Clinical studies of drug addiction, III A critical review of the withdrawal treatments with method of evaluating abstinence syndromes
Clinical studies of drug addiction, III A critical review of the withdrawal treatments with method of evaluating abstinence syndromes
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DOI：
10.1176/ajp.94.4.759
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发表时间：
1938-01-01
影响因子：
17.7
通讯作者：
Himmelsbach, CK
中科院分区：
文献类型：
--
作者：
Kolb, L;Himmelsbach, CK
鸦片成瘾，表现为对毒品的身体依赖和对大剂量鸦片的耐受性，是一种自我限制的状况，只要从病人身上取下毒品，无论给予何种治疗，都会迅速消失;但众所周知，吸毒者容易复发，特别是在美国这样的国家，鸦片贸易的管制非常有效，因此，相对而言，神经系统正常的人很少会对鸦片上瘾或长期上瘾。吸毒成瘾的老患者一次又一次地回来接受治疗，这无疑使人们相信，吸毒成瘾者因鸦片而遭受了一些身体损害或改变，除非可以通过某种形式的物理治疗来弥补损害和消除所谓的身体渴望，否则他将不可避免地重新使用鸦片。精神压力，缓解后产生诱人的平静，在大多数情况下导致使用阿片类药物，达到身体成瘾的程度;以及通过长期使用阿片类药物缓解精神和身体困扰和痛苦而建立的记忆联想和习惯。对这些因素的评价及其相对重要性已在另一篇论文中讨论过。在此只需说明，除了某些持续多年的成瘾情况外，身体因素的重要性并不重要。
Addiction to opium, as expressed by physical dependence upon the drug and tolerance to large doses of it, is a self-limited condition that quickly disappears regardless of and in spite of what treatment is given to cure it, provided the drug is taken away from the patient; but addicts are notoriously subject to relapse, especially in a country which, like the United States, so efficiently regulates the opium traffic that comparatively few persons with normal nervous constitutions become addicted to it or remain addicted for long periods. The old unstable addicts come back for treatment time after time and this doubtless has lent weight to the idea that the addict has suffered some physical damage or change due to opium that makes his return to the use of it inevitable unless the damage can be remedied and the supposed physical craving obliterated by some form of physical therapy.The relapse of cured drug addicts is due not only to physical dependence but to original psychic stresses, relief from which produces the seductive calm that leads in most cases to the use of opiates to the point of physical addiction; and to memory associations and habit that are built up by the practice over long periods of time of relieving mental and physical distress and pain by the use of opiates. The evaluation of these factors and the relative importance of them have been discussed in another paper.’It is sufficient here to state that the physical factor is of minor importance except in some cases of addiction that have lasted for years.