Mental and behavioral disorders caused by tobacco use (synonyms: tobacco smoking, tobacco addiction, nicotine addiction, nicotinism) are traditionally considered in domestic narcology as tobacco smoking (episodic or systematic) and tobacco addiction.
ICD-10 code
F17 Mental and behavioral disorders caused by tobacco use
Causes of nicotine addiction
On beginning of XXI V. Smoking remains a fairly common phenomenon among the population of all countries of the world. There are currently 1.1 billion smokers in the world, which is 1/3 of the planet's population over the age of 15 years. According to WHO forecasts, by 2020 the epidemic of nicotine addiction will move to developing countries, they are characterized by a lack of funds to finance anti-smoking programs. In Russia, 8 million women and 44 million men smoke, this is 2 times more compared to developed countries Western Europe and the United States of America.
It is known that most people start smoking in childhood and adolescence. In countries with a high smoking prevalence, 50-70% of children try smoking. In Russia, the problem of children's smoking is one of the most acute. Children start smoking in 5th-6th grade. The consequences of early smoking have a negative impact on life expectancy: if you start smoking at 15 years old, your life expectancy is reduced by 8 years.
Among the social factors, a significant influence on the prevalence of nicotine addiction among school students is exerted by irregular sports activities, a positive or indifferent attitude towards smoking in the family, lack of information about its harm, and frequent conflicts in the family. The following educational factors play an important role in the development of nicotine addiction among students: frequent conflicts at the place of study, difficulties in adapting to studies in high school, complaints about deterioration of well-being due to study load, number of unloved items (more than 7). The most significant biological risk factors for the development of nicotine addiction in schoolchildren: passive smoking, a symptom of psychosomatic dissociation after the second attempt at smoking, frequent alcohol intake, and the absence of a stage of episodic smoking. If a combination of biological, educational and social factors takes part in the occurrence of nicotine addiction, then in the occurrence of tobacco smoking in adolescents the most significant role belongs mainly to social factors.
There are three critical periods in the emergence and development of tobacco smoking and nicotine addiction among schoolchildren. The first period occurs at the age of 11 years, when the number of people who have their first experience of smoking increases by 2.5 times. The second period corresponds to the age of 13 years, and is characterized by a significant (2-fold) increase in the prevalence of episodic tobacco smoking. The third period is the age of 15-16 years, while the prevalence of systematic tobacco smoking exceeds the prevalence of episodic smoking, and the number of people with nicotine addiction doubles. Factors contributing to smoking in childhood and adolescence include female gender, single-parent family, lack of intention to continue studying after school, a feeling of alienation from school and its values, frequent alcohol consumption, ignorance or misunderstanding of health risks, and the presence of at least one parent who smokes. , parental permission to smoke, amount of pocket money, visiting discos.
The formation and formation of nicotine addiction occurs against the background of the action of two main factors - social and biological. The social factor can be traced in the form of tobacco smoking traditions, and biological factor is reflected in the initially existing individual reactivity of the body to inhalation of tobacco smoke. The interaction of “external” and “internal” factors ultimately shapes the development of addiction to tobacco smoking. There are three levels of risk factors. Leading factor of rank I - hereditary predisposition to smoking tobacco. At the same time, familial smoking, passive smoking, and an indifferent or positive attitude to the smell of tobacco smoke are detected. Risk factors of rank II include the symptom of psychosomatic dissociation, which manifests itself at the stage of the first attempts to smoke tobacco. Factors of rank III include premorbid soil. Tobacco addiction includes all three risk factors for tobacco smoking against the background of a microsocial environment with traditions of tobacco smoking.
The motivation for smoking in most teenagers is formed as follows: curiosity, the example of adults and friends, pleasure, fear of being out of date, the desire to keep up with peers, to assert oneself, to support the company, “out of nothing to do” or “just because.”
Harm of smoking
Numerous studies have proven that smoking causes irreparable damage to the health of the population. The medical consequences of tobacco use include diseases of the cardiovascular and respiratory systems, digestive tract, and malignant neoplasms of various locations. Cigarette smoking remains one of the leading causes of death. Up to 300 thousand people die prematurely in Russia every year from smoking-related causes. The health consequences of cigarette smoking on the cardiovascular system are characterized by damage to the coronary arteries (angina, myocardial infarction), aorta (aortic aneurysm), cerebral vessels and peripheral vessels. Nicotine causes systemic vasospasm and increases blood clotting due to activation of platelets. The most common respiratory system disease among tobacco smokers is chronic bronchitis; the prevalence of acute and chronic forms pneumonia, emphysema. Diseases of the digestive tract, considered as consequences of tobacco use, are represented by acute gastritis, peptic ulcer of the stomach and duodenum, which occurs with frequent relapses. Nicotine acts as an atherogenic factor and leads to the development of malignant neoplasms. According to various researchers, in 70-90% of cases, lung cancer develops as a result of smoking tobacco. Share deaths from malignant neoplasms caused by smoking is quite high. It is noteworthy that the mortality rate in women from lung cancer due to tobacco smoking is higher than the development of breast cancer. Among tobacco smokers, a significant specific gravity malignant neoplasms of the oral cavity, pharynx, esophagus, trachea and larynx. Possible damage to the kidneys, ureters, bladder, and cervix. About 25% of cases of stomach and pancreatic cancer are associated with tobacco use. A serious medical consequence of tobacco use is passive smoking. Non-smoking family members of smokers are at high risk of developing lung cancer, cardiovascular diseases, and children under 2 years of age are predisposed to respiratory diseases. Data on the dangers of passive smoking, which increases the risk of diseases in healthy people, became the reason for the ban on smoking in public places.
Smoking products have significant harm on the female body. Women who smoke experience infertility, vaginal bleeding, circulatory disorders in the placenta, and ectopic pregnancy are more likely to develop. The number of spontaneous abortions increases 5 times compared to non-smoking women. There is a higher risk of premature birth (premature babies), delayed labor, or placental abruption (stillbirth). The consequences of exposure to the fetus include slowing of fetal growth (decreased height and weight at birth); increased risk of congenital anomalies, the possibility of sudden death of a newborn increases 2.5 times; possible consequences affecting the further development of the child (mental retardation, behavioral deviations).
Pathogenesis
One cigarette contains on average 0.5 mg of nicotine (the active ingredient in tobacco. Nicotine is a surfactant ( psychoactive substance) stimulating effect. Possessing narcotic properties, it causes addiction, addiction and dependence. The physiological effects of nicotine include peripheral vasoconstriction, increased heart rate, and blood pressure, increased intestinal motility, tremor, increased release of catecholamines (norepinephrine and epinephrine). general decrease in metabolism. Nicotine stimulates the hypothalamic pleasure center, which is associated with the appearance of addiction to tobacco. The euphoric effect is somewhat similar to the effects of cocaine. Following brain stimulation, a significant decline occurs, even depression, which causes a desire to increase the dose of nicotine. A similar two-phase mechanism is characteristic of all narcotic stimulants, first exciting, then depressing.
Nicotine is easily absorbed through the skin, mucous membranes and the surface of the lungs. With the pulmonary route of administration, the effect on the central nervous system appears within 7 s. Each puff has a separate reinforcing effect. Thus, with 10 puffs per cigarette and smoking one pack of cigarettes per day, the smoking habit receives approximately 200 reinforcements per day. Specific time, the situation, the ritual of preparing for smoking, when repeated, is conditionally reflexively associated with the effect of nicotine.
Over time, signs of tolerance arise, expressed in a weakening of subjective sensations upon repeated use of nicotine. Smokers usually report that the first cigarette in the morning after a night of abstinence has the most pronounced refreshing effect on them. When a person starts smoking again after a period of abstinence, sensitivity to the effects of nicotine is restored, and he may even experience nausea if he immediately returns to the previous dose. First-time smokers may develop nausea even when the concentration of nicotine in the blood is low, while long-term smokers experience nausea when the concentration of nicotine exceeds their usual level.
Negative reinforcement refers to the relief an individual experiences at the cessation of an unpleasant sensation. In some cases of nicotine addiction, smoking is used to avoid withdrawal symptoms, as the urge to smoke may occur when nicotine levels in the blood drop. Some smokers even wake up in the middle of the night to smoke a cigarette, perhaps to relieve withdrawal symptoms that occur when blood nicotine levels are low and interrupt sleep. If nicotine levels in the blood are artificially maintained through a slow intravenous infusion, the number of cigarettes smoked and the number of puffs taken are reduced. Thus, people may smoke to maintain the rewarding effects of nicotine or to avoid the pain associated with nicotine withdrawal or, more likely, a combination of these reasons.
A combination of depressed mood (due to dysthymia or another affective disorder) and nicotine dependence is often observed, but it remains unknown whether depression predisposes to smoking initiation or whether it occurs as a consequence of nicotine dependence. According to some data, adolescents with depressive symptoms are more likely to become addicted to nicotine. Depression increases significantly during the period of abstinence from smoking - this is called one of the reasons for relapse. The connection between smoking and depression is indicated by the discovery of the ability of the non-nicotine component of tobacco smoke to inhibit the activity of monoamine oxidase (MAO-B). The degree of inhibition of enzymatic activity is less than that of antidepressants - MAO inhibitors, but it may be sufficient to cause an antidepressant (and possibly antiparkinsonian) effect. Thus, smokers who are prone to depression may feel better when smoking, making it more difficult to quit.
Symptoms of nicotine addiction
F17. Acute nicotine intoxication
Symptoms that occur with nicotine poisoning: nausea, vomiting, excessive drooling and abdominal pain; tachycardia and hypertension (early onset of symptoms); bradycardia and hypotension (late manifestation), tachypnea (early symptom) or respiratory depression (late manifestation); miosis; confusion and urge (late onset); mydriasis; convulsions and coma (late manifestation).
In the process of systematic smoking of tobacco, a disease is gradually formed - tobacco addiction, which has its own clinical features, dynamics of development, stages and complications.
(F 17.2) Clinical picture of nicotine dependence
It is represented by syndromes of altered reactivity of the body to the effects of nicotine (changes in tolerance, disappearance of protective reactions observed during the first samples of tobacco, changes in the form of consumption), pathological craving for smoking tobacco, withdrawal syndrome, personality change syndrome.
When you first try smoking, the toxic effect of tobacco smoke on the body as a whole usually manifests itself - a psychosomatic reaction develops: a drop in blood pressure, fainting, tachycardia, a feeling of lightheadedness, severe dizziness, painful muscle weakness, vomiting, a feeling of insufficient inhalation, melancholy, anxiety, fear of death ( protective reaction of the body). People who have suffered this form of reaction usually no longer smoke. In others, the body’s reactions to tobacco smoke are split in nature (a symptom of psychosomatic dissociation). They experience slight dizziness, calmness, and a feeling of mental comfort, simultaneously combined with muscle weakness, nausea and vomiting. The symptom of psychosomatic dissociation, together with the traditions of the microsocial environment, contributes to tobacco smoking in such people.
When using tobacco, an increase in tolerance is observed in the dynamics of the disease and its change during the day. After daytime smoking for 6-8 hours, resistance to the effects of tobacco disappears the next morning. This is why many smokers describe the strong effects of their first cigarette. With each subsequent cigarette smoked, tolerance increases.
The core disorder that characterizes tobacco addiction is a pathological attraction to smoking tobacco, while abstinence from smoking causes a complex of psychosomatic disorders. In most people, craving syndrome occurs a few years after the start of systematic smoking. In other cases, systematically smoking people do not develop tobacco addiction; a smoking habit is formed. The syndrome of pathological attraction to tobacco smoking is a psychopathological symptom complex, including ideational, vegetative-vascular and mental components.
The ideation component is characterized by the presence of a mental, figurative or mental-imaginative memory, idea, desire to smoke tobacco, which is recognized by patients. Thoughts about smoking become painfully persistent, stimulating the search for tobacco products.
The vegetative-vascular component manifests itself in the form of individual transient symptoms: cough, thirst, dry mouth, pain of different localization, dizziness, tremor of the fingers of outstretched arms, hyperhidrosis, instability of blood pressure, gastrointestinal dyskinesia.
The mental component is expressed by asthenic and affective disorders. When abstaining from smoking, psychogenic asthenic reactions occur with transient fatigue, exhaustion, restlessness, irritable weakness, sleep disorders, appetite, decreased performance, and deterioration of well-being. Affective disorders are characterized by asthenic or anxious subdepression. Patients complain of depression, weakness, tearfulness, irritability, anxiety, and restlessness. Pronounced manifestations of the syndrome of pathological craving for tobacco smoking can be represented by illusory and hallucinatory disorders in the form of a sense of taste and smell of tobacco smoke.
The syndrome of pathological attraction to tobacco smoking goes through several stages in development (initial, formation, final). On initial stage, lasting up to 1 month, a symptom of psychosomatic dissociation is observed. formed during the first attempts to smoke tobacco and is expressed in the multidirectionality of mental and somatic forms of response to the toxic effect of tobacco smoke. The formation stage lasts up to 2-3 years, characterized by the formation of a syndrome of pathological craving for smoking tobacco with simultaneous deactualization of the symptom of psychosomatic dissociation. At the final stage, the dominance of the syndrome of pathological craving for tobacco smoking in the clinical manifestations of the disease determines the individual’s behavior aimed at searching for a tobacco product and smoking it (occurs in the 3-4th year of systematic smoking).
(R17.3) Quitting nicotine use
Causes the development of withdrawal syndrome (AS, deprivation syndrome), its manifestations reach their peak 24-28 hours after the last smoking. These include: anxiety, sleep disturbance, irritability, intolerance, an irresistible desire to smoke, impaired concentration, drowsiness, increased appetite and headache. The intensity of symptoms decreases after 2 weeks. Some symptoms (increased appetite, difficulty concentrating) may persist for several months.
There are two types of nicotine addiction: periodic and constant. The periodic type of course is characterized by light periods of time during the day, when patients forget about smoking for 30-40 minutes. The intensity of tobacco smoking with a periodic type of flow is smoking from 15 to 30 pieces of tobacco products. The constant type of progression is characterized by the presence of a constant craving for smoking tobacco, despite current activity. With this type, patients smoke from 30 to 60 pieces of tobacco products during the day.
The clinical picture of the syndrome of pathological craving for tobacco smoking and the types of course of the disease determine the main forms of nicotine addiction described in the literature: ideation, psychosomatic and dissociated.
The ideatorial form is characterized by a combination of the ideatorial and vegetative-vascular components in the structure of the syndrome of pathological craving for smoking tobacco in persons with schizoid features in premorbidity. The ideational form is characterized by: an early age at the first attempt at smoking tobacco (10-12 years), the absence of a stage of episodic smoking, a rapidly occurring need for systematic smoking, a gradual increase in the initial tolerance by 8-10 times, late start smoking tobacco during the day (1-4 hours after waking up), early awareness of cravings for smoking, periodic type of disease, the ability to independently stop smoking for a period of 2-3 months to 1 year.
In the psychosomatic form of nicotine addiction, a combination of ideational, vegetative-vascular and mental components is noted in the structure of the syndrome of pathological craving for smoking tobacco in people with epileptoid features and premorbidity. This form is characterized by a relatively late age at the first smoking attempt (13-18 years), the absence of a stage of episodic smoking, a late age at the onset of systematic smoking, a rapid increase in tolerance exceeding the initial one by 15-25 times, early morning smoking (immediately after waking up, on an empty stomach) , late awareness of craving for smoking, permanent type course of the disease, unsuccessful attempts self-cessation of smoking.
The dissociated form of nicotine addiction is distinguished by the presence in the structure of the syndrome of pathological desire, which is not realized at the ideational level of the desire to smoke tobacco. Its manifestation is internal, poorly differentiated, painful vital sensations that appear during long breaks in smoking. They are localized in different areas of the body: in the pancreas, tongue, throat, trachea, lungs, back, shoulder blade, etc. The dissociated form is characterized by an early onset of smoking (the first try at 8-9 years), a periodic type of the disease, a short stage of episodic smoking , smoking on an empty stomach. A feature of this form should be considered “flickering” tolerance. The patient can smoke 2-3 cigarettes in one day without feeling the need for more, but on other days he smokes 18-20 cigarettes. Compared to other forms of nicotine addiction, the latest awareness of craving for tobacco is revealed, appearing in the structure of the withdrawal syndrome. In the process of self-cessation of tobacco smoking, remissions can last from 5 days to 2-3 months. The dissociated form is characterized by the presence of a delayed withdrawal syndrome (can be qualified as an actualization of the pathological craving for tobacco).
Combined addiction
Smoking is very common among those addicted to alcohol, cocaine or heroin. Because nicotine is a legal substance, many addiction treatment programs in the past have ignored nicotine addiction and focused primarily on alcohol or illegal drugs. IN last years hospitals began to combat smoking, encouraging hospitalized patients to quit smoking with the help of nicotine patches. This measure can be an excellent opportunity to begin treatment for nicotine addiction, even if this requires simultaneous correction of other forms of addiction. The same principles can be applied to patients undergoing outpatient treatment for addiction to certain substances. Nicotine addiction, which has devastating effects, should not be ignored. Treatment can begin with the correction of the most acute problems, but patients’ attention should also be paid to nicotine addiction, correcting it using the above combination of means.
Nasal substance abuse
In recent years, among children and adolescents living in Central Asia, Kazakhstan, and in some regions of Russia, the use of nasa, a mixture of crushed tobacco leaves, lime and ash in water or vegetable oil, has become widespread. Depending on the preparation technology, three types of nas are distinguished: water made from tobacco and ash; on water from tobacco, ash, lime; on oil from tobacco, ash, lime. We are placed in the oral cavity under the tongue or behind lower lip.
Research in recent years, conducted by various specialists, indicates the toxic effect of us on many human organs and systems. In an experiment on animals, it was found that we are caused by lesions of the stomach and liver, precancerous changes. Individuals who consume it have a much higher risk of developing cancer than those who do not consume it. If among 1000 examined people who use us, precancerous processes in the oral mucosa were found in 30.2 cases, then among those who do not use us this figure was 7.6.
The most pronounced pathological changes in people who consume us are observed in the oral cavity. mainly in places of laying. If we are placed under the tongue, tongue cancer is more common; among residents of Kazakhstan, where we are laid behind the lower lip, the lower gum is most often affected.
In children and adolescents, the addiction to using nas as an intoxicating substance usually begins with curiosity, imitation, and the desire to keep up with peers. The particular harm of its use by children and adolescents lies in the fact that they, putting it under the tongue secretly from adults, are often forced to swallow it under unforeseen circumstances, this aggravates the pathological effect of us due to its direct effect on the esophagus, stomach, and intestines.
Laying the nose for the first time in your life causes a pronounced tingling and tingling sensation under the tongue, and increased salivation. Mixing with us, it accumulates in large quantities, this causes the need to spit it out after 2-3 minutes. Part of the nas is involuntarily swallowed with saliva. The state of acute intoxication is characterized by mild dizziness with increasing intensity, palpitations and sudden muscle relaxation. When children and adolescents try to stand up, surrounding objects begin to spin, “the ground disappears from under their feet.” Against the background of increasing dizziness, nausea occurs, then vomiting, which does not bring relief, for about 2 hours the state of health remains poor: general weakness, dizziness, nausea are bothersome, this necessitates the need to remain in a horizontal position. Unpleasant memories of this persist for 6-7 days.
Some children and adolescents who have the most pronounced manifestations of intoxication when using nas for the first time do not subsequently resort to it. Others, having information from others that during subsequent doses of nas, do not observe painful sensations, but. on the contrary, a pleasant state arises and they continue to use it. In such cases, after 2-3 doses the clinical picture of intoxication changes. Characteristic is the disappearance of the body's protective reaction of nausea, vomiting, and increased salivation. A slight euphoria, relaxedness, a feeling of comfort, vigor, and a surge of strength appears. Intoxicated people become talkative and sociable. The described state continues for 30 minutes. Over the next 2-3 months, the frequency of taking nas increases from 2-3 times a week to 7-10 times a day. At this stage, the amount of nas used at one time increases, and there is a need to keep it in the mouth for a longer period (15-20 minutes) to prolong the state of intoxication.
Systematic intake of Nas contributes to the formation of pathological desire syndrome, manifested by decreased mood, irritability, short temper, and deterioration in performance. Thoughts about us prevent you from concentrating and make it difficult to do your usual work. 2-3 days after stopping the use of nas (for various reasons), signs of withdrawal syndrome appear: headache, dizziness, feeling of weakness, sweating, palpitations, loss of appetite, irritability, anger, decreased mood, insomnia. The described condition is accompanied by a pronounced desire to take nasal juice and lasts up to 2-3 days. At this stage, the systematic use of nas is due not only to the desire to induce a state of intoxication, but also to the need to relieve the withdrawal symptoms described above. The formation of a withdrawal state is accompanied by a further increase in the single and daily dose. In people who use us for a long time, a decrease in tolerance to it can be observed.
The most noticeable mental disorders when using nas are in children and adolescents who show signs of brain failure (skull injuries, residual effects of neuroinfection, personality anomalies). They manifest themselves as a sharp worsening of their previously characteristic incontinence, irritability, conflict, and aggressiveness. They note a progressive decline in memory, weakening of concentration, and ingenuity - the reasons for the decline in academic performance, discipline, and quarrelsomeness in the school community.
The appearance of people who show signs of substance abuse is very characteristic: the skin is flabby with an earthy tint, they look older than their years. They are more likely to have chronic diseases of the digestive system.
Stages
- (F17.2.1) Initial stage - smoking is systematic, the number of cigarettes consumed is constantly growing (change in tolerance). Smokers experience increased performance, improved well-being, and a state of comfort (signs of pathological desire). At this stage of the disease, manifestations of psychosomatic dissociation disappear, and there are no signs of somatic and mental changes. The duration of the stage varies between 3-5 years.
- (F17.2.2) Chronic stage - tolerance first continues to increase (up to 30-40 cigarettes per day), then becomes stable. The desire to smoke arises with any change in the external situation, after minor physical or intellectual stress, with the appearance of a new interlocutor, a change in the topic of conversation, etc. The manifestation of the syndrome of pathological attraction to smoking tobacco is aggravated, and symptoms of withdrawal syndrome are formed. The patient is worried about a morning cough, discomfort in the heart area, fluctuations in blood pressure, heartburn, nausea, a feeling of general discomfort, low mood, sleep disturbances, increased irritability, decreased performance, a constant and persistent desire to continue smoking, including at night. The duration of this stage of nicotine addiction varies from person to person, on average from 6 to 15 years or more.
- (F17.2.3) Late stage - smoking becomes automatic, non-stop. disorderly and without cause. The type and type of cigarettes does not matter to the smoker. There is no feeling of comfort when smoking. There is constant heaviness in the head, headache, decreased and loss of appetite, deterioration of memory and performance. At this stage, smokers become lethargic, apathetic, and at the same time easily irritated and “lose their temper.” The phenomena of somatic and neurological ill-being are growing and intensifying. The pathology of the respiratory organs is clearly expressed, gastrointestinal tract, cardiovascular system, central nervous system. The skin and visible mucous membranes of a smoker acquire a specific icteric tint.
The stages of nicotine addiction develop purely individually and depend on many reasons - the time of initiation of tobacco use, its type and variety, age, gender, health status, resistance to nicotine intoxication.
Every smoker tries to quit using tobacco on their own. The duration of clear intervals and spontaneous remissions can be completely different and depends on many factors. Breakdowns usually occur due to various external influences, situational circumstances, and mood swings.
Only a small proportion of patients with nicotine addiction are able to stop smoking on their own; the rest require medical assistance. Short remissions and frequent relapses characteristic of this disease make it difficult to solve the problem of tobacco smoking among the population.
(F17.7) A comparative study of the clinical manifestations of therapeutic and spontaneous remissions in patients with nicotine addiction showed: the occurrence of remissions goes through three stages - formation, formation and stabilization. Each stage has clinical features and a time interval of existence. The main types of remission: asymptomatic, residual with neurosis-like symptoms and hyperthymic without symptoms of craving for smoking tobacco.
Asymptomatic type of remission - there are no residual symptoms of nicotine addiction. This type characteristic of spontaneous remissions, as well as the ideational form of nicotine addiction during therapeutic remission. This type is most resistant to relapses, which are absent during self-cessation of smoking, and during therapeutic remissions, observed in patients with the ideation form of nicotine addiction, they are rarely encountered against the background of psychogenic disorders.
The residual type of remission is characterized by complete abstinence from smoking tobacco; there is residual symptomatology of a pathological craving for smoking tobacco in the form of spontaneously or by association mental and figurative memories and ideas about smoking tobacco in the daytime or at night, during sleep, dreams. The residual type among therapeutic remissions is characteristic of the dissociated and psychosomatic form of nicotine addiction. In the dissociated form of nicotine addiction, neurosis-like symptoms in remission are manifested by mentalism, absent-mindedness, distractibility, fatigue, and mood swings during the day. In case of residual remission with neurosis-like symptoms, its instability is noted. The appearance of a sensitive coloring of experiences is accompanied by an exacerbation of the symptoms of pathological attraction to smoking tobacco. Stressful situations and alcohol intoxication also lead to exacerbation of symptoms of nicotine addiction. Relapses into smoking resumption during the residual type of remission occur quite often.
The hyperthymic type of remission is characterized by an elevated mood in the absence of craving for nicotine. The phase nature of affective disorders is noted. This type is characteristic only of the dissociated form of nicotine addiction during therapeutic remissions.
As you can see, the types of remission are determined clinical form nicotine addiction and premorbid personality characteristics. The clinical picture of the types of remission is a prognostic criterion for its duration. Prognostically, the most favorable (longest duration and smallest number of relapses) is the asymptomatic type. The less favorable type is the residual type with neurosis-like symptoms, and the unfavorable one is the hyperthymic type of remission.
In the structure of violations mental activity In patients with nicotine addiction, the main place is occupied by general neurotic (asthenic) disorders, more pronounced than in non-smokers. Smoking tobacco is no longer early stages The development of nicotine addiction is accompanied by affective disorders, which act as factors contributing to the maintenance and aggravation of nicotine addiction.
IN Lately, in connection with the increasing interest of researchers in the problem of comorbid conditions in psychiatry and narcology, the mutual influence of cynical diseases, tobacco smoking and nicotine addiction was studied. The main characteristics of tobacco smoking and nicotine addiction are the duration of smoking, the age of the first try and the beginning of systematic smoking, incentives, degree of dependence on nicotine, clinical manifestations tobacco addiction(they differ in patients with mental disorders of different registers depending on the phenomenology of the disorders they have). Affective disorders comorbid with nicotine addiction have some clinical features: non-psychotic level of manifestations, low intensity, flickering nature of the course, low progression. Affective disorders are first diagnosed only when seeking medical help to stop smoking tobacco. These disorders are not considered a consequence of nicotine addiction or its cause; they arise against the background of already formed nicotine addiction and in the presence of unfavorable premorbid conditions. Psychogenic factors usually trigger the development of affective disorders, which become a determining factor in the motive for quitting smoking. Among patients with neurotic pathology, the ideational form of nicotine addiction with an average degree of dependence on nicotine predominates, while patients with schizophrenia are characterized by a psychosomatic form with a high degree of dependence. The type of accentuation (excitable, cyclothymic, emotive, exalted and demonstrative) is considered to be an increased risk factor for tobacco smoking and the formation of nicotine addiction in patients with neurotic disorders. Elimination of nicotine addiction improves clinical course neurotic disorder, but aggravates the manifestations of schizophrenia.
Diagnosis of nicotine addiction
Below are the diagnostic signs of acute intoxication due to tobacco use (acute nicotine intoxication) (F17.0). It must meet the general criteria for acute intoxication (F1*.0). The clinical picture necessarily includes dysfunctional behavior or perceptual disorders. This is evidenced by at least one of the signs: insomnia; bizarre dreams; mood instability; derealization; impairment of personal functioning. In addition, at least one of the following signs is detected: nausea or vomiting, sweating, tachycardia, cardiac arrhythmias.
The diagnosis of withdrawal syndrome (F17.3) is made based on the following signs:
- compliance of the condition with the general criteria for withdrawal syndrome (F1*.3);
- in the clinical picture, any two of the manifestations are observed: a strong desire to use tobacco (or other nicotine-containing products); feeling unwell or weak; anxiety; dysphoric mood; irritability or restlessness; insomnia; increased appetite; severe cough; ulceration of the oral mucosa; decreased concentration and attention.
Treatment of nicotine addiction
The problem of treating nicotine addiction has not lost its relevance to this day. More than 120 methods of treating nicotine addiction are known, of which about 40 are widely used. The main methods of treating typical nicotine addiction include various options for reflexology, suggestive forms of psychotherapy, auto-training, behavioral therapy, nicotine replacement therapy (intranasal spray, inhaler, transdermal patch , chewing gum), etc.
There are currently no radical methods for curing nicotine addiction. All existing methods of treating nicotine addiction in the arsenal of a narcologist are grouped as follows: behavioral therapy; replacement therapy; drug therapy: non-drug therapy.
Behavioral therapy for nicotine addiction
Behavioral therapy includes activities carried out in some countries to develop behavioral strategies aimed at maintaining a healthy lifestyle (physical education and sports, balanced nutrition, optimal alternation of work and rest, elimination of bad habits). Popularizing a healthy lifestyle means, first of all, stopping smoking, which is becoming a vital important need person, other work should be carried out in educational institutions, healthcare institutions, in print and electronic media. There are many approaches to behavior therapy. Those wishing to quit smoking should use certain rules.) reduce daily cigarette consumption according to a certain pattern; increase the interval between smoked cigarettes; start smoking a type of cigarette you don’t like.
Clinical manifestations of nicotine addiction allow us to offer some behavioral therapy techniques. It is known that activities usually accompanied by smoking cause a strong desire to smoke. That is why you should avoid activities related to smoking, develop replacement habits (using chewing gum, lollipops, drinking mineral water, juices, etc.). Smoking after eating tends to enhance pleasure. In this regard, it is advisable to choose alternative options for obtaining pleasure (watching your favorite films, listening to musical works, reading fiction). Quite often, relapses into smoking occur in high spirits. Smokers need to adjust themselves and think through their behavior in situations that evoke positive emotions (pleasant excitement, anticipation of a meeting, anticipation), in which there is an increased risk of resuming smoking (an evening in the company of friends, colleagues, visiting a cafe, restaurant, fishing trips, hunting and etc.). Desire smoking may occur in a state of psycho-emotional stress. Apparently, relapses occur when smokers feel sad, sad, depressed, restless and irritable. In such cases, they should take psychotropic drugs (tranquilizers, antidepressants), as well as use behavioral methods to overcome negative emotions (self-hypnosis in a state of relaxation, seeking support from specialists). The increase in body weight observed during abstinence from tobacco use is one of the main causes of smoking relapse. Organizations play an important role here proper nutrition, exercise, sports.
Hypnosutgestive express method
Among the non-drug approaches to treating nicotine addiction, the hypnosugestive express method is used. In a hypnotic trance, suggestions with therapeutic guidelines are carried out. They instill the necessity of severe health consequences with continued smoking; the possibility of premature death; disappearance of the consequences of smoking, improvement of health when quitting smoking. With the help of suggestion, they remove the pathological attraction to smoking, develop indifference, indifference and aversion to tobacco. They form a stereotype of the patient’s behavior in society with a refusal to smoke in any situation, even when exposed to traumatic factors that provoke attraction. Strengthen the patient’s own attitude towards quitting smoking.
Among the methods of psychotherapy for smoking, stress psychotherapy according to A.R. occupies a certain place. Dovzhenko. When influencing a patient, this therapy includes a system of positive reinforcement as a universal mechanism of self-regulation and self-control of body functions.
Substitution therapy for nicotine addiction
As replacement therapy For nicotine addiction, special preparations containing nicotine are widely used. Imitation of the effects of nicotine occurs as a result of the use of chewing gum with nicotine and nicotine in solution. Chewing gum with nicotine should not be considered as a panacea. Its use gives a certain effect in a complex of medical, social and other measures in the fight against tobacco smoking.
Preparations containing nicotine cause effects for which patients resort to smoking: maintenance Have a good mood and performance, self-control in stressful situations etc. According to clinical studies, the drug Nicorette affects the symptoms of nicotine withdrawal syndrome - evening dysphoria, irritability, anxiety, inability to concentrate. reduces the number of somatic complaints.
Studies have shown that treatment of nicotine addiction using a nicotine patch is much more effective compared to placebo treatment. A high dose of nicotine in a patch (25 mg) is preferable to a low dose (15 mg). A transdermal approach to nicotine addiction replacement therapy is carried out using large quantity drugs: habitrol, nicodermar, prostepa, as well as nicotrol three types, containing 7, 14, 21 mg of nicotine, with an absorption duration of 16 or 24 hours.
Increasing the effectiveness of tobacco smoking therapy can be achieved through the combined use of nicotine chewing gum and a nicotine-releasing transdermal system, which ensures a constant and stable supply of nicotine to the body. The patient uses chewing gum occasionally, as needed. Combination therapy is carried out sequentially. In this case, the patient first uses a mini nicotine patch, and then periodically uses chewing gum to maintain long-term remission.
Nicotine aerosol makes it easier to abstain from smoking, but only in the first days of its use. Nicotine inhalers are used in the form of a plastic tube with a nicotine capsule to deliver nicotine through the mouth. 4-10 inhalations are used per day. Nicotine inhalations are useful for short-term smoking cessation.
The pronounced need to smoke during withdrawal syndrome is the reason for unsuccessful attempts to quit smoking. That is why adequate nicotine replacement during acute withdrawal syndrome allows you to overcome the desire to smoke. To do this, use the nicotine-containing preparations presented above. The indication for their use is severe dependence on nicotine (using more than 20 cigarettes daily, lighting the first cigarette within 30 minutes after waking up, unsuccessful attempts to quit smoking: strong attraction to cigarettes in the first week of withdrawal). Nicotine replacement therapy can also be prescribed to patients with strong motivation to quit smoking. When using replacement therapy, the need for the usual daily amount of cigarettes is reduced, and with immediate cessation of smoking, the withdrawal syndrome is mitigated. A long course of replacement therapy (2-3 months) does not solve the problem of quitting tobacco. It should be remembered that in case of somatic contraindications (previous myocardial infarction, hypertension, hyperthyroidism, diabetes mellitus, kidney and liver diseases), the prescription of nicotine patches and nicotine chewing gum is inappropriate. An overdose of nicotine is possible in cases of continued smoking, as well as side effects and complications when combined with pharmacotherapy (weakness, headaches, dizziness, hypersalivation, nausea, vomiting, diarrhea).
To develop negative conditioned reflex To prevent smoking, emetics are used in combination with smoking. We are talking about apomorphine, emetine, tannin, solutions of silver nitrate, copper sulfate for rinsing your mouth. Their use when smoking tobacco is accompanied by altered sensations in the body: unusual taste of tobacco smoke, dizziness, dry mouth, nausea and vomiting.
Reduced desire
In 1997, the FDA approved bupropion as a nicotine craving reducer. The registration of the new indication for the drug, which was already used as an antidepressant, was based on the results of double-blind trials demonstrating the ability of bupropion to reduce cravings and ease nicotine withdrawal. According to the recommended regimen, bupropion is started a week before the intended smoking cessation. In the first three days, take 150 mg once a day, then 2 times a day. After the 1st week, an additional nicotine patch is prescribed to relieve withdrawal symptoms, and bupropion is combined with behavioral therapy to reduce the risk of relapse. However, there have been no studies of the long-term effectiveness of such combination therapy.
Studies show that when stopping smoking using a patch or chewing gum with nicotine, confirmed abstinence after 12 months was observed in 20% of cases. These are lower treatment success rates than for other addiction types. The low effectiveness is partly explained by the need to achieve complete abstinence. If ex-smoker“breaks” and tries to smoke “a little bit at a time,” he usually quickly returns to his previous level of addiction. Thus, the only criterion for success can be complete abstinence. The combined use of behavioral and drug therapy may be the most promising approach.
Reflexology and nicotine addiction
In recent years, reflexology and its modifications (electroreflexotherapy) have been widely used in the treatment of nicotine addiction. These methods are in many ways superior to traditional drug therapy.
The method of electropuncture on biologically active points (corporal and auricular) is painless, does not cause skin infection, does not cause complications, and does not require much time (3-4 procedures per course). During the procedure, patients lose the desire to smoke and symptoms of nicotine withdrawal disappear. After completing the course of treatment, when trying to smoke, patients develop an aversion to the smell and taste of tobacco, and the pathological attraction to it disappears. Patients stop smoking. Auricular reflexology is the most effective method treatment of nicotine addiction.
Combined treatment of nicotine addiction
It has been established that the combination is very effective for nicotine addiction following methods treatment: acupuncture or acupuncture to get rid of physical dependence; session (ideally a course) individual psychotherapy for mental adjustment to a new life, a new solution to problems associated with emotional experiences: inclusion in a mutual support group to form a new way of life; abstaining from smoking for a sufficient time (prevention of relapse).
A complex technique using acupuncture in combination with hypnosuggestion quickly and effectively deactivates the craving for nicotine, this is an important point for many patients who are determined to get rid of nicotine addiction at once. This approach allows you to eliminate the functional symptoms that provoke the desire to smoke.
Acupuncture is carried out according to the classical “Antitobacco” method, developed by the Frenchman Nogier, using mainly auricular points. The goal of a verbal hypnotherapy session is to achieve a shallow waking state. The suggestion formulas used take into account not only the patient’s motivation to quit smoking, but also his understanding of the motives for craving for tobacco. During the session, which lasts about 30 minutes, the pathological craving for tobacco is stopped. Repeated sessions are carried out every other day with additional inclusion corporal points of influence, enhance the impact of the needles by twisting them.
It is known that smoking cessation causes hormonal-mediator dissociation, which affects the state of mental and physical comfort of a person. The use of modifications of reflexology accompanies the normalization of the functional state of the sympathoadrenal system. That is why the use of laser methods of influence, which have a powerful stimulating and normalizing effect, contributes to rapid recovery hormonal mediator dysfunction that occurs during the treatment of nicotine addiction (withdrawal syndrome).
When developing the medical section of the national anti-smoking project, it is necessary to take into account:
- treatment of nicotine addiction requires special knowledge and skills and should be concentrated within the clinical discipline of narcology;
- in the implementation of certain sections of treatment programs for smoking cessation, narcologists can involve non-medical specialists (psychologists, sociologists, teachers, etc.);
At any age, a person can become addicted to alcohol. In most cases, there are people behind the alcoholic who want his recovery - relatives, colleagues, friends would give a lot for the patient to be cured. Unfortunately, there are people caught up in the network of alcoholism who do not have loved ones nearby who are ready to help. For them, the only method of salvation is free treatment in a public clinic.
What is alcoholism
Alcoholic drinks of various brands and types are in demand among the vast majority modern people. Only the reasons and regularity of drinking alcohol are different. Many people know the measure, dose and when to stop. Some become addicted to the intoxicating potion. Alcoholism is a mental illness in which a person drinks alcohol excessively.
As a result of constant intoxication, ability to work, moral values, and well-being decrease, and health deteriorates greatly. The patient becomes mentally and physically dependent on strong drinks. When there is no alcohol, a person suffers, and to alleviate them, he drinks again and again. The National Institute on Alcohol Abuse recognizes alcoholism as a chronic disease that must be treated in its early stages to prevent serious complications.
A person can rarely get rid of alcohol addiction on his own. The disease progresses unnoticed, and at this time the alcoholic loses his health. Alcohol is a universal cytoplasmic poison that easily penetrates cells, affecting all systems and organs of the human body. With its systematic use, the cardiovascular, digestive, and central nervous systems are irreversibly destroyed, the kidneys and liver cease to function normally, and chronic diseases develop.
Even severe alcoholism is treatable. Modern techniques include both drug and psychological treatment regimens. Separately, he undergoes treatment aimed at aversion to alcohol, which is called coding. Principles of getting rid of alcohol addiction:
- detoxification – elimination of the consequences of alcohol poisoning;
- development of aversion to the smell and taste of alcohol-containing drinks at the reflex level;
- maintenance therapy lasting 2-3 years.
There are many drug treatment clinics where alcoholics are treated, both public and private. Paid clinics provide comprehensive treatment that helps cure strong cravings for strong drinks, but at the same time ensuring complete anonymity. Government agencies and churches usually provide social adaptation, alternative or psychological treatment for alcoholism free of charge.
Modern methods
Both paid and free assistance to alcoholics is carried out in several stages:
- Conditioned reflex. Therapy is aimed at developing a negative reaction in the patient to alcohol-containing drinks. The alcoholic is given small doses of vodka along with emetic medications.
- Sensitization. The method allows not only to conduct a psychological analysis of the problem, but also helps to create in a person an attitude towards alcohol intolerance.
- One of the most effective methods of getting rid of alcohol addiction. Aimed at persistent aversion to alcoholic beverages. Hypnosis is effective when the patient voluntarily turns to a narcologist.
- Encoding. Sometimes free help for alcoholics is carried out using the Dovzhenko method. The therapy is also based on the hypnotic suggestion of aversion to alcohol, but has several stages.
In any course there is a final phase – maintenance therapy. It consolidates the result to reduce the risk of relapse. This includes drug therapy, which includes taking supportive medications, and constant communication with a psychotherapist. The effectiveness of treatment depends on the patient himself. A person must remember that there are no such thing as former alcoholics, and should forever stop taking intoxicating drinks. Even a small dose of alcohol on holiday can again lead to a long binge.
As already mentioned, help for alcoholism can be found free of charge in government agencies. It should be understood that the services provided may not be at the highest level. Free treatment has both pros and cons. Positive sides:
- help for alcoholics is provided free of charge, because drinking people there are often no funds for paid treatment;
- the right to inpatient treatment remains when calling an ambulance at any time;
- the alcoholic is referred for compulsory treatment, which is especially important for loved ones.
The main disadvantage of the free government program is registration. The doctor enters relevant information into the medical history that could derail a person’s promotion. For many people, this procedure is the main reason for refusing treatment for alcoholism. Also, free drug treatment is not particularly effective due to the negative attitude of medical personnel towards patients. Government institutions where you can receive alcoholism treatment without payment:
- social centers;
- churches;
- drug treatment clinics.
Drug treatment clinic
At the dispensary you can get free treatment for alcoholism, but it is better to find out in advance what methods a particular clinic uses. More often this is a social rehabilitation program in which psychotherapeutic assistance is used, and drug treatment is carried out on on a paid basis. In severe cases, alcoholics can be sent to the general ward of a hospital for free treatment, but for this you need to have an insurance policy. Narcological dispensaries provide patients with the following types of services, carried out under constant monitoring:
- Primary detoxification. The procedure includes cleansing the body of ethanol breakdown products. It is carried out using a dropper through infusion. In a hospital setting, plasmapheresis is also performed - deep blood purification. In addition to detoxification, the patient receives vitamin therapy and auxiliary support for the central nervous system, liver, kidneys, and heart.
- Relieving withdrawal symptoms. In the chronic stage, alcoholism is characterized by the formation of severe physical condition when you stop drinking alcohol. The person suffers from depression, muscle pain, tremors and other symptoms. Narcological clinics in hospitals relieve alcohol withdrawal with tranquilizers, magnesia, magnesium, sodium, potassium and other medications.
- At this stage, the patient’s body is cleansed of toxins, the alcoholic is returned to a normal physical state, and all physiological functions are restored. At the same time, addiction treatment is carried out using prohibitive medications. Additionally, the patient is prescribed a special diet and physiotherapeutic procedures.
- Psychological help. IN drug treatment institutions There are always full-time psychologists who provide rehabilitation support to patients. Eliminating physiological alcohol dependence does not give 100% success, so correction of the mental state is necessary.
Where to surrender an alcoholic without his consent
It is not so easy to admit a patient with alcohol addiction to the hospital, because the current legislation protects all members of society. An adult alcoholic can only be treated at a drug treatment center on a voluntary basis. They have no right to force a person to undergo therapy both on an outpatient basis and in a hospital - only to persuade. The same current legislation also takes care of the patient’s relatives, so an alcoholic can be forcibly taken to a clinic under exceptional circumstances. life situations without going to court:
- If he is inadequate and does not independently control his actions. In this case, relatives need to prove that the patient needs special care and qualified medical assistance.
- The patient behaves aggressively towards others. If the patient poses a threat to society, he will also be sent for compulsory treatment.
- Suicide attempt. Suicidal tendencies are evidence that a person needs compulsory treatment.
- Commission of crime. Any offense is punishable by law, and intoxication is not a mitigating circumstance.
Where to get rid of alcoholism
Free treatment for alcoholism is carried out only with medications and psychological help. They code in private clinics for money. In every city there are many specialists offering their services different prices. It is better to contact a trusted doctor, because an incorrectly performed procedure will, at best, not produce results, and at worst, it will provoke a lot of adverse reactions that will worsen the already deteriorating health of the alcoholic.
There are many coding techniques for alcoholism. The best therapy, according to patients, is considered to be sessions of hypnotic and psychological influence using the Dovzhenko method. Treatment of alcohol dependence with an injection (Vitamerz, Torpedo, Aqualong) or the sewing method (Radotel, Esperal) is considered effective. These drugs remain in the body.
IN normal conditions they do not harm in any way, but as soon as even a small dose of ethanol gets into the blood, the active substance of any of the above drugs reacts with it. The body’s negative response to alcoholic drinks after coding is several times greater than the usual hangover. After this, a person develops a fear of drinking alcohol.
Free consultation with a narcologist by phone
The Internet has taken the opportunity to receive free alcoholism treatment to a new level. Almost all alcoholics are afraid of a real meeting with a narcologist. Now they have the opportunity to find out all the information they are interested in anonymously online or by phone. It is clear that full recovery the person will not receive it, but such a conversation can be the first step towards conscious treatment. A narcologist will help identify aspects of addiction that are beyond the understanding of the patient, because drinking alcohol destroys both the physical and mental state of the patient.
Not only an addict, but also his relative who wants to help, but does not know how, can ask for free help over the phone. The convenience of online consultation is that it can be obtained without leaving home and without leaving the patient alone in a state of intoxication. Benefits of free help from a narcologist:
- obtaining motivation to start treatment;
- Possibility of round-the-clock communication;
- a chance to see the whole problem.
How to quit binge drinking at home
Narcologists say that self-medication is dangerous, but if the drinking was short-lived, then interrupting it can be made less painful on your own. The main thing is that the person himself realizes the need to quit binge drinking. To alleviate the condition after drinking, you need to:
- gather your strength and stop drinking alcohol in the evening;
- in the morning, give up the hangover and drink 1.5-2 liters of liquid in the form of brine, freshly prepared juice, mineral water, herbal tea from chamomile, thyme, mint, lemon balm;
- then you need to drink Activated carbon(1 tablet per 10 kg of body weight), 20 drops of Corvalol, 1 tablet of Aspirin for headaches (if necessary);
- Next, it is advisable to eat fatty broth and take a contrast shower;
- During the day you should sleep a lot, walk, read, watch movies, drink more fluids;
- In the evening, taking medications and contrast showers should be repeated to consolidate the result.
If a person drinks alcohol for a long time (more than 4 days), it will be very difficult to stop drinking alcohol on his own. A narcologist can help you get out of binge drinking at home, but this will not be a free service. For this manipulation, a doctor is invited from a specialized or private clinic. The narcologist puts the patient on a drip with rehydration and detoxification solutions, which quickly neutralize and remove ethanol breakdown products from the body, replenish lost fluid, missing vitamins and minerals.
The drugs administered are prescribed to each patient individually. Selection occurs depending on the severity of the alcoholic’s condition, age, and history of chronic diseases. After the situation improves, the doctor conducts a conversation with the patient and his family, during which he explains what the features and negative consequences of the addiction are. For some patients, a comprehensive rehabilitation course is being developed to help get rid of alcohol addiction. For others, a coding service is offered, and for others, the doctor assigns them to drug control.
New generation medications act without harm to the patient. There is no post-alcohol syndrome after use. and tablets can not only discourage cravings for alcohol, but also improve the health of the body.
Dropper for alcohol intoxication at home
Intravenous administration of drugs using a dropper speeds up withdrawal ethyl alcohol due to the diuretic effect of drugs and neutralization of toxins. This treatment helps to quickly eliminate dehydration and provide the body with the necessary microelements lost during binge drinking. The price for such a service will depend on the number of drugs used and the professionalism of the doctor. At its core, an IV drip is an accelerated detoxification course. It must include:
- solution of magnesium sulfate on glucose, physiological solution or glucose;
- detoxification agents (Sodium thiosulfate, Unithiol, Gelatinol, Hemodez);
- soda solution;
- rehydration medications (Trisol, Disol);
- vitamins B1, C;
- sedatives(Seduxen, Relanium).
Alcoholism pills
The prescription of any medications for the treatment of alcoholism is carried out after additional laboratory tests (blood biochemistry, ECG, etc.). The test results help the doctor select medications that are more gentle for the patient’s internal organs. Some of the prescribed medications can only be sold with a doctor's prescription, as they have dangerous side effects. The most popular drugs for the treatment of alcoholism:
- It disrupts the process of neutralizing alcohol, as a result, while taking the drug together with alcoholic beverages, the patient experiences extremely unpleasant symptoms (heart pain, hyperemia, etc.). As a result of these sensations, the alcoholic develops a persistent aversion to drinking. Tablets are taken with meals according to a specific regimen of 200-500 mg/day. Duration of treatment is up to 3 years. The drug is not prescribed for diabetes, epilepsy, mental disorders and many other pathologies.
- Cyanamide. The drug disrupts the normal process of breakdown of ethyl alcohol in the body, increasing the patient's sensitivity to alcohol. After combined use, a patient with alcoholism experiences a feeling of fear, palpitations, convulsions, and chills. This reaction leads to the development of aversion to the smell and taste of alcoholic beverages. The effect of Cyanamide occurs 40-60 minutes after administration and lasts about 12 hours. Take 12-25 drops orally every 12 hours for 1-3 months. The drug is contraindicated in serious illnesses heart, liver failure, pathologies of the kidneys and respiratory tract.
All alcoholics need treatment. Unfortunately, there are often various obstacles when recovering from addictions. How to be treated and is there free treatment for alcoholism?
One of the most important factors in effective treatment is motivation. The patient must want to get rid of addiction. However, most patients have no desire.
This is due to the fact that it is difficult for a person to understand and assess the extent of his illness and how serious his problem is. It is difficult for a person to admit that he is addicted to alcoholism.
Alcohol addiction develops gradually; often not only relatives, but also the patient himself realizes the problem too late. Over time, the disease only gains strength, developing chronic symptoms, provoking difficult relationships with loved ones, and situations at work. Looking at all this, others begin to understand the consequences of alcoholism and the problem of the situation. Unfortunately, at this stage the patient is no longer able to independently assess his condition and does not want to seek medical help. In addition, not everyone knows that free treatment for alcoholism exists.
A person understands what dangerous action Alcoholism has an impact on his body and life in general, relationships with family, and his situation at work. In the first stages of alcoholism, the patient often accepts the situation with regret. However, even then the person may not realize that the problem is alcohol. He does not realize that constant drinking has become an addiction.
For effective treatment of alcoholism, experts advise AlcoLock product. This drug:
In most cases, patients do not want to be helped: “Why do I need help? I’m not addicted, I can quit if I want, I have everything under control.” However, at this stage there is no control.
At this stage, it is important that the patient himself wants to be cured. From contacting medical Center a person is held back by shame. Treatment is also necessary because addiction never stands still, but constantly develops. Constant consumption of alcohol can lead to harmful changes in the structure of internal organs and the nervous system. In such a situation, it may become too late; time is against the addict. The time may quickly come when any procedures, even complex treatment, will no longer be effective. If a person does not have money, he can go for free restoration of the body. The patient not only provides negative action on your health and psychological state, but also on your environment.
Places for alcoholism treatment
There are several places that help people suffering from alcoholism:
free public services(dispensaries, clinics);
- individual clinics;
Do you still think that it is impossible to cure alcoholism?
Judging by the fact that you are now reading these lines, victory in the fight against alcoholism is not yet on your side...
Have you already thought about getting coded? This is understandable, because alcoholism is a dangerous disease that leads to serious consequences: cirrhosis or even death. Liver pain, hangover, problems with health, work, personal life... All these problems are familiar to you firsthand.
But maybe there is still a way to get rid of the torment? We recommend reading Elena Malysheva’s article about modern methods of treating alcoholism...
Read completely- rehabilitation programs(in churches and social centers, free);
- anonymous centers for rehabilitation after alcoholism (are not free).
Most patients require free treatment for alcoholism. The fact is that the cost of therapy in private clinics is often large sums, especially in Moscow, that a person simply cannot afford it. How can a patient without work and home pay such a price for rehabilitation? In this situation, he has no choice but to continue drinking.
However, free treatment for alcoholism is provided in government clinics and churches.
State aid
Help for alcoholism is provided free of charge in government agencies. At the same time, people understand that free healthcare cannot be of high quality, so they are distrustful of such institutions. Such clinics have both weak areas and their advantages.
Pros of free alcohol treatment centers:
- free stationary courses;
- the right to hospitalization at any time of the day when calling an ambulance;
- referral of the patient for free, sometimes compulsory, treatment.
Disadvantages of free treatment for alcoholism:
- staff work (patients receive free services - the staff can do anything);
- low efficiency;
- patients are assigned to drug control (treatment is not anonymous);
- not so much free places for the sick;
- Outpatient therapy methods are mainly used.
Treatment at a drug treatment clinic
Before going to a drug treatment clinic, where alcoholism is treated for free, it is worth knowing what methods the public clinic uses:
- fight against long drinking bouts;
- drips (detoxification);
- drug therapy for the rehabilitation of parts of the liver;
- work of the patient with psychologists.
In the most severe cases, alcoholism treatment centers refer the patient to a hospital free of charge. However, there are not many places in them; often the patient cannot get in even with high degree necessary. Referral to such institutions follows the standard procedure (you need an insurance policy and a passport).
Treatment methods for alcoholism
Addiction treatment, including free treatment, is divided into several stages. First, you need to remove toxins and cleanse your body of the effects of addiction. The patient is prescribed a whole course of drugs. Next, the treatment method is selected.
Treatment methods:
What doctors say about alcoholism
Doctor of Medical Sciences, Professor Malysheva E.V.:
I have been studying the problem of ALCOHOLISM for many years. It’s scary when the craving for alcohol destroys a person’s life, families are destroyed because of alcohol, children lose their fathers, and wives lose their husbands. Often it is young people who become drunkards, destroying their future and causing irreparable harm to their health.
It turns out that a drinking family member can be saved, and this can be done in secret from him. Today we will talk about a new natural remedy, which turned out to be incredibly effective, and also participates in the federal Healthy Nation program, thanks to which until 13.5.2018(inclusive) the remedy can be get it for just 1 ruble.
- Conditioned reflex. Therapy for the appearance of a strong reaction to alcoholic beverages. Methodology: the patient is given small doses of alcohol along with emetic medications.
- Sensitization. This treatment method is popular all over the world. It acts not only on psychological aspect problems, but also creates intolerance to alcohol. Unfortunately, the method does not have a lasting effect. After a while, the patient can start using again.
- Hypnosis. The method for getting rid of alcoholism has existed for many years. One specialist (V.M. Bekhterev) tried to use a complex of suggestion and hypnosis. Treatment is aimed at developing the effects of alcohol and aversion from it. Therapy is effective only with voluntary treatment.
- Free coding for alcoholism. The method was introduced into practice by the scientist doctor A.R. Dovzhenko, who instilled a strong fear of alcoholic beverages in patients without introducing third-party drugs into the body. The therapy is based on suggestion during hypnosis. The encoding process has three levels: a negative attitude towards alcohol appears, cravings for the right image life, consolidation of the effect of suggestion. Coding is a method of prolonging remission in chronic addiction. It is used as a measure rather educational plan. She is able to keep the patient from desire. This type of treatment is popular among patients who are not ready to analyze their condition and undergo serious therapy, and also claim free rehabilitation.
Maintenance therapy is the last stage in any course of treatment, including free ones. It is needed to consolidate the result and reduce the risk of relapse. Therapy includes both supportive medications and constant communication with a psychotherapist, who must monitor the patient’s condition and the effectiveness of therapy.
The patient should develop an aversion to alcohol on his own.
Even a small dose of alcohol can lead to a dangerous long-term binge. Changes in the body due to long-term alcoholism cannot go away immediately, within a few months. It takes a lot of time.
With even a small dose, there is a risk of addiction and craving for alcohol returning, sometimes even with greater force. So, both with paid and free treatment, the condition and support of the patient by loved ones is important.
Alcoholism is an uncontrollable disease that always has a negative impact on both the physiological and psycho-emotional state of a person. If you ignore this problem, then very soon irreversible changes in organs and systems will develop, which will mark the beginning of many chronic pathologies. That is why treatment at a drug treatment clinic for alcoholism should begin as early as possible.
Modern medicine can offer enough ways to eliminate this problem with minimal complications - a variety of specially designed programs with high final effectiveness.
Treatment at the drug treatment clinic "Alkoklinik"
Eliminating alcohol dependence is the best option for today, which involves the full rehabilitation of patients from their addiction.
The specialists of our dispensary have developed a comprehensive method of treating alcoholism, which includes:
- primary measures to relieve withdrawal symptoms;
- full ;
- drug therapy;
- coding;
- correctional psychotherapy;
The therapy carried out in our clinic allows us to effectively restore body functions impaired as a result of alcoholism, prevent chronic mental and somatic diseases, improve well-being during the period of recovery from binge drinking and say goodbye to destructive addictions forever.
How is treatment for alcoholism carried out in a drug treatment clinic?
Despite the variety of methods, the treatment regimen is always drawn up on the basis of certain criteria, which ultimately allows for maximum results.
In particular, narcologists at our clinic take into account the following points:
- characteristics of the patient as an individual;
- relationships between the patient and others;
- the presence of various pathologies;
- behavior in his usual way social society;
- age criterion;
- tolerability and absence of allergies to drugs;
- patient preferences;
- severity of symptoms;
- type of previous therapy, its effectiveness.
Based on the data obtained, the doctor draws up for each patient an individual treatment program for alcoholism in a drug treatment clinic, which includes:
- Detoxification. This is the first point of treatment. It is very important to cleanse the patient’s body of toxins and metabolic products that accumulate in it due to excessive alcohol consumption. Special techniques allow you to eliminate a hangover and restore work important functions, eliminate cravings for alcohol and a number negative consequences addictions (headache, hand tremors, pathological fear, swelling, feelings of unreasonable anxiety, mental disorders, depression, etc.).
- Stabilization of mental state. This is the stage of work with the patient by professional and qualified psychologists. They help him take control of his emotions, give up alcohol, normalize his mental state, and correct his behavior. Thanks to doctors, a person begins to again feel like a necessary and full-fledged member of society, his life again has meaning. At this stage, the support of loved ones is very important. The clinic's psychologists will always help outline ways to solve a variety of problems in the family, at work, in relationships, in order to solve them as quickly and painlessly as possible.
- Coding. It can be performed immediately after quitting binge drinking or after completing a course of therapy. The purpose of this procedure is to block the patient’s desire for alcohol. After coding, a person can return to his usual society. The Alkoklinik center offers such coding methods as filing of long-acting medications, the Dovzhenko method, tablet drugs of imported and domestic production.
For many, treatment of alcoholism in a drug treatment clinic has become a lifeline and allowed them to return to a normal life, family, relatives, and children. Treatment programs in our clinic are focused exclusively on promoting healthy and sober image life. Timely assistance from a narcologist and the latest scientific developments and technologies make it possible to recover from alcoholism in the shortest possible time, forever getting rid of this harmful and personality-destroying habit.