Name: 我們意外發現的新型戒毒療法 (The New Addiction Treatment We Found By Mistake)
Uploaded: 2023-09-23T21:01:20.000Z
Duration: 7 min 55 s

Thanks to Linode for supporting this SciShow video.

感謝 Linode 贊助這個 SciShow 影片。

You can get $100 60-day credit on a new Linode account at linode.com/ scishow.

你可以在 linode.com/scishow 上的新 Linode 帳戶獲得 100 美元的 60 天信用。

In the early 1990s, researchers in the UK began clinical trials using a drug called Sildenafil to treat chest pain.

在1990年代初，英國的研究人員開始使用一種名為西爾那非的藥物進行臨床試驗，以治療胸痛。

It didn't turn out to be particularly promising for that purpose, but subjects reported an unexpected side effect that caught the researchers' attention.

結果表明，它在這方面並不特別有前途，但受試者報告的一種意想不到的副作用引起了研究人員的注意。

They began focusing on that instead, and in 1998, the FDA approved sildenafil for sale under the brand name Viagra.

他們開始專注於這一點，並在1998年，美國食品和藥物管理局（FDA）批准了西爾那非以威而鋼品牌名稱銷售。

This isn't the only time that a drug has been repurposed because of useful side effects.

這並不是唯一一次因為有用的副作用而改變藥物用途。

In fact, it might be about to happen again, but this time, we may be honing in on a treatment for addiction.

事實上，這種情況可能會再次發生，但這一次，我們可能正在研究一種治療成癮的方法。

Our star today is a medication called semaglutide, which you may be familiar with by its brand names, Ozempic and Wegovy.

我們今天的主角是一種名為 semaglutide 的藥物，你可能對它的品牌名稱 Ozempic 和 Wegovy 比較熟悉。

The two brands are the same active compound but at different doses and they also have different uses.

這兩種品牌的活性化合物相同，但劑量不同，用途也不同。

Ozempic was originally approved by the FDA in 2017 to treat type 2 diabetes, and Wegovy was approved in 2021 for what doctors refer to as "chronic weight management."

Ozempic 最初於 2017 年獲得 FDA 準許用於治療二型糖尿病，並於 2021 年獲批用於醫生所說的慢性體重管理。

After semaglutide was approved for weight management, the drug skyrocketed in popularity.

在 semaglutide 被批准用於體重管理之後，這種藥物的受歡迎程度急劇上升。

Which turned out to be kind of a problem, because people who'd been taking it for years to treat their diabetes were all of a sudden having trouble getting their hands on it, due to supply shortages.

這事實上變成了一個問題，因為多年來一直使用它來治療糖尿病的人突然間發現很難獲得它，因為供應短缺。

But as more people began taking semaglutide, some of them also began reporting that once they started taking Ozempic, they were no longer all that interested in drinking alcohol.

但隨著更多人開始服用 semaglutide，其中一些人也開始報告說，一旦他們開始服用 Ozempic，他們對飲酒不再感興趣。

Even those who'd self-reported addictive tendencies or unhealthy fixations on alcohol suddenly felt cravings stop, just like that.

即使是那些自稱有上癮傾向或對酒精有不健康固著的人，也會突然感到渴望就這樣停止了。

And that isn't quite as far out of left field as it sounds, once you understand exactly how semaglutide works.

這聽起來並沒有那麼出乎意料，一旦你了解 semaglutide 的原理，就會明白。

Semaglutide mimics a naturally occurring hormone called glucagon-like peptide 1, or GLP-1, that's released primarily in the gut after eating, and raises insulin levels to stabilize your blood sugar.

Semaglutide模擬了一種自然生成的激素，稱為類胰高血糖素1或GLP-1，它主要在進食後在腸道中釋放，並提高胰島素水平以穩定血糖。

Semaglutide is only one of many medications that mimic GLP-1, and the first of these drugs was approved in 2005.

Semaglutide只是許多模擬GLP-1的藥物中的一種，而這些藥物中的第一種於2005年獲得批准。

They work by binding with receptors in the pancreas to stimulate insulin production.

它們通過與胰腺中的受體結合來刺激胰島素分泌。

Plus, they can also slow down how quickly your stomach empties, which leaves you feeling fuller for longer.

此外，它們還能延緩胃排空的速度，讓你有更長時間的飽腹感。

The entire class of drugs is actually named after those receptors the hormone binds with, not the hormone itself, so they're called GLP-1 receptor agonists.

實際上，整個藥物類別是以激素結合的那些受體命名的，而不是以激素本身命名的，因此它們被稱為GLP-1受體激動劑。

It's the insulin boosting effect that GLP-1 receptor agonists capitalize on to treat diabetes.

GLP-1受體激動劑利用的是增加胰島素的效應來治療糖尿病。

The increased feeling of fullness means less appetite and fewer cravings for high-fat foods, which can result in weight loss.

增加的飽足感意味著食慾減少，對高脂食物的渴望減少，這可能會導致體重減輕。

Even though GLP is mostly released in the gut, there are GLP-1 receptors throughout the body including areas of the brain typically associated with reward and addiction.

儘管GLP主要在腸道中釋放，但全身都有GLP-1受體，包括通常與獎勵和成癮有關的大腦區域。

And so scientists have studied various GLP-1 agonists to see how they might affect addictive behaviors.

因此，科學家研究了各種GLP-1激動劑，以了解它們如何影響成癮行為。

In mice, rats, and even non-human primates, giving an animal a GLP-1 agonist reduces how much alcohol they drink and decreases the rewarding effects of drinking alcohol.

在小鼠、大鼠，甚至非人類靈長類動物中，給予動物GLP-1受體激動劑會減少它們飲酒的量，降低飲酒的獎賞效應。

And in other animal studies, those GLP-1 agonists have also been shown to decrease cocaine consumption, cocaine-related hyperactivity, and dopamine release in reward-related areas of the brain.

在其他動物研究中，這些GLP-1激動劑還顯示出可以減少可卡因的消耗，可卡因相關的過度活躍，以及大腦中與獎勵相關的區域的多巴胺釋放。

Rodent studies also show decreased rewarding effects of nicotine as well as decreased nicotine-induced hyperactivity.

囓齒類動物的研究也顯示，尼古丁的獎賞效應減少，尼古丁誘導的過度活躍也減少了。

In other words, this class of drugs may make addictive substances less desirable by blunting the effects and making them less rewarding.

換句話說，這類藥物可能會使上癮物質的效果減弱，從而降低它們的吸引力。

That's different from the current treatments that make you feel sick when you take drugs or drink alcohol 
so you stop doing it.

這與目前的治療方法不同，後者會讓你在吸毒或飲酒時感到不適，所以你就不做了。

These GLP-1 agonists appear to actually be changing how much of a dopamine hit comes from the addictive substance, although scientists don't yet know exactly how they interact with that dopamine.

這些 GLP-1 激動劑似乎實際上改變了上癮物質對多巴胺的刺激程度。

But there still aren't many human studies on GLP-1 and addiction that have been completed yet, and almost none involve semaglutide specifically.

雖然科學家們還不清楚它們如何與多巴胺相互作用，但關於 GLP-1 和成癮的人體研究還不多，而且幾乎都不涉及半過剩問題。

One of those few human studies found that one GLP-1 receptor agonist reduced alcohol use in patients who were obese, but not in patients who weren't.

其中一項少數人類研究發現，GLP-1 受體激動劑減少了肥胖患者的酒精消耗，但對非肥胖患者則無影響。

As of June 2023, there have only been a handful of studies published that specifically look at semaglutide and addiction.

截至 2023 年 6 月，只有少數幾項研究專門探討了 semaglutide 和成癮的關係。

Those studied rodents, and they suggested semaglutide decreases alcohol intake and the activity of reward-mechanisms in the brain, so they're a really promising start.

這些研究主要針對小鼠進行，並且暗示 semaglutide 可以減少酒精攝入量，並降低大腦中的獎賞機制活動，所以這是一個非常有希望的開始。

But the jury's still out on whether GLP-1 receptor agonists in general will work to reduce addictive behaviors in clinical trials on humans.

但就一般情況下，關於GLP-1受體激動劑是否能夠在人類的臨床試驗中減少成癮行為，目前尚無定論。

Semaglutide definitely seems to have an effect in people, but right now we only have anecdotal reports of reduced interest in drinking and other addictive behaviors.

Semaglutide似乎在人體中產生了效果，但目前我們只有減少飲酒和其他成癮行為的個別報告。

It's possible that this only happens in a small minority of people, it just feels like a lot right now because so many people have recently started taking it and we're paying attention to those reports.

這可能只發生在少數人中，目前之所以感覺有很多這樣的報告，是因為最近很多人開始使用它，我們正在關注這些報告。

Plus, a lot of the rodent testing has focused on short-term effects after getting a GLP-1 receptor agonist injection.

此外，許多囓齒動物測試都集中在註射 GLP-1 受體激動劑後的短期效果。

That doesn't really tell us if a drug will continue to be effective for long-term treatment.

這並不能真正告訴我們一種藥物是否會繼續對長期治療有效。

And since substance use disorders are long term chronic issues, that's an important question to answer to.

由於藥物濫用是長期的慢性問題，因此這是一個需要回答的重要問題。

Really, just about any question about addiction treatment is an important one.

實際上，關於戒毒治療的任何問題都很重要。

Addiction is incredibly difficult to treat.

There are only a few medications on the market to treat some substance use disorders, and they don't work for everyone.

市面上只有幾種藥物可以治療某些物質使用問題，而且它們並不適合所有人。

And while a few drugs show promise, there are currently no approved medications for cocaine or methamphetamine addiction, so finding and approving new drugs could truly be a gamechanger.

雖然有些藥物顯示出希望，但目前還沒有批准用於治療可卡因或甲基安非他命成癮的藥物，因此尋找和批准新藥物可能真正改變遊戲規則。

But we can't do that without human studies looking at semaglutide and substance use, which are currently underway.

但如果沒有針對索馬魯肽和物質使用的人體研究，我們就無法做到這一點，目前正在進行這些研究。

And if it does work, an added bonus is that drugs already approved by the FDA for another condition are approved more quickly than brand-new drugs.

如果它確實有效，還有一個額外的好處是，已經獲得 FDA 批准用於另一種疾病的藥物比全新藥物獲得批准的速度更快。

New drugs take years of animal and human safety testing to get the green light.

新藥需要經過多年的動物和人類安全測試才能獲得批准。

With an already approved drug, the mechanism of how it works is already known, as are the side effects, which makes the whole process move faster.

對於已經批准的藥物，其作用機制和副作用都是已知的，這使得整個過程進展得更快。

It even happened with Viagra in 2005, when the active ingredient was finally approved for pulmonary hypertension, on a shorter timeline than it took to get the first one.

22005 年威而鋼的發生了這種情況，當時該活性成分最終被批准用於治療肺動脈高壓，但時間比獲得第一種威而鋼所需的時間更短。

Hopefully, the clinical trials of semaglutide are successful, and these anecdotal reports will be the first step toward more effective treatment of addiction.

希望 semaglutide 的臨床試驗能夠成功，這些軼事報告將成為更有效治療成癮的第一步。

It could save a lot of lives and a lot of pain, all because a new drug happened to have very useful side effects.

它可以挽救很多生命並減輕很多痛苦，這一切都是因為一種新藥恰好具有非常有用的副作用。

This episode of SciShow is supported by Linode: a cloud computing company from Akamai. Cloud computing is technology.

本期 SciShow 由 Linode 贊助播出。Linode 是 Akamai 旗下的一家雲端運算公司。 雲端運算是一種技術。

I mean, it practically has the word "computer" in the name.

我的意思是，它的名字中幾乎就有「computer」這個詞。

But Linode has found ways to keep the human connection front and center, even in the tech world.

但 Linode 已經找到了保持人與人之間聯繫的方法，即使在科技領域也是如此。

Linode has award-winning customer support staff, so you can talk to a real person any time, any day.

Linode 擁有屢獲殊榮的客戶支援人員，因此您可以隨時隨地與真人交談。

Or you can check out their website, full of video tutorials, blogs, and guides that explain the tech in plain language so you don't have to be a developer to understand what's going on.

或者您可以查看他們的網站，其中包含大量視訊教學、部落格和指南，以簡單易懂的語言解釋了該技術，因此您不必成為開發人員即可了解正在發生的事情。

But the community of people who love Linode expands beyond their employees.

但熱愛 Linode 的人們的社群不僅限於他們的員工。

As a Linode customer, you can communicate with other people just like you in forums to troubleshoot new applications and work together to achieve your goals.

作為 Linode 客戶，您可以在論壇中與其他像您一樣的人進行交流，對新應用程式進行故障排除並共同實現您的目標。

To get started with Linode, you can click the link in the description down below or go to linode.com/scishow for a $100 60-day credit on a new Linode account.

要開始使用 Linode，你可以點開下面說明欄中的連結，或者前往 linode.com/scishow，為新的 Linode 帳戶獲取 100 美元的 60 天信用額度。

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