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[Addiction disorders: a new management.]

Gianni Testino1, Patrizia Balbinot1, Lorenzo Sampietro2

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Summary

Dependence Medicine (DM) requires a clearer definition and management approach due to evolving diagnostic criteria like Substance Use Disorders (SUDs) and Alcohol Use Disorders (AUDs). This field integrates public health, internal medicine, and psychiatry for comprehensive care.

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Area of Science:

  • Psychiatry
  • Addiction Medicine
  • Public Health

Background:

  • Psychiatry and addiction disorders are closely linked, necessitating a redefinition of "dependence medicine" (DM).
  • The DSM-5 introduces new terms like Substance Use Disorders (SUDs) and Alcohol Use Disorders (AUDs), moving beyond the traditional term 'addiction'.
  • These disorders contribute to significant organic, psychic, familial, and social problems, particularly in young individuals.

Purpose of the Study:

  • To effectively define the discipline of Dependence Medicine (DM).
  • To review and propose changes in the management of SUDs and AUDs.
  • To advocate for an integrated approach to managing behavioral disorders and substance use.

Main Methods:

  • Review of current epidemiological and clinical evidence.
  • Analysis of diagnostic shifts proposed by DSM-5.
  • Conceptualization of DM as an interdisciplinary field.

Main Results:

  • The rise of young individuals with multiple dependencies (40-70% experiencing SUDs/AUDs) necessitates avoiding premature psychiatrization.
  • DM integrates diverse medical and public health elements, including internal medicine, pharmacology, neurology, and psychiatry.
  • A shift in management is proposed, emphasizing DM's comprehensive scope.

Conclusions:

  • Dependence Medicine (DM) requires a distinct definition and updated management strategies.
  • The interdisciplinary nature of DM is crucial for addressing complex SUDs and AUDs.
  • A public health and integrated medical approach is recommended over solely psychiatric interventions for young poly-dependents.