Transcript Министерство здравоохранения и социаль

Government of Moscow
Moscow Department of Public Health
Moscow Research and Practical Center on
Addictions
Drug demand reduction in
RUSSIAN FEDERATION
E.A.Bryun
Moscow, 13-15 may 2013
In 2010 the fundamental documents defining a vector of development and
improvement of the narcological help to the population of the Russian
Federation were accepted.
It is Strategy of the state anti-drug policy of the Russian Federation till
2020, approved by the Decree of the President of the Russian Federation of
June 9, 2010 № 690.
It is the Concept of a state policy on decrease in scales of abuse by
alcoholic products and alcoholism prevention among the population of the
Russian Federation till 2020, approved as the Russian Prime Minister on
June 23, 2010.
Order of rendering the narcological help to the
population of the Russian Federation, approved by
the order of the Minister of Healthcare and Social
Development of the Russian Federation of 15
november 2012 № 929н.
Medical-economic standards, approved by the order
of the Minister of Healthcare and Social Development
of the Russian Federation 4 september 2012 №№
125н – 135н..
The diseases connected with addictions – are uniform disease process
(nozos), having various clinical forms, including: chemical addictions:
alcoholism,drug addictions, toxic substance abuse; food addictions, gambling
and other forms of addicted behavior and phenomenologically being shown
frustration of inclinations. Biological basis of narcological diseases makes
mental dysontogenesis,etiological removed from biochemical violations of a
brain (genetic predisposition , injury, mental and somatic diseases), and also
psychological disharmony, the ethnocultural and social disparity, the
distorted information environment. Thereby, modern narcology are
recognizes the bio-psycho-soсio-spiritual nature of a narcological disease,
which is realized in connection with accumulation of pathogenic factors.
At the same time, be aware that the majority of patients in
the case of formation of remission and stop the disease
process (nozos) there is a sum of contributing factors, that
is the pathological condition (patos) remains, that dictates
need of long medical supervision and antirecurrent
treatment, on the one side, and medical-psychological,
medical-social, professional, legal, sociocultural and so
forth, and the rest rehabilitations at a coordinating role of
medicine.
SCHEME OF SOCIAL PRESSURE
ON NARCOLOGICAL POPULATION
Isolation in ITU FSIN Russian
Federation
and obligatory treatment
Narcological
service
SOCIAL PRESSURE
NARCOLOGICAL POPULATION
Y level
Obligatory and alternative
treatment by court definition in
narcological establishment
IY level
Tertiary prevention:
Medical rehabilitation programs for
different groups of patients
III level
The second prevention:
Socio-therapeutic intervention
(early identification and
intervention)
II level
Primary prevention:
Detection of risk factors
Сourseware in the organized
collectives
Anti-drugs propagation in mass
media
I level
I.
Primary prevention (work with a family, in the organized collectives, including with children of
preschool age). Interaction with mass media and the interested departments.
II.
The second prevention –socio-therapeutic intervention (early identification and intervention (work
with groups of risk, the contingents of the commissions on affairs of minors, neglected children and
teenagers, the consumers of drugs abusing alcohol and tobacco, and also persons with behavior
frustration).
III.
Intervention target (primary consultation of patients, their relatives and citizens and motivation of
the patient on inclusion in the medical program)
IV.
Disintoxication (treatment of an abstinentny syndrome, somatic, neurologic and sharp
psychopathological frustrations);
V.
Treatment of a syndrome of a pathological inclination, affective and other frustrations, both
premorbid, and the psychoactive agents connected with the chronic use;
VI.
Psychotherapy and correction of personal frustrations;
VII.
Rehabilitation and antirecurrent actions (medical supervision and formation of the rehabilitation
environment). Interaction with family, with the interested organizations and departments.
VIII.
Development of the treatment subculture as an opposite to alcohol- and drug subcultures
Dependence of annual remission on quantity of the
passable stages of treatment
IV
III
II
I
Rehabilitation programs
Psychotherapy programs
Treatment of
psychopathological frustration
Rapid relief of withdrawal
syndrome
1-5%
15-20%
25-30%
40-50%
Remission duration after passing of
rehabilitation or medical programs
50,00%
45,00%
40,00%
35,00%
30,00%
25,00%
20,00%
15,00%
10,00%
5,00%
0,00%
48,10%
40,70%
rehabilitation
14,20%
12,40%
6 months- 1 year
1 -1,5 years
medical programm
Remission duration after
rehabilitation(drug addiction)
80,00%
71,60%
70,00%
59,70%
60,00%
48,50%
50,00%
43,40%
36,90%
40,00%
31,10%
2006 y.
31,90%
26,80%
30,00%
23,20%
20,00%
12,50%
10,00%
0,00%
3 months
and more
Remissions
6 months
and more
1 year and
more
2 years
and more
3 years
and more
4 years
and more
2012 y.
Conclusion :
In this connection in the organization of
rendering the narcological help includes the
decision not only medical tasks, but, first of all,
organization of system approach, including
both medical, and psychological, sociocultural,
information aspects of treatment and
corrections of a deviation of mental
development in patients of a narcological
profile.
Zone of the next development
• The Ministry of Education and Science of the Russian
Federation brought in the government the draft of the
federal law on prevention of the use of drugs among
the school students, providing voluntary testing.
• Ministry of Health of Russia prepared the project the
order on soсio-therapeutic intervention and testing of
school students on drugs.
• Further improvement of the legislation.
Thanks for
attention!