As well as than treat dependence?
Most of consumers of psychoactive agents (alcohol, drugs, toksikant) extremely reluctantly ask for the specialized help, even recognizing painful nature of consumption. The reasons of it root in unwillingness to be put on the narcological account and rather high cost of the medical services rendered without registration (anonymously). But the fact that the condition of sobriety is perceived by them with the sign " is the main reason; minus “ and intoxications - with the sign “ plus “. It burdens already unfavourable forecast of these frustration. Treatment without motivation, at the expense of relatives, usually has the minimum effect.
As a rule, psychotic states are subject to treatment in a psychiatric hospital, heavy abstinency - in a narcological hospital, overdose - in toxicological office with reanimation. Other cases can be lechima both in out-patient conditions, and in a hospital at the request of the patient.
Really achievable result (practically for 100%) is the detoxication of an organism and removal of abstinent symptoms. These actions do not influence expressiveness of an inclination to substance, the patient gets again that Wednesday where he comfortably felt only in a condition of intoxication. The only thing effective (70% and above) way to prevent recurrence is inclusion of the patient in the rehabilitation program (therapeutic community).
the Detoxication - acceleration of removal of substance and its metabolites from an organism with correction vodno - electrolytic balance and functions of vitals. It is carried out parenteral (more often intravenous) by introduction of colloidal and kristalloidny solutions with vitamins and other preparations or extracorporal methods (haemo sorption, a plasma exchange).
Psychotropic drugs of various groups (neuroleptics, tranquilizers, antidepressants, normotimik, nootropa). Are widely applied as to knocking over of symptoms of abstinency in various schemes, and to the supporting therapy on a minovaniye of the abstinent phenomena and abstention from substance reception. Efficiency is very high (about 40 - 45% at the correct application), however control of regular reception is required. Even if there does not come the absolute recovery, then the use of substances is made at least less often and in smaller doses.
Replacement therapy means introduction to an organism of substances close to habitually used, but deprived of pathogenic effect, or with much smaller effect. Treatment of opiate addiction by means of a methadone (in our country it is not applied), nicotinic plasters can be examples at the tobacco use, consumption of the coffee peeled of caffeine. Efficiency - no more than 30%.
Bioactive additives - as a rule, a phytogenesis. Facilitate process of a detoxication and an exit of abstinency, increase adaptive resources of an organism. It is necessary to carry rather high cost of the majority of them and need of a long course of reception to shortcomings. Efficiency of long-term reception is doubtful.
The preparations blocking and causing disgust. Reception of a teturam or its implantation (esperal) at alcoholics can be an example. At alcohol intake there are extremely burdensome feelings, the fear of the use is formed. Efficiency - not less than 50 - 60% at observance of regular reception, however in the most part of cases is required replacement therapy by psychotropic drugs.
Suggestive psychotherapy (treatment by suggestion). One of the methods of treatment of alcoholism and tobacco smoking, most widespread in our country. There are many techniques of different authors (emotionally - stressful therapy across Dovzhenko, acupuncture programming, adversivny counterattribution and others), the general for which is suggestion use. Efficiency in comparison with other methods of classical psychotherapy is very high (more than 40%), however a shortcoming is “ validity period “ suggestions. As a rule, before the end his patient decides to try, “ works “ whether it. As a result again recurrence begins.
Other types of psychotherapy - from psychoanalysis before therapy by creative self-expression. Application is admissible, but the effect is lower average (less than 25 - 30% of abstention in a year).
Rehabilitation programs. Arose for a long time (“ Sobriety societies “) but only recently are widely adopted. Their effect is based on inclusion of the patient in a special environment and group interaction with the former consumers. Examples - " clubs; Anonymous alcoholics “ “ Anonymous addicts “ and other communities up to sects. Permanent installation on refusal of substance reception can be created. The effect is rather high and steady (70% and more after a year).
Most of consumers of psychoactive agents destructively influence a mental condition of members of the family - spouses, children, parents. In modern psychiatry there is a concept of codependence characterizing sincere shape living together with dependent. It causes need of carrying out family psychotherapy and separate work with sozavisimy. Practice shows expediency of carrying out similar actions (the quantity of cases of abstention increases).