Drug demand reduction in RUSSIAN FEDERATION E.A.Bryun

1. Government of MoscowMoscow Department of Public HealthMoscow Research and Practical Center on Addictions Drug demand reduction in RUSSIAN FEDERATION E.A.Bryun Moscow, 13-15 may 2013

2. In 2010 the fundamental documents defining a vector of development and improvement of the narcological help to the population of the Russian Federation were accepted. It is Strategy of the state anti-drug policy of the Russian Federation till 2020, approved by the Decree of the President of the Russian Federation of June 9, 2010 № 690. It is the Concept of a state policy on decrease in scales of abuse by alcoholic products and alcoholism prevention among the population of the Russian Federation till 2020, approved as the Russian Prime Minister on June 23, 2010.

3. Order of rendering the narcological help to the population of the Russian Federation, approved by the order of the Minister of Healthcare and Social Development of the Russian Federation of 15 november 2012 № 929н. Medical-economic standards, approved by the order of the Minister of Healthcare and Social Development of the Russian Federation 4 september 2012 №№ 125н – 135н..

4. The diseases connected with addictions – are uniform disease process (nozos), having various clinical forms, including: chemical addictions: alcoholism,drug addictions, toxic substance abuse;food addictions, gamblingand other forms of addicted behavior and phenomenologically being shown frustration of inclinations. Biological basis of narcological diseases makes mental dysontogenesis,etiological removed from biochemical violations of a brain (genetic predisposition , injury, mental and somatic diseases), and also psychological disharmony, the ethnocultural and social disparity, the distorted information environment. Thereby, modern narcologyare recognizes the bio-psycho-soсio-spiritual nature of a narcological disease, which is realized in connection with accumulation of pathogenic factors.

5. At the same time, be aware that the majority of patients in the case of formation of remission and stop the disease process (nozos) there is a sum of contributing factors, that is the pathological condition (patos) remains, that dictates need of long medical supervision and antirecurrent treatment, on the one side, and medical-psychological, medical-social, professional, legal, sociocultural and so forth, and the rest rehabilitations at a coordinating role of medicine.

6. Isolation in ITU FSIN Russian Federation and obligatory treatment Ylevel Obligatory and alternative treatment by court definition in narcologicalestablishment IYlevel Narcologicalservice Tertiary prevention: Medical rehabilitation programs for different groups of patients III level The second prevention: Socio-therapeutic intervention (early identification and intervention) IIlevel Primary prevention: Detection of risk factors Сourseware in the organized collectives SOCIAL PRESSURE Ilevel NARCOLOGICAL POPULATION Anti-drugs propagation in mass media SCHEME OF SOCIAL PRESSURE ON NARCOLOGICAL POPULATION

7. Primary prevention(work with a family, in the organized collectives, including with children of preschool age). Interaction with mass media and the interested departments. • The second prevention –socio-therapeutic intervention (early identification and intervention (work with groups of risk, the contingents of the commissions on affairs of minors, neglected children and teenagers, the consumers of drugs abusing alcohol and tobacco, and also persons with behavior frustration). • Intervention target(primary consultation of patients, their relatives and citizens and motivation of the patient on inclusion in the medical program) • Disintoxication (treatment of an abstinentny syndrome, somatic, neurologic and sharp psychopathological frustrations); • Treatment of a syndrome of a pathological inclination, affective and other frustrations, both premorbid, and the psychoactive agents connected with the chronic use; • Psychotherapy and correction of personal frustrations; • Rehabilitation and antirecurrent actions (medical supervision and formation of the rehabilitation environment). Interaction with family, with the interested organizations and departments. • Development of the treatment subculture as an opposite to alcohol- and drug subcultures

8. Dependence of annual remission on quantity of the passable stages of treatment Rehabilitation programs IV Psychotherapy programs III Treatment of psychopathological frustration II Rapid relief of withdrawal syndrome I 1-5% 15-20% 25-30% 40-50%

9. Remission duration after passing of rehabilitation or medical programs

10. Remission duration after rehabilitation(drug addiction) Remissions

11. Conclusion: In this connection in the organization of rendering the narcological help includes the decision not only medical tasks, but, first of all, organization of system approach, including bothmedical, andpsychological, sociocultural, information aspects of treatment and corrections of a deviation of mental development in patients of a narcological profile.

12. Zone of the next development • The Ministry of Education and Science of the Russian Federation brought in the government the draft of the federal law on prevention of the use of drugs among the school students, providing voluntary testing. • Ministry of Health of Russia prepared the project the order on soсio-therapeutic intervention and testing of school students on drugs. • Further improvement of the legislation.

13. Thanks for attention!