Treatment of substance use disorders. The new frontier of integrated pharmacological and psychosocial interventions

Author/s Cristiano Chiamulera, Mauro Cibin, Fabio Lugoboni
Publishing Year 2016 Issue 2016/2 Language Italian
Pages 23 P. 103-125 File size 223 KB
DOI 10.3280/RSF2016-002007
DOI is like a bar code for intellectual property: to have more infomation click here

Below, you can see the article first page

If you want to buy this article in PDF format, you can do it, following the instructions to buy download credits

Article preview

FrancoAngeli is member of Publishers International Linking Association, Inc (PILA), a not-for-profit association which run the CrossRef service enabling links to and from online scholarly content.

The authors, under the form of an interview, present data and insights from their research and clinical experience with the use of new pharmacological treatments for substance use disorders. A common understanding of the interviewee is that the reverse process of the neuro-adaptation to these substances works through appropriate integrated care interventions, i.e. pharmacological and psychosocial, which allow therapeutic work on addiction memoirs. The results of this approach can be either the cessation of drug use, or the reduction of the compulsive consumption. The misuse of opioid analgesics and more in general iatrogenic addictions are nowadays a worrying aspect of the new frontier of clinical interventions in addiction.

Keywords: Substance use disorders (SUD), alcohol use disorders (AUD), addiction memoirs, posttraumatic stress disorder (PTSD), reverse engineering

  1. [1] Lovaste R, Colasante E, Pitino A, Gori M. Valutazione dell’efficacia dei trattamenti metadonici effettuati nei SerD della Provincia Autonoma di Trento. Mission 2010; 29:53-9.
  2. [2] Silins E, Sannibale C, Larney S, Wodak A, Mattick R. Residential detoxification: essential for marginalised, severely alcohol- and drug-dependent individuals. Drug Alcohol Rev 2008; 27:414-9.
  3. [3] Smyth BP, Barry J, Keenan E, Ducray K. Lapse and relapse following inpatient treatment of opiate dependence. Ir Med J 2010; 103:176-9. [4] Amodeo M, Lundgren L, Chassler D, Witas J. High-frequency users of detoxification: who are they? Subst Use Misuse 2008; 43:839-49.
  4. [5] Lugoboni F, Quaglio GL, Faccini M, Pajusco B, Casari R, Albero A, Mezzelani P. Un’Unità di degenza interamente dedicata alla dipendenza da sostanze: i primi 10 anni di attività di Medicina delle Dipendenze del Policlinico di Verona. Mission 2010; 31:9-15.
  5. [6] Maremmani I, Cibin M, Pani PP, Rossi A, Turchetti G. Harm Reduction as “Continuum Care” in Alcohol Abuse Disorder. Int J Environ Res Public Health 2015; 12 (11): 14828-41.
  6. [7] Soares Pinto SP, Zambon A, Cibin M, et al. Poliabuso e doppia diagnosi nelle residenzialità alcologiche ospedaliere: caratteristiche dei pazienti e dei percorsi terapeutici/riabilitativi. Mission 2013; 37: 19-28.
  7. [8] Chiamulera C. Cue reactivity in nicotine and tobacco dependence: a “multipleaction” model of nicotine as a primary reinforcement and as an enhancer of the effects of smoking-associated stimuli. Brain Res Brain Res Rev. 2005; 48(1):74-97.
  8. [9] Kalivas PW, O’Brien C. Drug addiction as a pathology of staged neuroplasticity. Neuropsychopharmacology 2008; 33(1):166-80.
  9. [10] Sandrini M, Cohen LG, Censor N. Modulating reconsolidation: a link to causal systems-level dynamics of human memories. Trends Cogn Sci. 2015; 19(8): 475-82.
  10. [11] Casartelli L, Chiamulera C. The motor way: Clinical implications of understanding and shaping actions with the motor system in autism and drug addiction. Cogn Affect Behav Neurosci. 2016; 16(2):191-206.
  11. [12] Chiamulera C, Cibin M. Drinking reduction and reversibility of neuroadaptation in alcoholism. J Psychopharmacol. 2014; 28(8):810-2.
  12. [13] Piazza PV, Deroche-Gamonet V. A multistep general theory of transition to addiction. Psychopharmacology 2013; 229(3):387-413.
  13. [14] Chiamulera C, Hinnenthal I, Auber A, Cibin M. Reconsolidation of maladaptive memories as a therapeutic target: pre-clinical data and clinical approaches. Front Psychiatry 2014; 5:107.
  14. [15] Kim J, Song B, Hong I, Kim J, Lee J, Park S, Eom JY, Lee CJ, Lee S, Choi S. Reactivation of fear memory renders consolidated amygdala synapses labile. J Neurosci. 2010; 30(28): 9631-40.
  15. [16] Monfils MH, Cowansage KK, Klann E, LeDoux JE. Extinction-reconsolidation boundaries: key to persistent attenuation of fear memories. Science 2009; 324 (5929): 951-5.
  16. [17] Schiller D, Monfils MH, Raio CM, Johnson DC, Ledoux JE, Phelps EA. Preventing the return of fear in humans using reconsolidation update mechanisms. Nature 2010; 463 (7277): 49-53.
  17. [18] Nader K, Schafe GE, Le Doux JE. Fear memories require protein synthesis in the amygdala for reconsolidation after retrieval. Nature 2000; 406 (6797): 722-6.
  18. [19] Nader K. Memory traces unbound. Trends Neurosci. 2003; 26(2): 65-72. [20] Torregrossa MM, Taylor JR. Learning to forget: manipulating extinction and reconsolidation processes to treat addiction. Psychopharmacology 2013; 226(4):659-72.
  19. [21] Auber A, Tedesco V, Jones CE, Monfils MH, Chiamulera C. Post-retrieval extinction as reconsolidation interference: methodological issues or boundary conditions? Psychopharmacology 2013; 226(4): 631-47.
  20. [22] Agren T. Human reconsolidation: a reactivation and update. Brain Res Bull. 2014; 105:70-82.
  21. [23] Cai WH, Blundell J, Han J, Greene RW, Powell CM. Postreactivation glucocorticoids impair recall of established fear memory. J Neurosci. 2006; 26(37): 9560-6.
  22. [24] Wang XY, Zhao M, Ghitza UE, Li YQ, Lu L. Stress impairs reconsolidation of drug memory via glucocorticoid receptors in the basolateral amygdala. J Neurosci. 2008; 28(21):5602-10. DOI: 10.1523/JNeurosci.0750-08.2008
  23. [25] Rodriguez WA, Rodriguez SB, Phillips MY, Martinez JL Jr. Post-reactivation cocaine administration facilitates later acquisition of an avoidance response in rats. Behav Brain Res. 1993; 59(1-2):125-9.
  24. [26] Logan DE, Marlatt GA. Harm reduction therapy: a practice-friendly review of research. J Clin Psychol. 2010; 66(2):201-14.
  25. [27] Sinclair JD Evidence about the use of naltrexone and for different ways of using it in the treatment of alcoholism. Alcohol and Alcoholism 2001; 36(1): 2-10.
  26. [28] Fantozzi F, Sinclair D. La ricaduta nell’alcol: un concetto vincente, ma … in via di estinzione? Personalità/Dipendenze 2004; 10: 219-243.
  27. [29] Gual A, He Y, Torup L, van den Brink W, Mann K; ESENSE 2 Study Group, A randomised, double-blind, placebo-controlled, efficacy study of nalmefene, asneeded use, in patients with alcohol dependence. Eur Neuropsychopharmacol. 2013; 23(11):1432-42.
  28. [30] Van den Brink W, Sørensen P, Torup L, Mann K, Gual A, for the SENSE Study Group. Long-term efficacy, tolerability and safety of nalmefene as-needed in patients with alcohol dependence: A 1-year, randomised controlled study. J Psychopharmacol. 2014; 28(8):733-744.
  29. [31] Bowen S, Chawla N, Marlatt GA. Mindfulness e Comportamenti di Dipendenza. Milano: Raffaello Cortina ed.; 2013.
  30. [32] Shapiro F, Vogelmann-Sine S, Sine LF. Eye movement desensitization and reprocessing: treating trauma and substance abuse. J Psychoactive Drugs 1994; 26(4):379-91.
  31. [33] Hase M, Shallmayer S, Sack M, EMDR reprocessing of the Addiction
  32. Memory: pretreatment, Postreatment and 1-month follow up. J EMDR
  33. Practice and research 2008; 2,3:170-179.
  34. [34] Hinnenthal I, Cibin M. Il trattamento residenziale breve delle Dipendenze da
  35. Alcol e Cocaina: il modello Soranzo. Torino: SEED Editore; 2011.
  36. [35] Caputo F, Bernardi M. Medications Acting on the GABA System in the
  37. Treatment of Alcoholic Patients. Curr Pharm Des, 2010; 16: 2118-2125. [36] Chick J, Nutt DJ. Substitution therapy for alcoholism: time for a reappraisal? J Psychopharmacol 2012; 26:205-212.
  38. [37] Keating GM. Sodium oxybate: a review of its use in alcohol withdrawal syndrome and in maintenance of abstinence in alcohol dependence. Clin Drug Investig. 2014; 34: 63-80.
  39. [38] Quaglio GL, Pattaro C, Gerra G, Mezzelani P, Montanari L, Des Jarlais DC, Lugoboni F. Buprenorphine in maintanance treatment: experience among italian physician in drug addiction centers. Am J Addiction 2010; 10:1-9
  40. [39] Kasliwal R, Wilton LV, Shakir SAW. Safety and drug utilization profile of varenicline as used in general practice in England. Drug Saf 2009; 32:499-507.
  41. [40] Lugoboni F, Quaglio G. Exploring the dark side of the moon: the treatment of benzodiazepine tolerance. Br J Clin Pharmachol 2013. DOI: 10.1111/bcp.12148.[Epubaheadofprint]Editorial
  42. [41] Lader M. Benzodiazepines revisited--will we ever learn? Addiction 2011; 106: 2086-2109.
  43. [42] Madrak LN, Rosenberg M. Zolpidem abuse. Am J Psychiatry 2001; 158: 1330-1.
  44. [43] Faccini M, Leone R, Pajusco B, Quaglio G, Casari R, Albero A, Donati M, Lugoboni F. Lormetazepam Addiction. Data Analysis from an Italian Medical Unit for Addiction. Risk manage Healthcare Pol 2012; 5:43-8.
  45. [44] Dart RC, Surratt HL, Cicero TJ, Parrino MW, Severtson SG, Bucher-Bartelson B, Green JL. Trends in opioid analgesic abuse and mortality in the United States. N. Engl. J. Med. 2015; 372:241-248.
  46. [45] Weisberg DF, Becker WC, Fiellin DA, Stannard C. Prescription opioid misuse in the United States and the United Kingdom: cautionary lessons. Int. J. Drug Policy 2014; 25: 1124-1130.
  47. [46] Manchikanti L, Helm II S, Fellows B, Janata JW, Pampati V, Grider JS, Boswell MV. Opioid epidemic in the United States. Pain Physician 2012; 15: 9-38.
  48. [47] Lugoboni F, Faccini M, Casari R, Guadagnini P, Delaini P. La formazione sulle dipendenze patologiche: possono i SerD avere una funzione didattica vicariante nei confronti dell’Università? Alcune opportunità da non tralasciare. Mission 2013; 37: 55-60.

Cristiano Chiamulera, Mauro Cibin, Fabio Lugoboni, Le nuove frontiere dell’intervento integrato farmacologico e psicosociale per il trattamento dei disturbi da uso di sostanze in "RIVISTA SPERIMENTALE DI FRENIATRIA" 2/2016, pp 103-125, DOI: 10.3280/RSF2016-002007