<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1659-0201</journal-id>
<journal-title><![CDATA[Población y Salud en Mesoamérica]]></journal-title>
<abbrev-journal-title><![CDATA[PSM]]></abbrev-journal-title>
<issn>1659-0201</issn>
<publisher>
<publisher-name><![CDATA[Universidad de Costa Rica. Centro Centroamericano de Población]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1659-02012022000100531</article-id>
<article-id pub-id-type="doi">10.15517/psm.v0i19.48064</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Dependencia de sustancias psicoactivas en Costa Rica: aspectos epidemiológicos y neurobiológicos de una enfermedad incomprendida]]></article-title>
<article-title xml:lang="en"><![CDATA[Substance dependence in Costa Rica: epidemiological and neurobiological aspects of a misunderstood disease]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sequeira-Cordero]]></surname>
<given-names><![CDATA[Andrey]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Blanco-Vargas]]></surname>
<given-names><![CDATA[Marilyn]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Brenes Sáenz]]></surname>
<given-names><![CDATA[Juan Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Costa Rica  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de Costa Rica  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad de Costa Rica  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Costa Rica</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2022</year>
</pub-date>
<volume>19</volume>
<numero>2</numero>
<fpage>531</fpage>
<lpage>552</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S1659-02012022000100531&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S1659-02012022000100531&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S1659-02012022000100531&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen Introducción: se estima que entre un 80 % y un 90 % de la población mundial ha consumido sustancias psicoactivas (SPA), pero solo un 15 % llega a desarrollar una dependencia. El objetivo de este ensayo es describir los antecedentes epidemiológicos, los aspectos clínicos y los mecanismos neurobiológicos asociados a la dependencia de SPA. Luego, se reflexiona sobre algunas estrategias ambientales para su prevención y/o tratamiento. Proposición: la dependencia no es un simple vicio producto de la holgazanería o la falta de carácter, sino, un trastorno neuropsquiátrico que debe ser reconocido como tal. Para ello, es indispensable conocer sus factores etiológicos, así como los mecanismos neurobiológicos involucrados. Argumentos para la discusión: todas las SPA activan directa o indirectamente el sistema dopaminérgico mesolímbico, el cual, tras el abuso, produce la sensibilización del sistema motivacional y la desensibilización del sistema hedónico. Este fenómeno provoca el uso más frecuente y en mayor cantidad, a pesar de que los efectos placenteros sean cada vez menores. El malestar físico y emocional causado por el síndrome de abstinencia contribuye a dicha compulsión, la cual se sale de control producto de las alteraciones del funcionamiento ejecutivo y la corteza prefrontal. Conclusiones: la dependencia es una enfermedad del cerebro inducida por el consumo crónico de las SPA en conjunto con factores neurobiológicos y psicosociales de vulnerabilidad. El acceso a contacto social, ejercicio físico y estimulación sensorio-cognitiva podría representar una estrategia altamente eficaz para el manejo de la dependencia y el mejoramiento de la salud mental.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Introduction: It has been estimated that 80% to 90% of the population worldwide has ever consumed psychoactive substances (PAS), but only 15% will develop addiction. The goal of the current essay is to describe concisely the epidemiological background, the clinical foundations, and neurobiological mechanisms of addiction. Finally, it will briefly examine some environmental strategies aimed to prevent and/or treat addiction. Addiction is not a simple vice consequence of laziness or lack of character, but a neuropsychiatric disorder that must be recognized as such. Proposal: To attain this ultimate goal, the etiological factors and the neurobiological mechanisms of addiction must be revealed and disseminated. Arguments for discussion: All PAS directly or indirectly activate the mesolimbic dopaminergic system, which &#8211;after repeated intake&#8211; sensitizes and desensitizes the motivational and the hedonic system, respectively. This phenomenon causes PAS to be consumed more frequently and at higher doses despite their effects being progressively less rewarding. Consequently, the physical and emotional distress derived from the withdrawal syndrome exacerbates the compulsive PAS intake, while the completely loss of control results from impairments in the executive functions and the prefrontal cortex. Conclusions: Addiction is a brain disease induced by the chronic consumption of PAS combined with neurobiological and psychosocial risk factors. Exposure social contact, physical exercise, and sensory-cognitive stimulation may constitute a highly effective strategy for preventing and treating addiction and improving mental health as well.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[dependencias]]></kwd>
<kwd lng="es"><![CDATA[prevalencia]]></kwd>
<kwd lng="es"><![CDATA[factores neurobiológicos]]></kwd>
<kwd lng="es"><![CDATA[enriquecimiento ambiental]]></kwd>
<kwd lng="en"><![CDATA[Addiction]]></kwd>
<kwd lng="en"><![CDATA[prevalence]]></kwd>
<kwd lng="en"><![CDATA[neurobiologic factors]]></kwd>
<kwd lng="en"><![CDATA[environmental enrichment]]></kwd>
</kwd-group>
</article-meta>
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