Opioid Dependence: Mechanisms and Treatment by Abraham Wikler

By Abraham Wikler

A significant issue within the remedy of opioid dependence has been the endurance of relapse regardless of detoxing and enforced lengthy abstention from drug use, without or with traditional psychotherapy and different efforts at rehabilitation. either preliminary habit and next relapses tend to be ascribed to the hunt for opioid-produced euphoria in individuals with personality issues. This formula is in accord with one-half of the common-sense "pleasure-pain" precept, however it ignores the opposite part, particularly, the enduring dysphoric effects of re­ peated opioid use (distressing abstinence phenomena, sexual distur­ bances, disruption of marital prestige, unemployment, enmeshment in felony actions, arrests, and imprisonment). as a minimum, the pleasure-pain precept is an empty tautology because it is incapable of refutation via any feasible aim facts that will look contradic­ tory, inasmuch because it should be "saved" by means of invocation of untestable uncon­ scious intervening variables. much less tied to the pleasure-pain precept is the view that relapse is because of long-lasting sequelae of prior opioid dependancy, due to complicated conditioning strategies, either operant and classical, concerning pharmacological, environmental, social and private variables. during this view, relapse isn't easily a re-enactment of preliminary opioid use, yet is a "disease, sui generis" a disorder of its personal type. the criteria contributing to this sickness, sui generis are reviewed during this book.

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