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Substance Abuse, Neurobiology, and Ideology
John C. M. Brust, MD
Arch Neurol. 1999;56:1528-1531.
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INTRODUCTION
The term substance abuse refers to the recreational use of a drug despite potentially harmful effects. Depending on the substance, such use produces psychic dependence, physical dependence, tolerance, or sensitization. In addition, substance abusers are subject to numerous neurologic complications, notably trauma, infection, stroke, seizures, cognitive impairment, and fetal injury.1 In some individuals, genetic factors increase the risk of substance abuse.2 Effective pharmacotherapy of substance abuse is available for some drugs, unavailable for most, and optimal for none. The purpose of this brief review is to acquaint clinical neurologists with recent developments in what is basically a neurobiologic problem. Whether these developments have had a favorable effect on public attitudes is another matter.
PSYCHIC DEPENDENCE, PHYSICAL DEPENDENCE, AND OPIATES
Psychic dependence (addiction) refers to compulsive recreational drug use ("craving"). In contrast, physical dependence refers to withdrawal symptoms and objective signs following cessation of drug use. It has long been recognized that . . . [Full Text of this Article]
TOLERANCE, SENSITIZATION, AND COCAINE
CANNABIS RECEPTORS AND LIGANDS
PHENCYCLIDINE AND GLUTAMATE
ETHANOL, GABA, OPIATES, AND GLUTAMATE
MEANWHILE, BACK IN THE REAL WORLD
From the Department of Neurology, Harlem Hospital Center and Columbia University College of Physicians and Surgeons, New York, NY.
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