Vol 9, No 4 - Addictive Substances
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I n  t h i s  i s s u e... As already described in the Editorial, we felt that it was of great importance to address the various problems related to recent developments in addictive behaviors. However before turning to modern-day issues in addic- tion, we wished firstly to place it in a historical context. This was the task performed by Marc-Antoine Crocq, in the first State of the art article (p 355). The theme of his article is: “The historical and cultural aspects of man’s relationship with addictive drugs.” Recent scientific discoveries in the area of drug depen- dence, and the targets and mechanisms of action of addictive  substances,  have  required  a  biological approach. To this end we invited a contribution from Mary Jeanne Kreek; this is the second State of the art of this issue (p 363), and it focuses on perspectives from the Laboratory of the Biology of Addictive Diseases and related National Institutes of Health/National Institute on Drug Abuse Research Center. The variety and extent of available substances of abuse has changed the clinical picture of substance addiction. Addictions to a single substance have to a large extent given way to multiple addictions. The need for individu- als to satisfy their addictive personalities, and the ensu- ing generalized psychological dependence, thus pre- dominate over the addiction to a given substance. This new scenario of substance addiction is clearly changing addictive behaviors in general. The predominant trend appearing in modern times is based on the weakening of barriers and of moral, social, and religious taboos, and thus on the resulting increase in  opportunities  and  permissiveness.  Psychological dependence now takes center stage in the clinical picture of addiction, and in this context, addictive behavior is increasing in keeping with the discovery of new sub- stances, or the abuse of substances designed for medic- inal use. We have attempted to target the areas about which we are asking the most questions. So, two Translational research papers follow the State of the art. The first one, by Martin P. Paulus (p 379) looks at the neural basis of reward and craving, and the second, from Peter W. Kalivas (p 389), provides a review of the neurocircuitry and glutamate neuroplasticity of cocaine and ampheta- mine-like stimulants. There are two Clinical research papers. The first one, by Henning Krampe, Sabina Stawicjki, Margret R. Hoehe, and Hannelore Ehrenreich (p 399) presents OLITA—Out- patient Long-Term Intensive Therapy for Alcoholics. The second, by Natalya M. Kogan and Raphael Mechoulam (p 413) presents a review of the use and effects of cannabi- noids, both as a drug of addiction in healthy subjects and as a possible therapeutic option in certain diseases. The first Pharmacological aspects article, by Tracie J. Gardner and Thomas R. Kosten (p 431), provides a very comprehensive look at the treatment options for sub- stance abuse, and the challenges that still remain in this field. Nadia S. Hejazi (p 447), in the second Pharmaco- logical aspects article, examines the pharmacogenetics of addictive behaviors. And in the third Pharmacologi- cal aspects paper, Herbert D. Kleber (p 455) discusses the range of pharmacologic options available for treat- ment of opioid dependence, and the associated detoxi- fication and maintenance options. Finally, the Poster by Margret Hoehe (p 471) presents individual differences in response to addictive substances, and the search for predisposing genetic aspects. As previously stated, this issue does not claim to discuss exhaustively the theme of addictive behaviors, but rather to examine specific problems posed in this field in current times.  We  would  like  to  warmly  thank  the  various authors who have provided brilliant contributions to this issue. Jean-Paul Macher, MD; Margret Hoehe, MD, PhD