ISSN 1592-1638 Vol. 10 • N. 1 • March 2008 Heroin A ddiction and Related C linical P roblems Periodico trimestrale - Sped. in Abb. Post. - D.L. 353/2003 conv. in L. 27/02/2004 n° 46 art. 1, comma 1, DCB PISA - PISA DCB 1, comma 1, art. 46 n° 27/02/2004 L. in conv. 353/2003 - D.L. Post. Abb. in - Sped. trimestrale Periodico 9-3-2000 del n.5 Pisa di tirb. Aut. the official journal of Europad EUROPEAN OPIATE ADDICTION TREATMENT ASSOCIATION EUROPAD formerly EUMA was founded in Geneva (Switzerland) on September 26, 1994. It shall remain independent of political parties and of any government. The vision EUROPAD exists to improve the lives of opiate misusers and their families and to reduce the impact of illicit drug use on society as a whole. The Association works to develop opiate addiction treatment in Europe but also aims to make a major contribution to the knowledge of, and attitudes to, addiction treatment worldwide BOARD OF DIRECTORS Icro Maremmani President Pisa, Italy Marc Reisinger Vice-President Brussels, Belgium Andrej Kastelic General Secretary Lubiana, Slovenia Rainer Schmid Vienna, Austria Gabriele Fischer Vienna, Austria Oleg Aizberg Minsk, Bielorussia Nermana Mehic-Basara Sarajevo, Bosnia and Herzegovina Alexander Kantchelov Sofia, Bulgaria Ante Ivancic Porec, Croatia Didier Touzeau Paris, France Marc Auriacombe Bordeaux, France Albrecht Ulmer Stuttgard, Germany Stepah Walcher Munich, Germany Paul Quigley Dublin, Ireland Matteo Pacini Pisa, Italy Pier Paolo Pani Cagliari, Italy Michael Arieli Jerusalem, Israel Haim Mell Jerusalem, Israel Emilis Subata Vilnius, Lithuania Helge Waal Oslo, Norway Luis Patricio Lisboa, Portugal Wojcjech Rudalski Warszawa, Poland Karina Stainbarth-Chmielewska Warszawa, Poland Sergey Koren Moscow, Russia Alexander Kozlov Moscow, Russia Nikola Vuckovic Novi Sad, Serbija and Crna Gora Marta Torrens Barcelona, Spain Mercedes Lovrecic Lubiana, Slovenia Andrej Kastelic Lubiana, Slovenia Lubomir Okruhlica Bratislava, Slovak Republic Olof Blix Jönköping, Sweden Jean Jacques Deglon Geneve, Switzerland Peter Vossenberg Deventer, The Netherlands Sergey Dvoryak Kiev, Ukraine Michael Farrell London, United Kingdom Colin Brewer London, United Kingdom www.europad.org Editorial Board Editor "Santa Chiara" University Hospital, Department of Psychiatry, University of Icro Maremmani Pisa, Italy, EU Associate Editor Social-health Integration Service, Sardinia Health and Social Administration Pier Paolo Pani Cagliari, Italy, EU International Advisory Board Marc Auriacombe Victor Segalen University, Bordeaux 2, France, EU James Bell Langton Centre, Sydney, Australia Olof Blix County Hospital Ryhov, Jönköping, Sweden, EU Barbara Broers University Hospital of Geneva, Switzerland Miguel Casas University Hospital of "Vall d’Hebron" - Autonomous University of Barcelona, Spain, EU Michael Farrell King’s College, University of London, UK, EU Loretta Finnegan National Institutes of Health, Bethesda, ML, USA [Retired] Gabriele Fischer University of Vienna, Vienna, Austria Gilberto Gerra Global Challenges Section - Division for Operations - United Nations Office on Drugs and Crime, Vienna, Austria, EU Gian Luigi Gessa Emeritus, University of Cagliari, Italy, EU Michael Gossop King’s College, University of London, UK, EU Leift Grönbladh University Hospital of Uppsala, Sweden, EU Lars Gunne Emeritus, University of Uppsala, Sweden, EU Andrej Kastelic Centre for Treatment of Drug Addiction, Lubiana, Slovenia Michael Krausz St..Paul’s Hospital, University of British Columbia, Canada Mary Jeanne Kreek The Rockfeller University, New York, USA Mercedes Lovrecic Institute of Public Health of the Republic of Slovenia, Lubiana, Slovenia, EU Joyce Lowinson Emeritus, Albert Einstein College of Medicine, The Rockfeller University, New York, USA Robert Newman International Centre for Advancement of Addiction Treatment, Baron Edmond de Rothschild Chemical Dependency Institute of Beth Israel Medical Centre, New York, NY, USA Charles P. O'Brien University of Pennsylvania, Philadelphia, USA Mark Parrino American Association for the Treatment of Opioid Dependence, New York, USA Giulio Perugi Department of Psychiatry, University of Pisa, Italy, EU Marc Reisinger European Opiate Addiction Treatment Association, Brussels, Belgium, EU Marlene Stenbacka Karolinska Institute, Stockholm, Sweden, EU Alessandro Tagliamonte University of Siena, Italy, EU Marta Torrens Autonomous University of Barcelona, Spain, EU Research Foundation on Public Health and Addiction, associated with Zurich Ambros Uchtenhagen University, Switzerland Helge Waal Center for Addiction Research (SERAF), University of Oslo, Norway George Woody University of Pennsylvania, Philadelphia, USA Editorial Coordinators Association for the Application of Neuroscientific Knowledge to Social Aims, Marilena Guareschi AU-CNS, Pietrasanta, Lucca, Italy, EU Matteo Pacini "G. De Lisio" Institute of Behavioural Sciences, Pisa, Italy, EU Publishers Association for the Application of Neuroscientific Knowledge to Social Aims, AU-CNS Not for profit Agency "From science to public policy" Via XX Settembre, 83 - 55045 Pietrasanta, Lucca, Italy, EU Phone +39 0584 790073 - Fax +39 0584 72081 - E-mail: [email protected] Pacini Editore Via A. Gherardesca - 56121 Ospedaletto, Pisa, Italy, EU Phone +39 050 313011 - Fax +39 050 3130300 - E-mail: [email protected] Internet:http:// www.pacinieditore.it Cited in: EMBASE Excerpta Medica Database Free download at: http://www.atforum.com/europad.html http://pain-topics.org/opioid_rx/europad.php Open Access at: http://www.europad.org CONTENTS Sexual Behaviour of Heroin Addicts in Treatment 5-12 Igna Brajević-Gizdić and Magda Pletikosa First Experience of Opioid Therapy with Buprenorphine in Ukraine 13-18 Sergey Dvoryak and Irina Grishayeva Administration of Nalbuphine to Heroin Addicts. Feasibility and Short-Term Effects 19-24 Michael Voronkov, Daria Ocheret, Svetlana Bondarenko, Yuriy Ivanov Yu, and Sergey Koren Evidence of Reliability and Validity of the Opiate Dosage Adequacy Scale (ODAS) in a 25-38 Sample of Methadone Maintenance Patients Francisco González-Saiz, Oscar Lozano Rojas, Rosario Ballesta Gómez, Izaskun Bilbao Acedos, Javier Galiana Martínez, Mª Angeles García Collantes, Antonio López Fernández and Serum Methadone Levels Study Group Improvement in the Quality of Live in Heroin Addicts: Differences Between Methadone 39-46 and Buprenorphine Treatment Icro Maremmani, Pier Paolo Pani, Dina Popovic, Matteo Pacini, Joseph Deltito, and Giulio Perugi Methadone: A Fast and Powerful Anti-anxiety, Anti-depressant and Anti-psychotic 47-54 Treatment Jean-Jacques Déglon and Eva Wark Explaining Agonist Treatment Through Movie Language: The Interesting Allegory of 55-56 ‘Videodrome’ Matteo Pacini HEROIN ADDICTION & RELATED CLINICAL PROBLEMS www.europad.org Pacini Editore & AU CNS Regular article Heroin Addict Relat Clin Probl 2008; 10(1): 5-12 Sexual Behaviour of Heroin Addicts In Treatment Igna Brajević-Gizdić and Magda Pletikosa Public Health Institute of Split and Dalmatia County, Department for the Prevention of Addiction Diseases, Split, Croatia Summary Addicts are a high risk group for diseases transmissible sexually or through the blood. Their pathological behaviour caused by addiction makes it a priority to collect information about the sexual conduct of addicts, especially those who are trying to cure themselves. It is important to get results about how they assess the risks related to certain kinds of behaviour and how they see the need to be educated about the issue. The aim of this study is to determine the sexual behaviour patterns of heroin addicts who have already begun treatment, while getting insights into how they assess the risks associated with being sexually active, and whether they need to be informed about the whole issue. According to the survey, heroin addicts displayed an uncritical attitude towards the risk assessment of their sexual behaviour and failed to understand that they need to be informed about protection. Key Words: Sexual behaviour, Heroin addicts, Addiction, Drug abuse 1. Introduction complex problem, and that both the inclination towards ‘experimenting’ with psychoactive substances and The World Health Organization defines addiction regular consumption itself result from the simultaneous as a state of physiological or psychological depend- impact of various interconnected factors. In other words, ence on any psychoactive substance [39]. This state is none of the aetiological factors appear to be decisive in characterized by changes in behaviour and other psy- a way capable of determining the individual’s experi- chological reactions, always including the compulsive ences with psychoactive substances independently of need for occasional or regular substance use, guided other factors [32, 5, 11]. by the pleasant psychological effects of the substance The extent of drug abuse in Croatia has reached the or, at least, of avoiding abstinence symptoms. Addic- levels of some West European countries. On the basis tive behaviour is a major medical, psychological and of epidemiological data and the data provided by the societal problem, especially in view of the increasing judiciary and by a repressive law enforcement system, incidence and availability of drugs. Although most the number of people addicted to illicit substances in epidemiological studies have depicted an increasing Croatia has been estimated at 13,000 (a rate of 2.7 per trend in drug abuse incidence among adolescents, only 1,000 population). This figure is