HARCP Archives

Browse by article

Browse by volume

Heroin Addiction and Related Clinical Problems: 2003, 05, 3 (pages: 5 - 12)

Understanding the pathogenesis of drug addiction in order to implement a correct pharmacological intervention

Maremmani I., Pacini M.

Summary: Meaningful therapeutic interventions for addictive diseases should be designed with a hierarchy of targets from the very beginning. The ability to target the core symptoms and the underlying dynamics imply a deep knowledge of the clinical picture, the links between observed behaviours and their psychopathological roots. First of all, a distinction should be drawn between habit and addiction, as the former cannot be considered a target for medical intervention. The identification of craving, loss of control over appetitive behaviour, and relapse proneness are crucial to the singling out ot drug addicts within a wider population of drug users. Secondly, addiction should be approached as a relationship between the addict and the substance he is hooked on, as most environmental variables are consequential, and, in any case, aspecific. Effective treatments target the relationship between the individual and the substance from within the addicted patient's brain. Different strategies may be indicated for the disease process, at its different stages, but all available options do share a common psychopathological target. Moreover, treatments should be planned so as to fit the spontaneous chronic course of addiction, that is, as maintenance programmes.