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La dependencia de drogas, una enfermedad médica crónica: implicaciones para el tratamiento, el seguro y la evaluación
A T McLellan1, D C Lewis, C P O'Brien
1The Treatment Research Institute, 150 S Independence Mall W, Suite 600, Philadelphia, PA 19106-3475, USA. tmclellan@tresearch.org
JAMA
|October 4, 2000
Resumen
La adicción a las drogas es una enfermedad médica crónica, no solo un problema social. El cuidado efectivo a largo plazo, al igual que otras enfermedades crónicas, mejora los resultados y reduce la recaída.
Área de la Ciencia:
- Ciencias Médicas Ciencias Médicas.
- Investigación de adicciones Investigación de adicciones.
- Salud Pública La salud pública.
Sus antecedentes:
- La dependencia de drogas a menudo se ve como un problema social, lo que lleva a estrategias médicas inadecuadas de prevención y tratamiento.
- Esta perspectiva pasa por alto las importantes implicaciones para la salud y los fundamentos biológicos de la adicción.
Objetivo del estudio:
- Examinar la evidencia que apoya la dependencia de drogas como una enfermedad médica crónica.
- Para comparar la dependencia de drogas con otras enfermedades crónicas como la diabetes tipo 2, la hipertensión y el asma.
Principales métodos:
- Se realizó una revisión de la literatura.
- Los aspectos clave comparados incluyeron diagnósticos, heredabilidad, etiología (genética y ambiental), fisiopatología y respuesta al tratamiento (adherencia, recaída).
Principales resultados:
- La dependencia de drogas comparte herencia genética comparable, factores etiológicos (elección personal, entorno) y curso de la enfermedad con otras enfermedades crónicas.
- Causa cambios duraderos en la química y la función del cerebro.
- Existen medicamentos efectivos para algunas dependencias (nicotina, alcohol, opiáceos), pero no para todas (estimulantes, marihuana).
- Las tasas de adherencia y recaída son similares en todas estas condiciones.
Conclusiones:
- La dependencia de drogas debe tratarse como una enfermedad crónica, que requiere estrategias de gestión a largo plazo.
- El seguro, el tratamiento y la evaluación deben alinearse con los de otras afecciones médicas crónicas.
- La atención a largo plazo, incluida la administración y el monitoreo de la medicación, produce beneficios duraderos.
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