Erratum to: Agonist Opioid Treatment as historical comprehensive treatment (‘Dole &amp; Nyswander’ methodology) is associated with better toxicology outcome than Harm Reduction Treatment

Bizzarri, Jacopo V.; Casetti, Valentina; Sanna, Livia; Maremmani, Angelo Giovanni Icro; Rovai, Luca; Bacciardi, Silvia; Piacentino, Daria; Conca, Andreas; Maremmani, Icro

doi:10.1186/s12991-017-0132-8

Cited by 4 publications

(2 citation statements)

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“…During the fourth phase (medically supervised withdrawal) gradual reduction of agonist dose is applied until the patient is completely drug-free; typically, in association with psychosocial support [122,127,128,129]. AOT is more efficient in treating OUD than HRT [130], and the blocking doses are highly protective against overdoses [131].…”

Section: Discussionmentioning

confidence: 99%

Non-Medical Use of Novel Synthetic Opioids: A New Challenge to Public Health

Lovrečič

Lovrečić

Gabrovec

et al. 2019

IJERPH

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Background: In the last decade there has been a progressive increase in the use of new psychoactive substances (NPSs) that are not yet under international control. In particular, novel synthetic opioids (NSOs) have reappeared on the recreational drug market in the last few years. As a result, the use of NSOs has increased rapidly. This poses an emerging and demanding challenge to public health. Aim: To raise awareness among clinicians and other professionals about NPSs, especially NSOs, to summarize current knowledge about pharmacological properties, forms of NSO on the market, pattern of use, effects and consequences of use. Methods: An electronic search was carried out on the Medline/PubMed and Google Scholar databases to find selected search terms. Results: Some NPSs are already controlled, while others can be legally sold directly on the drug market (mainly via internet, less so by drug dealers) or be used as precursors for the synthesis of other designer drugs that mimic the psychoactive effects of controlled substances. Potential side-effects of NSOs include miosis, sedation, respiratory depression, hypothermia, inhibition of gastrointestinal propulsion, death (from opioid overdose). Conclusions: The severity of the opioid crisis has intensified with the introduction of highly potent NSOs on the drug market. As long as addicts are dying from overdose or similar causes, there is something more constructive to do than waiting for addicts to overdose on heroin at a place located near a remedy, as if to say, within reach of naloxone.

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Section: Discussionmentioning

confidence: 99%

Non-Medical Use of Novel Synthetic Opioids: A New Challenge to Public Health

Lovrečič

Lovrečić

Gabrovec

et al. 2019

IJERPH

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“…It should, eventually, be followed by a preventive strategy to counter residual cravings and breakthrough episodes of mood disorders or psychotic episodes by using long-term pharmacological maintenance with a double target [53,54]. Relapse prevention must never be understood as complete extinction, but as a trend towards a lower grade of severity, a reduction in frequency, while successfully delaying the possible occurrence of a relapse [55,56]. HUD patients should be considered as a population in which it is possible to register and study the effects of chronic opioid injury and its consequent opioid dysfunctions.…”

Section: Towards a Hierarchical Approach To Dual Disorder Treatmentmentioning

confidence: 99%

The Conceptual Framework of Dual Disorders and Its Flaws

Pacini¹,

Maremmani

2020

JCM

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When psychiatric illness and substance use disorder coexist, the clinical approach to the patient is, unsurprisingly, awkward. This fact is due to a cultural context and, more directly, to the patient’s psychiatric condition and addiction behaviors—a situation that does not favor a scientific approach. In dual disorder facilities, several types of professionals work together: counselors, social workers, psychologists, and psychiatrists. Treatment approaches vary from one service to another and even within the same service. It is crucial to provide dual disorder patients with multiple treatments, comprising hospitalization, rehabilitative and residential programs, case management, and counselling. Still, when treating dual disorder (DD) heroin use disorder (HUD) patients, it is advisable to follow a hierarchical algorithm. First, we must deal with addiction: by detoxification, whenever possible. This means starting most patients on anti-craving pharmacological maintenance, though aversion therapy may be appropriate for a few of them. Opiate antagonists may be used with heroin-addicted patients as long as those patients are only mildly ill. In contrast, agonist opioid medications, i.e., buprenorphine and methadone suit moderately and severely ill patients, respectively. Achieving control of mood instability or psychotic episodes is the next step, to be followed by a prevention strategy to counteract residual cravings and dominate mood disorders or psychotic episodes through long-term pharmacological maintenance that is focused on a double target.

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