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Can the migration process influence the clinical expression of heroin use disorder in migrants to Italy?

Published online by Cambridge University Press:  23 January 2020

Icro Maremmani Open the ORCID record for Icro Maremmani [Opens in a new window] ,
Manuel G. Carbone ,
Claudia Tagliarini ,
Marina Ricci ,
Anna M. Lupi ,
Lucia Sarandrea ,
Angela Ceban ,
Angelo G.I. Maremmani  and
Pietro Casella
Icro Maremmani*
Affiliation:
Association for the Application of Neuroscientific Knowledge to Social Aims (AU-CNS), Pietrasanta, Lucca, Italy G. De Lisio Institute of Behavioural Sciences, Pisa, Italy Vincent P. Dole Dual Disorder Unit, 2nd Psychiatric Unit, Santa Chiara University Hospital, University of Pisa, Pisa, Italy
Manuel G. Carbone
Affiliation:
School of Psychiatry, Department of Experimental and Clinical Medicine, University of Pisa, Pisa, Italy
Claudia Tagliarini
Affiliation:
School of Psychiatry, Department of Experimental and Clinical Medicine, University of Pisa, Pisa, Italy
Marina Ricci
Affiliation:
Drug Addiction Unit, Italian NHS, Region of Latium, ASL Roma 1, Rome, Italy
Anna M. Lupi
Affiliation:
Drug Addiction Unit, Italian NHS, Region of Latium, ASL Roma 1, Rome, Italy
Lucia Sarandrea
Affiliation:
Drug Addiction Unit, Italian NHS, Region of Latium, ASL Roma 1, Rome, Italy
Angela Ceban
Affiliation:
Drug Addiction Unit, Italian NHS, Region of Latium, ASL Roma 1, Rome, Italy
Angelo G.I. Maremmani
Affiliation:
Association for the Application of Neuroscientific Knowledge to Social Aims (AU-CNS), Pietrasanta, Lucca, Italy G. De Lisio Institute of Behavioural Sciences, Pisa, Italy Department of Psychiatry, Tuscany Region National Health System, Viareggio, Lucca, Italy
Pietro Casella
Affiliation:
Drug Addiction Unit, Italian NHS, Region of Latium, ASL Roma 1, Rome, Italy
*
Icro Maremmani, MD, Email: [email protected]
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Abstract

Background

For some time now, there has been a strong consensus that the migration process can influence the onset, course, development, outcome, and clinical aspects of psychiatric pathologies.

Methods

In this study, we have analyzed the influence of the migration process on the clinical expression of heroin use disorder (HUD). In a naturalistic case–control study, we compared, both at univariate and multivariate level, 30 migrant HUD (M-HUD) patients with 30 age/gender-matched Italian HUD (IT-HUD) patients. We also analyzed demographic data, drug addiction history, psychopathological symptoms, addictive behavior, and emotional reactivity to life events.

Results

Compared with IT-HUD pairs, at HUD Agonist Opioid Treatment, M-HUD patients were characterized by inadequate income and the presence of legal problems. They were more frequently at stage 3 of heroin addiction, with a concomitantly less frequent use of stimulants. Their age at the onset of heroin use was greater than that of subjects in the IT-HUD group. HUD post-traumatic stress disorder spectrum was present and was more severe in all M-HUD patients, but grief reactions and maladaptive behavior were the most discriminant traits. No differences were found in terms of addictive behaviors related to heroin craving or with respect to the severity/typology of psychopathology specific to HUD.

Conclusions

The migratory process does not seem to be correlated with addictive behaviors or with psychopathology specific to HUD. It partly affects HUD history, and specifically correlates with emotional reactivity to loss and traumatic life events, so suggesting that in M-HUD individuals, the link between the migratory syndrome and HUD is very close.

Keywords

Migrationheroin use disorderaddiction
Type
Original Research
Information
CNS Spectrums , Volume 26 , Issue 1 , February 2021 , pp. 62 - 70
Copyright
© Cambridge University Press 2020

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