AVANCES EN LA INVESTIGACIÓN SOBRE DEPENDENCIA DE SUSTANCIAS
Abstract
Los objetivos del presente artículo son: (1) Presentar el origen de los términos de adicción y dependencia de sustancias; (2) estudiar las causas de la adicción a sustancias, mostrando los nuevos hallazgos de los estudios empíricos desde una perspectiva biopsicosocial; y (3) realizar sugerencias de cara a la intervención clínica. La investigación empírica reivindica el término de adicción por expresar más claramente la dimensión comportamental compulsiva o de pérdida de
control. A su vez, los estudios neurocientíficos destacan el papel central de los mecanismos de refuerzo natural y de control de la conducta apetitiva sobre la etiología de estos trastornos, sin restar importancia al factor de evitación de la abstinencia. Asimismo, estos estudios destacan que los síntomas de aburrimiento, desmotivación y baja tolerancia al estrés son los síntomas más persistentes de la abstinencia prolongada, y que resultan del reajuste del sistema de refuerzo natural. Precisamente, estos síntomas residuales junto a la estrategia aprendida de aliviarlos con el consumo de drogas constituyen los principales factores causales de la alta tasa de recaídas al año (del 70 al 90% de los casos tratados). De ahí que el tratamiento debe enfocarse tanto en los síntomas residuales como en la estrategia de afrontamiento, ofreciendo reforzadores y modelos sociales competitivos con la droga y su mundo. A tal fin se sugiere fomentar la implicación personal del paciente en grupos de autoayuda, organizaciones no gubernamentales y comunidades religiosas.
Palabras claves: Adicción a sustancias, Dependencia de sustancias, Desregulación del refuerzo, Tratamiento, Recaídas.
Substance addiction, Substance dependence, Reinforcement deregulation, Treatment,
Relapses.
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