Drug Addiction and Related Clinical Problems

1. Front Matter

   Pages I-XVI

   PDF

2. Opposing Tonically Active Endogenous Opioid System Modulating the Mesolimbic Dopamine Reward Pathway

   • A. Herz

   Pages 1-11

3. Recent Advances in the Understanding of Membrane Opioid Receptor

   • A. P. Smith, H. H. Loh

   Pages 13-18

4. Central Dopaminergic Mechanisms of Alcohol and Opiate Withdrawal Syndromes

   • M. Diana, Z. L. Rossetti, G. L. Gessa

   Pages 19-26

5. Endogenous Morphine and Codeine As Possible Physiological Ligands of µ-Opiate Receptors

   • A. Tagliamonte, M. Guarna, E. Bianchi

   Pages 27-35

6. Drugs of Abuse Craving in Free-Choice Experimental Conditions

   • M. Sala, D. Braida, M. Colombo, M. P. Leone, E. Gori

   Pages 37-44

7. Methadone Maintenance Comes of Age

   • V. P. Dole

   Pages 45-49

8. Pharmacotherapy for Craving

   • I. Maremmani, O. Zolesi, L. Daini, M. R. Capone, M. Aglietti, P. Castrogiovanni

   Pages 51-56

9. The Use of GHB in Anticraving Therapy. Preliminary Experimental Data of its Use in Alcohol and Heroin Dependence

   • O. Zolesi, L. Daini, M. R. Capone, M. Aglietti, F. Raimondi, I. Maremmani

   Pages 57-62

10. Development of an Italian Version of the “Readiness to Change Questionnaire” for Alcoholism and Addiction

    • M. Scaglia, E. Baiardo, I. Baldasso, E. Cristina, S. Deodato, W. O. Faustman et al.

    Pages 63-67

11. Mood Disorders in Heroin Dependence and Clinical Differences Between Heroin Addicts with and without Mood Disorders

    • L. Daini, M. R. Capone, T. Agueci, M. Aglietti, O. Zolesi, I. Maremmani

    Pages 69-77

12. Nature and Magnitude of Problems Associated with Psychoactive Drugs

    • A. H. Ghodse, S. Rawaf

    Pages 79-89

13. The Street Life and Treatment Response of 105 Heroin Addicted Women

    • L. M. Gunne, L. Grönbladh, L. S. Öhlund

    Pages 91-107

14. The Pharmacological Rationale for Methadone Treatment of Narcotic Addiction

    • R. G. Newman

    Pages 109-118

15. Reducing Heroin Consumption During Methadone Treatment and Limitation of Post Treatment Relapses: Two Crucial Public Health Problems

    • J. J. Déglon

    Pages 119-128

16. Methadone Against AIDS. The Swedish Experience

    • O. Blix

    Pages 129-136

17. Addiction and Pregnancy: Maternal and Child Issues

    • L. P. Finnegan

    Pages 137-147

18. Tuberculosis. The Comeback of a Killer

    • J. H. Lowinson, M. Gourevitch

    Pages 149-155

19. Lowering the Threshold: A Comparative Overview of AIDS Prevention Among Injecting Drug Users Using Outreach Technology

    • C. D. Kaplan

    Pages 157-164

20. Pharmacological Treatment of Addiction: Normalization of Physiology and AIDS Risk Reduction

    • M. J. Kreek

    Pages 165-173

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.

• AIDS
• AIDS prevention
• Emotion
• Epidemiology
• HIV
• Intervention
• Syndrom

• Institute of Pharmacology, University of Siena, Siena, Italy

  Alessandro Tagliamonte

• Psychiatric Institute, University of Pisa, Pisa, Italy

  Icro Maremmani

Policies and ethics