IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v16y2019i3p447-d203253.html
   My bibliography  Save this article

What we have learned from the Methadone Maintenance Treatment of Dual Disorder Heroin Use Disorder patients

Author

Listed:
  • Angelo G.I. Maremmani

    (Department of Psychiatry, North-Western Tuscany Region NHS Local Health Unit, Versilia Zone, 55049 Viareggio, Italy
    Association for the Application of Neuroscientific Knowledge to Social Aims (AU-CNS), Pietrasanta, 55045 Lucca, Italy
    G. De Lisio, Institute of Behavioral Sciences, 56127 Pisa, Italy)

  • Matteo Pacini

    (G. De Lisio, Institute of Behavioral Sciences, 56127 Pisa, Italy)

  • Icro Maremmani

    (Association for the Application of Neuroscientific Knowledge to Social Aims (AU-CNS), Pietrasanta, 55045 Lucca, Italy
    G. De Lisio, Institute of Behavioral Sciences, 56127 Pisa, Italy
    V.P. Dole Dual Disorder Unit, 2nd Psychiatric Unit, Santa Chiara University Hospital, University of Pisa, 56126 Pisa, Italy)

Abstract

Mental Disorders and Heroin Use Disorder (HUD) often co-occur and constitute correlated risk factors that the authors believe are best considered from a unitary perspective. In this article we review and discuss data collected by the V.P. Dole Research Group in Dual Disorder (V.P. Dole DD-RG) patients according to the following six discussion points: (1) Treatment of personality disorders during Methadone Maintenance Treatment (MMT); (2) Treatment of Mood Disorders during MMT; (3) Treatment of Anxiety Disorders during MMT; (4) Treatment of Psychotic Disorders during MMT; (5) Treatment of violence during MMT; (6) Treatment of Alcohol Use Disorder (AUD) during MMT. In treating Mood Disorder in HUD patients, we must bear in mind the interactions (potentiation and side effects) between psychopharmacology, used substances and agonist opioid medications; the use of psychiatric medications as an anti-craving drug, and the possible use of agonist and antagonist opioid medications in treating the other mental disorders. In treating chronic psychosis in HUD patients, we must consider the potentiation and side effects of antipsychotic drugs consequent on HUD treatment, worsening addiction hypophoria and inducing a more severe reward deficiency syndrome (RDS) in hypophoric patients. Violence and AUD during MMT can benefit from adequate dosages of methadone and co-medication with Sodium gamma-hydroxybutyrate (GHB). The experience of our V.P. Dole DD-RG suggests the following: (a) DD is the new paradigm in neuroscience in deepening our understanding of mental health; (b) To successfully treat DD patients a double competence is needed; (c) In managing DD patients priority must be given to Substance Use Disorder (SUD) treatment (stabilizing patients); (d) Antidepressant use is ancillary to SUD treatment; antipsychotic use must be restricted to acute phases; mood stabilizers must be preferred; any use of Benzodiazepines (BDZs) must be avoided.

Suggested Citation

  • Angelo G.I. Maremmani & Matteo Pacini & Icro Maremmani, 2019. "What we have learned from the Methadone Maintenance Treatment of Dual Disorder Heroin Use Disorder patients," IJERPH, MDPI, vol. 16(3), pages 1-26, February.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:3:p:447-:d:203253
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/16/3/447/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/16/3/447/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Deykin, E.Y. & Levy, J.C. & Wells, V., 1987. "Adolescent depression, alcohol and drug abuse," American Journal of Public Health, American Public Health Association, vol. 77(2), pages 178-182.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Ashim Gupta & Abdalla Bowirrat & Luis Llanos Gomez & David Baron & Igor Elman & John Giordano & Rehan Jalali & Rajendra D. Badgaiyan & Edward J. Modestino & Mark S. Gold & Eric R. Braverman & Anish Ba, 2022. "Hypothesizing in the Face of the Opioid Crisis Coupling Genetic Addiction Risk Severity (GARS) Testing with Electrotherapeutic Nonopioid Modalities Such as H-Wave Could Attenuate Both Pain and Hedonic," IJERPH, MDPI, vol. 19(1), pages 1-12, January.
    2. Morgane Guillou-Landreat & Antoine Dany & Gaëlle Challet-Bouju & Edouard Laforgue & Juliette Leboucher & Jean Benoit Hardouin & Caroline Victorri-Vigneau & Marie Grall-Bronnec, 2021. "What Differs between Patients under Methadone and under Buprenorphine for Opioid Use Disorder (OUD) in Daily Clinical Practice in France? A Short Report," IJERPH, MDPI, vol. 18(4), pages 1-7, February.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Bach Xuan Tran & Anh Kim Dang & Nu Thi Truong & Giang Hai Ha & Huong Lan Thi Nguyen & Ha Ngoc Do & Tuan Quoc Nguyen & Carl A. Latkin & Cyrus S. H. Ho & Roger C. M. Ho, 2018. "Depression and Quality of Life among Patients Living with HIV/AIDS in the Era of Universal Treatment Access in Vietnam," IJERPH, MDPI, vol. 15(12), pages 1-14, December.
    2. Lee, Jung Wun & Chung, Hwan & Jeon, Saebom, 2021. "Bayesian multivariate latent class profile analysis: Exploring the developmental progression of youth depression and substance use," Computational Statistics & Data Analysis, Elsevier, vol. 161(C).
    3. Wenyi Lu & Siyuan Fan, 2024. "Drinking in despair: Unintended consequences of automation in China," Health Economics, John Wiley & Sons, Ltd., vol. 33(9), pages 2088-2104, September.
    4. Romeo B Lee & Madelene Sta Maria & Susana Estanislao & Cristina Rodriguez, 2013. "Factors Associated with Depressive Symptoms among Filipino University Students," PLOS ONE, Public Library of Science, vol. 8(11), pages 1-1, November.
    5. Orton, Heather D. & Riggs, Paula D. & Libby, Anne M., 2009. "Prevalence and characteristics of depression and substance use in a U.S. child welfare sample," Children and Youth Services Review, Elsevier, vol. 31(6), pages 649-653, June.
    6. Shane, Patricia A. & Jasiukaitis, Paul & Green, Rex S., 2003. "Treatment outcomes among adolescents with substance abuse problems: the relationship between comorbidities and post-treatment substance involvement," Evaluation and Program Planning, Elsevier, vol. 26(4), pages 393-402, November.
    7. Reed, Karen P. & Nugent, William & Cooper, R. Lyle, 2015. "Testing a path model of relationships between gender, age, and bullying victimization and violent behavior, substance abuse, depression, suicidal ideation, and suicide attempts in adolescents," Children and Youth Services Review, Elsevier, vol. 55(C), pages 128-137.
    8. Salazar, Amy M. & Jones, Kevin R. & Amemiya, Jamie & Cherry, Adrian & Brown, Eric C. & Catalano, Richard F. & Monahan, Kathryn C., 2018. "Defining and achieving permanency among older youth in foster care," Children and Youth Services Review, Elsevier, vol. 87(C), pages 9-16.
    9. Darden, Michael E. & Papageorge, Nicholas W., 2024. "Rational self-medication," Economics & Human Biology, Elsevier, vol. 53(C).

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:16:y:2019:i:3:p:447-:d:203253. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.