Government of MoscowMoscow 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.

Anti-drugs propagation in mass media

The second prevention:Socio-therapeutic intervention

(early identification and intervention)

Tertiary prevention:Medical rehabilitation programs for

different groups of patients

Isolation in ITU FSIN Russian Federation

and obligatory treatment

I level

Primary prevention:Detection of risk factors

Сourseware in the organized collectives

III level

II level

Y level

IY level

Narcological service

NARCOLOGICAL POPULATIONNARCOLOGICAL POPULATION

SOCIAL PRESSURESOCIAL PRESSURE

Obligatory and alternative treatment by court definition in

narcological establishment

SCHEME OF SOCIAL PRESSURE SCHEME OF SOCIAL PRESSURE ON NARCOLOGICAL POPULATIONON NARCOLOGICAL POPULATION

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 Dependence of annual remission on quantity of the passable stages of treatmentpassable stages of treatment

1-5% 15-2015-20% 25-3025-30% 40-5040-50%%

Treatment of psychopathological

frustration

Rapid relief of withdrawal syndrome

Psychotherapy programs

Rehabilitation programsIV

III

II

I

Remission duration after passing of rehabilitation or medical programs

0,00%5,00%

10,00%15,00%20,00%25,00%30,00%35,00%40,00%45,00%50,00%

6 months- 1 year1 -1,5 years

48,10%

40,70%

14,20%12,40%

rehabilitation

medical programm

Remission duration after Remission duration after rehabilitationrehabilitation(drug addiction)(drug addiction)

0,00%

10,00%

20,00%

30,00%

40,00%

50,00%

60,00%

70,00%

80,00%

3 months and more

6 months and more

1 year and more

2 years and more

3 years and more

4 years and more

43,40%

36,90%

31,10%

26,80%23,20%

12,50%

71,60%

59,70%

48,50%

31,90% 2006 y.

2012 y.

Remissions

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!