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January 31 | Innovation

«We have no narcology»

In 2015 Russia was at the sixth place among the mostly drinking nations of the world, and consumption of alcohol in the Christmas and New Year holidays just rolls over. It is alcohol that is somehow connected with significant number of deaths, including poisoning and cardiovascular diseases. According to statistics, more than a half of the criminals commit illegal acts while being intoxicated with alcohol. Today, drug addiction problem goes hand in hand with alcoholism. Experts in the field of medicine and psychology told about the real picture of these diseases in Russia and the methods necessary to fight with them at the meeting of the Versus discussion club organized by the I.M. Sechenov First Moscow State Medical University.


Do not panic

In fact the situation is not as hopeless as it was before, experts believe. So, the level of alcohol consumption per capita has fallen from monstrous 18 to 12 liters per year over the past six years.

"The official statistics of the Ministry of Health shows that the number of people who use drugs and alcohol has been steadily declining. You can say that this statistic is not complete, but you cannot deny that it reflects trends

Alexei Nadezhdin, the Head of the Department of Child and Adolescent Addiction of FSBI V.P. Serbsky Federal Medical Research Center of Psychiatry and Addiction, said. – The marker of the heaviness of the alcohol situation in Russia is the number of alcoholic psychoses. And it has been steadily declining since 2005. For example, we fix sporadic cases of psychotic disorders related to alcohol or drug intoxication among older teens all over the Russia".

At the same time the critical rate of alcohol consumption is 8 liters per person per year according to the WHO recommendations, and Russia is still in the "red zone".

Nevertheless, the trend is favorable and, apparently, it is apparent not only for narrow specialists. For example, manufacturers of alcoholic beverages have noticed a steady decline in demand, because of which they are forced to reduce production. But do not forget that not only natural factors affect the balance of supply and demand. "Adjustments of the supply are possible with the help of government regulation, and it is spelled out in the government program: the price, the time of sell, the age of buyer for selling alcohol. But the demand is the people. So it is necessary to work with them, – Nikolai Ivanec, the Head of the Department of Psychiatry and Addiction of I.M. Sechenov MSMU, said. – A person needs something to replace the time that he otherwise would spent on booze. And it is the most difficult and most important task".

According to Nadezhdin, the problem of drug addiction is also not as bad in Russia, as it is sometimes imagined. "Drug use is not growing, admission to substance abuse hospitals is low. But the most important thing is that there was a change in the spectrum of drug use". As the expert said, there is a reduction in heroin consumption and a reduction in mortality from heroin, but at the same time new synthetic mixture (called SPICE) appear, that can carry no less danger to health. The solution to this problem is to accelerate the work of state bodies authorized to include such substances in a list of banned ones.

Causes and effects

But no matter how quickly law enforcement and regulatory authorities work, the problem of alcoholism and drug addiction cannot be solved by just bans and increased excise taxes.

"Using alcohol, psychotropic substances are not separate problems, but the symptoms of a disadvantage of society as a whole and of the individual.

Alcohol and drugs are the adaptogens, at least at the first stage; all these are the ways to build a relationship with the world and with yourself – Oleg Zykov, the director of the Institute of narcological health of the nation, said. – Therefore, recovery from alcoholism and drug addiction is first of all finding yourself in this world".

Drug addiction and alcoholism are bio-psycho-socio-spiritual diseases, and they should be treated with appropriate methods. "I believe that we have no narcology, – Zykov added. – Narcology is something that changes the destiny of a person and helps him or her to see the other colors in the world. And we rather have toxicology, not narcology".

Thorny paths

How can be built such a system that would open up eyes of a person with drug or alcohol addiction for the "other colors" of the world and would give him a second chance for a normal life?

On the one hand, some people become aggressive and can hurt themselves and others, even to take away life in a state of intoxication. Petty theft – a way to get money for another dose – is a common "side effects" among addicts. It would be logical to isolate such people from society. That is what the Soviet system of medical-labor dispensaries (MLD) was aimed to.

"In my youth I believed that MLD is a prison, and absolutely unnecessary institution, but with age I realized what they are necessary for – Nikolai Ivanec told. – Family rests, society rests, and people are forced to work there. Moreover, when they began to study the remission after being in MLD (not to say "cure" because there was no medical treatment), it was higher for those who were "treated" with labor. Therefore, I support the restoration of MLD".

But on the other hand, when a person gets into such an institution, it imposes stigma on him (and mark in the personal file is not the worst manifestation of it). This is a special world, rather brutal one, and getting into it, the person does not get close to a healthy social life, but stucks in another parallel reality. The ambiguity of this practice encourages the experts and the public to seek alternative approaches.

For example, participants suggested dividing the process of treatment and assistance during the remission for a few steps. "Urgent assistance" can be fulfilled on a basement of principle similar to the Soviet one, but not by "throwing everything into one heap". "The Soviet detoxification center merged the things that cannot be merged: the function of public order, transporting the patient to the detoxification center and medical care on the spot, if necessary", – Zykov said, adding that these functions are important as they are.

The participants of the meeting offered to divide MLD functions into three components: logistic, designed for the transportation of people intoxicated to the place of residence; medical, comprising the health system institutions and designed to assist the fighting against identified disease; punitive and repressive, included in the Ministry of Interior structure and designed to deal with persons who violate public order.


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