available hospital beds. The prophylactics of social illnesses like
alcoholism, misuse of narcotics and toxic chemicals cannot be built upon
the same methods as the treatment of serious infectious diseases. Alongside
pharmaceutics, it requires psychological aid and education which more and
more often involves the addicts' families and friends. It is naive to
believe that medicines and injections alone can bring about the desired
results and that the selection of individually suitable pharmaceutical
preparations gives a clue to the problem of treatment. Good results are
yielded by a combination of psychology and pharmacy. Therefore, the
treatment for drug addiction consumes much painstaking effort of a doctor,
psychologist, educator and other specialists working with a person who is
likely to develop the illness or is ill already.
On the face of it, the issues of treatment and prophylactics
necessitate comprehensive programming and proficient organization. Their
solution lies in the medico-biological, medico-psychological and medico-
social spheres.
From the standpoint of government policy, public health institutions
have the exclusive authority to treat drug addicts by officially approved
methods, including compulsory treatment of the addicts who pose danger to
society.
According to the results expected in this field, health centers must
organize and effectuate a series of measures destined to establish firm
grounds for progress in the drug abuse situation.
In the first place, this means the early identification, diagnosis and
registration of the persons who use drugs for non-medical purposes and
hence stand in need of prophylactic and treatment. However, shortcomings in
the existing methods of express-diagnostics and in the expert check-ups of
drug addicts make establishing the degree and the type of drug dependence
somewhat problematic.
Identification, Diagnosis, and Registration of Drug Users:
The identified addicts may belong to different age and social groups;
their condition may have a different degree of narcotic neglect. This fact
may influence the choice, distribution and intensity of medical measures,
as well as their combination with other types of aid.
Of particular importance is the early identification of addicts among
the young and the adolescents. A timely medical interference, caring
participation and influence of parents, relatives, teachers, police
officers, and the atmosphere of friendliness can stop the youngsters' slump
into illness.
When the consumers of different drugs have been identified, it is
exigent to inform the police to enable it to find the sources of drugs and
trafficking channels and execute other preventive measures.
Information is especially important if the drugs have been manufactured
illegally or their origins are unclear.
The following list of measures can help identify the individuals who
misuse narcotic substances:
medical check-ups of industrial labor staffs, school and college
students;
medical check-ups of inmates in jails and penitentiaries;
medical examination of the perpetrators of drug abuse for further
registration and treatment, including compulsory treatment;
specialized testing of certain professionals (the military, pilots,
drivers of all means of transport, police officers) for the bodily presence
of narcotic substances;
revealing the most dangerous forms of drug abuse that complicated
detoxification, revealing the cases of multiple drug misuse (the combined
use of more than one drug) and the cases of an intertwined abuse of drugs
and alcohol;
identification of addicts who carry the HIV and other infectious
diseases, elimination of the consequences of infectious transmission;
timely registration, treatment and rehabilitation of those who need it.
Another way to improve the health servicing of drug abusers is to
organize:
fundamental research; development of efficacious pharmaceutical
preparations and novel methods of treatment for different types of narcotic
dependence, their speedy translation into public health practices; large-
scale contribution to research from Russian and foreign scientists (the
Academy of Sciences, medical, pedagogical, psychological and other research
institutions, application of practices adopted abroad);
accelerated training of highly qualified personnel (addictive
conditions psychiatrists, psychologists, educators, social workers) at
medical colleges and upper level courses, specialized training of medical
attendants, nurses and technicians. The study program should cover not only
the novel methods of treatment, but also the specifics of contacts with the
drug addicts and methods of readiness for treatment and prophylactic
practice;
organization of new preventive-treatment/ registration clinics, out-
patient departments at industrial facilities and offices, emergency aid
centers and a wide publication of data on their mode of operation,
anonymous and commercial treatment centers for drug addicts;
extensive adoption by drug-abuse monitoring services of the
achievements in the medical science, psychology, pedagogy, pharmacy, and
special-purpose technology;
modernization of drug-abuse monitoring services, improvement of
material supplies and provision of the necessary personnel.
The post-treatment rehabilitation measures should include: a) the
creation of purpose-oriented government-run and charity funds, ex-drug
abusers support funds and diverse forms of work with them; b) development
of rehabilitation methods based on the effective analysis of the existing
rehabilitation procedures and of qualification levels of the personnel; c)
psychological assistance to the former abusers' families, relatives, and
friends who must be taught the techniques of exerting favorable influence
on the patients.
Equally important is the organization of other anti-narcotics efforts
taken by public health institutions.
The health of the nation is an important element of the social and
economic development of a country. From this angle, the popularization of a
rational way of life, the cultivation of respect for human health as the
basic value of society ranks high among the priorities of medical
institutions.
Publicizing Information Against Drugs:
A skillful and persistent dissemination of knowledge about the
destructive impact of drugs and their detriment for the future generations
is a crucial activity of medical institutions in the struggle against
narcotics.
It is advisable to find a particular audience and do masterly
presentations. Lectures and discussions are not the only means of knowledge
dissemination. Meetings with former drug addicts and presentations about
broken human lives have also proved productive.
To increase the prophylactic effects of popularization, it would be
useful to train the instructors on the methods and tactics of campaigning
against narcotics, design a system of mass anti-narcotic education, based
on medical science, provide the necessary teaching aids, control and
stimulate this activity.
Organization of Control Over the Use of Narcotic Substances:
Public health institutions have responsibilities in exercising control
over narcotic substances under international conventions, treaties,
agreements and other forms of international cooperation in combating drug
abuse. As mentioned earlier, their primary responsibility is to control the
proper use of drugs, the correct taking of their stock, their storage,
distribution and removal. The issue of special prominence is the storage of
narcotic substances at medical institutions and warehouses and the
thwarting of attempts to misappropriate them. Inspections often expose
serious flaws in this field.
To rule out a possible abuse, leakage or misappropriation of drugs, the
following list of measures is essential:
guarding narcotic substance storage facilities, fitting them out with
new equipment and fire/break-in alarm systems connected to the central
control panel or to the 24-hour operational medical personnel or guards
mail;
proper protection of the points where drugs are stored in small
quantities for distribution as administered by the physicians;
tightened control over big-batch long-term storage facilities like the
warehouses of regional drug-store administrations, and strategic reserves
warehouses;
regular inspections at narcotic drug warehouses;
strict abidance by the rules of taking stock, storage and use of drugs
for medical purposes;
a timely exchange of information with the police on the above issues
and cooperation in drawing up the lists of drug storage facilities.
Experience suggests that a successful solution of the problem depends
on the depth of our insight into it. This is especially true of such a
complex issue as the treatment and rehabilitation of drug addicts
regardless of what stage they are at. That is why the fullest and the most
objective information is essential for the medical and other institutions
to organize a counter-offensive against drug abuse. With that goal in mind,
public health centers should adhere to the following organizational
guidelines:
gathering and analysis of information on the conditions of drug
addicts, tendencies in and results of their treatment and rehabilitation,
and types and means of using drugs and the impact they have;
interaction with other institutions and departments in concrete forms
of anti-narcotics activities in such large-scale operations as Poppy and
Doping, in check-ups and research;
control surveys prepared by the narcology service.
Organizational support for these guidelines could be achieved through:
Страницы: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23
