إدمان (مخدرات): الفرق بين النسختين

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{{معلومات مرض
{{معلومات مرض|Name=الاعتماد على مادة|field=[[علم نفس]]|Field=[[علم نفس]]|ICD10={{ICD10|F|10||f|10}}.2-{{ICD10|F|19||f|10}}.2|ICD9={{ICD9|303}}-{{ICD9|304}}|MeshID=D019966}}'''الاعتماد على مادة '''المعروف أيضا باسم '''الاعتماد على المخدرات''' هي حالة تكيفية تنتج من تكرار تعاطي مادة أو <nowiki/>[[عقار (مادة كيميائية)|دواء]]، مما يؤدي إلى أعراض ا<nowiki/>[[أعراض انسحابية|نسحابية]] عند التوقف عن الاستخدام.<ref name="NHM terms-DSM flaw">{{مرجع كتاب|title=Molecular Neuropharmacology: A Foundation for Clinical Neuroscience|publisher=McGraw-Hill Medical|year=2009|ISBN=9780071481274|edition=2nd|pages=364–368|chapter=Chapter 15: Reinforcement and Addictive Disorders|quote=The defining feature of addiction is compulsive, out-of-control drug use, despite negative consequences.&nbsp;...<br /></span>Addictive drugs are both rewarding and reinforcing.&nbsp;... Familiar pharmacologic terms such as tolerance, dependence, and sensitization are useful in describing some of the time-dependent processes that underlie addiction.&nbsp;... <br />''Dependence'' is defined as an adaptive state that develops in response to repeated drug administration, and is unmasked during ''withdrawal'', which occurs when drug taking stops. Dependence from long-term drug use may have both a somatic component, manifested by physical symptoms, and an emotional–motivation component, manifested by dysphoria. While physical dependence and withdrawal occur with some drugs of abuse (opiates, ethanol), these phenomena are not useful in the diagnosis of addiction because they do not occur with other drugs of abuse (cocaine, amphetamine) and can occur with many drugs that are not abused (propranolol, clonidine).<br /><br />The official diagnosis of drug addiction by the Diagnostic and Statistic Manual of Mental Disorders (2000), which makes distinctions between drug use, abuse, and substance dependence, is flawed. First, diagnosis of drug use versus abuse can be arbitrary and reflect cultural norms, not medical phenomena. Second, the term substance dependence implies that dependence is the primary pharmacologic phenomenon underlying addiction, which is likely not true, as tolerance, sensitization, and learning and memory also play central roles. It is ironic and unfortunate that the Manual avoids use of the term addiction, which provides the best description of the clinical syndrome.}}</ref><ref name="NIH">{{مرجع ويب
| الاسم = الاعتماد على مادة
| url = https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002490/
| اختصاص = [[علم نفس]]
| title = Substance use disorder
{{معلومات مرض|Name=الاعتماد على مادة|fieldاختصاص=[[علم نفس]]|Field=[[علم نفس]]|ICD10={{ICD10|F|10||f|10}}.2-{{ICD10|F|19||f|10}}.2|ICD9={{ICD9|303}}-{{ICD9|304}}|MeshID=D019966}}'''الاعتماد على مادة '''المعروف أيضا باسم '''الاعتماد على المخدرات''' هي حالة تكيفية تنتج من تكرار تعاطي مادة أو <nowiki/>[[عقار (مادة كيميائية)|دواء]]، مما يؤدي إلى أعراض ا<nowiki/>[[أعراض انسحابية|نسحابية]] عند التوقف عن الاستخدام.<ref name="NHM terms-DSM flaw">{{مرجع كتاب|titleعنوان=Molecular Neuropharmacology: A Foundation for Clinical Neuroscience|publisherناشر=McGraw-Hill Medical|yearسنة=2009|ISBN=9780071481274|editionإصدار=2nd|pagesصفحات=364–368|chapter=Chapter 15: Reinforcement and Addictive Disorders|quoteاقتباس=The defining feature of addiction is compulsive, out-of-control drug use, despite negative consequences.&nbsp;...<br /></span>Addictive drugs are both rewarding and reinforcing.&nbsp;... Familiar pharmacologic terms such as tolerance, dependence, and sensitization are useful in describing some of the time-dependent processes that underlie addiction.&nbsp;... <br />''Dependence'' is defined as an adaptive state that develops in response to repeated drug administration, and is unmasked during ''withdrawal'', which occurs when drug taking stops. Dependence from long-term drug use may have both a somatic component, manifested by physical symptoms, and an emotional–motivation component, manifested by dysphoria. While physical dependence and withdrawal occur with some drugs of abuse (opiates, ethanol), these phenomena are not useful in the diagnosis of addiction because they do not occur with other drugs of abuse (cocaine, amphetamine) and can occur with many drugs that are not abused (propranolol, clonidine).<br /><br />The official diagnosis of drug addiction by the Diagnostic and Statistic Manual of Mental Disorders (2000), which makes distinctions between drug use, abuse, and substance dependence, is flawed. First, diagnosis of drug use versus abuse can be arbitrary and reflect cultural norms, not medical phenomena. Second, the term substance dependence implies that dependence is the primary pharmacologic phenomenon underlying addiction, which is likely not true, as tolerance, sensitization, and learning and memory also play central roles. It is ironic and unfortunate that the Manual avoids use of the term addiction, which provides the best description of the clinical syndrome.}}</ref><ref name="NIH">{{مرجع ويب
| website = Pubmed Health
| urlمسار = https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002490/
| publisher = National Institutes of Health
| titleعنوان = Substance use disorder
| archiveurl = https://web.archive.org/web/20140331180947/http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002490/
| websiteموقع = Pubmed Health
| archivedate = 31 March 2014
| publisherناشر = National Institutes of Health
| deadurl = no
| archiveurlمسار أرشيف = https://web.archive.org/web/20140331180947/http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002490/
| accessdate = 12 September 2014
| archivedateتاريخ أرشيف = 31 March 2014
| quote = Drug dependence means that a person needs a drug to function normally. Abruptly stopping the drug leads to withdrawal symptoms. Drug addiction is the compulsive use of a substance, despite its negative or dangerous effects
| وصلة مكسورة = no
}}</ref> بينما ''[[إدمان|الإدمان]]،'' وهو مفهوم خاص من الاعتماد على مواد، يعرف بأنه سلوك <nowiki/>[[سلوك قهري|قهري]] وخارج عن السيطرة، على الرغم من العواقب السلبية. ΔFosB، عامل <nowiki/>[[نسخ (وراثة)|النسخ الجيني]]، من المعروف الآن أنه عنصر حاسم وعامل مشترك في تكوين تقريبا جميع أشكال الإدمان السلوكية والإدمان على المواد،<ref name="Nestler">{{Cite journal|title=Transcriptional and epigenetic mechanisms of addiction|date=November 2011|journal=Nat. Rev. Neurosci.|issue=11|DOI=10.1038/nrn3111|volume=12|pages=623–637|PMID=21989194|quote=ΔFosB has been linked directly to several addiction-related behaviors&nbsp;... Importantly, genetic or viral overexpression of ΔJunD, a dominant negative mutant of JunD which antagonizes ΔFosB- and other AP-1-mediated transcriptional activity, in the NAc or OFC blocks these key effects of drug exposure14,22–24. This indicates that ΔFosB is both necessary and sufficient for many of the changes wrought in the brain by chronic drug exposure. ΔFosB is also induced in D1-type NAc MSNs by chronic consumption of several natural rewards, including sucrose, high fat food, sex, wheel running, where it promotes that consumption14,26–30. This implicates ΔFosB in the regulation of natural rewards under normal conditions and perhaps during pathological addictive-like states.}}</ref><ref name="ΔFosB reward">{{Cite journal|title=Sex, drugs, and rock 'n' roll: hypothesizing common mesolimbic activation as a function of reward gene polymorphisms|journal=J. Psychoactive Drugs|issue=1|DOI=10.1080/02791072.2012.662112|year=2012|volume=44|pages=38–55|PMID=22641964|quote=It has been found that deltaFosB gene in the NAc is critical for reinforcing effects of sexual reward. Pitchers and colleagues (2010) reported that sexual experience was shown to cause DeltaFosB accumulation in several limbic brain regions including the NAc, medial pre-frontal cortex, VTA, caudate, and putamen, but not the medial preoptic nucleus. Next, the induction of c-Fos, a downstream (repressed) target of DeltaFosB, was measured in sexually experienced and naive animals. The number of mating-induced c-Fos-IR cells was significantly decreased in sexually experienced animals compared to sexually naive controls. Finally, DeltaFosB levels and its activity in the NAc were manipulated using viral-mediated gene transfer to study its potential role in mediating sexual experience and experience-induced facilitation of sexual performance. Animals with DeltaFosB overexpression displayed enhanced facilitation of sexual performance with sexual experience relative to controls. In contrast, the expression of DeltaJunD, a dominant-negative binding partner of DeltaFosB, attenuated sexual experience-induced facilitation of sexual performance, and stunted long-term maintenance of facilitation compared to DeltaFosB overexpressing group. Together, these findings support a critical role for DeltaFosB expression in the NAc in the reinforcing effects of sexual behavior and sexual experience-induced facilitation of sexual performance.&nbsp;... both drug addiction and sexual addiction represent pathological forms of neuroplasticity along with the emergence of aberrant behaviors involving a cascade of neurochemical changes mainly in the brain's rewarding circuitry.}}</ref><ref name="Natural and drug addictions">{{Cite journal|title=Natural rewards, neuroplasticity, and non-drug addictions|date=December 2011|journal=Neuropharmacology|issue=7|DOI=10.1016/j.neuropharm.2011.03.010|volume=61|pages=1109–22|PMID=21459101|last=Olsen CM}}</ref> ولكن ليس الاعتماد.
| accessdateتاريخ الوصول = 12 September 2014
| quoteاقتباس = Drug dependence means that a person needs a drug to function normally. Abruptly stopping the drug leads to withdrawal symptoms. Drug addiction is the compulsive use of a substance, despite its negative or dangerous effects
}}</ref> بينما ''[[إدمان|الإدمان]]،'' وهو مفهوم خاص من الاعتماد على مواد، يعرف بأنه سلوك <nowiki/>[[سلوك قهري|قهري]] وخارج عن السيطرة، على الرغم من العواقب السلبية. ΔFosB، عامل <nowiki/>[[نسخ (وراثة)|النسخ الجيني]]، من المعروف الآن أنه عنصر حاسم وعامل مشترك في تكوين تقريبا جميع أشكال الإدمان السلوكية والإدمان على المواد،<ref name="Nestler">{{Cite journal|titleعنوان=Transcriptional and epigenetic mechanisms of addiction|dateتاريخ=November 2011|journal=Nat. Rev. Neurosci.|issue=11|DOI=10.1038/nrn3111|volumeالمجلد=12|pagesصفحات=623–637|PMID=21989194|quoteاقتباس=ΔFosB has been linked directly to several addiction-related behaviors&nbsp;... Importantly, genetic or viral overexpression of ΔJunD, a dominant negative mutant of JunD which antagonizes ΔFosB- and other AP-1-mediated transcriptional activity, in the NAc or OFC blocks these key effects of drug exposure14,22–24. This indicates that ΔFosB is both necessary and sufficient for many of the changes wrought in the brain by chronic drug exposure. ΔFosB is also induced in D1-type NAc MSNs by chronic consumption of several natural rewards, including sucrose, high fat food, sex, wheel running, where it promotes that consumption14,26–30. This implicates ΔFosB in the regulation of natural rewards under normal conditions and perhaps during pathological addictive-like states.}}</ref><ref name="ΔFosB reward">{{Cite journal|titleعنوان=Sex, drugs, and rock 'n' roll: hypothesizing common mesolimbic activation as a function of reward gene polymorphisms|journal=J. Psychoactive Drugs|issue=1|DOI=10.1080/02791072.2012.662112|yearسنة=2012|volumeالمجلد=44|pagesصفحات=38–55|PMID=22641964|quoteاقتباس=It has been found that deltaFosB gene in the NAc is critical for reinforcing effects of sexual reward. Pitchers and colleagues (2010) reported that sexual experience was shown to cause DeltaFosB accumulation in several limbic brain regions including the NAc, medial pre-frontal cortex, VTA, caudate, and putamen, but not the medial preoptic nucleus. Next, the induction of c-Fos, a downstream (repressed) target of DeltaFosB, was measured in sexually experienced and naive animals. The number of mating-induced c-Fos-IR cells was significantly decreased in sexually experienced animals compared to sexually naive controls. Finally, DeltaFosB levels and its activity in the NAc were manipulated using viral-mediated gene transfer to study its potential role in mediating sexual experience and experience-induced facilitation of sexual performance. Animals with DeltaFosB overexpression displayed enhanced facilitation of sexual performance with sexual experience relative to controls. In contrast, the expression of DeltaJunD, a dominant-negative binding partner of DeltaFosB, attenuated sexual experience-induced facilitation of sexual performance, and stunted long-term maintenance of facilitation compared to DeltaFosB overexpressing group. Together, these findings support a critical role for DeltaFosB expression in the NAc in the reinforcing effects of sexual behavior and sexual experience-induced facilitation of sexual performance.&nbsp;... both drug addiction and sexual addiction represent pathological forms of neuroplasticity along with the emergence of aberrant behaviors involving a cascade of neurochemical changes mainly in the brain's rewarding circuitry.}}</ref><ref name="Natural and drug addictions">{{Cite journal|titleعنوان=Natural rewards, neuroplasticity, and non-drug addictions|dateتاريخ=December 2011|journal=Neuropharmacology|issue=7|DOI=10.1016/j.neuropharm.2011.03.010|volumeالمجلد=61|pagesصفحات=1109–22|PMID=21459101|lastالأخير=Olsen CM}}</ref> ولكن ليس الاعتماد.
 
 
في الطبعة الرابعة من ''[[الدليل التشخيصي والإحصائي للاضطرابات النفسية]]'' (''DSM-IV'')، الاعتماد على مادة يتم تعريفه على أنه إدمان للمخدرات، و يمكن تشخيصه دون حدوث متلازمة الانسحاب.<ref>{{مرجع ويب
| urlمسار = http://behavenet.com/node/21516
| titleعنوان = Diagnostic criteria for Substance Dependence: DSM IV–TR
| websiteموقع = BehaveNet
| archiveurlمسار أرشيف = http://archive.wikiwix.com/cache/20150612225125/http://behavenet.com/node/21516
| archivedateتاريخ أرشيف = 12 June 2015
| deadurlوصلة مكسورة = no
| accessdateتاريخ الوصول = 12 June 2015
}}</ref> الآن يتم وصف الاعتماد على مادة كالتالي: "عندما يستمر الفرد في استخدام الكحول أو المخدرات الأخرى على الرغم من المشاكل المتعلقة باستخدام المادة، قد يمكن تشخيص الحالة بأنها اعتماد على مادة". الاستخدام القهري والمتكرر قد يؤدي إلى حدوث [[تحمل الدواء|تحمل]] لتأثير المادة و<nowiki/>[[أعراض انسحابية|أعراض الانسحاب]] عند انخفاض أو توقف الاستخدام. هذا الموضوع جنبا إلى جنب مع سوء استخدام المواد يعتبرا من اضطرابات تعاطي المواد."<ref>{{مرجع ويب
| urlمسار = http://behavenet.com/substance-dependence
| titleعنوان = Substance Dependence
| websiteموقع = BehaveNet
| archiveurlمسار أرشيف = http://archive.wikiwix.com/cache/20150613213129/http://behavenet.com/substance-dependence
| archivedateتاريخ أرشيف = 13 June 2015
| deadurlوصلة مكسورة = no
| accessdateتاريخ الوصول = 12 June 2015
}}</ref>
 
* National Institute on Drug Abuse: "[http://teens.drugabuse.gov/drug-facts/brain-and-addiction NIDA for Teens: Brain and Addiction العقل والإدمان]".
* {{مرجع ويب
| urlمسار = http://apps.who.int/medicinedocs/fr/d/Js4896e/9.html
| titleعنوان = WHO Expert Committee on Drug Dependence – WHO Technical Report Series, No. 915 – Thirty-third Report
| dateتاريخ = 2003
| websiteموقع = apps.who.int
| accessdateتاريخ الوصول = 26 February 2015
}} - [http://apps.who.int/medicinedocs/pdf/s4896e/s4896e.pdf pdf]
* [http://jari.podbean.com/2013/01/14/trips-beyond-addiction-special-program-for-living-hero-w-jari-chevalier-radio-show-at-wgdrorg/ Trips Beyond Addiction] | Living Hero Radio Show and Podcast special. With Dimitri Mobengo Mugianis, Bovenga Na Muduma, Clare S. Wilkins, Brad Burge, Tom Kingsley Brown, Susan Thesenga, Bruce K. Alexander, PhD ~ the voices of ex-addicts, researchers from The Multidisciplinary Association for Psychedelic Studies and Ibogaine/Iboga/Ayahuasca treatment providers sharing their experiences in breaking addiction with native medicines. January 2013