«The progress in medical science that has been achieved at unprecedented speed in recent years has added much to our knowledge, whether the viewpoint taken is neurobiological, physio-pathological or clinical. This has brought urgency to the task of investigating the changes to be made in updating our perspectives on how best to classify the whole area of mental diseases.
The series of classifications provided in successive editions of DSM has, over the years, evolved in its way of naming dependence on toxic substances, which is referred to in this volume by using the technical terms ‘Substance Use Disorder’ (SUD) and, partly to indicate the severity of the condition, ‘addiction’. In DSM, this severe condition had, for many years, been considered as no more than a single symptom of a personality disorder, until a radically different status was assigned to it – that of playing the role of an independent psychiatric disease.
Over time, the precondition for writing a diagnosis switched from ascertaining a state of physical dependence and/or a withdrawal syndrome to a search for behaviours linked with craving together with behavioural dyscontrol, but to date no psychopathology specific to SUD has, as such, been identified or described. It must be pointed out that the very idea that SUD might be the one and only mental pathology to have no distinctive psychopathology whatsoever appears to be highly improbable, as is the notion that every single aspect linked with the dimensions of impulsivity, thought and affect must be viewed as induced by the substance used only in the phases of dependence or abstention, or otherwise as being the outcome of psychiatric comorbidity.
The term ‘craving’ is used to refer to an irresistible desire for the substance being used and, only a short while ago, it was officially added to the list of criteria required to authorise a diagnosis of SUD. Even if craving is a central feature of the evolution of that condition, with special reference to the clinical picture, studies on craving have so far been neglected, just as no measurement scales have so far been devised to provide a profile of behaviours linked with craving…»
Pedro Ruiz, MD
President American Psychiatric Association (2006-2007)
President, World Psychiatric Association (2011-2014)
President, World Association on Dual Disorders (2015 to 2021)
The proceeds from the sale of this book will be used to support the activities of the Association for the Application of Neuroscientific Knowledge to Social Aims (AUCNS, Associazione per l’Utilizzo delle Conoscenze Neuroscientifiche a fini Sociali). AUCNS is a not-for-profit agency responsible for organizing the meetings of the European Opiate Addiction Treatment Association (EUROPAD) and publishing Heroin Addiction and Related Clinical Problems, the free-of-charge official journal of EUROPAD and of the World Federation for the Treatment of Opioid Dependence (WFTOD), an NGO with Special Consultative Status with the United Nations’ Economic and Social Council (ECOSOC).
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Icro Maremmani. Born in Pietrasanta (Lucca) on May 18th, 1951. He graduated in Medicine at Pisa University in 1979, becoming a specialist in Psychiatry cum laude there in 1983. In 2014 he was officially recognised as possessing all the credentials required to become a Full Professor of Psychiatry, and has been teaching Addiction Medicine at Pisa University since 1994. His main field of interest is opiate agonist treatment of opiate use disorder patients, especially in dual disorder patients. He has been a collaborator of the American Association for the treatment of Opioid Dependence (AATOD) since 1988 (working on its Executive Committee); the Italian Society of Addiction Medicine (SITD) since 1990 (co-founder and past President); the European Opiate Addiction Treatment Association (EUROPAD) since 1994 (co-founder and President from its foundation). He is President of the World Federation for the Treatment of Opioid Dependence (WFTOD), a non-governmental organization recognised by the United Nations. He is a member of the Executive council of the WPA Section of Dual Disorders Pathology, and general secretary of the World Association of Dual Disorders (WADD). He was the first non-American to be awarded the Dole and Nyswander prize, in Washington DC, in 1994. He was given the Chimera career-award in 2004 in Paris, and became an honorary member of the Spanish Society of Dual Pathology (SEPD) in 2015 in Barcelona. He became fellow (FISAM) of ISAM (International Society of Addiction Medicine) in 2016 in Montreal. He has published scientific papers both in Italian (totalling over 400) and in English (over 300). He has actively participated in more than 500 scientific seminars and congresses. He is editor of Heroin Addiction and Related Clinical Problems and Scientific Director of Italian Journal of Addictions. He is a member of the editorial board of Odvinosti, Addictive Disorders and their Treatment, Frontiers in Psychiatry, International Journal of Environmental Research and Public Health, and Journal of Clinical Medicine. He lives in Pietrasanta and works in Pisa.
Angelo Giovanni Icro Maremmani. Born in Pietrasanta (Lucca) on April 21st, 1984. He graduated in Medicine at Pisa University in 2009, and became a specialist in Psychiatry cum laude again in Pisa in 2015. He is currently working on the Doctorate Programme in Biochemistry and Molecular Biology at Siena University. In 2017 he was officially recognised as possessing all the credentials required to become an Associate Professor of Psychiatry. He has been teaching Addiction Medicine at Pisa University from 2013. His field of interest is Addiction Medicine, with special regard to opiate addiction, and dual diagnosis patients. He is a member of AU-CNS, and is an active collaborator of EUROPAD, WFTOD and the V.P. Dole Disorder Unit at the Santa Chiara Hospital in Pisa. He is President of the Pisa School of Clinical and Experimental Psychiatry founded in 2017. He was fellow at the British Columbia University (Vancouver, Canada) in the spring and summer of 2014, and at Rockefeller University (NY, USA) in the fall of 2014. He has been working as a physician in charge at ASL Toscana Nord Occidentale (Versilia, North-Western Tuscany) from 2016. He has published papers both in Italian (over 20) and in English (over 90), and has actively contributed to more than 20 congresses and seminars. He is Associate Director of Frontiers in Psychiatry, section of Addictive Disorders, and is a member of the editorial board of Heroin Addiction and Related Clinical Problems. He lives in Marina di Pietrasanta and works in Viareggio.
Matteo Pacini. Born in Pisa on January 24th, 1975. He graduated in Medicine at Pisa University cum laude in 1999, and specialised in Psychiatry there from 2003. He has been teaching Addiction Medicine in university post-graduate courses from 2011. His fields of interest are Addiction Medicine, Forensic Psychiatry and Dual Disorders. He collaborates with Europad, representing Italy on its international scientific committee. He received the Europad Chimera career award in Krakow, 2018, and won research prizes for one paper about QT prolongation during methadone maintenance (Europad, Pietrasanta, 2001), and then for another one on the long-term outcome of dual diagnosis heroin addicts in agonist treatment (SOPSI, Rome, 2002). He has published over 30 works in Italian and over 90 in English. He has actively contributed to over 50 congresses and seminars. He is a member of the editorial board of Heroin Addiction and Related Clinical Problems. He lives and works in Pisa.