Drug Addiction and Related Clinical Problems

ISBN-13: 9783211826744 / Angielski / Miękka / 1995 / 232 str.

Tagliamonte; Alessandro Tagliamonte; Icro Maremmani

Opis

Many of the questions related to the treatment of drug addiction originate from the confusion that still characterizes this issue, even though biology is irreversibly changing our outlook on the physiology and psychopathology of the mind. In fact, prejudices stemming from the archaic concept of mind-body dualism are so difficult to eradicate that even a skilled psychiatrist may find it hard to distinguish a psychiatric symptom from a socially transgressive behavior. The dilemma becomes even more salient for drug addiction, since many of the substances which induce abuse and dependence are illegal, and their production, trade and use are forbidden by law. If the use of heroin is connoted as a crime, it may become controversial to recognize its chronic sequelae as a disease. Hence, withdrawal symptoms may alternatively be attributed to drug effects, or labelled as immoral attitudes arising from a vicious personality. However, the physician's judgement, which has to be merely instrumental at improving the patient's quality of life, should never be influenced by such complex setting. In fact, the only concern of the physician must be that of ascertaining the causes of symptoms and of removing them: if symptoms are induced by the toxic effect of a drug, he has to use the most effective antidote, and then proceed towards a detoxification; if they are due to withdrawal, a substitutive substance should be given initially. In the case of narcotics, substitutive therapy on a maintenance basis may become mandatory.

Spis treści

1. Opposing Tonically Active Endogenous Opioid System Modulating the Mesolimbic Dopamine Reward Pathway.- 2. Recent Advances in the Understanding of Membrane Opioid Receptor.- 3. Central Dopaminergic Mechanism of Alcohol and Opiate Withdrawal Syndromes.- 4. Endogenous Morphine and Codeine As Possible Physiological Ligands of ?-Opiate Receptors.- 5. Drug of Abuse Craving in Free-Choice Experimental Conditions.- 6. Methadone Maintenance. Comes of Age.- 7. Pharmacotherapy for craving.- 8. The Use of GHB in Anticraving Therapy. Preliminary Experimental Data of its Use in Alcohol and Heroin Dependence.- 9. Development of an Italian Version of the “Readiness to Change Questionnaire” for Alcoholism and Addiction.- 10. Mood Disorders in Heroin Dependence and Clinical Differences Between Heroin Addicts with and without Mood Disorders.- 11. Nature and Magnitude of Problems Associated with Psychoactive Drugs.- 12. The Street Life and Treatment Response of 105 Heroin Addicted Women.- 13. The Pharmacological Rationale for Methadone Treatment of Narcotic Addiction.- 14. Reducing Heroin Consumption During Methadone Treatment and Limitation of Post-Treatment Relapses: Two Crucial Public Health Problems.- 15. Methadone Against AIDS. The Swedish Experience.- 16. Addiction and Pregnancy: Maternal and Child Issues.- 17. Tuberculosis. The Comeback of a Killer.- 18. Lowering the Threshold: A Comparative Overview of AIDS Prevention Among Injecting Drug Users Using Outreach Technology.- 19. Pharmacological Treatment of Addiction: Normalization of Physiology and AIDS Risk Reduction.- 20. Methadone Treatment and the Epidemiology of AIDS in the European Community.- 21. Public Health in Face of Drug Addiction and AIDS.- 22. The Dark and Light Aspects of Italian Legislation on Substances of Abuse.- 23. Methadone and Criminality. Euro-methwork Workshop.- 24. Workshop of the European Collaborating Centres in Addiction Studies (ECCAS).- Methadone Substitution Therapy and its Impact on HIV Risk Behaviors.- A Report from Denmark.- A Report from Germany.- A Report from Ireland.- A Report from Italy: Methadone Treatment in Opiate Addicts: 12 Years Experience in Italy.- The Padova Centre Report.- A Report from Spain. The Methadone Maintenance Programs in Barcelona.- A Report from Switzerland. Methadone Treatment in Switzerland.- 25. 1st European Methadone Conference. Opening Remarks.- 26. Incorporating a Methadone Maintenance Program into a Drug-free Treatment System.- 27. Heroin Dependence. Theory of Different Levels of Intervention.