Drug addiction is a worldwide disaster. Drug addiction is a disease that is formed on the basis of the use of substances that cause persistent addiction. A person who wants to get a dose of euphoria, pleasant relaxation, ultimately acquires an irrepressible craving for drugs.

Taking the next dose, the addict brings himself as a gift and a number of psychotropic effects. In case of non-receipt of the necessary drug substance, a person is visited by painful symptoms at the physical and mental level. To return a person to a normal state, a comprehensive treatment of drug addicts is required.

Home drug addiction treatment is possible only with a mild degree of addiction

Treatment of drug addiction at home, according to narcologists, is quite realistic and feasible. But this requires the fulfillment of the following conditions:

1. Awareness of the addict of his problem.
2. Treatment must be carried out with the involvement of a psychotherapist. Moreover, the doctor can also come to the patient's home.

Drugs are very insidious substances. To defeat them and cope with addiction, desire alone is not enough. The qualified help of specialists is also required.

The first and main step on the way to a healthy "clean" life is having your own desire to heal and understanding the problem at hand.

Drug addiction is a chronic disease. As with every similar pathology, in this case, there are periods of remission and exacerbation. Even if the person completely stopped using drugs, his brain biochemistry underwent a major change. Therefore, a relapse can come at any time.

Addiction is a chronic disease

But with a competent approach, knowledge of how drug addicts are treated, remission can last the rest of a person's life. It should be borne in mind that not only specialists, but also all family members take part in the treatment of a drug addict.

Benefits of home treatment

Addiction is the hardest problem of all modern world... According to statistics, there are about 1.6 million people in Russia who constantly take drugs (this figure does not include individuals who use soft drugs). How to cure drug addiction if there is no desire to send a person to a drug dispensary?

Experts say that home treatment is quite acceptable for milder forms of drug addiction. Moreover, this approach to therapy has a number of undeniable advantages:

1. A person is more willing to be treated at home. After all, this is a familiar atmosphere, familiar and loving people next to you, who will always come to the rescue and provide support. In such a difficult situation, it is extremely important for the patient to feel that he is not alone.
2. After a complete detoxification and cleansing of the body of all metabolites of the drug, the person will need rest. And it can only be achieved in a familiar home. Providing a calm and peaceful atmosphere is much easier for the patient to endure withdrawal symptoms.

But still, one cannot do without the presence of a narcologist. In modern practices of drug treatment, a doctor can be called at home. This is necessary for detoxification therapy. A visit to a doctor is a prerequisite for competent home treatment for drug addiction.

Drug addiction goes back to the distant past

Calling a narcologist at home is also convenient because transporting a drug addict to a hospital requires a lot of effort, coupled with nerves and anxiety. And home treatment does not require such an expense. Strength will still be needed by relatives and the addict himself during rehabilitation.

Treatment of drug addicts at home: where to start

With persistent drug addiction after refusal to take a dose, the patient begins the most difficult time. Withdrawal syndrome comes ("withdrawal", as drug addicts call it). The emergence of painful symptoms is formed on the basis of the body not receiving the next dose of the drug.

After all, the drug has already become an active participant in metabolic processes. In its absence, a global violation of all metabolic processes occurs and a person experiences a number of painful symptoms:

• tachycardia;
• hallucinations;
• increased blood pressure;
• delusional states;
• excruciating migraines;
• convulsive syndromes;
• nausea, vomiting;
• severe joint pain;
• heat exchange problems (fever, chills, fever).

The sad result of this condition (if no assistance is provided to the patient) can be a fatal outcome. Such cases are far from rare, given the weakening of the body by prolonged use of drugs.

External signs of drug addiction

In order to prevent an extremely undesirable outcome and remove unbearable suffering, the patient needs to cleanse the body. This is where drug addict treatment begins. Understanding how to cure a drug addict, we can say that the first thing to do is to save a person from death, that is, to carry out detoxification, which consists in:

1. Relief of withdrawal symptoms.
2. Elimination of drug metabolites from the body.
3. Removal of the strongest psychological and physical shock.

Do folk methods help

Can it help in drug addiction therapy? folk recipes? If drug addiction is developed in a person at a severe stage, then folk recipes are unlikely to cope with addiction. It is worth trying to use them if the person is not yet very addicted to drugs.

In medical terminology, there is no expression "recover from drug addiction." This disease is chronic, and it is almost impossible to recover from it. If a person has completely stopped taking drugs, doctors talk about "long-term remission."

When treating long-term drug addiction, there is a very high risk of returning to the previous state and resuming the addiction. Therefore, you should still prefer a good drug treatment clinic, especially if the drug addiction continues for a long time.

Home drug addiction treatment is feasible only in the early stages of addiction

As for mild drug addiction, you can try to cope with the disaster at home. For example, use the recipes of healers. Of the most effective methods you can advise one healing tincture. To make it, the following herbs should be mixed in equal amounts:

• mint;
• horsetail;
• tansy;
• succession;
• sage;
• Oak bark;
• calendula;
• motherwort;
• yarrow.

The herbal mixture must be steamed with boiling water (at the rate of 200 ml of water per 3 g of raw materials). Then leave to infuse for 10-15 minutes. The drug should be taken three times a day, 100 ml on an empty stomach.

But you should not limit yourself to folk ways of helping someone suffering from drug addiction. They are not enough to overcome addiction. There are a number of other actions that need to be taken. The advice of a professional psychologist will be of great help. Moreover, they should be used both by the patient himself and by those close to him.

What is a drug addict

Be sure to find a replacement for your old hobby. This is necessary to distract from the thoughts that periodically visit the desire to take the dose again. What kind of occupation it will be, it does not matter - sports, floriculture, knitting, modeling, drawing. The chosen hobby needs to be developed and improved in it.

Remove from your field of vision and communication all the former environment. This should be done, especially if friends and acquaintances also used drugs. In this case, the risk of plunging back into the drug world is too great. It is very easy to be seduced by the suggested dose, but it is much more difficult to leave the dope.

For a family, having a drug addict is a heavy burden that brings with it shame, financial loss, disappointment, pain, anger. This daily experience is literally maddening. But, if hope for recovery loomed on the horizon, every effort should be made to save the person and pull him out to a normal life. What should be done for this?

1. Study all the information regarding the condition of the addict. Remember that this is a serious illness and the person should be treated like a seriously ill person who needs care and attention. But for this, you should know everything about the type of drug addiction with which you will have to fight: causes, symptoms, consequences, dynamics of development. This knowledge will help with treatment.
2. Any financial aid is taboo. A drug addict always needs money. And she will try to get them by any means: volunteer to go to the store, pay for the communal apartment, whatever. When dealing with drug addiction, never entrust a patient with financial matters. The risk is too great that the money will be spent on the purchase of the next dose.

But do not lock the sick person into your own experiences. Communicate with him more often, explain and talk about his condition. The only thing that cannot be done is to talk with the patient in a raised, accusing tone. Tantrums and relationship litigation will play a bad role in reducing attempts to return a person to healthy life to zero.

What are the types of addiction

But remember that the addict may not want to go into the conversation. Then you should leave communication for the next time. If contact does not work at all, you should discuss compulsory treatment drug addicts. Do not forget that it is almost impossible to defeat drug addiction at home.

Compulsory treatment

In some cases, it is impossible to avoid the forced placement of a drug addict in a dispensary. Measures that are applied at home, family members and even visiting doctors are sometimes not enough.

The only effective and efficient way to help a person cope with drug addiction is professional treatment provided by specialists from drug clinics.

But what is the best way to do this? The intervention of the drug treatment team should be organized in places where the addict feels most comfortable and safe. Do not try to block his path, block the exits. Better to have an experienced psychotherapist present who can calm the person down and persuade him to “give up”.

But no matter what kind of struggle you tune in and what tactics of therapy you take - home treatment or compulsory, get ready for the fact that the battle for a person will be long and difficult. The result can only be achieved with perseverance and patience.

Medical care for patients with drug addiction and substance abuse is carried out by outpatient and inpatient units of the narcological service. The narcological service is a network of specialized institutions that provide treatment and prophylactic, medico-social and medico-legal assistance to patients with alcoholism, drug addiction and substance abuse. Has a hospital, a semi-hospital and an outpatient department.

The main institution-center of the service is a dispensary, the tasks of which include: early detection of patients, treatment-diagnostic, consultative and psycho-preventive work; dynamic dispensary observation of patients; study of the incidence of alcoholism, drug and substance abuse, analysis of the effectiveness of medical and preventive care; social assistance to the sick; psychological and preventive work, etc. etc. The dispensary operates on a local basis. Persons suffering from alcoholism, drug addiction and substance abuse are registered in the dispensary. A successful outcome of self-medication is extremely rare.

Specialized care is based on the principle of the earliest and most complete detection and treatment of patients, an individualized approach, taking into account the characteristics of the patient's personality and the course of his disease; compliance with the continuity of inpatient and outpatient treatment, its stages depending on the patient's condition; unity of drug, psychotherapeutic and rehabilitation treatment.

Outpatient drug treatment is the main type of care for patients with alcoholism, drug addiction and substance abuse, it includes primary and secondary prevention of this pathology. Implemented given view medical care in the narcological dispensary, or in the narcological offices of the Central regional hospitals.

The narcological dispensary has a full-time psychiatrist-narcologist who provides assistance to children and adolescents who abuse alcohol, narcotic and toxic substances. Adolescents are registered at dispensary and preventive care until the age of 18, and then they are transferred under the supervision of narcologists who serve the adult population. The main task of the adolescent drug treatment room is preventive work in schools, secondary specialized educational institutions and vocational schools.

The teenage narcologist works in close contact with the juvenile affairs inspectorate and the relevant commissions, the parents of adolescents who are observed in the office, and school teachers. This specialist is trained not only in narcology, but also in child and adolescent psychiatry. The staff of the adolescent office has a psychologist who, in addition to a special psychological examination of adolescents to clarify the diagnosis, conducts psychocorrectional work with children and adolescents.

Patients are hospitalized in specialized departments. Hospitalization ensures the isolation of patients and excludes the receipt of narcotic substances. General principles therapies include:

• - preliminary stage (carried out in a hospital) - detoxification, restorative, stimulating therapy in combination with the termination of the drug intake;
• - the main active anti-drug treatment;
• - supportive therapy (carried out on an outpatient basis, necessarily includes psychotherapy).

All patients with drug addiction and substance abuse, as well as patients who are re-starting drug addiction treatment, are subject to hospitalization.

Addiction. Narcotic substances, their effect on humans, classification

The abuse of narcotic drugs and illicit trafficking in them in recent times in many, especially developed countries of the world, have taken catastrophic proportions. The official press of the USA, Germany, France, England, Sweden almost daily abusively reports on the death of their victims by psychotics as a result of the follow-up. captured even adolescents in many countries.

The widespread prevalence of drug addiction in developed countries is largely a consequence of the social conditions that exist there, namely: unemployment, uncertainty about tomorrow, daily stress, a difficult mental state, the desire to get doping, which creates the impression time lapse to get away from the surrounding reality.

Along with the already well-known narcotic drugs, over the past 10 years in many countries the number of drug addicts who use the so-called psychotropic drugs has increased. In this respect, amphetamines and glucinogens, LSD and other derivatives of lysopergic acid, in contrast to psychoactive , medical and representing an exceptional danger to humans.

The International Antinarcotics Center in New York named the approximate number of drug addicts around the world; the figure turned out to be terrible: a billion addicts! At the same time, one cannot fail to mention that in our days drug trafficking has become one of the most terrible forms of exploitation of man by man, one of the most terrible crimes against mankind.

What is a "drug"? Based on the definition given by the World Health Organization, a drug should be any substance (with or without legal use in medicine) that is abused for purposes other than medical ones.

Scientists, trying to penetrate into the mystery of dope, are overwhelmed by the extraordinary virulence of drugs that can sink into the very depths of the feelings and thoughts of their consumers. The lengthy and in-depth research carried out by generations of scientists has not been fruitless. The poison, hidden in most "heavenly" drugs, was revealed. Back in the 60s, experts established that excessive use of glucinogenic substances causes mental disorders, severe pathological conditions. The physiological properties of drugs, involved in a complex chemical process occurring in the human body, have an attractive force and force the victim to turn to them repeatedly or continuously after the addiction or addiction has firmly entered into its own. Narcotics, depending on their effect on the human body, can be conditionally divided into two large groups: 1) exciting; 2) causing depression. It should be borne in mind that each of the drugs has a large variety of hidden properties that affect the nervous system in different ways.

There are drugs that calm and anesthetize (they are called depressed), and there are others that have a stimulating effect, stimulating the body. Hallucinogenic drugs cause ecstasy and rampage, nightmares or excruciating anxiety. Moreover, each of these substances, even the most dangerous from the point of view of abuse, can have a healing, beneficial effect, but only if it is used absolutely correctly.

Indian hemp, coca leaves, poppy seeds are considered some of the most ancient natural narcotic substances. Opium and its derivatives: morphine, heroin - have an analgesic effect and eliminate the state of anxiety and fear, reduce, often to complete disappearance, the feeling of hunger and thirst, weaken libido, lower urine output, plunge a person into a drowsy state or, in the case of heroin, into a riot. In a similar respect, hashish, marijuana and other derivatives of the Cannabis savita plant in the Indian or American version stand out. Cocaine usually causes the most violent reactions, usually accompanied by hallucinations or strange euphoria mixed with paranoid impulses. At times, the kinogenic nature of this drug gives rise to violence and stimulates human mental activity. In the 60s, LSD, lysergic acid diethylamide, a semisynthetic substance derived from lysergic acid, extracted from the rye ergnum, appeared on the horizon. LSD, far from the last descendant of the drug family, has paved the way for even more potent drugs. To understand the danger posed by such an explosion of drugs, recall that it is enough to take a millionth of a gram of LSD per kilogram of weight to make him hallucinate.

The state of addiction is characterized by three properties: 1) an irresistible desire or need to continue to take drugs and get them by any means; 2) the desire to increase the dose; 3) dependence of a mental and sometimes physical nature on the effects of a drug.

The so-called addiction syndrome occurs only as a result of taking a narcotic drug, regardless of whether it happens by accident or after systematic use. The stages of this process, proceeding more slowly or more quickly, are basically the following:

• 1) Initial euphoria, often very short-lived. It is characteristic for certain narcotic substances (especially morphine and opium), and not for all drugs. In such a state of increased irritability, fanciful and often erotic visions, a person loses control over himself ...
• 2) Tolerance is temporary. This phenomenon is explained by the reaction of the body to the action of the same dose of the substance, taken repeatedly. Gradually, the body reacts weaker.
• 3) Addiction. Most researchers have come to the conclusion that addiction is both physical and mental. It is expressed by the classic symptoms of abstinence, or "withdrawal", which the addict carries very hard and with the risk of severe organic or functional symptoms.
• 4) Withdrawal (withdrawal syndrome) usually occurs 12-48 hours after stopping the drug. The addict cannot tolerate this condition, which causes him nervous disorders, tachycardia, spasms, vomiting, diarrhea, salivation, increased secretion of glands. At the same time, there is an obsessive desire to find a toxic substance - a drug - at any cost! Abrupt "withdrawal" of the addict leads to violent and extremely dangerous manifestations, which in some cases can cause real collapses, as it happens with morphinists. This is a type of terrible delirium tremens - a white heat, in which the alcohol is consumed by itself ... a state of acute need in the poison, which has become a necessary factor in internal processes.

We now turn to the classification of addictions. Let's take a classic division developed by experts from the World Health Society. So, all drugs and their actions are divided into the following groups.

• 1) Sedative poisons that calm mental activity. They reduce up to the complete elimination of the functions of excitability and perception, misleading a person, presenting him with a bouquet of pleasant states. These substances (opium and its alkaloids, morphine, codeine, coca and cocaine) change brain functions and are classified as Euforica.
• 2) Hallucinogenic drugs, represented by a large number of substances of plant origin, are very different in their chemical composition... These include mescaline from cucktus, Indian hemp, hashish and other tropein plants. All of them cause cerebral excitement, expressed in the deformation of sensations, hallucinations, distortion of perceptions, visions, and therefore they are classified as Fantastica.
• 3) These include substances that are easily obtained by chemical synthesis, causing first cerebral excitement, and then deep depression. Such media include: alcohol, ether, chloroform, gasoline. This category is Inebrantia.
• 4) Category Hypnotica, which includes sleep poisons: chloral, barbiturates, sulforol, kava-kava, etc.)
• 5) Excitantia. Here plant substances predominate, stimulating brain activity without immediate effect on the psyche; the force of impact on different persons is different. This includes plants that contain caffeine, tobacco, betel nut, and others.

In most countries involved in the fight against drugs, only a small part of the production is controlled, that is, drugs included in the list of prohibited drugs, so diverse in their properties that cause addiction. The stages of drug addiction lead ever lower, defining the aggravation of the disaster, which, as the experiments of the World Health Organization emphasize, is a great threat to public health on a global scale. This danger increases as more and more new types of manufacturers and laboratories strong and harmful.

Medical care for those suffering from drug addiction and substance abuse is provided, as a rule, by outpatient and inpatient units of the narcological service. Narcological service is a method drug and substance abuse treatment, as well as a set of specialized organizations that provide treatment-and-prophylactic, medico-social and medico-legal assistance to patients with alcoholism, drug addiction and substance abuse. There is also a hospital, a semi-hospital and an outpatient department.

The main institution-center of the service can be called a dispensary, which conditions the early diagnosis of patients, treatment and diagnostic, counseling and psychoprophylactic work; carries out dynamic dispensary observation of patients; analysis of the incidence of alcoholism, drug addiction and substance abuse, research on the effectiveness of medical and preventive care; provision of social assistance to the sick; psychological and preventive work, etc. A similar dispensary functions according to the district principle. People who suffer from alcoholism, drug addiction and substance abuse are assigned to the dispensary. A successful outcome of self-medication is observed in very rare cases.

It should be noted that drug and substance abuse treatment outpatient type of drug treatment is becoming the main type of care for those suffering from alcoholism, drug addiction and substance abuse, it consists of primary and secondary prevention of such a pathology. This type of medical care is carried out in the narcological dispensary, or in the narcological rooms of the Central regional hospitals.

The narcological dispensary includes a full-time psychiatrist-narcologist, who is designed to provide assistance to children and adolescents who are addicted to excessive use of alcohol, drugs and toxic substances. Teenagers, as a rule, are under dispensary and preventive care until they reach the age of 18, and subsequently they are transferred under the supervision of narcologists who treat the adult population. The main task of the adolescent drug treatment room is to carry out preventive work in schools, secondary specialized educational institutions and the Vocational Technical School.

The adolescent narcologist is in close cooperation with the juvenile affairs inspectorate and the appropriate commissions, parents of adolescents who are under observation in the office, and school teachers. Such a specialist is well trained not only in narcology, but also in child and adolescent psychiatry. There is a psychologist on the staff of the adolescent office who, in addition to a special psychological examination of adolescents, conducts psychocorrectional work with children and adolescents to confirm the diagnosis.

Addicts and drug addicts doctors-narcologists are placed in specialized departments. All initially established drug and substance abuse patients, as well as patients undergoing repeated drug addiction treatment, are subject to hospitalization. Hospitalization helps to isolate patients, which prevents the acquisition of drugs. Addiction and substance abuse treatment is carried out according to the following principles:

1) the initial stage (carried out only in a hospital) is a detoxification, restorative, stimulating therapy in combination with the termination of the use of a narcotic substance;

2) basic active anti-drug treatment;

3) supportive therapy (carried out on an outpatient basis, certainly includes a conversation and treatment with a psychiatrist).

Substance abuse is caused by a pathological craving for the use of toxic substances, which, according to the existing legislation, are not prohibited. From a medical point of view, there is no difference between

This disease and drug addiction, since in both cases, a persistent physical and mental dependence is formed. In substance abuse, toxic substances are consumed by inhalation, that is, by inhalation through the mouth or nose. Their absorption occurs almost instantly. The danger of substance abuse lies in the extremely negative effect of toxins on the human central nervous system, liver, kidneys and other organs. If such a problem is found, voluntary and compulsory treatment is possible, which is carried out mainly in a hospital, but in some cases therapy at home is also allowed.

Therapies

The treatment of drug addiction and substance abuse should begin with diagnostic measures. Evaluation of the patient's neurological, mental and somatic state is of paramount importance in this matter. To establish the fact of the use of a toxic substance allows the method of gas-liquid or thin-layer chromatography. At the same time, a single use of the drug does not give grounds for the diagnosis of "substance abuse". The patient should also show signs of mental dependence, manifested in an irresistible craving for drug use, as well as physical dependence, characterized by the occurrence of withdrawal symptoms when the intake of toxic substances is canceled.

Today there are specialized clinics in which you can undergo complex treatment of substance abuse, including compulsory treatment. The existing types of therapy used for this addiction are divided into two main groups: etiological and pathogenetic.

Etiological treatment involves the use of techniques that completely eliminate the causes of pathological dependence. This means that it is necessary to completely eliminate the effect of toxic substances on the body, depriving the patient of access to inhalants. In parallel, psychological and psychotherapeutic work is carried out with the patient, helping to identify the social and psychological factors that have become the starting point for the development of the disease.

Pathogenetic treatment is directly related to the patient. The doctor makes individual program, in accordance with which the patient begins to treat. First of all, toxins and their decay products are removed from his body with the help of medicinal and biological methods... In parallel, symptomatic therapy is carried out, as well as treatment aimed at combating the negative consequences of substance abuse. In severe cases, efferent therapy is prescribed. This can be hemodialysis, plasmapheresis, hemofiltration, etc.

Stages

It is necessary to treat substance abuse, like any other pathological addiction, in a comprehensive manner using detoxification methods and competent psychotherapy. After the removal of intoxication and relief of drug withdrawal, an appropriate correction of the patient's somatic and mental disorders is carried out. Rehabilitation of patients is equally important. So, the treatment of addiction to toxic inhalants includes the following steps:

It is recommended to carry out the first two stages in specialized clinics, especially if the treatment is compulsory. The subsequent stages are carried out on an outpatient basis. Detoxification is also possible at home. Toxic substances are removed from the patient's body by means of drip administration of drugs. Further rehabilitation is recommended to take place in a hospital, since in order to avoid breakdowns and complications, the patient needs constant monitoring, and access to drugs should be completely limited.

Substance abuse treatment begins with detoxification. The purpose of the treatment is to eliminate toxic substances from the patient's body. The procedure provides for the elimination of not yet absorbed poisons, restoration of water and electrolyte balance and maintenance of such vital functions as respiration, blood circulation, etc. Also, the removal of already assimilated poisons is carried out using methods that are selected individually.

Removal of the phenomena of intoxication is carried out using standard drugs (vitamins, glucose, blood substitutes). Along with them, drugs from the group of nootropics can be used. If substance abuse is associated with the use of sleeping pills or sedatives, their substitutes are used, since a sharp decrease in the dose can lead to acute manifestations of withdrawal symptoms. So, the dose reduction occurs very gradually - by about 10% per day. If the patient has psychoses, antipsychotics are prescribed and sedatives, which also have a good supportive effect in correcting behavioral disorders and overcoming pathological cravings for drugs. It is recommended to treat the manifestations of withdrawal symptoms with the help of appropriate medications and physiotherapy, as well as acupuncture, which together give a good effect.

In the course of detoxification of the body, the issue of complete restriction of access to narcotic substances becomes fundamentally important. In most cases, it is recommended to stop using intoxicating substances abruptly, replacing them with appropriate drugs. Unlike mental addiction, which can persist for years, physical addiction can usually be stopped in a few days. A gradual decrease in the dose of substances consumed by a toxicomaniac is advisable only in the case of severe dependence, in which there is a risk of developing life-threatening complications with withdrawal symptoms.

Elimination of the consequences of poisoning

Since with prolonged use of toxic substances literally all organs of the body suffer, after detoxification measures, it is necessary to correct the disorders caused by drugs. Treatment at this stage is prescribed on an individual basis with the help of pharmacological agents and physiotherapeutic procedures prescribed as needed, depending on the patient's disorders.

In the complex treatment of substance abuse, various biophysical methods can also be used. These include electrostimulating treatments, reflexology, etc. practically at all stages of the treatment of substance abuse, physiotherapeutic procedures are prescribed, which practically have no contraindications. It can be hydrogen sulfide baths, electrosleep, electrophoresis and others.

Psychotherapy

The hardest part in treating any form of drug addiction is overcoming mental addiction. Here, the main role belongs to educational therapy - group or individual psychotherapy, etc. In the course of psychocorrection, group discussions are held, the main purpose of which is to form in patients a negative attitude towards drug addiction, a clear understanding of the whole essence of the disease and the harm it causes to the body. The sessions also practice behavioral responses in high-risk situations.

Family therapy is no less important, because a relative suffering from substance abuse is a huge stress for family members. An experienced psychotherapist helps to establish family relationships and create a comfortable atmosphere. Individual psychotherapy assists patients in creating motivation to conduct healthy way life, as well as practicing positive self-regulation skills.

During the rehabilitation period, the doctor may recommend taking various herbal remedies as additional means that normalize the patient's condition and neutralize the negative phenomena of the main therapy. Decoctions and infusions of medicinal herbs will help normalize the psycho-emotional background and improve well-being. Beneficial effects are also seen with the use of aromatherapy.

Treatment of drug addiction and substance abuse begins with a sharp withdrawal of the drug (the only exceptions are cases of abuse of sedative-hypnotics and the combination of other drugs with high doses of these drugs).

Withdrawal of the drug is carried out in stages.

The first stage includes relief of withdrawal symptoms and detoxification measures aimed at normalizing somatoneurological disorders and correcting mental disorders. At the second stage, treatment is aimed at the complete restoration of metabolic disorders, behavioral disorders and the normalization of the mental state (including sleep). The third stage of treatment consists in identifying the main syndrome of mental dependence and conducting targeted therapy. This refers to the definition of the psychopathological design of the pathological craving for drugs and the characteristics of its dynamics (periodic, constant), etc. The last, fourth, stage consists in determining the conditions for the occurrence of relapses of the disease in order to prescribe anti-relapse maintenance therapy. Particular attention is paid to the reasons for the exacerbation of the craving for drugs. Situations and factors that cause the actualization of attraction are determined, including endogenous factors that lead to spontaneous actualization. The first two stages are usually carried out in a hospital setting, the third and fourth - on an outpatient basis.

Since chronic intoxication with narcotic drugs causes an imbalance in certain neurochemical systems of the brain, therapy should be aimed at restoring this imbalance, i.e. on the use of pathogenetically grounded therapeutic agents in combination with traditional methods of detoxification and psychotropic drugs.

Pathogenetically based therapy is naturally determined by the chemical structure and mechanism of action of the drug, as well as the structure of the clinical syndrome.

The most effective means of stopping opium withdrawal sivdroma are clonidine (clonidine), an a2-adrenergic receptor agonist in the central nervous system, tiapride (tiapridal), an atypical neuroleptic from the group of substituted benzamines, and tramal (tramadol hydrochloride), a centrally acting anesthetic. Complex application These drugs allow you to most effectively stop the main manifestations of withdrawal symptoms.

Clonidine therapy begins on the 1st day of withdrawal and continues for 5-9 days, gradually decreasing the dose. The initial daily dose of the drug taken orally should not exceed 0.6-0.9 mg for 3-4 doses. Clonidine most quickly and completely relieves somatovegetative disorders, to a much lesser extent affecting psychopathological and algic symptoms. Side effects of the drug include dry mouth, pronounced sedation, lowering blood pressure. In the case when blood pressure falls below 90/60 mm Hg, the dose of clonidine is reduced and cardiotonic drugs are prescribed (cordiamine, caffeine, etc.).

Tiaprid is highly effective against algic syndrome, psychopathic and affective disorders. Treatment is carried out according to the following scheme: tiapride is administered intramuscularly at a dose of 200 mg 3-4 times a day for the first 3-4 days, then during the next day the dose is reduced to 100 mg.

Tramal is prescribed in the first days of drug deprivation with a pronounced pain syndrome: 2-4 ml (100-200 mg) of tramal intramuscularly

3 times a day, then switch to oral administration of 50-100 mg 3-4 times a day, gradually reducing the dose as the intensity of the pain syndrome decreases. In the presence of joint pain, pheninbutazone (rheopyrin), ibuprofen (brufen) are also used, as well as warm baths, massage, etc.

For the relief of opium withdrawal syndrome, hemineurin (chlormethiazole, dextraneurin) can be used, which normalizes the function of the catecholamine system. Hemeineurin has an impact on disorders such as persistent insomnia, psychopathic disorders, and anxiety. Treatment with hemineurin begins with the onset of the initial signs of opium withdrawal syndrome. The drug is prescribed in capsules of 300 mg orally. On average, a single dose is 600-900 mg, daily - from 1800 to 3900 mg, in most cases - 2700 mg (in 3-4 doses). The duration of the drug intake is 3-6 days. Of the side effects, it is possible to note the rarely occurring feeling of weakness, weakness, and headache. This symptomatology stops after dose reduction. The most expedient use of this drug in patients with opium addiction, complicated by the use of barbiturates or other sedatives, since, due to its anticonvulsant component, hemineurin, in addition to relieving the above symptoms, reduces the likelihood of convulsive seizures during the period of withdrawal. In these cases, it is important that under the influence of hemeneurin, sleep disturbances are eliminated, which with opium withdrawal are extremely painful for patients and do not respond well to therapy.

To relieve opium withdrawal symptoms, they resort to a combination of opiate antagonists (naloxone, naltrexone) with clonidine. Naloxone accelerates the release of opium metabolites from receptors, which reduces the time for relief of withdrawal symptoms to 5-6 days. In the first days of therapy, the maximum doses of clonidine (0.9-1.2 mg) and the minimum doses of naloxone hydrochloride (0.2 mg) are prescribed, then the doses of the first are gradually reduced and the doses of the second are increased (up to 1.8 mg / day). so that by the end of the course of therapy, the patient receives only naloxone.

One of the promising directions in the treatment of opium addiction is the use of neuropeptides [Voronin KE, 1993]. Among them are cholecystokinin (pancreozymin), which is close to it in its pharmacological action, tacus (ceruletide), as well as a peptide that induces delta sleep (PVDS).

Takus is a decapeptide isolated from the Australian amphibian and subsequently synthesized. To relieve opium withdrawal syndrome, it is administered intravenously slowly (the dose is determined per 1 kg of the patient's body weight). Apply a solution of the drug in ampoules (in 1 ml

5 mcg). The average single dose is 3.5-4 mcg, the daily dose is 9-10.5 mcg. The contents of one ampoule are dissolved in 10 ml of isotonic sodium chloride solution. This dose is based on 100 kg of body weight. Then, depending on the patient's body weight, 1 ml is poured out for every 10 kg of the patient's body weight and isotonic sodium chloride solution up to 20 ml is added.

Tacus therapy is usually started on the 1-2 day of the development of withdrawal symptoms, when the patient develops pain in the muscles, joints, headache, weakness, lethargy, weakness, lack of appetite, diarrhea, lacrimation, sleep disturbances and other specific signs of this condition. Functional dysfunctions are also observed during this period. nervous system- changes in tendon reflexes, nystagmus, mydriasis, dynamic and static ataxia, etc.

15-20 minutes after the administration of tacus, the majority of patients show a marked improvement in their general condition. The effect of a single injection of the drug lasts about 4-5 hours, so 2-4 injections are usually required per day. The total duration of the course of treatment with tacus is from 1 to 6 days (depending on the patient's condition, an average of 3 days), but the main manifestations of withdrawal symptoms usually stop by the 2nd day. Only asthenic phenomena and neurological disorders remain, which are eliminated in the following days.

Among the side effects of tacus treatment in rare cases (mainly with the first injections), there are nausea, vomiting, sweating, a feeling of heat, stomach cramps that develop during the administration of the drug. They can be avoided by slower administration of the drug and a decrease in its concentration in the injected solution.

For the relief of opium withdrawal syndrome, slow intravenous administration of cholecystokinin is also used. The drug is prescribed per 1 kg of the patient's body weight. Before administration, the contents of one bottle are dissolved in 15-20 ml of isotonic sodium chloride solution. A single injection of the drug gives an effect within 5-10 hours. Usually 2-3 injections of cholecystokinin are required per day. The duration of treatment is from 2 to 6 days - an average of 4 days. The main manifestations of opium withdrawal syndrome (chills, joint pain, sweating, etc.) usually stop by the end of the 2nd day of treatment, and only asthenic disorders remain (weakness, lethargy, weakness, increased fatigue, etc.). Among the side effects should be noted rarely occurring nausea, vomiting, sweating, dizziness, fever, stomach cramps that develop during drug administration. However, in most cases, they are observed only with the first injections of cholecystokinin, and they can be avoided by increasing the time of administration or by decreasing the concentration of the drug in the injected solution.

For the relief of opium withdrawal use pyrroxan, which has adrenergic blocking properties [Pyatnitskaya IN. et al., 1974]. To relieve acute withdrawal symptoms and suppress the pathological craving for drugs, pill forms of pyrroxan (0.015 g in 1 tablet) are prescribed in large dosages: 0.03 g (2 tablets) 4-5 times a day or 0.45 g (3 tablets) 3 once a day. But it helps to reduce blood pressure, therefore it is contraindicated in severe atherosclerosis, coronary insufficiency, chronic cardiopulmonary syndrome, cerebrovascular accident, blood diseases, pregnancy.

A.G. Hoffman et al. (1979) for the relief of opium withdrawal recommend the use of increased doses of atropine sulfate, believing that the introduction of atropine blocks the cholinergic system. In this case, the excess acetylcholine formed during the withdrawal of opiates is destroyed by cholinesterase. Subsequent administration of eserine removes the blockade of cholinergic systems, establishing a dynamic equilibrium of acetylcholine and cholinesterase, disturbed during withdrawal of opiates, and restores synaptic transmission in cholinergic synapses. Sympathicotonia in this case is replaced by vagotonia, contributing to the elimination of withdrawal symptoms. For this purpose, 2-3 ml of a 1% solution of atropine sulfate is injected intramuscularly. At the same time, 0.25% eserine ointment is placed in the conjunctival sac, and the mucous membrane of the mouth is smeared with vaseline oil. After 1.5-2.5 hours from the moment of administration of atropine, 2 ml of a 0.1% solution of physostigmine (eserin) is injected subcutaneously. After the development of atropine delirium, withdrawal disorders, primarily autonomic disorders, quickly reverse development and sleep occurs. The next day, patients complain mainly of general physical weakness, a slight decrease in appetite.

For the treatment of opium addiction abroad, buprenorphine is widely used, which is a partial antagonist and partial agonist of opioid receptors. In small doses, this drug has a more pronounced antagonistic effect, and in large doses, it is agonistic. Buprenorphine has similar effects to other opiates and cross-tolerance to them.

1988]. Having a slight antagonistic effect on opioid receptors, the drug is able to stop clinical manifestations, characteristic of morphine intoxication, and due to its partially agonistic effect, it relieves acute manifestations of opium withdrawal syndrome. The latter served as the basis for the assumption about the possibility of using this drug for the treatment of patients with opium addiction. For the relief of acute manifestations of opium withdrawal syndrome, buprenorphine is administered intramuscularly, an average single dose of 1-2 ml (0.3-0.6 mg). The daily dose depends on the individual dosages of the drug used, the duration of anesthesia, and the patient's somatic state. The average daily dose is 3-6 ml (0.9-1.8 mg) for 2-3 injections. Due to its agonistic action, buprenorphine relieves the algic syndrome rather quickly. At the same time, somatovegetative symptoms are reduced, and emotional tension is relieved. However, the use of the drug can cause the development of addiction to it. In Russia, buprenorphine is not used.

In the United States and a number of Western European countries, methadone, a synthetic opiate agonist, is also used to treat heroin addiction. It relieves acute manifestations of opium withdrawal syndrome, is a means of substitution therapy with supportive anti-relapse treatment.

Methadone was synthesized in Germany during World War II. It was first clinically studied in 1946 in the United States at a Kentucky hospital, where it was used to treat withdrawal symptoms in patients with opium addiction. Almost 20 years later, American scientists W. Bole, M. Muz ^ apdeg (1965) developed a method of methadone substitution therapy for patients with heroin addiction, which was based on the following features of the drug: its prolonged action (it can have an effect within 24-36 hours , therefore, it is administered 1 time per day) and the possibility of ingestion, since it is produced in the form of a powder (there is also a liquid form, which is used mainly to relieve withdrawal symptoms). The initial dose of methadone is 30-40 mg / day. Doses can be increased by 10 mg every 2 days or every week until stable dosages are achieved without withdrawal symptoms. These stable doses range from 50 to 80 mg / day. At the beginning of the outpatient course

supportive care, patients visit the clinic every day, receiving a daily dose of the drug. Then the frequency of visits is reduced to 2-3 times a week. There are short-term methadone programs, when patients receive stable doses of the drug for 6 months, and long-term, when stable doses are prescribed from 6 months to 2 years.

In the late 1960s and early 1970s, studies were conducted on a more long-acting and methadone-related drug - levo-alpha-acetylmethadyl (LAAM), which can be administered not daily, but once every 2-3 days.

There are many supporters of methadone maintenance therapy who justify the need for the active development of methadone programs by the following circumstances: 1) since few patients themselves can stop using opiates, maintenance methadone treatment carried out by medical personnel contributes to the gradual return of patients to a full life; 2) substitution therapy with methadone significantly reduces the criminality of patients, since it eliminates the need to purchase drugs on the "black market", their theft from pharmacies, and reduces the number of clients of drug dealers; 3) since methadone is used orally, not intravenously, methadone substitution therapy is an important preventive measure for infectious diseases, primarily AIDS and hepatitis [Ba11 I.

E! a1., 1987; Spinger E. 1991; Bgaskeg E., 1995]. But at the same time, during methadone treatment, there is a risk that patients, along with this drug, will continue to use heroin, and this can lead to drug overdose [Ba11. GB., Kozh A., 1991; Kozh A., 1991]. The possibility of the formation of dependence on methadone is also possible. Substitution therapy with the latter, according to A.G. Hoffman (1994), is the replacement of one drug with another. In addition, methadone can cause complications. Patients on the specified treatment can trade in the drug and thus involve other persons in drug addiction. In Russia, methadone treatment is prohibited.

When treating patients who abuse drugs of the sedative-hypnotic group (mainly barbiturates), the dose of the drug is gradually reduced to exclude the possibility of the development of convulsive seizures and psychosis in the structure of the withdrawal syndrome. At the same time, on the 1st day, * / s DOSE of barbiturates taken by the patient is prescribed, followed by a decrease every day by * / s- It should be noted that patients often overestimate the doses of drugs taken, therefore, one must focus primarily on clinical picture and the behavior of patients. If the dose of barbiturates is relatively small, you can cancel them at once, and for the prevention of seizures and psychoses, prescribe replacement therapy: pagluferal (Sereisky's mixture), 1 tablet 2-3 times a day for 3-4 days, phenobarbital - 30 mg for each 100 mg of sleeping pills used by the addict, i.e. about * / W D ° zy. Only after a 2-day stabilization of the patient's condition at the selected dose of phenobarbital, it is gradually reduced until the drug is completely discontinued.

In cases where the patient hid the intake of sleeping pills or the dose of the drug was sharply reduced, seizures, deceptions of perception and psychomotor agitation may develop. In this case, it is necessary to enter the patient with an additional dose of the drug, which he abused. In order to avoid the development of seizures and psychotic disorders, detoxification measures should be carried out with caution.

When stopping withdrawal symptoms that develop in patients with barbituric drug addiction, substance abuse with sedatives (benzodiazepine tranquilizers, antihistamines, etc.), as well as polydrug addiction, including the systematic use of barbiturates or other sedatives, nice results were obtained using mildranate [Petrakova LB, 1992; Voronin KE, 1993]. Mildranate is a structural analogue of carmitine, its maximum concentration in blood plasma is reached within 2-3 hours. It is produced in capsules of 0.25 g or as a 10% solution in ampoules of 5 ml. It has an anticonvulsant and stimulating effect. Parenteral use of this drug from the first days of withdrawal syndrome (3-4 injections of 5 ml of 10% solution per day) prevents the development of convulsive phenomena inherent in barbituric withdrawal syndrome and relieves severe asthenic disorders characteristic of these forms of drug addiction (feeling of weakness, weakness, lethargy, etc.). The duration of treatment is on average 5-7 days. Side effects and complications were not observed [Voronin KE, 1993].

The optimal treatment regimen for the withdrawal syndrome in drug addiction caused by the use of psychostimulants is a combination of drugs that affect the dopaminergic mechanisms (bromocriptine), which primarily relieve the asthenic symptom complex and partly neurological disorders, and antidepressants that affect the serotoninergic system (fluvoxamine) (fluvoxamine). Bromocriptine (parlodel) is prescribed to patients in the first days of the development of withdrawal syndrome in a daily dose of 2.5-3.75 mg. After the relief of acute withdrawal symptoms, treatment with bromocriptine is continued, prescribing it for oral administration at 1-1.25 mg per day for several months to prevent possible actualization of pathological drug cravings and prevent relapses. Fluvoxamine is indicated when the main signs of withdrawal syndrome appear - decreased mood, apathy, weakness, lethargy, irritability. The average daily dose is 150 mg (for 3 doses). The duration of therapy is from 1 week to 2 months.

Simultaneously with the described pathogenetic therapy of drug addiction, detoxification and restorative treatment is carried out. For this purpose, a complex of various vitamins, especially of group B, is used: 6% solution of vitamin B [(thiamine) - 4-6 ml intramuscularly per day; 5% solution of vitamin B5 - 2-4 ml per day; 1% solution of vitamin PP - 1-2 ml per day. A 25% solution of magnesium sulfate is also used from 2 to 8 ml with 15-20 ml of a 40% glucose solution. Less commonly, intravenous administration of rheopolyglucin, hemodez, isotonic sodium chloride solution is used (in patients who inject drugs intravenously; in this case, there may be an exacerbation of pathological attraction to them).

For the relief of mental disorders present in the structure of withdrawal symptoms, it is recommended to use antipsychotics and antidepressants. Depending on the condition of the patients and the compatibility of these drugs with other drugs used to relieve acute withdrawal symptoms, antipsychotics and antidepressants are prescribed either from the first days or a few days after the start of therapy. The prescription of these drugs is most relevant when psychopathological disorders come to the fore. Doses of psychotropic drugs are selected individually.

When choosing antidepressants, preference should be given to drugs that, along with thymoleptic, have a sedative or balanced effect. Among antidepressants, amitriptyline is recommended - an average daily dose of 75-100 mg, herfonal (trimepramine) - 100-150 mg, anafranil (clomipramine) - 75-100 mg, pyrazidol - 150-200 mg, ludiomil - 75-100 mg, fluvoxamine - 150-200 mg, azafen - 100-125 mg, miansan (lerivon) - 60-120 mg. With more pronounced depression, amitriptyline is administered parenterally in 2 ml of 1% solution 2-3 times a day. Because depression in drug addiction is usually associated with dysphoria, anxiety, and motor restlessness, antidepressants are best combined with mild antipsychotics. Depending on the severity of anxiety, agitation, hypochondriacal disorders, and behavioral disorders in patients, you can prescribe melleril (sonapax) - 75-100 mg / day, teralen (alimenazine) - 15-20 mg / day, haloperidol - 4, 5-9 mg / day, neuleptil (periciazine) - 20-30 mg / day, eglonil (sulpiride) - 300-600 mg / day. The latter has antidepressant and anxiolytic effects. To correct affective lability and dysphoric disorders, lithium salts (0.6-0.9 g / day) are used, as well as carbamazepine (tegretol, finlepsin) - 600 mg / day.

After relief of acute withdrawal disorders at stages 2-3 of treatment, intravenous drip administration of melipramine (200-300 mg / day), amitriptyline (200-300 mg / day), ludiomil (75-100 mg / day) gives a high therapeutic effect. N.N. Ivanets, I.P. Anokhina, N.V. Strelets (1997) recommend prescribing the procedure in the evening. The entire daily dose is administered slowly over 1.5-2 hours. Subjective improvement in patients' well-being is noted after 1-2 procedures. A total of 7-10 procedures are performed. But in this case, it should be remembered that in patients who inject drugs intravenously, any additional intravenous injections can exacerbate the pathological craving for the drug. To suppress the latter, long-acting and short-acting antipsychotics are used. Among the drugs with prolonged action, the most effective are piportil L-4 (25-50 mg once every 2-3 weeks) and haloperidol decanoate; among short-acting neuroleptics - haloperidol (4.5-6 mg / day by mouth or 1-2 ml of 0.5% solution 2-3 times a day), tisercin (50-75 mg / day), stelazine (15-20 mg / day). You can also use carbamazepine (tegretol, finlepsin) and eglonil. Neuleptil (30-40 mg / day), Sonapax (100-125 mg) are also recommended to correct the behavior of patients, to relieve irritability and dysphoria.

With a pronounced asthenic symptom complex, in addition to other therapeutic agents, mild stimulants and nootropic drugs can be prescribed. However, it should be noted that in some cases, nootropics, in particular piracetam, contribute to the exacerbation of the pathological craving for the drug.

It should be noted the importance of the treatment of agripnic disorders characteristic of most drug addicts at the initial stages of treatment. Therefore, tranquilizers are added to the main complex of funds at night (phenazepam, rohypnol, reladorm, radedorm, seduxen, relanium, etc.). Sometimes it is advisable to use a combination of short-acting benzodiazepines (for example, diazepam or intramuscular rohypnol) with composite preparations, which include benzodiazepines and a small amount of barbiturates. However, such drugs, of course, should be prescribed with caution, and it is more preferable to prescribe antipsychotics with a pronounced hypnotic effect (leponex 12.5-25 mg), haloperidol, tizercin, chlorpromazine (in conventional doses intramuscularly). In severe sleep disorders, a combination of these antipsychotics with benzodiazepines can be effective.

The relief of mental disorders is most important in the second and third stages of treatment.

In cases of abstinence caused by abrupt withdrawal of cannabis drugs (marijuana, hashish), symptomatic remedies for relieving headaches, sleep disorders, decreased appetite, palpitations, irritability or apathy, etc. bromides with valerian and motherwort, meprotan, trioxazine, oxylidine, elenium, seduxen, chlorpromazine, tizercin at night, as well as iron preparations, belloid or bellaspon.

Therapy of inhalation substance abuse and abuse of hallucinogens is symptomatic.

In addition to drugs, reflexology (acupuncture), neuroelectrostimulation, extracorporeal detoxification methods, in particular plasmapheresis, are used to alleviate withdrawal symptoms. N.N. Ivanets, I.P. Anokhina, N.V. Strelets (1997) recommend carrying out two methods of plasmapheresis: discrete, when plasmapheresis is used starting from the moment the first signs of withdrawal symptoms appear and then repeated several times, and simultaneous, when the plasmapheresis procedure is carried out at the final stages of the development of acute withdrawal symptoms. GM Mitrofanova (1995) recommends plasmapheresis on the 5-7th day of therapy.

It is advisable to use physiotherapy methods, taking into account individual indications and contraindications.

Psychotherapy occupies a major place in the treatment of drug addiction. The first examination and the first conversation with the patient should be used as the first session of psychotherapeutic influence. Subsequent psychotherapeutic conversations should be aimed at achieving positive attitudes of patients for complete abstinence from the use of drugs and other drugs that cause painful addiction, as well as for the patient's systematic passage of courses of supportive anti-relapse treatment in an out-of-hospital setting. Special types of psychotherapy are carried out after the relief of acute withdrawal symptoms until the moment of discharge. Their goal is to develop an attitude towards abstinence from drugs.

Anti-relapse treatment. When using drugs of the opium group, one of the means of specific pathogenetic anti-contradictory therapy is naltrexone hydrochloride (naltrexone), an opium receptor antagonist. The mechanism of its action is the blockade of opium receptors, as a result of which the opiates taken by the patient do not cause their inherent effects. A prerequisite for the use of naltrexone in these cases is the preliminary complete relief of withdrawal symptoms. Naltrexone is taken by mouth at 350 mg per week. There are 2 schemes for taking it: 1) 1 tablet (50 mg) daily in the morning; 2) 2 tablets (100 mg) 2 times a week (for example, on Monday and Wednesday) and 3 tablets (150 mg) once a week (on Friday). The course of treatment is up to 180 days or more. Side effects(skin redness, chills, weakness due to individual sensitivity and incomplete detoxification) usually disappear during therapy. Orthostatic collapses may occur with alcohol overdose during therapy. When psychopathological symptoms of primary pathological craving for drugs appear, additional prescription of appropriate psychotropic drugs is required.

Bromocriptine and fluvoxamine can serve as pathogenetic agents of anti-relapse therapy of drug addiction caused by taking psychostimulants.

In addition to specific treatment programs, the entire spectrum of psychotropic drugs (neuroleptics, antidepressants, tranquilizers, nootropics, lithium salts, etc.) is widely used, which is determined by the clinical and psychopathological picture of the syndrome being stopped.

With the actualization of signs of a primary pathological craving for drugs, characterized by a persistent periodicity and a gradual or sudden development of affective disorders, lithium salts with the addition of antidepressants, if necessary, are the means of choice for therapy; with a predominance of asthenic disorders, nootropics are used: piracetam (nootropil) at a dose of 2-2.4 g per day, encephabol - 200-300 mg, gammalon (aminalon) - 1.5-3 g, picamilon at a dose of 0.02-0, 15 g per day; lithium salts: lithium oxybutyrate - 1-1.5 g, micalite - 2-3 capsules (0.8-1.2 g of lithium carbonate) per day, lithonite - 300-400 mg per day; antidepressants - amitriptyline, miansan, maprotil, floxiral, azafen, pyrazidol. The courses of treatment are from 2 to 12 months with interruptions from 2 weeks to 1 month.

In the presence of psychopathic disorders in the structure of the primary pathological craving for drugs, neuroleptics such as neuleptil (peritsiazine) at a dose of 10-20 mg, sonapax - 30-100 mg, teralen (alimenazine) - 15-75 mg per day, etc. mild antipsychotics is ineffective, prolonged forms of piportil or haloperidol are prescribed. Benzodiazepine tranquilizers (lorazepam, phenazepam, diazepam, chlordiazepoxide, alprazolam, etc.) are used to relieve symptoms such as anxiety, fear, anxiety. To stop "outbreaks" of actualization of pathological craving for drugs, it is advisable to use anticonvulsants - carbamazepine (finlepsin, tegretol), difenin, konvuleks.

An important place in anti-relapse programs should be occupied by psychotherapy and rehabilitation effects.