What can we expect from the pharmacological treatments for dependences presently available?

Abstract

The problematic use of substances such as alcohol, marijuana, cocaine, tobacco, and others imposes a major destabilization as regards the well-being of individuals and societies in several countries, including Brazil. In addition to the risk of dependence, those substances might entail various types of aggression to the human body and contribute to a significant increase in the onset of diseases, incapacitation, and mortality (Saitz 2007). The damage caused by the use of alcohol and tobacco, substances whose use is permitted, that is, licit drugs, is certainly more prevalent and costly all over the world than that resulting from the use of illicit drugs, such as marijuana, cocaine, and crack. We should also mention that some medications prescribed by physicians may become drugs of abuse, as in the case of benzodiazepines and opioid analgesics, with extremely harmful consequences to their users. The problems associated with all those substances are disseminated in populations around the world, reaching the various strata that compose society, with no restriction as to socioeconomical power. The damage inherent to the use of drugs (here we include alcohol, tobacco, and any other substances classified in the patterns of abuse) can be detected in both the users and those close to them. Even those who do not have direct contact with the users and are often not aware of the extension of the damage caused by those substances can be affected. An American study demonstrated that 63 % of the society reported, by the time the study was being carried out, suffering the negative impact of alcohol, tobacco, or illicit drug use, independently of having direct contact with the user (Jupp and Lawrence 2010). Therefore, one should not be surprised at the great concern of multiple sectors of society, such as health professionals who work directly with users, public health managers in charge of creating policies targeted to the collectivity, policy makers, religious leaders, and the general population, as they understand the severity of the problem.