBN 92 4 156235 8 (LC/NLM classification: WM 270) Pagetit 19.1.2004, 12:362 Contents Foreword ix Acknowledgements xi List of background papers and contributors xv Abbreviations xvii Chapter 1. Introduction 1 Structure of the report 1 Psychoactive substances and their sociolegal status 1 Global use of psychoactive substances 4 Tobacco 4 Alcohol 5 Illicit use of controlled substances 9 Adverse effects of psychoactive substances and their mechanisms of action 10 Substance dependence in relation to neuroscience 12 The burden of harm to health from psychoactive substance use 16 Chapter 2. Brain Mechanisms: Neurobiology and Neuroanatomy 19 Introduction 19 Organization of the brain 19 The neuron 25 Cell body 26 Dendrites 26 Axon 28 Terminal buttons 28 Neurotransmission 29 Action potential 29 Neurotransmitter release 30 Receptors 31 Neurotransmitters 32 Acetylcholine 33 γ-aminobutyric acid 33 Glutamate 33 Dopamine 34 Norepinephrine 34 iii Pagetit 19.1.2004, 12:363 NEUROSCIENCE OF PSYCHOACTIVE SUBSTANCE USE AND DEPENDENCE iv Serotonin 35 Peptides 35 Genes 35 Cellular and neuronal effects of psychoactive substances 36 Cellular effects 36 Neuronal effects 38 Conclusion 39 Chapter 3. Biobehavioural Processes Underlying Dependence 43 Introduction 43 Defining terms 44 Classical or Pavlovian conditioning 44 Instrumental or operant conditioning 46 Reinforcer 47 Reward 47 Incentive 47 Motivation 48 Incentive-motivational responding 48 Drug reward alone does not explain drug dependence 48 Drug dependence as a response to incentive-motivation 49 Drug dependence as a response to drug withdrawal 50 Dopamine and reinforcement learning 50 Dependence-producing drugs as surrogates of conventional reinforcers 51 Dopamine and incentive sensitization 52 Psychomotor sensitization 53 Sensitization and drug reward 53 Sensitization and tolerance 54 Individual differences 55 Summary 58 Chapter 4. Psychopharmacology of Dependence for Different Drug Classes 67 Introduction 67 Alcohol (ethanol) 69 Introduction 69 Behavioural effects 69 Mechanism of action 70 Tolerance and withdrawal 70 Neurobiological adaptations to prolonged use 72 Pharmacological treatment of alcohol dependence 72 Sedatives and hypnotics 73 Introduction 73 Behavioural effects 73 Mechanism of action 74 Pagetit 19.1.2004, 12:364 ...