The practice of addiction psychiatry and the relevant training vary among different world regions and countries. Despite the challenges that the subspecialty has been facing, the past decade has witnessed new insights and advances in the field. In particular, the rapid development of technologies has contributed to a better understanding of addiction and its mechanisms and to the development of new therapeutics, but has also facilitated the emergence of new forms of behavioral addiction as well as the accessibility and dissemination of a variety of substances of abuse.

The WPA Section on Addiction Psychiatry was established to provide a global platform to discuss national, regional and international challenges and solutions for substance use and other forms of addictive disorders among psychiatrists and their colleagues in the related clinical disciplines.

During the World Congress of Psychiatry held in Vienna in 2023, the renovated section was officially launched. The Section chair, A. Baldacchino, shared the Section's vision based on the values of collegiality, democracy, transparency, inclusion, diversity and global representativeness. The key aim is to establish collaboration with other WPA Sections, scientific societies and organizations. The Section, therefore, plans to support global surveys, discussion panels, advocacy initiatives, and development of intersectional guidelines, consensus statements, best practices and policy documents to support such a vision. New members are being actively attracted.

The Section has strived to identify pressing topics for the next triennium action plan. It acknowledged various areas of needs, including regional drug situations, behavioral addictions, forced displacement in light of the current geopolitical disputes, as well as the impact of the COVID-19 pandemic^{1, 2}. However, in order to ensure a wider scope that covers advances, challenges, recent trends and training needs, we finally identified four main themes to focus on.

First, there is an ongoing effort to develop mechanism-informed therapeutics and preventive tools for substance use disorders³. The approval or clearance by the US Food and Drug Administration (FDA) of neuromodulatory interventions – including auricular vagus nerve stimulation to reduce the symptoms of opioid withdrawal, and deep transcranial magnetic stimulation of prefrontal cortex for smoking cessation – opened up doors for efforts to identify and target addiction neurocircuits to develop new treatments. Repurposing medications based on mechanistic understanding has shown promises to contribute to addiction recovery by targeting N-methyl-D-aspartate (NMDA), orexin, kappa opioid, and other receptors.

The next generation of mechanism-informed therapeutics for substance use disorders and their comorbidities will include neuroimaging-informed individualized neuromodulation, biomarker-informed digital therapeutics, mechanism-informed pharmacotherapeutics, neuroscience-informed behavioral interventions, and neuroscience-based individualized preventive strategies.

The Section is interested in supporting global contribution to these technological advances, while discussing how patients and addiction psychiatrists around the world may have equal access to these new advancements. The Section is working to shape international working groups and consortiums to support these efforts⁴.

Second, the rise of telemedicine and its rapid development with the COVID-19 pandemic has extended to addiction psychiatry. The Section is interested in exploring this field, focusing on the development and implementation of innovative digital solutions to meet the needs of people facing addiction. This will be pursued through creating a network of shared knowledge and a design philosophy based on person centredness and inclusive communication.

The essence of this effort is to add value to the opportunities arising from digital platforms and to promote accessibility by marginalized populations. The process will not only aim to improve inclusion, but also to embrace complexity and facilitate systems change⁵.

Third, neurodiversity has been a topic of growing interest over the past few years. In the field of addiction psychiatry, emerging evidence is indicating a link between substance use disorders and a variety of neurodevelopmental disorders. Attention-deficit/hyperactivity disorder (ADHD) and autism have been associated with increased risk of substance misuse⁶, as well as of behavioral addictions such as gaming disorder⁷.

The fourth identified priority is training in addiction psychiatry. The training gap is currently a major challenge in addressing addiction as a global public health problem. Several countries have taken initiatives in this area. However, the lack of standardization and human resources are limiting scaling up of training programmes. A recent global survey by the International Society of Addiction Medicine (ISAM) among early career addiction medicine professionals highlighted these issues. The ISAM also developed a training need assessment tool and conducted a survey to assess training needs. The close collaboration between the ISAM and the WPA will foster developments in this area.

The WPA has developed training modules for various psychiatric disorders, including addiction disorders, which have potential to contribute to the reduction of this gap^8-11. A working group will implement the Section's collaboration with different stakeholders to formulate a global strategy in this respect¹².

Discussions with other WPA Sections, national and international associations and scientific societies are also ongoing to explore further areas of potential collaborations. The Section is looking forward to a fruitful triennium with activities aiming at improving practice, bridging gaps, and fostering an inclusive and diverse learning environment for all generations of professionals.

世界不同地区和国家的成瘾精神病学实践和相关培训各不相同。尽管该专业一直面临着挑战，但过去十年见证了该领域的新见解和进步。特别是，技术的快速发展有助于更好地了解成瘾及其机制，并促进新疗法的开发，但也促进了新形式的行为成瘾的出现以及各种成瘾药物的获取和传播。滥用的物质。

WPA 成瘾精神病学部分的成立是为了提供一个全球平台，让精神病学家及其相关临床学科的同事讨论药物使用和其他形式成瘾性疾病的国家、区域和国际挑战和解决方案。

2023年在维也纳举行的世界精神病学大会期间，翻新后的专区正式启用。该部门主席 A. Baldacchino 分享了该部门基于合作、民主、透明、包容、多样性和全球代表性价值观的愿景。主要目标是与 WPA 的其他部门、科学协会和组织建立合作。因此，该科计划支持全球调查、讨论小组、宣传倡议以及制定交叉指南、共识声明、最佳实践和政策文件，以支持这一愿景。正在积极吸引新成员。

该科努力确定下一个三年期行动计划的紧迫主题。它承认各个领域的需求，包括地区毒品状况、行为成瘾、由于当前地缘政治争端而被迫流离失所，以及 COVID-19 大流行的影响^{1, 2} 。然而，为了确保更广泛的范围涵盖进展、挑战、最新趋势和培训需求，我们最终确定了四个需要关注的主题。

首先，人们正在不断努力开发药物滥用障碍的基于机制的治疗方法和预防工具³ 。美国食品和药物管理局 (FDA) 批准或批准神经调节干预措施，包括通过耳迷走神经刺激来减轻阿片类药物戒断症状，​​以及对前额叶皮层进行深部经颅磁刺激以戒烟，这为识别疾病打开了大门。并针对成瘾神经回路开发新的治疗方法。基于机制理解的药物再利用已显示出有望通过靶向 N-甲基-D-天冬氨酸 (NMDA)、食欲素、κ 阿片类药物和其他受体来促进成瘾恢复。

下一代药物滥用障碍及其合并症的基于机制的治疗将包括基于神经影像的个体化神经调节、基于生物标志物的数字治疗、基于机制的药物治疗、基于神经科学的行为干预和基于神经科学的个体化预防策略。

该科有兴趣支持全球对这些技术进步的贡献，同时讨论世界各地的患者和成瘾精神病学家如何平等地获得这些新的进步。该科正在努力组建国际工作组和联盟来支持这些努力⁴ 。

其次，远程医疗的兴起及其随着 COVID-19 大流行的快速发展已经扩展到成瘾精神病学。该科有兴趣探索这一领域，重点关注创新数字解决方案的开发和实施，以满足面临毒瘾的人们的需求。这将通过创建一个共享知识网络和基于以人为本和包容性沟通的设计理念来实现。

这项努力的本质是为数字平台带来的机会增加价值，并促进边缘化人群的使用。该过程不仅旨在提高包容性，而且旨在拥抱复杂性并促进系统变革⁵ 。

第三，神经多样性在过去几年中一直是人们越来越感兴趣的话题。在成瘾精神病学领域，新出现的证据表明物质使用障碍与各种神经发育障碍之间存在联系。注意力缺陷/多动障碍 (ADHD) 和自闭症与物质滥用⁶以及游戏成瘾等行为成瘾的风险增加有关⁷ 。

第四个确定的优先事项是成瘾精神病学培训。目前，培训差距是解决成瘾这一全球公共卫生问题的一个重大挑战。一些国家已在这一领域采取了举措。然而，标准化和人力资源的缺乏限制了培训计划的扩大。国际成瘾医学协会 (ISAM) 最近对早期职业成瘾医学专业人士进行的一项全球调查强调了这些问题。 ISAM 还开发了培训需求评估工具，并进行了评估培训需求的调查。 ISAM 和 WPA 之间的密切合作将促进这一领域的发展。

WPA 开发了针对各种精神疾病（包括成瘾性疾病）的培训模块，这有可能有助于缩小这一差距^8-11 。一个工作组将负责该科与不同利益攸关方的合作，以制定这方面的全球战略¹² 。

与 WPA 其他部门、国家和国际协会以及科学协会的讨论也在进行中，以探索进一步的潜在合作领域。该科期待着一个富有成效的三年期，其活动旨在改进实践、缩小差距，并为各代专业人士营造一个包容和多样化的学习环境。