Drug Addiction and Related Clinical Problems
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, prejudi
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Drug Addiction and Related Clinical Problems
Springer-Verlag Wien New York
Alessandro Tagliamonte, M.D. Professor of Pharmacology University of Siena, Institute of Pharmacology, Siena, Italy
Icro Maremmani, M.D. Professor of Medicine and Drug Addiction University of Pisa, Psychiatric Institute, Pisa, Italy
This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically those of translation, reprinting, re-use of illustrations, broadcasting, reproduction by photocopying machines or similar means, and storage in data banks. © 1995 Springer-Verlag Wien
Product Liability: The publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check its accuracy by consulting other pharmaceutical literature. The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Typesetting: Camera ready by editors Printed on acid-free and chlorine-free bleached paper
With 39 Figures Library of Congress Cataloging-in-Publication Data Drug addiction and related clinical problems / edited by Alessandro Tagliamonte and lero Maremmani. p. cm. Includes bibliographical references. ISBN-13:978-3-211-82674-4 (alk. paper) 1. Substance abuse - Chemotherapy. 2. Substance abuse - Molecular aspects. 3. Methadone maintenance. 4. AIDS (Disease) - Prevention. I. Tagliamonte, Alessandro. II. Maremmani, lero. [DNLM: 1. Substance Dependence - rehabilitation. 2. Methadonetherapeutic use. 3. Health Policy - Europe. WM 270 D79348 1995] RC564.D779 1995 616.86'061 - dc20 DNLM/DLC
ISBN-13:978-3-211-82674-4 DOl: 10.1007/978-3-7091-6901-8
e-ISBN-13:978-3-7091-6901-8
PREFACE
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 ascert
