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Аддиктивное поведение: профилактика и реабилитация

Издатель: Московский государственный психолого-педагогический университет

Год издания: 2011

 
Полный текст

The prevention and treatment of addictive behavior and its concurrent disorders have long been studied, researched, written about, experimented with. There has been progress toward these ends with much work yet to be done.

Among early pioneers working with alcoholics was the Swedish Doctor Magnus Huss who labeled alcoholism ‘chronic relapsing disease’ in 1849.  A century later the American Medical Association agreed in 1956.  Dr. Elvin Morton Jellinek published his famous curve in 1960 illustrating the progression, course of, and result of this addictive disease.  The ascending side of the Jellinek Curve represents the recovery process, which must continue for a life time because this disease of addiction is still today incurable.  There are many assessment tools to gauge the patient’s stage of  addiction in order to apply the appropriate modality of treatment.  There are more than 50 of these professional assessments available in the US.

A modern working definition of addiction should include the following concepts:  physiological or emotional dependence upon a substance, activity, or modus operandi, so strong that it has harmful negative effects on the life of the addict and his interactions with others; a biopsychosocial-emotional-spiritual disturbance of normal human  functioning; loss of control of behavior which then becomes determined by the source of addiction; addict behavior becomes increasingly inconsistent with the addict’s personal moral and ethical values, and in the final stages leads to insanity, isolation from others, institutions, prisons, psychiatric hospitals, or possibly to recovery.

Remission is possible when the sufferer takes care of his condition, acquires self-care skills, gathers a support network of fellow-sufferers and mentors, and is diligent in his abstinence from the source of addiction, for example, drugs and alcohol.  The most effective programs for alcohol/drug recovery are the 12-Step Fellowships of Alcoholics Anonymous and Narcotics Anonymous.  Medical attention may be required before a patient is stable enough to participate in a 12-Step Program.

There exist other serious addictions now being recognized as such.

Some of these afflicting mankind today are gambling, food, sex, work, internet, pornography, etc, and are now classified into 2 basic groups: ingestive “substance” addictions and activity “process” addictions.  Both types have observable, predictable courses of development similar to each other.  In some, progression of disease occurs more rapidly than in others, intensity is usually a factor.

Addictions have physical symptoms, of course; obsessive thinking, compulsive actions, mental-emotional symptoms manifested in observable behaviors, along with spiritual consequences for the individual.  Ingestive addictions can be smoked or inhaled, drunk orally, injected by needle, absorbed into the skin by osmosis, placed under the skin by cutting.   Ingested or “substance” addictions include all mind/mood, (that is, brain chemistry) altering drugs, both legal and illegal, and prescriptions by doctors, which is the most widely spreading addiction today in America.  The issues of food abuse are various:  bulimia – vomiting after food intake, anorexia – restricting food intake, volume consumption, food addiction to sugar and flour.  The language referring to food problems is widely called ‘eating disorder;’ food addiction being uncontrollable use of sugar or flour products, or binging on these products.  The essence of treatment and recovery requires abstinence from the substance or process, as the first step toward remission of the disease.

Abstinence is the basis for changing all other negative addictive behaviors of the patient.  These behaviors may last even years after abstinence has been established.  Abstinence alone is not enough for remission of addiction.  Addictive behavior patterns can be activated in a multitude of ways:  triggering events of stress and trauma, sensual sights, scenes, smells, tastes, and tactile events.  Old negative patterns of behavior     must change to promote a stable recovery.  Work toward these ends is ongoing, as relapse is always a threat, even to people who have a firm, solid positive basis for their lives in recovery.

REMEMBER! These are incurable conditions which require attention and vigilance to avoid relapse throughout the lifetime of the sufferer.

The issue of prevention is such a huge undertaking that is so complex and complicated that there are no simple, easy answers.  The drug prevention programs developed in the USA for school children have been dismal failures; we had high hopes for the DARE program, but after many years it has not yielded improvement in the numbers of substance addicted young people.  Prevention must begin at birth in the formative years, in the family and society as a whole.  Entire ethnic groups have more or less tendency to become substance addicted.  Genetics, societal norms, education, and the many negative risk factors in early life predispose individuals to becoming addicted.  The education and adopting of values mitigating addiction by society at large are of primary importance.   The family and child-rearing traditions and beliefs are factors toward or away from addictive tendencies.  Education of parents and teachers, availability of help by social workers and psychologists for families at risk must be  societal efforts in combating the horrible scourge of addictions.

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