薬物依存症,慢性疾患:治療,保険,結果評価への影響
A T McLellan1, D C Lewis, C P O'Brien
1The Treatment Research Institute, 150 S Independence Mall W, Suite 600, Philadelphia, PA 19106-3475, USA. tmclellan@tresearch.org
JAMA
|October 4, 2000
まとめ
薬物依存症は慢性疾患であり,単なる社会問題ではない. 効果的な長期治療は,他の慢性疾患と同様に,治療結果を改善し,再発を減少させます.
科学分野:
- 医学科学 医学科学 医学科学 医学科学
- 依存症の研究 依存症の研究
- 公衆衛生は公衆衛生である.
背景:
- 薬物依存症はしばしば社会問題として見られ,医学的な予防と治療戦略が不十分である.
- この視点では,依存症の重大な健康上の影響と生物学的基盤が無視されています.
研究 の 目的:
- 薬物依存症を慢性的な医学疾患として支持する証拠を検証する.
- 2型糖尿病,高血圧,喘息などの他の慢性疾患との薬物依存を比較する.
主な方法:
- 文献レビューが行われました.
- 比較された主な側面には,診断,遺伝性,病因学 (遺伝的および環境的),病理生理学,および治療反応 (アデレンス,再発) が含まれていた.
主要な成果:
- 薬物依存症は,他の慢性疾患と同様の遺伝的遺伝性,病因的要因 (個人の選択,環境),および病変の経過を他の慢性疾患と共有しています.
- それは脳の化学と機能に永続的な変化を引き起こす.
- 一部の依存症 (ニコチン,アルコール,オピエイト) に対して有効な薬は存在しますが,すべて (刺激剤,マリファナ) に対してそうではありません.
- これらの症状において,アデレンス率と再発率は類似しています.
結論:
- 薬物依存症は慢性疾患として扱われ,長期的な管理戦略が必要である.
- 保険,治療,評価は,他の慢性疾患に関するものと一致する必要があります.
- 薬剤の管理とモニタリングを含む長期的なケアにより,長期的な利益が得られます.
関連する概念動画
Drug Dependence
Medications are typically administered to achieve therapeutic effects. Some drugs can modify an individual's mood and perception, frequently resulting in various enjoyable experiences. However, this can result in drug dependency, a condition marked by continuous drug use despite potential negative consequences. Drug dependency primarily falls into two categories: psychological and physical dependence. Psychological dependence occurs when the pleasurable feelings induced by the drug...
Drug Abuse and Addiction: Pharmacological Phenomena
Drug dependence, abuse, and addiction are complex phenomena that can precipitate various abnormal states. Physical dependence refers to a state of pharmacological adaptation to a drug. This adaptation often results in tolerance—a reduced response to the drug after repeated administrations. When the drug use is abruptly stopped, withdrawal symptoms occur due to the body's need to readjust from the pharmacologically induced imbalance. However, tolerance and withdrawal symptoms do not necessarily...
Analgesia and Pain Management
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
Therapeutic Drug Monitoring: Affecting Factors
Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
Substance Use Disorders Affecting Sleep
Substance use disorders involve a pattern of using drugs more extensively than intended and continuing use despite harmful consequences. This includes legal substances like alcohol and nicotine, as well as illegal drugs. These disorders often involve both physical and psychological dependence, reflecting compulsive use of substances that significantly alter thoughts, feelings, and behaviors, contributing to a major public health issue.
Understanding the concepts of physical dependence,...
Understanding the concepts of physical dependence,...
Drug Therapy
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications


