신체의존

탐닉 및 의존증 관련 용어[1][2][3][4]
탐닉 addiction 보수자극과 관련되어 부정적 결과에도 불구하고 충동적 행동을 하는 것으로 특징지어지는 뇌기능 장애
탐닉성 행동 addictive behavior 보상과 보강 작용을 동시에 일으키는 행동
탐닉성 약물 addictive drug 보상과 보강 작용을 동시에 일으키는 약물
의존 dependence 자극에 대한 지속적 자극을 중단할 경우 금단증후군을 동반하는 적응 상태
내성 tolerance 약물을 정량 반복적으로 사용했을 때 효과가 감소하는 것
역내성 reverse tolerance 약물을 정량 반복적으로 사용했을 때 효과가 증가하는 것
약물 금단 drug withdrawal 약물의 반복적 사용을 중단했을 때 나타나는 증상
신체의존 physical dependence 지속적인 육체적 금단증상(피로감, 섬망 등)을 나타내는 의존
심리의존 psychological dependence 심리정신적 금단증상(불쾌감, 무쾌감 등)을 나타내는 의존
보강자극 reinforcing stimuli 자극을 받으면 행동을 반복할 가능성을 증가시키는 자극
보수자극 rewarding stimuli 뇌가 본질적으로 긍정적이고 욕망하고자 하는 것으로 받아들이는 자극
민감화 sensitization 자극에 반복적으로 노출됨으로써 자극에 대한 반응이 증폭되는 것
약물사용장애 substance use disorder 약물을 사용함으로써 임상적 기능적으로 심각한 해로움이나 고통을 유발하는 상태
(편집 | 역사)

신체의존내성 (약물) 형성 약물의 만성 사용으로 인해 발생하는 신체 상태로, 갑자기 또는 점진적으로 약물을 중단하면 불쾌한 신체 증상이 발생한다. 벤조디아제핀, 오피오이드, 각성제, 항간질제, 항우울제와 같은 특정 약물의 저용량 치료 사용뿐만 아니라 알코올, 오피오이드 및 벤조디아제핀과 같은 약물의 기분 전환 오용으로 인해 신체적 의존이 발생할 수 있다. 사용된 용량이 높을수록, 사용 기간이 길어지고, 사용 시작 연령이 어릴수록 신체적 의존성이 악화되어 금단 증후군이 더욱 심각해질 것으로 예상된다. 급성 금단 증후군은 며칠, 몇 주 또는 몇 달 동안 지속될 수 있다. 급성 금단 증후군 또는 "PAWS"라고도 알려진 장기간 금단 증후군은 급성 금단 증상 중 일부가 낮은 등급으로 지속되는 것으로 일반적으로 완화-재발 패턴으로 나타나며 종종 재발 및 장기 장애를 초래한다. (합법적인 고용 가능성을 배제하는 정도) 장기간 금단 증후군은 수개월, 수년 동안 지속될 수 있으며, 개인 요인에 따라 무기한 지속될 수도 있다. 장기간 금단 증후군은 벤조디아제핀에 의해 가장 흔히 발생하는 것으로 알려져 있다. 탐닉과의 잘못된 연관성을 없애기 위해 약물에 대한 신체적 의존성을 당뇨병 환자의 인슐린 의존성과 비교하기도 한다.

같이 보기

각주

  1. Malenka RC, Nestler EJ, Hyman SE (2009). 〈Chapter 15: Reinforcement and Addictive Disorders〉. Sydor A, Brown RY. 《Molecular Neuropharmacology: A Foundation for Clinical Neuroscience》 2판. New York: McGraw-Hill Medical. 364–375쪽. ISBN 9780071481274. 
  2. Nestler EJ (December 2013). “Cellular basis of memory for addiction”. 《Dialogues Clin. Neurosci.》 15 (4): 431–443. PMC 3898681. PMID 24459410. Despite the importance of numerous psychosocial factors, at its core, drug addiction involves a biological process: the ability of repeated exposure to a drug of abuse to induce changes in a vulnerable brain that drive the compulsive seeking and taking of drugs, and loss of control over drug use, that define a state of addiction. ... A large body of literature has demonstrated that such ΔFosB induction in D1-type [nucleus accumbens] neurons increases an animal's sensitivity to drug as well as natural rewards and promotes drug self-administration, presumably through a process of positive reinforcement ... Another ΔFosB target is cFos: as ΔFosB accumulates with repeated drug exposure it represses c-Fos and contributes to the molecular switch whereby ΔFosB is selectively induced in the chronic drug-treated state.41. ... Moreover, there is increasing evidence that, despite a range of genetic risks for addiction across the population, exposure to sufficiently high doses of a drug for long periods of time can transform someone who has relatively lower genetic loading into an addict. 
  3. “Glossary of Terms”. 《Mount Sinai School of Medicine》. Department of Neuroscience. 2015년 2월 9일에 확인함. 
  4. Volkow ND, Koob GF, McLellan AT (January 2016). “Neurobiologic Advances from the Brain Disease Model of Addiction”. 《N. Engl. J. Med.》 374 (4): 363–371. doi:10.1056/NEJMra1511480. PMID 26816013. Substance-use disorder: A diagnostic term in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) referring to recurrent use of alcohol or other drugs that causes clinically and functionally significant impairment, such as health problems, disability, and failure to meet major responsibilities at work, school, or home. Depending on the level of severity, this disorder is classified as mild, moderate, or severe.
    Addiction: A term used to indicate the most severe, chronic stage of substance-use disorder, in which there is a substantial loss of self-control, as indicated by compulsive drug taking despite the desire to stop taking the drug. In the DSM-5, the term addiction is synonymous with the classification of severe substance-use disorder.
     

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