The problem of routing of patients using psychoactive substances

Cover Page

Cite item

Full Text

Abstract

Alcoholism and drug addiction are concomitant or indirect causes of death in almost all subclasses of diseases, as well as frequent causes of violent death. In the field of detection, treatment, prevention and support of the studied group of patients, there is a huge number of problems, such as anosognosia, possible limitation of patients' rights, socially restrictive nature of addiction care, etc. As a result, patients taking psychoactive substances, have significantly reduced motivation to appeal to narcologists. There are many systemic organizational problems in the work of the addiction service, which significantly hamper the routing of patients, which differs from the routing of patients of somatic profile. In relation to this, scientific research aimed at optimizing drug addiction service is of particular relevance. In addition, each subject of the Russian Federation has a number of features (territorial, economic, i.e.), and this indicates the need to study certain types of specialized assistance, taking into account the characteristics of each specific region. There are several levels of patient routing, each of which includes certain tasks, components, and indicates the expected result. The routing of addictive patients has its own peculiarities, related both to temporary isolation of patients and to further long-term rehabilitation. As a result, the model of highly specialized care for patients using psychoactive substances does not allow involving the greatest possible number of people in need in each stage of therapy and does not contribute to solving the main public health problems. Despite the obvious availability of this type of assistance, for most potential customers it remains unattractive.

About the authors

A N Pichugin

Psychiatric Hospital No. 19

Author for correspondence.
Email: dr.a.pichugin@yandex.ru
Domodedovo, Russia

References

  1. Kalashnikov G.V. Alcoholism and drug addiction as the cause of population mortality. Molodoy uchenyy. 2011; 10 (2): 132–133. (In Russ.)
  2. Koshkina E.A., Spector S.I., Sentsov V.G. et al. Medicinskie, social'nye i ehkonomicheskie posledstviya narkomanii i alkogolizma. (Medical, social and economic consequences of drug addiction and alcoholism.) Moscow: PER SE. 2008; 288 p. (In Russ.)
  3. Nemtsov A.B., Razvodovskiy Yu.E. Alcohol situation in Russia, 1980–2005. Social'naya i klinicheskaya psikhiatriya. 2008; (2): 52–60. (In Russ.)
  4. Nemtsov A.V. The Russian death rate in the light of alcohol consumption. Demograficheskoe obozrenie. 2015; 2 (4): 111–135. (In Russ.)
  5. Nemtsov A.V., Shelygin K.V., Savel'ev D.V. Seasona­lity of fatal alcohol poisoning, alcohol psychosis and alcohol consumption (sales) in Moscow in 2000–2015. Social'naya i klinicheskaya psihiatriya. 2017; 27 (4): 32–37. (In Russ.)
  6. The decree of the President of the Russian Federation from June 9, 2010 №690 «On approval of the Strategy of the state anti-drug policy of the Russian Federation till 2020». (In Russ.)
  7. Mendelevich V.D. Therapy of narcological disorders in the General medical network: paradigm change. Voprosy narkologii. 2014; (2): 141–153. (In Russ.)
  8. Nemtsov A.V., Shelygin K.V. Alcohol — a significant factor in suicides. Konsul'tativnaya psikhologiya i psikhoterapiya. 2016; 24 (3): 164–180. (In Russ.)
  9. Nemtsov A.V., Orlov A.V. Alcoholism in the late 1980s and early 2010s. Zhurnal nevrologii i psi­hiatrii. 2016; 116 (6): 60–65. (In Russ.)
  10. -65.
  11. Nemtsov A.V., Shelygin K.V. Suicide and alcohol consumption in Russia, 1956–2013. Suicidologiya. 2016; 7 (3): 3–12. (In Russ.)
  12. Al'tshuler V.B. Effective and evi­dence-based narcology in the era of HIV (comments to the conference). Narkologiya. 2008; (10): 95–97. (In Russ.)
  13. Kazakovtsev B.A. Modern forms of psychiatric care. Zhurnal nevrologii i psihiatrii im. S.S. Korsakova. 2003; 103 (9): 66–68. (In Russ.)
  14. Ayvazova A.E. Psiholo­gicheskie aspekty zavisimosti. (Psychological aspects of addiction.) Saint Petersburg: Rech'. 2003; 120 p. (In Russ.)
  15. Blagov L.N., Demina M.V. Mo­dern problems of rehabilitation of patients with opioid dependence. Narkologiya. 2004; (10): 52–55. (In Russ.)
  16. Blagov L.N. Psychopathological phenomenon of rentness and manipulative behavior of a narcological patient. Narkologiya. 2008; (11): ­87–98. (In Russ.)
  17. Kol'tsova O.V. Psihologiya raboty s narkozavisimymi. (Psychology of work with drug addicts.) Saint Petersburg: Rech'. 2007; 160 p. (In Russ.)
  18. Griffiths P., McKetin R. Developing a global perspective on drug consumption patterns and trends the challenge for drug epidemiology. Bull. Narcotics. 2003; (1–2): 1–9.
  19. Luoma J., Drake C.E., Kohlenberg B.S., Hayes S.C. Substance abuse and psychological flexibility: The development of a new measure. Addiction Res. Theory. 2011; 19 (1): 3–13. doi: 10.3109/16066359.2010.524956.
  20. Klimenko T.V. Comment on V.D. Mendelevich's article «Ways of modernization of drug treatment ­service: time to choose a professional approach». ­Narkologiya. 2013; (3): 84–85. (In Russ.)
  21. Mendelevich V.D., Ziganshin F.T., Gur'yanova T.V. Psychiatry, society and security of citizens: the all-Russian and Tatarstan trends. Nevrologicheskij vestnik. 2011; (1): 3–8. (In Russ.)
  22. Mendelevich V.D. Ways of modernization of drug treatment service: time to choose a professional approach. Narkologiya. 2013; (3): 77–83. (In Russ.)
  23. Belo­krylov I.V., Kuznetsov A.G., Rayzman E.M. Psychotherapy in drug addicted patients with low motivation for treatment. ­Voprosy narkologii. 2010; (2): 28–35. (In Russ.)
  24. Federal law №323-FZ of 21.11.2011 (as amended on 13.07.2015) «On the principles of public health protection in the Russian Federation» (amended and suppl., in force with 24.07.2015) (In Russ.)
  25. Order of the Ministry of health of the Russian Federation of November 15, 2012 №929n «About the statement of the Order of rendering medical care on the profile “narcology”. Within the order “About the statement of the Order of rendering the narcological help to the population of the Russian Federation”» (with changes by March 15, 2011) (is invalid since 06.05.2013 on the basis of the order of Ministry of health of Russia of 15.11.2012 №929n) (In Russ.)
  26. Приказ Минздрава России от 05.06.2014 №263 (ред. от 07.12.2015) «Об утверждении Концепции модернизации наркологической службы Российской Федерации до 2016 года». [(Order of Ministry of health of the Russian Federation of 05.06.2014 N 263 (edition of 07.12.2015) «About the approval of the concept of modernization of narcological service of the Russian Federation till 2016».) (In Russ.)]
  27. Bubeev Yu.A., Kozlov V.V., Krugovykh N.F. Narkoticheskie addikcii: profilaktika i korrekciya s pomoshch'yu integrativnyh psihotekhnologij. (Drug addiction: prevention and correction using an integrative psycho.) Moscow: Slovo. 2009; 464 p. (In Russ.)
  28. Dudko T.N. System of basic principles of construction of treatment and rehabilitation process in narcology. Voprosy narkologii. 1999; (2): 28–34. (In Russ.)
  29. Igonin A.L., Baranova O.V., Shevtaova Yu.B. Spiritually-oriented and biological methods of correction of violations of social behavior of narcological patients (comparative assessment). Narkologiya. 2010; (9): 40–45. (In Russ.)
  30. Bryun E.A., Buzik O.Zh., Sokol'chik E.I. et al. Standarty organizacii i programma reabilitacii v narkologii (Stacionarnoe otdelenie. Polustacionar «Dom-na-polputi»). (The standards of the organization and program of rehabilitation in addiction (Inpatient unit. Semi-stationary «House-on-halfway»).) Moscow: Media-Studiya. 2008; 30 p. (In Russ.)
  31. Order of the Ministry of health of the Russian Federation of October 22, 2003 №500 «On approval of the Protocol of management of patients “Rehabilitation of drug addicts (Z50.3)”»). Narkologiya. 2004; (4–5): 11–17; 20–36. (In Russ.)
  32. Valentik Yu.V. Reabilitaciya v narkologii. (Rehabilitation in addiction.) Moscow: Progressivnye biomedicinskie tekhnologii. 2001; 36 p. (In Russ.)
  33. Dudko T.N. A systematic approach in the provision of rehabilitation assistance to people with addictive disorders. Voprosy narkologii. 2008; (3): 80–93. (In Russ.)
  34. Dudko T.N. Rehabilitation of drug-addicted patients (rehabilitation and rehabilitation concepts). Voprosy narkologii. 2006; (1): 31–41. (In Russ.)
  35. Mutakhetdinov M.N., Khozieva V.B. Psihologicheskie usloviya reabilitacii narkomanov: opyt issledovatel'skoj rekonstrukcii. (Psychological conditions drug addicts rehabilitation: research experience of reconstruction.) Moscow-Nizhnevartovsk. 2004; 160 р. (In Russ.)
  36. Mendelevich V.D. Narcology in the mirror of psychiatry. Voprosy narkologii. 2016; (5–6): 123–138. (In Russ.)
  37. Katkov A.L. Management of quality in the system of drug treatment (basic concepts and General implementation algorithm). Narkologiya. 2009; (6): 25–38. (In Russ.)
  38. Stitze M.L., Petry N.M., Peirc J. Motivational incentives research in the National Drug Abuse Treatment Clinical Trials Network. J. Substance Abuse Treat. 2010; 38: 61–69. doi: 10.1016/j.jsat.2009.12.010.
  39. Al'tshuler V.B. Alkogolizm. (Alcoholism.) Moscow: GEOTAR-Media. 2010; 264 p. (In Russ.)

© 2019 Pichugin A.N.

Creative Commons License

This work is licensed
under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.




This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies