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Heroin Addiction and Related Clinical Problems: 2005, 07, 2 (pages: 37 - 48)

Medical meaning of psychosocial issues of heroin addiction

Pacini M., Maremmani I.

Summary: Drug addiction is often characterized by psychosocial highlights, so that it has been repeatedly depicted as a social disease, although to differing degrees. A variety of interventions have been proposed and applied as therapies, more on the basis of intentions than of scientific prospects of success: in fact, they all seem to share common roots in conceptions of addiction as being the outcome of a vicious social dynamic. The scientific vision of addiction as a medical issue allows a more reasonable evaluation of addiction-related social issues, both on pathophysiological and therapeutic grounds. To date, advisable first-line interventions for drug addiction have not been of a psychosocial kind. On the other hand, psychosocial markers have been crucial in assessing the effectiveness of pharmacological treatments since the very earliest stages of research in the field of methadone treatment. Furthermore, psychosocial adjustment and well-being should always be measured when newer approaches are tested, since they are crucial in allowing meaningful comparisons between treatment options. Lastly, a subgroup of heroin addicts, who suffer from severe psychosocial impairment, partly unrelated to addiction, should be offered psychosocial facilities as soon as they have been stabilized on an agonist treatment: predictably, their psychosocial well-being will not, as happens with others, follow the remission of drug abuse, but maintenance treatment will make them suitable for so-called pharmacologically assisted rehabilitation programmes.