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Alcohol and drug addiction are perhaps the most serious and dangerous scourges of our time. This is not a problem of one person and those around him, but a problem of the whole society, nation, since each person is a part of society.

Hostages of alcohol

These negative habits shorten a person's life, thereby increasing mortality, entail the birth of defective offspring with congenital anomalies.

By leaps and bounds, the figure that reflects the global amount of alcohol consumed is growing. Both young and old suffer from this. An incredible number of people become hostages of alcohol.

The problem of drug addiction has reached no less catastrophic proportions. Illicit trade, drug abuse, increased deaths from overdose - such headlines can be found in press reports of any country from an underdeveloped country to a giant country of economic and political scale.

Like a serious illness that destroys the body from the inside, drug addiction and alcoholism, in addition to health, destroy a person’s life, cause trouble and failure, where they begin to pursue life path. The insidiousness also lies in the fact that these diseases subdue not only the person himself, but bring suffering and torment to his family, close circle. Often the life of most of these people comes down to the fight against alcohol and drugs, but, unfortunately, this struggle does not always bring a positive result.

It has been repeatedly noted that in a family with an alcoholic father, the most negative consequences are reflected in children. Not every woman will have enough love, strength, patience to fight her husband's illness. Often the wife gives up and, succumbing to the influence of alcohol, she begins to drink. It is easy to imagine that children, having lost parental attention and care, are left to their own devices.

This free space, lack of control, freedom of action in most cases leads to the fact that the children of alcoholics begin to commit excesses, become delinquents. Drinking parents whose children are minors may be deprived of parental rights. This is a very unpleasant process, but, unfortunately, there are much worse options when a child, looking at a parental example, also begins to abuse alcohol. He often becomes an inveterate drunkard, ruins his body and has much more terrible chances of dying young.

There are families that lack the strength and patience to deal with these terrible ailments. As a result, the closest people refuse to suffer from alcoholism in order to avoid a life of constant fear and stress. The family members of those who have not escaped this disease simply give up in the fight against this evil.

Drug addiction and alcoholism

There is a parallel between drug addiction and alcoholism. Both the first and the second are elemental dependence on chemicals. Drug addiction is dependence on the substance contained in the drug. Although in themselves these substances can be medicines. The main component of alcohol is ethyl alcohol, which causes a habit. Unfortunately, this dependence is the work of the person himself.

Science has proven that once inside the body, alcohol travels through the bloodstream to every human organ, harming and destroying it. It is not necessary to exclude the content of carcinogenic and toxic substances in low-quality alcohol. Alcohol helps them freely enter the human body.

It has an irreversible and detrimental effect on brain cells, the sexual centers located in the spinal cord are weakened. In abusing women, the functioning of the mammary glands is disrupted, and subsequently, in general, it may stop.

In order to provide assistance to an alcohol- or drug-addicted person, it is necessary to have an idea of ​​the causes and consequences with which they are fraught.

There is such a thing as "addictive behavior". It is characteristic of those people who are predisposed to habits of one kind or another. An important imprint leaves heredity on it. A rather dangerous category can be safely attributed to those people who had drug addicts or alcoholics in their family. This in no way prejudges the fate of a person, it is simply necessary to be aware of such a predisposition and control your actions.

Biochemical characteristics of a person under the influence of alcohol

Each organism is individual, and each has its own biochemical characteristics.

In the human body there is an enzyme that breaks down ethyl alcohol - alcohol dehydrogenase. But in different quantities. For example, women are more deprived of it than the male part of the population. From which we can conclude that alcohol addiction will quickly overcome the fair sex. One of the causes of dependence in women is the psychological background - their excessive emotionality and susceptibility. But in contrast, you can call the instinct of self-preservation, which by nature is more inherent in ladies. This may be one of the reasons why there are more men than women in drug treatment clinics.

Society, habitat, family traditions, upbringing, in which the formation of personality takes place, has two opposite properties - to protect a person, and to push him to any form of dependence. Simple casual curiosity or a dysfunctional environment can be fertile ground for a first introduction to drugs or alcohol. Further, the substance itself performs its dirty “work”, interfering with the biochemical processes of the body. People with a predisposition to alcoholism and drug addiction already have a need for this substance, despite the knowledge of the harm it brings.

Drugs have their roots in ancient times. The Greek translation of this word is numbness, madness passion. Abnormal, insane fun after the use of substances of plant origin accompanied more than one religious holiday of different tribes of the jungle, bacchanalia in Greece and Rome ...

Drug addiction is a continuous process of using toxic substances that are very similar in one of their features - they create in people the illusion of temporary support and pleasure.

The sharpest process of imaginary pleasure, for the sake of which drug addicts are ready for any offense, lasts no more than a few minutes. Then comes the stage of a kind of amorphousness, complete indifference to the surrounding reality. The person is half asleep, delusional relaxed state.

The reason for the prevailing opinion about the greater evil of drug addiction than alcohol is unclear. Drinking alcohol in huge doses is not as shameful as becoming a drug addict. Some countries are striking in their loyalty in this regard. People who use narcotic substances will be punished in accordance with the Criminal Code, and anyone can buy alcohol both in terms of cost and availability, which leads to complete national degradation, the drinking of a huge number of the population.

Although, in fact, it is pointless to compare whose appearance is more pathetic and depressing - alcoholics with shaking hands or thin drug addicts with sunken burning eyes. And with that, and with another it is necessary to struggle cardinally.

The fight against alcoholism

The first outbreak of widespread drug use was an attempt to exterminate mass alcoholism.

In the most banal way, one evil was replaced by another - alcohol began to be replaced by drugs.

Thomas de Quincey, a poet who lived in England in the 19th century, suffered from alcoholism. In his works, he colorfully described the sensations that he experienced by using a drug. He came up with a crazy idea how to cure one addiction by another. Thanks to a large number of fans, this idea has grown at a tremendous speed. There were communities, clubs of opiate smokers, which were visited by many people, comforting themselves with the idea that they were fighting alcoholism. For more than a dozen years, one generation of England after another fought evil in the most absurd way, using no less harmful means.

The cause of drug addiction can be a number of reasons:

• curiosity;
• stressful situation;
• serious illness;
• basic imitation.

A negative example is set by celebrities, some of whom do not use drugs easily, but also advertise such an unflattering lifestyle in a peculiar way.

Not only is it not hidden, but becomes public knowledge, some describe the sensations experienced in colors, thereby fueling interest and arousing the desire to try.

There are some kind of youth drugs that allow you to party in clubs without getting tired. A large percentage of young people swallowing these pills do not even bother to think that this is a harmless drug that produces energy, but in fact the same narcotic substance.

Unfortunately, there are circumstances when, for health reasons, a person is forced to take painkillers, sleeping pills, psychotropic drugs, one of the components of which is a drug. Such situations are quite risky, since the systematic use of drugs containing drugs can lead to addiction. As a result, the sick person needs a dose of medication not for the purpose of treatment, but to combat the brittleness and unpleasant sensations that accompany it.

Quite often you can hear the opinion that alcohol is less of a problem than drug addiction. What the person himself chooses to face and his choice does not depend on the “lightness” or “severity” of the problem. It is convenient for him, he, unfortunately, likes it, in the end, it suits him and corresponds to his personality.

Negative Functions of Addiction

Alcoholism and drug addiction cause irreparable harm to the human body, destroy its personality. The only difference is that drugs accomplish their terrible purpose more quickly.

The life expectancy of people who use drugs is very short. Only a few survive to old age. Often drug addicts die not of their own death, but by accident or overdose. A drug overdose is a process that only takes a few seconds. In the human brain, the respiratory center is blocked and the person dies due to respiratory arrest. Since this process is practically instantaneous, there is simply not enough time to save the life of a dying person and doctors remain powerless.

Alcohol, too, cannot be written off, only it, unlike drugs, acts more slowly. Many people who drink alcohol believe that this is not a problem and vodka with wine, unlike narcotic substances, does not cause withdrawal symptoms.

Doctors - narcologists who deal with the problem of alcoholism believe that addiction has already appeared in those people who drink alcohol-containing drinks more than once a week. Of course, stronger drinks do their job faster due to the higher percentage of alcohol they contain. But the same beer in its negative qualities is ahead of another, stronger alcohol. It has a negative effect on the endocrine and cardiovascular system human body.

You can repeatedly observe how people after a working day allow themselves to drink a couple of bottles of beer. For no reason, just believing that beer relaxes and relieves stress after work. If we are naturally designed to relax, is it worth resorting to such artificial, deceptive relaxation through chemicals? The production of endorphins, the so-called pleasure hormones, is incorporated in human body from nature, so you need to safely avoid artificial and far from harmless substitutes for them.

Unfortunately, alcohol and drug addiction are getting younger every day. Drug addiction is very widespread among adolescents and young people. For many children, acquaintance with the potion takes place on school grounds.

First of all, parents themselves have no right to set a bad example for their children - to use alcohol or drugs.

But unfortunately, even in prosperous families, no one is immune from the fact that a child will take the path of alcoholism or drug addiction.

Often parents do not notice what is happening with their child. Slight suspicions can turn into conviction when the situation is already on the verge. There is a category of parents who, like snails, hide in their shell, dismissing even the slightest thought that the child has taken the wrong path.

But only the mother and father have every chance not to let the brewing problem take its course. Who, if not they, will notice the slightest nuances:

• in the behavior and mood swings of your child;
• a new company or individuals with whom he began to communicate more often;
• hear unusual, suspicious music;
• catch notes of deceit;
• resourcefulness.

The behavior of teenagers "high" is different from normal and habitual. An attentive parent will notice the difference.

Signs of Addiction

A person under the influence of a drug has dilated pupils. This is one of the clear signs. But experienced drug addicts solve this problem with the help of special drops. In addition to the pupils, at first there appears an increased and not quite adequate to the situation hysterical laughter, or vice versa:

• excessive calmness;
• complete indifference to what is happening.

Another alarming call may be an unusual smell coming from a teenager, strange objects that parents did not notice before:

• tubes;
• plastic bottles with cut holes;
• spoons burnt over fire.

Along with the habit of using drugs, children develop the habit of lying and dodging. And do it with special pleasure and passion. This painful need to lie and get out can be safely considered one of the signs of impending trouble.

There is an opinion - to prevent, you need to warn. But this is debatable enough. Each person is individual, and the personality of a teenager is even more vulnerable and may not be fully formed, so it is necessary to take into account all the subtleties of his character and capabilities in order to correctly convey the idea of ​​the dangers of alcohol and drugs.

Strong curiosity of teenagers

Excessive curiosity inherent in the child can play bad joke and only push to the fact that he wants to experience it for himself. And vice versa, a suspicious, timid child will forever leave the idea of ​​​​acquainting with alcoholic beverages or narcotic substances.

This is not the easiest task for parents, but who, if not they, will pick up the key to their child and will not let him stumble.

If, nevertheless, disturbing suspicions led to disappointing conclusions, then there is an easy way to make sure - to conduct a urine test.

In the pharmacy, along with other tests, there are devices that check for the presence of several types of drugs. You can carry out this procedure at home and the result will not keep you waiting.

In monitoring the younger generation, there is flip side medals - excessive suspicion. If several family members begin to simultaneously look for something unusual in the appearance and behavior of the youngest in the family, this can aggravate the situation. In order not to aggravate the relationship and not undermine the child's trust in you, carefully but firmly make sure that the suspicions are not groundless.

The harmful effects of alcohol and drugs

In addition to the fact that alcoholism and drug addiction bring great harm to the person who uses them, the life of society as a whole depends on them.

A large percentage of illegal actions occur under the influence of alcohol and drugs:

• hooliganism;
• personal violence.

There comes a peculiar stage of aggressive excitement, when people in intoxication commit unpredictable and often wrong actions.

Narcotic substances are quite expensive and drug addicts commit many crimes in search of funds for a new dose.

The number of accidents is much higher in those people who use alcohol and drugs:

• they have reduced concentration;
• work capacity decreases;
• labor discipline begins to “limp”.

A huge number of traffic accidents occur most often at the moment when there is a drunk driver or pedestrian on the road.

Studies show that drug addiction and alcoholism in most cases are characteristic of people who have no social prospects, are unsettled in family, work, household life. These problems also come from the country as a whole:

• economic crisis;
• social injustice;
• unemployment;
• lack of opportunities for cultural development.

Of great importance are the traditions of the country in relation to alcohol. Naturally, where the use is not elevated to the rank of permissibility, the percentage of alcoholics and drug addicts is much lower.

How to get rid of addiction?

Getting rid of addiction is not an easy and rather long process. One has only to imagine how difficult it will be to fight, to change one's habits, to completely abandon what occupied almost the first place in a person's life.

There are several ways to help fight addiction. But one of the most important components is the desire of the person himself to part with the addiction.

One of the most effective ways is coding, long-term treatment in a system with psychological and drug therapy.

There is a category of addicts who visit anonymous groups of drug addicts or alcoholics, where psychotherapists work with them. As a result, many of them achieve a state of stable remission and, upon stopping their treatment, try to help those who are addicted.

Unfortunately, there are often patients who need a lot of work to bring to a doctor or clinic. They show denial of the disease. To be left alone, they can repeatedly promise that they will cope with their addiction themselves. But one desire is not enough and the process should be led by a doctor. You should not look for specialists in narcology by an ad in a newspaper. It is recommended to contact a specialized clinic to find a competent doctor.

It is not easy in this situation for the relatives of the patient. It is quite natural that you want to understand, regret, make concessions. But this is a kind of disservice. We need to separate the person from the disease. A daily mention of the disease, poking your nose will be erroneous. But it’s not worth letting the treatment be put on the back burner. It is necessary to make every effort to ensure that the dependent person gives the go-ahead to visit a specialist. After all, a competent narcologist will be able to assess the extent of the problem, establish the correct diagnosis, give recommendations not only to the patient, but also help his relatives find the right approach to getting rid of addiction.

Addiction treatment

Treatment is accompanied by considerable psychological difficulties, because it is not physically enough to cope with the problem. In the world, enough methods have been invented that are used in the fight against addiction:

• hypnosis;
• coding;
• sewing up the ampoule;
• drug treatment;
• psychotherapy.

And the opportunities are not over yet, but are developing every day.

Medications help to cope with physical cravings, reduce the sensations that cause discomfort. These are only the first steps in the fight against the disease.

An alcoholic or drug addict who is worried that the withdrawal process will be very difficult, his whole life will be broken by treatment, it is worth considering, a life full of healthy human joys is worth fighting for.

Medicine and scientific discoveries do not stand still. There are medications that can help manage addiction without causing the thrill of withdrawal or reducing it to a tolerable level. In addition to coding, there are a large number of treatment regimens for which it is not always necessary to go to a hospital or a closed clinic. Often a person can continue to lead a normal life, study, work, travel, but at the same time wage the most important struggle with his addiction.

Psychological restructuring of the worldview

The most difficult is the psychological restructuring of the worldview. An experienced drug addict or alcoholic is used to living differently, not thinking about others, not thinking about relatives and friends, not caring about anything, except how to get a new portion of funds that help achieve euphoria. A person has acquired new acquaintances, where people think the way he does. And as we think, so we live.

If possible, it is necessary to change the social circle of an addicted person, protect him from contacts with past harmful, acquaintances, tear away from the harmful environment where he previously lived.

In this situation, it is the organizations for the fight against drug or alcohol addicts that can help. There, people come into contact with the same people who are bogged down in addiction, jointly look for a way out of a difficult situation, and provide support to each other. Under the influence of the above factors, old negative habits gradually fade away, a person’s outlook on surrounding reality, he sees other life examples, a change in stereotypes, and, accordingly, he can change himself.

Summing up, alcohol and drugs can be safely called a virus that hovers in society. Everyone should remember that this very society is not abstract, not somewhere outside the window, on the TV screen, on the other street ... It is nearby and surrounds us every day. You, neighbors, shop assistants, passers-by on the next street, people on the other side of the city, this is the whole society, one big organism. And everyone knows what can happen if a dangerous destructive virus enters the body.

Cardinal life change

wanting to live happy life, to achieve success, solve emerging problems and change your life for the better, you need to be able to realize what is happening, not hide from problems and look for possible ways to solve them. Drugs and alcohol often make people indifferent, unable to understand anything. It is unlikely that drug addicts think about the fact that their body is falling apart by leaps and bounds and they are moving by leaps and bounds to the edge of the abyss. Homeless alcoholics do not realize how impartial, repulsive they look and how unpleasant the smell coming from them.

With each dose of a drug, with a new sip of alcohol, people's ability to realize the negative changes taking place in their lives decreases. As a result, the last realization will be the thought of how to get more. And before that, a person will pass by the realization that he lies a lot, commits illegal actions, causes suffering and pain to the people around him.

This problem needs to be addressed at the level of each person. There are countries where prohibitions are practiced, but as you know, the forbidden fruit is always sweet, and can lead not to a recession, but to an even greater wave of addiction. While it is not too late, it is necessary to educate the younger generation, to give a correct idea of ​​these diseases, to show the true "face" of alcoholism and drug addiction. After all, if humanity does not stop, does not start thinking about the future of not only its own, but also future children, then it will doom itself to a slow but certain extinction.

Page 17 of 22

Alcoholism, drug addiction and substance abuse

In the group of mental disorders arising from the use of psychoactive substances (that is, those that, even with a single dose, cause the desired euphoria, arousal, activity and other psycho-emotional states for the consumer, and if they are abused, mental and physical dependence), chronic alcoholism, drug addiction, substance abuse. This is primarily due to the fact that the mental changes caused by these diseases significantly disrupt the social stabilization of society. The proportion of subjects who committed illegal acts while intoxicated and undergoing a forensic psychiatric examination due to “wrong behavior” reaches one third. The most criminogenic is antisocial behavior with simple and pathological alcohol intoxication, advanced forms of chronic alcoholism, alcohol and drug addiction psychoses.

Alcoholism, drug addiction and substance abuse are progressive chronic mental diseases of non-psychotic etiology, artificially induced and widespread. With these diseases, individuals gradually develop a mental dependence on psychoactive substances, to which physical dependence joins, then a pathological craving for their use and a change in the reactivity of the body, and in the absence of the possibility of repeated intake of these substances, it is difficult to tolerate withdrawal state (hangover syndrome).

Patients gradually develop vegetovascular, somato-neurological and psychopathological disorders, specific personality changes and their corresponding behavioral reactions. The latter are dominated by the desire to get and take alcohol (drugs) or other substances, ignoring the moral and material interests of the family and the moral and ethical restrictions of society. Ultimately, such individuals experience an increase in social and labor maladjustment, which greatly contributes to the growth of offenses and their severity. At the remote stages, as alcoholism, drug addiction and substance abuse progress, psychiatrists state in this group of patients (as a result of long-term and chronic intoxication effects on the body of ethanol, drugs and toxic substances) organic brain damage and, as a result, increasing dementia.

Alcoholism. The greatest difficulty is the establishment of a diagnosis of simple or pathological intoxication, which is determined mainly by clinical manifestations, while laboratory studies are only of auxiliary importance.

At the core mere intoxication there are certain mental and somato-neurological disorders that occur as a result of taking even a small dose of alcohol. Alcohol selectively depresses primarily the central nervous system, disrupts the normal course of the physiological processes of inhibition and excitation, thereby determining human behavior. At the same time, the degree of intoxication depends not so much on the amount of alcohol taken, but on the state of the body, the functionality of the brain, addiction to alcohol-containing drinks, the method of its introduction into the body, and a number of other reasons.

Simple alcohol intoxication has certain mental, neurological and somatic dynamics, according to clinical features which forensic psychiatrists give a medical opinion.

Simple intoxication is often encountered in forensic psychiatric expert practice, and resolving the issue of sanity does not cause difficulties, since such persons retain contacts with external stimuli for a long time, the ability to critically perceive the situation, realize the nature and social danger of their actions and manage them. They do not develop psychotic states (in the form of twilight confusion, delirium, hallucinations) and therefore they are subject to criminal liability (Article 23 of the Criminal Code of the Russian Federation).

Pathological intoxication occurs only in individual cases in people who, as a rule, do not drink alcohol regularly, who have suffered brain injuries or diseases in the past and are considered mentally healthy persons, in conditions of emotional stress, overwork, chronic lack of sleep, insecurity, fearfulness. It is based on rather complex psychophysiological mechanisms, including those at the intramolecular level. This is a qualitatively different morbid state of the psyche than with simple alcohol intoxication, requiring a different (besides medical and legal) approach. This type of intoxication is possible literally a few minutes after drinking alcohol and usually proceeds regardless of the dose taken. Forensic psychiatrists in their retrospective studies, as a rule, establish that after some time after drinking alcohol, drunk, unexpectedly for others, became anxious, confused, detached, inaccessible to any contacts. Movement and posture acquired a protective character due to the fact that reality began to inspire them with unaccountable horror.

As a result of acute alcohol intoxication, such a person develops a short-term psychotic disorder with deep twilight clouding of consciousness, delusional and hallucinatory experiences and inadequate behavior resulting from this, largely depending on the characterological characteristics of the individual. But motor excitation usually ends suddenly (after a few minutes), passes into a state of physical weakness, and then into sleep, followed by amnesia of the events taking place.

During a forensic psychiatric examination, doctors, analyzing pathological intoxication, diagnose it as a rapidly occurring psychotic disorder in the form of psychosis and recognize such sub-experts as insane for the committed act.

Socially chronic alcoholism It is considered as the excessive use of alcoholic beverages, leading to violations of the norms of behavior in everyday life and society, causing significant damage to health, moral and material well-being of the family. In medical terms, alcoholism is a disease that leads to pathological changes in the internal organs (liver, heart, pancreas), nervous system and selectively the brain. Alcohol has a relaxing (relaxing, relieving stress), euphoric and partly sedative (calming) effect on the mental sphere. The need for such an effect is more characteristic of people who are poorly adapted, with neurotic and psychopathological characterological features. At the same time, the microenvironment, upbringing, traditions, mental and physical overstrain, and psychotraumatic situations matter. The causes of alcoholism are also (conditionally) heredity, a variety of metabolic (exchange) disorders of internal organs, some physiological disorders, primarily of the autonomic nervous system. There are three successive stages in its development:

- initial (compensated) with neurasthenic symptoms and mental dependence on alcohol;

- medium (subcompensated) with the addition of functional changes to organic symptoms, the appearance of physical dependence on alcohol, withdrawal (hangover) syndrome (alcohol psychoses are already possible);

- severe (decompensated) with irreversible somatoneurological disorders (dementia and personality disintegration), phenomena of mental and social degradation, the appearance of chronic hallucinations and other psychopathological disorders.

When analyzing the acts of forensic psychiatric examinations of patients with alcoholism, lawyers need to pay attention to the fact that the basis of the offenses committed by them is the activation of instinctive mechanisms (primitivism in their implementation), increased suspicion (acquiring a painful character), sharpening of personal characteristics (straightforwardness, truth-seeking), the emergence of a number of new traits that were unusual for them before alcoholism (deceit, cynicism, cruelty, etc.), which significantly affect the intent and nature of the actions (often aggressive, senseless and unpredictable).

Forensic psychiatric assessment of patients with chronic alcoholism is not difficult. In view of the fact that the disease itself (alcoholism) does not deprive them of the ability to realize the actual nature and social danger of their actions (inaction) and manage them, these persons are recognized as sane for offenses committed (part 1 of article 97 of the Criminal Code of the Russian Federation and part 2 of article 99 Criminal Code of the Russian Federation). Exceptions are those cases when alcoholism is combined with severe atherosclerosis of cerebral vessels or age-related involutional changes that have taken on the character of severe dementia (dementia).

Alcoholic psychoses are complications of chronic alcoholism. They can be provoked by: various psychogenies (including a criminogenic situation, arrest, investigation, detention in a pre-trial detention center, etc.); forced abstinence from habitual and regular intake of alcoholic beverages; in more rare cases - massive alcohol intoxication at the peak of binge. The most common in legal practice (depending on the prevailing symptoms) are the following acute alcoholic psychoses: delirium (delirious tremens), acute hallucinosis and paranoid. The behavior of such patients during psychosis is due to confusion and is adequate to hallucinatory-delusional experiences that determine the nature of their motor activity and may cause fear for the life of the patient and others. In such a state, they have no awareness of the actual nature and social danger of their actions and the ability to direct them (that is, criticism and will). Therefore, persons who have undergone alcoholic psychosis during the period of the incriminated acts are recognized as insane.

In forensic investigative practice, there are offenders with such a variant of alcoholic disease as true hard drinking (dipsomania). This is a paroxysmal, painful and irresistible craving for alcohol and its surrogates, which can be joined by melancholy, paranoid mood, olfactory hallucinations and other psychopathological symptoms leading to aggression.

In a forensic psychiatric analysis of dipsomania, it is necessary to take into account the possibility of an acute attack of innate biological dependence (insufficiency) to endogenous ethanol (produced by the body) and the recognition of such patients during an attack as insane, and outside of binge - sane for committed acts.

Addiction. This is a group of diseases united by painful addiction (addiction), as a rule, to the non-medical use of narcotic drugs, which are included in the list of narcotic substances by the Ministry of Health of the Russian Federation. In Russia, morphine, omnopon, codeine, poppy straw, hemp, synthetic substitutes (promedol, fentanyl, LSD), stimulants (perventin, caffeine) are most widely used. They have a specific effect (stimulating, euphoric, sedative, hallucinatory, etc.) on the central nervous system. Medicinal and other chemicals not included in this list (including “ folk remedies”), are classified as toxic, and the diseases they cause are called substance abuse; despite the fact that they have a number of narcotic properties, the social danger of their abuse is not so high. This division is rather conditional and is mainly of a legal nature.

Addiction- the general name of a group of diseases manifested by a pathological, irresistible attraction to the constant intake of increasing doses of narcotic drugs and substances due to persistent mental and physical dependence on them with the development of withdrawal symptoms when they stop taking them.

Drug addiction is characterized by adverse mental, somatic and social consequences. This is especially evident during the period of forced abstinence from habitual drug use. Drug addicts have a mental and physical dependence on drugs, a desire to increase the dose (increase tolerance) in order to obtain even greater euphoria, complacency, Have a good mood, a surge of strength, lightness, detachment from the outside world and emerging problems. Hence the painful need for repeated drug use and active actions for their acquisition. All this leads to sharpening of personality traits, somatoneurological and mental disorders, and then to mental, biological and social degradation. Psychiatrists often diagnose drug addicts with psychotic states with twilight confusion, delusions, hallucinations, and other manifestations of mental disorders.

Psychiatrists have also found that drugs cause noticeable changes in oral speech. When they are taken and acute intoxication and, accordingly, pleasant excitement and euphoria, there is a tendency to rapid speech, the use of slang expressions, a manic increase in defects in pronunciation, flat humor, cynicism, buffoonery, etc. With withdrawal symptoms (during forced abstinence from the usual doses) and accordingly, depression is marked by a slowdown in the pace of speech, an angry reaction to remarks (inadequate in form and intensity), “heavy speech”.

Another important diagnostic criterion is the defects in written and oral speech in drug addicts. Forensic experts note that their handwriting is distinguished by quite definite changes, consisting of general and particular features. So, under the influence of drugs - sensations of "complacency and euphoria" - handwriting noticeably improves, but when the effect of the drug stops (withdrawal changes occur), it "spoils", becomes uneven, "nervous", sharp, with a lot of damage to the integrity of the paper, blots , blot, etc. At the same time, the disorder (change) of handwriting under the influence of narcotic drugs also depends on the type of higher nervous activity and the mental state of a person, on the preliminary intake of sleeping pills and “sedatives” medicines. As established, the latter relax the psychomotor and muscle analyzers and thus have a certain effect on the qualitative and quantitative features of handwriting.

The main objective method for determining narcotic substances and their alkaloids (as well as alcohol and other "potent" substances) are chromatographic and spectral analyzes, as well as radioimmunochemical method. In narcological institutions of health authorities, an express method is used to determine drugs in dry form. In addition, for the diagnosis of drug intoxication in people suspected of taking drugs or toxic substances, these institutions use new imported and domestic devices that determine the presence of drugs in the blood and urine of the examined. In this regard, the recognition of drug addicts using the above criteria (according to appearance, changes in oral and written speech, clinical data, laboratory results) is important for improving the operational-search activity, developing investigative leads, building an accusation or defense in court. Ascertained by the employees of the investigation, the prosecutor's office, the court and the legal profession (in the process of personal contact or observation), the painful signs of drug addiction should be considered as subjective, of auxiliary importance, since for the diagnosis of drug addiction to be examined only by a psychiatrist or psychiatrist? Narcologist. Diagnostics clinical symptoms in the course of a dynamic course (and not in statics) of a mental illness of non-psychotic etiology (which is drug addiction) refers to objective research and is recognized by the courts as a type of evidence.

When analyzing the forensic psychiatric reports of persons who have committed crimes while intoxicated with drugs, in accordance with Art. 23 of the Criminal Code of the Russian Federation, as a rule, are recognized as sane. Cases of offenses directly related to acute drug intoxication are extremely rare (due to the severe somatic and mental state of drug addicts and their helplessness at this time).

Only acts committed by them in psychotic states (twilight clouding of consciousness, delirium and hallucinations) or with profound personality changes (degradation) and severe dementia make psychiatric experts recognize them as insane and send them to mandatory treatment in psychiatric hospitals.

Persons suffering from alcoholism and drug addiction complicate the conclusion of marriage, family, housing and property transactions. In civil proceedings, the examination of their legal capacity presents certain difficulties. Therefore, civil law allows for the possibility of limiting their legal capacity (Article 30 of the Civil Code of the Russian Federation) and establishing guardianship. The court, making a ruling on this, decides all issues individually, taking into account the behavior of these persons, the data provided by psychiatrists-narcologists and their mental state, the degree of degradation, and the possibility of medical and social rehabilitation.

Alcoholism, a disease caused by the systematic use of alcoholic beverages, characterized by craving for them, leading to mental and physical disorders and disrupting social relations person suffering from this disease.

Social problems, public problems - issues and situations that directly or indirectly affect a person and, in terms of everything or a significant number of community members are serious enough problems that require collective efforts to overcome them

The problem of alcoholism and drug addiction is always very relevant. It's no secret that alcoholism and drug addiction pose a very great danger to society. First of all, alcohol harms human health, alcohol consumption leads to the development of somatic and mental diseases, worsening the already sad picture of mortality. Accidents and injuries happen much more often with people who drink alcohol, alcoholics have low working capacity, work discipline suffers greatly. Alcoholism is one of the main reasons for the high level of crime in the country, the reason for the large number of accidents when a drunk driver at the wheel becomes the culprit of the tragedy. Drug addiction, like alcoholism, leads to an increase in crime, and everyone knows this: in order to get drugs, drug addicts are ready to commit serious and especially serious crimes. Alcoholics and drug addicts very often become criminals under the influence of alcohol and drugs. Drug addiction and alcoholism acute social problem of our time, the mortality among drug addicts and alcoholics is very high, in addition, all relatives and the environment also suffer greatly from alcohol dependence of drug addiction. It has long been known that prevention eliminates the need for treatment, because it is much more effective and easier to prevent a disease than trying to start treatment after waiting for the extreme stage of neglect. Laws of the Russian Federation addiction is defined as“a disease caused by dependence on narcotic drugs or psychotropic substances included in the List of narcotic drugs, psychotropic substances and their precursors ( Chemical substance, the initial component or participant in intermediate reactions in the synthesis of any substance) subject to control in Russian Federation». Alcoholism- this is a problem that in Russia is traditionally faced in many families. If earlier alcoholism mainly affected men aged 35-60, now a significant percentage of alcoholics are young and middle-aged women, as well as young men. There were also alcoholics among children. Alcoholism is not a bad habit, but a serious disease not only of a psychological but also of a physiological nature. Alcoholism is caused by the systematic use of alcoholic beverages, as a result of which a mental and physical dependence on alcohol develops. Alcoholism is caused by the use of both strong alcoholic drinks (vodka) and low alcohol drinks, such as beer and alcoholic cocktails. In alcoholism allocate three stages(Soloviev: for drug addicts too, only much faster): On first At the stage of alcoholism, a person develops a craving for the use of alcoholic beverages to improve mood. Tolerance to alcohol gradually increases, that is, a person needs to drink more alcohol in order to get drunk. This stage of alcoholism is most typical for "beer" alcoholics. The first stage can last for many years. In the second stage of alcoholism, a person develops a hangover (withdrawal syndrome) and the need to take alcohol in order to remove the manifestations of a hangover: hand trembling, headache, Bad mood. At this stage, people suffering from alcoholism begin to experience pathological changes in the internal organs. In addition, personality changes appear with subsequent alcoholic degradation of the personality. A characteristic sign of the second stage of alcoholism is the onset of "binge binges". Third the stage of alcoholism is characterized by a sharp increase in the body's susceptibility to alcohol. The state of intoxication occurs when taking small doses of alcohol. The condition worsens noticeably and the functions of internal organs are disturbed. Often people lose weight. Outwardly, alcoholics in the third stage of alcoholism can often be described as thin legs and a large belly. Thin legs become due to weight loss due to lack of appetite in a person suffering from alcoholism. AT severe cases An alcoholic vomits when eating. The abdomen is enlarged due to a significant increase in the liver. At this stage of alcoholism, the degradation of the personality progresses, asociality develops. The treatment of alcoholism is based on the development of a negative conditioned reflex to alcohol intake. The patient should be afraid to drink alcohol. An important factor in the treatment of alcoholism is the social rehabilitation of a person suffering from alcoholism, a change of scenery, a complete cessation of contacts with old drinking buddies.

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In 1985-1989, at the height of the anti-alcohol campaign, drug addiction epidemics swept through the USSR. They embraced, first of all, the younger generation. The sources of the toxic effect were household chemicals. Then, compared to the present state of affairs, there were not so many of them. We will not list them - they are widely known. Mortality from the use of toxic substances broke all records - dozens, hundreds died. Thus, in Barnaul in 1986, 300 children and adolescents aged 12 to 16 died. Teachers and narcologists, faced with such an epidemic, were completely unprepared. The treatment of drug addicts is still a very shaky topic: the disease as such does not exist! At the time of poisoning, there is a clinic for acute poisoning with a specific poison and treatment is carried out according to this clinic (ordinary detoxification therapy). But, having "recovered", the teenager goes outside and again and again takes (sniffs, swallows, breathes, or even injects under the skin or into a vein) a toxic substance.

Sociologists then took up the problem of substance abuse, but their surveys and testing did not lead to anything. Repressive measures remained: drug addicts were caught, attics and basements were closed, the parents of the instigators were fined ... Then, against the background of the social cataclysms that began in the USSR, the problem of substance abuse faded into the background. Nevertheless, it remains relevant to this day, both in our country and abroad. True, it partly gave way to the problem that came to the fore addiction. The bulk of drug addicts in Russia now are teenagers.

Alcoholism, substance abuse and drug addiction have a very hidden (endogenous) connection between them. In particular, this is manifested in the fact that no socio-economic or psychological conditions can explain these vices of human society. There is such an abstract concept as "social climate", which is sometimes resorted to to explain this social evil. After all, for example, it is impossible to imagine that there could be alcoholics, drug addicts and drug addicts in Sparta! But there were only a few of them in Nazi Germany. This problem does not exist in modern Iran either.

Genetic alcoholism, substance abuse and drug addiction (and this is confirmed modern research) are most likely related. Rather, it looks something like this: parents with a burdened mental pathology of heredity give birth to children - substance abusers or drug addicts (“mutants”, “degenerates”, “geeks”, according to different terminology). The determining "kind of mutation" cause is social environment. Therefore, alcoholism, substance abuse, drug addiction should become the object of social medicine, while clinical medicine (resuscitation, narcology and psychiatry) deals with the subjects of this pathology.

Below we will consider in detail the general and individual aspects of alcoholism, substance abuse and drug addiction. In the meantime, let's pay attention to the fact that practical and theoretical helplessness in relation to the indicated medical and social problems sometimes leads to strange "positions", the essence of which is to "understand" one's patients (be it an alcoholic, a drug addict or a drug addict). Thus, many kind words were said about alcoholics: “avoidance of cruel and unfair reality” (although it is hardly possible to imagine Hamlet drunk), “alcohol civilizes a person, softening his aggressiveness”, “alcohol promotes communication”, etc.

The same applies to drug addicts, and this position leads to the "protection" of teenage drug addicts from doctors, psychologists, educators, parents and other adolescents who do not take drugs. The general misfortune of psychologizers of drug addiction is that drug addicts, alcoholics and drug addicts are very different both in personal and characterological, and in the abilities of experiencing and thinking subjects. And they work the same way! Therefore, the point is not what they feel, but what makes them take poisons.

If we psychologize in relation to substance abuse and drug addiction, then from the point of view of not the human I, but the masses. You can start at least with the book by Z. Freud "The Psychology of the Masses and the Analysis of the Human Self." At the beginning of his work, Freud cites an excerpt from a book by G. Lebon, a well-known psychologist in his time.

“In the psychological mass, the strangest thing is the following: no matter what kind the individuals that make it up, no matter how similar or different their lifestyle, occupation, their character and degree of intelligence, but by the mere fact of their transformation into a mass, they acquire a collective soul , by virtue of which they feel, think and act in a completely different way than each of them individually felt, thought and acted. There are ideas and feelings that manifest or turn into action only in individuals united in masses. The psychological mass is a provisional being, which consists of heterogeneous elements, united for a moment, just as the cells of an organism, by their combination, create a new being with qualities completely different from those of individual cells.

We have quoted Le Bon in such detail, because his thoughts will help us to clarify some of the provisions of the next section on "Psychic epidemics and criminal mobs". It is the laws of the latter that substance abusers and drug addicts obey (of course, given that there are exceptions to this rule).

Hospitals and clinics all over the world know patients who come with a bag of various drugs, which they systematically, in various combinations take for decades (“from pressure”, “from the stomach”, “from the heart”, “from the liver”, etc.). .d.). These patients have plump, multi-volume outpatient charts and case histories. They are given various "chronic" diagnoses, they are usually treated with the medicines that they themselves call the doctor. it iatrogenic(jatros - Greek doctor) drug addicts, psychologically and physiologically (but not clinically!) Dependent on medications. If “their medicines” are taken away from them, then there will not be an exacerbation of some disease, but a real abstinence. There is nothing to treat them like drug addicts. It is too late to re-educate them, because, as a rule, they are people who are over 50, moreover, they are characterologically changed in the direction of psychopathization of the personality.

Another group of drug addicts are patients suffering from phobias(fear of getting sick). They systematically take drugs for a non-existent disease, thus turning into drug addicts. One of these patients with cardiophobia took up to 80 tablets of nitroglycerin per day (a tenfold lethal dose!). He did not suffer from any cardiovascular disease.

Now a few words about alcoholism. The social physician must clearly distinguish "domestic drunks" and sick chronic alcoholism. The main signs of chronic alcoholism: 1. the presence of a hangover; 2. the presence of hard drinking; 3. change in alcohol tolerance (according to the scheme: dose increase, plateau, dose reduction); 4. personality degradation according to the alcoholic type (bragging, deceit, a tendency to steal for the sake of drinking, overvalued ideas of jealousy with a decrease in potency, etc.).

In the differential diagnosis of chronic alcoholism, it is always necessary to identify whether the patient has "primary" or "secondary" alcoholism. "Secondary alcoholism" - this is an alcoholism syndrome in a patient suffering from some kind of sluggish mental illness (most often schizophrenia or manic-depressive psychosis, but sometimes epilepsy, "stopped" by systematic alcohol intake, which is clinically difficult to differentiate).

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