Drug addiction is a special case. Stas Piekha conducts group therapy with drug addicts

Natalya Gubareva

Despite the struggle of the state with the spread of drug addiction in Russia, the number of drug addicts in the country is steadily growing. But the level of their treatment still leaves much to be desired. About what is being done and what is needed to improve the quality of rehabilitation of drug addicts in Russia, about the shortcomings and prospects in this area, said in an interview with RIA Novosti a member of the working group at the Public Chamber of the Russian Federation on the reorganization of narcology in Russia, a practicing specialist at the Moscow rehabilitation center "Vershina" Alexander Savitsky.

Alexander, you are a member of the working group on the reorganization of narcology at the Civic Chamber of the Russian Federation. Can you please tell me what this structure is and what it does?

The Narcology Reorganization Group at the Civic Chamber of the Russian Federation, which includes 32 of the most successful practitioners in the field of rehabilitation of drug addicts, has been in existence for the third year. All this time we have been trying to draw the attention of the state to the need to treat drug addicts and start working in this direction, as Brazil, Israel, the USA, Iran and all of Europe have done. Over the 15 years that they have been actively dealing with this problem, they have managed to achieve significant results in this direction.

- And what about the rehabilitation of drug addicts in Russia?

In general, there is still no concept of "rehabilitation" of drug addicts in Russian legislation, and what should be included in it is not officially regulated in our country. But this is so - by the way.

To answer this question, it is enough just to give a few numbers. Today in Russia there are officially about 2.5 million drug addicts. Nobody counted alcoholics at all, but I think - more than five million. So, for about eight million patients in our country - only 400 state rehabilitation places a year. That is, only three or four centers for a huge country.
At the same time, I note that addictologists who study addictions and ways to treat them are not trained in Russian universities in principle. The treatment of drug addicts in our country is mainly carried out by narcologists-resuscitators. They are, of course, also necessary, but they are only indirectly related to rehabilitation.

- But someone is engaged in the rehabilitation of drug addicts in Russia?

A holy place is never empty. Today, according to various estimates in Russia, from 300 to 500
commercial and free rehabilitation centers of varying degrees of effectiveness. We have paid 12-step rehabs, hundreds of confessional rehabs based on the adoption of any religion, therapeutic communities, the most famous of which are Narcotics Anonymous and Alcoholics Anonymous. In addition to these more or less adequate rehabilitation centers that I have listed, there are also a lot of charlatans who treat with spanking therapy and other equally strange methods. Which is not surprising: if the state does not fulfill its functions, there are enterprising people who take them upon themselves, earning money from it.

And how do you, as a specialist, feel about the Yekaterinburg rehabilitation center "City Without Drugs" by Yevgeny Roizman, the material about which has recently interested readers of RIA Novosti?

How can you deal with violence? Roizman's methods are pure violence. How would you react if you were tied to a battery with the flu and were force-fed garlic? In this center, they do about the same thing, only with drug addicts. There are many centers like Yekaterinburg in our country, and all these stories are definitely not about recovery (ed. note - The head of the Yekaterinburg City Without Drugs Foundation, Evgeny Roizman, has repeatedly stated that treatment in the foundation’s rehabilitation center takes place exclusively at the request of parents child drug addicts and in accordance with the agreement with them).

- What should a Russian who wants to stop using drugs do?

There are free state rehabilitation centers in Moscow, St. Petersburg, Tatarstan, but it is extremely difficult for residents of other regions to get there. There are effective private commercial rehabilitation centers that combine 12-step rehabilitation programs with the methods of Christian centers. Here, a person is not required to adhere to a particular religion, which makes it possible for atheists to be there, as well as those who have lost their faith or believers "in their own way." However, most of these institutions are paid. Their cost varies from 10 thousand rubles a month to 500 euros a day. Recently, by the way, two private rehabilitation centers for Russian drug addicts have been opened - one in Thailand, the other in Bali. The cost of staying in each is 200 thousand rubles per month.

In general, we can say that the effectiveness of a rehabilitation center is evaluated depending on how well they work with the main areas of the personality: biological, psychological, social and spiritual. This integrated approach, used in the treatment of patients as early as Paracelsus, and Avicenna and Hippocrates, underlies the world's rehabilitation practice. If some area is left without attention, rehabilitation is much less effective.

In Russian narcology, for example, there is mainly a medical approach. And often rehabilitation is the work of a psychologist with a drug user pumped up with barbiturates. That is, the patient is actually transferred from street drugs to medical ones. A couple of days after discharge, the effect of the drugs weakens, and the addict goes for a new dose.

In other rehabilitation centers, on the contrary, there are spiritual and social components of rehabilitation, as in the centers "Transfiguration of Russia", but there is no detox (detoxification department - ed. note). And people leave not because they do not want to be treated, but because of unbearable pain.

On the whole, I can say that the majority of Russian centers are either medical institutions where female psychologists draw pictures of drug addicts under "barbitura", or private centers where drug addicts pray for miraculous healing. It helps some, but from the point of view of world experience, all these are rather strange places. And the number of cases of stable remission they have is 5-10%.

If we talk about Western experience, as far as I know, substitution therapy is often used as a method of treating drug addiction, when a drug user receives drugs from a doctor all his life, but in meager drug doses, which allow to remove physical cravings for drugs. How do you feel about the possibility of introducing substitution therapy in Russia, which the West is actively calling for?

I believe that narcologists in Russia are not ready for the mass introduction of OST, neither psychologically, nor socially, nor professionally. Who will supervise its appointment? The paradox is that narcology does not even want to engage in rehabilitation now: dispensaries often lack neither material resources nor doctors, especially specially trained ones, for this. Therefore, a strange situation is emerging, when, according to the "Strategy of the State Anti-Drug Policy of the Russian Federation until 2020", the Federal Drug Control Service will deal with rehabilitation in our country. That is, in fact - a punitive body.

At the same time, I am for the introduction in Russia of high-threshold substitution therapy for those who suffer from HIV and other serious concomitant diseases. Today, situations are common when drug addicts with HIV and tuberculosis end up in a specialized institution where drug treatment is not provided. They are going through an unbearable breakdown, so they either leave the hospital on their own, or they are discharged for violating the regime. This continues until the person dies. In this case, substitution therapy, in my opinion, is needed as a means of forming adherence to the treatment of HIV infection.

- What way out of the difficult situation with rehabilitation in Russia do you see?

I think the state needs to subsidize successful private rehabilitation centers, which are still available in Russia today. Confessional, 12-step, as well as various "mixes" of these models - the fact that they are different is very good. Each drug addict will be able to choose the path that will help him return to normal life.

But how to make society more tolerant and explain that a drug addict is not a malicious criminal, but simply a sick person?

You can also understand people. The drug addict steals, creates a lot of problems for others and is ready for anything for the sake of a dose. Therefore, it is not necessary for everyone, without exception, to know that he is sick and needs help. It is important that experts understand this. I think this will be enough.

Master class "Traps of addiction or when love kills"

Savitsky Alexander Grigorievich:

Master of Psychology, Gestalt Therapist, Chairman of the VOKS for Rehabilitation at the All-Russian Association of People Living with HIV, Member of the Public Council for Rehabilitation under the Directorate of the Ministry of Internal Affairs of Russia. Internship at the rehabilitation centers of the MONAR Foundation. Krakow and Warsaw branches. Internship in specialized rehabilitation programs for IDUs with the support of the Nordic Ministers' Fund. Norway. Borgestadtclinic, Denmark).

Soroka Alexey Anatolievich

Clinical psychologist Expert of the Public Chamber of the Russian Federation. Member of the coordinating council for the protection of citizens from alcohol, drug and tobacco addiction at the Civic Chamber of the Russian Federation. Head of the expert working group on the prevention of alcoholism, drug addiction and tobacco smoking and the promotion of a healthy lifestyle among young people at the Civic Chamber of the Russian Federation. President of the Regional Public Organization for the Prevention and Treatment of Drug Addiction and Alcoholism "Health of the Nation". Member of the Russian Narcological League. Board member of the Independent Drug Guild. Head of the rehabilitation council of the Independent Narcological Guild. Regional coordinator of the Federal project "Sober Russia" MO, Krasnodar Territory. Head of the Addiction Counseling School project.

Soroka Svetlana Vasilievna:

Practical psychologist, coach, individual and family consultant, short-term consultant, consultant on improving rehabilitation programs, head of the Satori-Vozrozhdeniye Psychological Center for Social Adaptation, Moscow, author and trainer of the Addiction Counseling School training programs, curator of the School in Institute of Practical Psychology and Psychoanalysis, Moscow; Moscow Institute of Psychoanalysis, Moscow.

Master class "Traps of addiction or when love kills"

Based on the situation in our country, this event can be useful to any practicing psychotherapist, psychologist, psychology student, social worker and professionals from other helping professions.

Participants will receive: basic knowledge about the main ideas and technologies for the rehabilitation of addicts and their close circle, about the stages of work and activities necessary for successful rehabilitation; knowledge of modern foreign and Russian approaches to the rehabilitation of addicts and their close environment, allowing to differentiate high-quality rehabilitation programs from low-quality ones; theoretical understanding of the stages and structure of the rehabilitation process; consolidation of theoretical material, with the help of practical exercises; information about the advanced training program "Comprehensive Approach to the Rehabilitation of Substance Addicts", which will be held in September 2017-2018 and other programs of the Addiction Counselor School.

Access is required to watch the video.

Master of Psychology, Chairman of the All-Russian Public Community Committee (VOKS) for Rehabilitation at the All-Russian Association of People Living with HIV, a member of the working group of the Public Chamber of the Russian Federation on improving anti-drug policy, tells about the real chances of returning a drug addict to a full life, ridding him of addiction and reform of the drug treatment system, member of the Public Council under the Main Directorate of the Ministry of Internal Affairs of Russia for Moscow, Alexander Savitsky.

“I joined the Public Council at the Main Directorate of the Ministry of Internal Affairs of Russia for Moscow as the president of the non-profit Healthy Country Foundation, where my colleagues and I provided medical and psychological support and promoted a healthy lifestyle,” says Alexander Grigoryevich.

Today I head the Unica Addictions Treatment Center (treatment of mental and psychosomatic diseases, depression, rehabilitation of patients, etc.). I do what I can do well - I teach, act as an author and trainer of training programs.

The training program is aimed at psychologists, psychiatrists, drug addiction psychiatrists, chemical addiction and HIV consultants, volunteers, psychology students, social workers, heads of rehabilitation centers who already have practical work experience or are just taking their first steps in the profession.

When a wave of addictions to spices began, they managed to bring it down - the power structures here worked quite effectively. But the scheme that exists now does not justify itself. First, when a person comes to the attention as a drug addict, the court obliges him to undergo treatment and rehabilitation. But the judge is not an expert in this area, the police are not specialists either, and those who watch these guys from the outside do not understand the difference between treatment and rehabilitation. According to the court order, any drug addict is given five days for treatment, and it turns out that he, as it were, passed it. However, it is impossible to recover from drug addiction in 5-6 days, more global measures are required. A full rehabilitation course lasts about a year. Secondly, in order to provide medical assistance, you first need to convince a person that he is suffering due to addiction. The specificity of the disease is of a biopsychosocial-spiritual nature, and the “addict” does not independently realize that he harms himself, his family and others - he makes everyone feel bad, not because he is a bastard, but because a person loses criticism.

Any addiction, be it alcohol, gambling or chemical addiction, has one root of evil and differs little in the nature of the course of the disease. Synthetic drugs and other narcotic substances lead to serious consequences: the personality changes, possible mental deviations develop, the psyche functions in a specific mode. It is difficult for a person with addiction to cope with his psycho-emotional state on his own, to “work through” problems, the help of a good specialist is needed. I would like to note that the most effective employees in rehabilitation work are former drug addicts who have gone through all the hellish addiction cycles, received professional training in this area and can help those who were themselves.

Now we are trying to create a self-regulatory organization of rehabilitation centers under the auspices of the Ministry of Health and the police department. There are a huge number of rehabilitation centers, some write that they guarantee 100% getting rid of addiction. I must say right away: these are qualified charlatans! A good rehabilitation center, after completing the full course, gives about 40% of those recovering, the rest return to use. Technologies do not yet exist in the world, and they are unlikely to appear, the idea of ​​completely eradicating drug addiction is a myth.

The only thing that can work, if we talk about prevention programs, is personal development, which is what the school does. Alas, there is a certain bias here - we study applied and fundamental sciences, but we are not taught how to cope with our feelings in the modern world, communicate correctly, and so on. Therefore, when a person cannot cope with his life, he finds what the street offers him.

A systematic approach to the rehabilitation of "addicted" patients is needed, and the methods of working with them have been worked out for a long time, they have been tested in Russia for twenty years and have been developed. There are hundreds of thousands of examples when drug addicts returned to society, became adequate people, because they were not pressed, they were treated like they were sick. Someone put an end to them, and we just extended our hand and competently helped.

Prepared by Irene DASHKOVA,

photo from the archive of Alexander SAVITSKY

The work of the international scientific and practical conference "Challenges of our time: the psychology of addiction", held in Moscow from February 9 to 12, was attended by pros familiar to many specialists in chemical addiction, such as,. From these well-known people not only in Russia, the leaders and specialists of the Liniya-Life fund for helping drug addicts and the rehabilitation center learn to overcome addiction and codependence.

Drug addiction is a special case

“How many needs a person has, so many dependencies. Drug addiction as a special case” is the title of a lecture by Igor Kuzichev, reflecting the relevance of the topic of addictions in the modern world.

There are no dependencies! Let's name some of them: alcohol, drug, nicotine, sexual, Internet addiction, workaholism, gambling, overeating. And each of these addictions has causes and consequences. It is impossible to cope with many of the addictions without specialists.

The conference participants discussed various aspects of obsessive behavior, codependency. For example, Valentina Novikova held a seminar "Addiction as a disease, symptoms of the disease and the dynamics of recovery." The theme of Ruslan Molodtsov's seminar is: "Trauma as a foundation for the formation of addictive and deviant behavior." Alexander Savitsky held a master class "Addiction Counselor - Professional Secrets".

Master class “Manic love. High States and Black Holes” was held by Natasha Markovich, best-selling author, including “Flutter, cool, damn it”, the host of wonderful unforgettable author trainings. One of these trainings Natasha Markovich held in Omsk in April 2011, among the participants of which was the author of this note.

Stas Piekha conducts group therapy with drug addicts

He shared his experience of overcoming drug addiction, who recently opened a rehabilitation center for people with chemical addiction. Stas got into drug addiction as a teenager. The reason for this was the difficult relationship in his family known throughout the country.
Currently, Piekha, having received a psychological education, personally conducts group therapy with drug addicts. As noted by Stas

In May 2014, a law came into force allowing courts to send drug addicts to compulsory treatment. Now, judges can send anyone who uses drugs or psychotropic substances for prevention, examination or treatment without a doctor's prescription. Such sentences will be issued not only in criminal cases, but also in administrative cases. This means that not only drug-addicted criminals, as it used to be before, but also people whose illegal activity consists only in the very fact of using illegal substances will be forcibly placed in a hospital bed.

For evading medical care and social rehabilitation, a fine of 4,000 to 5,000 rubles or an administrative arrest of up to 30 days is provided. To become an evader, it is enough not to visit or leave a medical institution without permission, and also not to follow the instructions of the attending physician more than twice. It is expected that about 2,000 drug addicts will be sent for compulsory treatment every year. But will these measures be enough to significantly reduce the number of drug addicts?

According to official estimates, about 8 million people use drugs in Russia today. The vast majority of addicts are people between the ages of 20 and 40. More than 80% are on "hard" drugs from the category of opiates. It is almost impossible to get rid of such an addiction without the help of specialists. However, many drug addicts deny the existence of the disease and therefore refuse treatment, which previously could only be voluntary.

So is it possible to cure a drug addict without his desire - forcibly?

How much money will the state allocate for the course of treatment and rehabilitation of one patient?

Which clinics will have compulsory treatment units?

How will drug addicts be treated? How long will the course of treatment last on average?

Does the law apply to minors? Can they be sent for compulsory treatment?

What is the difference between state, that is, free treatment for drug addiction today, from treatment in a private clinic?

Will parents be able to send their drug addicted child to treatment through the courts? In general, who will be able to initiate sending for compulsory treatment?

Who will give a conclusion that a person needs compulsory treatment?

Will compulsory treatment apply to alcoholics?

Methadone therapy: pros and cons? Are there drugs that can replace it today?

How to explain the decline in the number of hard drug users in countries where “soft” drugs have been legalized? Is it possible to apply this experience in Russia?

Participants of the discussion:

Nadezhda Galimova - Coordinator of the regional offices of the All-Russian Public Movement (VOD) STOPNARKOTIK

Yakov Marshak- narcologist, author of the method of rehabilitation of pathologically dependent

Tatiana Klimenko - Assistant to the Minister of Health of the Russian Federation

Tatiana Malchikova - President of the "Civil Commission on Human Rights" in Russia

Alexander Savitsky - President of the non-profit foundation "Healthy Country"

Alexey Lazarev- coordinator of the church service for drug addiction

Oleg Zykov- Director of the Institute of Narcological Health (via Skype)

Evgeny Roizman- Mayor of Yekaterinburg, founder of the "City Without Drugs" foundation (via Skype)