The principle of advanced training - start early preventive education, at least three years before it becomes necessary to make problematic decisions. Consideration of these principles provides a modern methodological and technological level of such training programs, their undoubted effectiveness. Thus, this article identifies some problems setting anti-drug educational preventive work, formulated the basic methodological principles of targeted training programs. The approbation of such a program was carried out over three years in a number of educational institutions in Moscow. Article published in zhurnaleLechaschy doctor
Saturday, 25 June 2011
Friday, 24 June 2011
They live in this particular community and not isolated from the adult world. Preventive work is not limited to the transfer of knowledge and clarification. The concept of prevention involves: the formation of an adequate attitude to a significant social phenomenon (a drunken, drug addict - it's unpleasant, painful for others, it is dangerous for the individual, etc.), training skills to overcome the external pressure, conformity (to know how to confront a stranger-pressed to say no ", to be independent) of the child's specific personal qualities (self-esteem, awareness of its uniqueness, the ability to speak about their difficulties and ask for help, etc.). Our curriculum prevention program based on the following methodological basis, responding to modern approaches to learning and education. These are: the dialogical communication, ie, the interaction of teacher and student as equal partners, without excessive authoritarianism on the part of teachers, the democratic style of teaching, based on sincerity, trust, openness, equal partnership. Based on the analysis and synthesis of international and domestic experience in the implementation technologies of psycho-hygiene-oriented training programs we have identified the following principles of their construction. Systematic approach - taking into account the totality of personal and social factors that determine children's readiness for the implementation of a safe conduct and risky behavior, deviant - in their relationship and interaction. Partial - anti-drug education as part of the overall sustainability of the educational process to the formation of psycho-hygiene behavior-based, providing the stability of risk factors. Subject adequacy - the maximum reflection in the program content to real life issues that are relevant to specific age groups and are directly related to the possible attached to the SAC (including in this city, district, school). Cognitive adequacy - that the content of teaching materials and techniques intellectual development of children. Socio-cultural relevance - Accounting peculiar to our culture, social values, behavior, communication, leisure activities, including rituals of consumption of the surfactant. Drug adequacy - the account of our "native" Drug culture - typical for Russia and Moscow's use of various forms of surfactant, the mechanisms involving in this consumption, especially the "People's attitude to the misuse of surfactants - a drunken, drug addicts. Using the phenomenon of mass consciousness, mass culture (including their age aspect) - as mentioned above. The principle of personalization - if possible, provide a direct impact on children as their favorite characters, and "winners blemish" - former patients who have a special right to speak about the need to reject the SAW, thus achieving genuine impact. The principle of mandatory alternative payoff - "I'm not going to smoke and drink more so, because I want to be strong, smart, beautiful."
This program is inculcated in several Moscow schools (№ 1256, 76) and the boarding school № 29. During the three academic years, beginning with the first class, they were special weekly lessons on raising skills of healthy and safe behaviors and lifestyles. Once children learn in an accessible form with information on substances hazardous to life and health, and in the form of a game taught the rules of careful handling, we were going to go to information about drugs. It was decided to determine the readiness of junior schoolchildren to accept this information. Before proceeding to the next level of prevention, we conducted a survey in two classes at school number 1256. Here are the results of the survey 58 children (38 girls and 20 boys). Children answer the following questions: What are the psychoactive substances do you know? Which of them often say adults? What kind of psychoactive substances you happened to hear from friends? Which drugs have you heard? Do you think that any psychoactive substances are the most dangerous to humans? What kind of psychoactive substances you learned from TV? The term "psychoactive substance" was already familiar to children from the material of the previous studies. Responses of the children enrolled at the last stage of primary school (third grade), showed that the majority of children referred to them are already familiar psychoactive substances: first of all - alcohol, in second place - nicotine - the third drug, and in fourth place - "Tablets" (drug). Children's responses also showed that the drugs are not a topic of conversation among them: friends, classmates, they hear most often about smoking (tobacco, cigarettes) of alcohol (vodka, alcohol, etc.) on drugs (small number of references, only in summary form - tablet). It is notable for a large share of responses "do not know" - so said 24 people, nearly half of those surveyed. This result can also be interpreted in favor of the thesis that there is no mass interest in drugs. We are aware that the set of surveyed primary school children can not be called a representative (representative): the results of this poll can not be judged on knowledge of drugs in this age group, even by Moscow as a whole. Nevertheless, the survey clearly revealed some trends in this subject area. Students surveyed were significantly different from their peers that they were engaged in according to our prevention program. They are already familiar with the phrase "psychoactive substance", although not all of them formed a clear understanding of the boundaries of this notion. They distinguish between "drugs" and "medicine", although encountered in the responses and the definition of "medical drugs". The answers of the respondents in their trends reflect the pattern of mass child consciousness: junior schoolchildren in Moscow mostly know about cigarettes and alcohol drug they know far less, and only in aggregated form. Specific names of drugs were able to specify only a few students. We feel justified the idea that you should not tell children about drugs.
Thursday, 23 June 2011
But how in the world and in domestic medical practice, the use of the term "drugs" sharply limited. One or another biologically active substance only if the drug is called when "simultaneously" it meets three criteria - medical, social and legal. Medical criterion is that the substance has a special specific effects on the central nervous system, psyche - an aphrodisiac, stimulant, depressant, hallucinogenic, etc., which is the reason for his non-medical use. Social criterion means that the non-medical use of this substance has assumed such proportions that has become a social, a nation-wide importance and require special responses. Legal criterion requires that country-specific relevant government department in charge of the state, its legislature has recognized this tool Narcotic and turned it into a special official list of drugs (in the Russian Federation, as before - in the Soviet Union, this institution - the Ministry of Health). Morbid dependency on drugs is called drug addiction. All other funds if they can be subject to abuse and dependence are known for abuse control (toxicants), a disease caused by reliance on them - substance abuse. By a circle of psychoactive substances include nicotine, alcohol, caffeine, theine (contained in tea), some drugs, a number of alkaloids and other substances contained in plants, fungi and their products, as well as synthesized in the laboratories of chemicals (including household products Chemistry and Industrial Chemistry - glues, solvents, etc.) Currently, there are scientific positions, an understanding which is crucial for effective prevention of various addiction: substance users occupy a place in popular culture (traditions, customs), they satisfy some psychological factors (physiological) needs of man (causing looseness, disinhibition, increasing sociability, creating a good, happy mood, etc.), and at the same time, they are undesirable for society as hazardous that are outside of medicine. Therefore the question of prevention of drug abuse may get a different and far from a definite answer in an adult (think about your parents and independent young people) or among teenagers. In the United States and some Western European countries already have practical experience of implementation of preventive anti-drug programs in kindergartens, elementary schools. Not too soon? Such a question arose, and in front of us in the work of our author's program "Fundamentals psychohygienic parenting skills of safe conduct (in relation to alcohol, drugs and other psychoactive substances) in children of primary school age." For simplicity, her perception of the school teachers and children learned this program was called "Rusty's healthy, take care of themselves."
Early prevention of drug addiction - the involvement of children in the consumption of psychoactive (drugs, for abuse) of substances - a growing problem not only on Addictions, and pedagogy, psychology and sociology. How to prevent the initiation of children to psychoactive substances, to exclude them even single test? After all, drugs and other surfactants today - it's not just some poisons, danger which clearly appreciated by all, and children as well. Their consumption - it is an integral part of the lifestyle of young people. How to resist the expansion of drug-oriented culture in our youth-podrostkovo environment? Prevention of drug addiction today is dealing with many unresolved questions. That is why it appears to be linked with a number of preconceptions - preconceptions, logic errors, which are characterized by solid principles based on faith, not knowledge. The first is a widespread bias: if the child is thoroughly and convincingly tell you about the dangers of surfactants, drugs, scare him once and for all ", he is unlikely to be using them. However, parents of adolescents who are already partaking in drugs, are well aware that such bullying is not effective or even useless. Children have not yet formed orientation towards the future, especially - in the distant future, healthy, little bolevshie children do not know what the disease is not afraid of it. Finally, the main idea: "I just try, and when it becomes dangerous - stop, we just need to find out all the better." So the first thing is quite common prejudice regarding surfactant based on the opinion: "intimidate" means "to convince of the need to avoid." The second mass bias: "know" about the dangers of surfactants, including drugs, means "to be able to avoid them." A simple example of real action such sophistry: We all know about the dangers of alcohol, that alcoholism is an illness - and yet do not always want us to refrain from drinking. The third part of Prejudice: "knowledge stirs interest kindles curiosity." From this conclusion: better, communicating or working with children, remain silent about drugs, then harm will be less. Here you can apply to the practice of sex education: Silence is never prevents and solves problems, it merely shifts the responsibility for the child and provides the circumstances, the case of complete freedom of action. Next prejudice associated with the view that drugs have an irresistible, rock strength and capable of permanently subjugate anyone, absolutely no resistance. This bias as it closes a vicious circle: we are afraid of drug when administered fear of increasing their destructive effect, signs of destruction caused a feeling of impending doom, the additional fear that veiled her eyes, hiding the existing opportunity to exit from the disease, seeking real help. Our lack of knowledge about drugs leads to another bias: drugs - is the most terrible evil. Indeed, according to the classification of the World Health Organization, drugs (drugs) are all substances that cause changes in mental status, and with prolonged use - addiction, addiction, the need for continuous use, mental and physical dependence.
Alcoholics - not a homogeneous group, although attempts to classify these patients, Jellinek undertaken in the 50 years, doctors did not leave, and to this day. It must be remembered that for such patients should be treated without bias, avoiding the possibility of stereotyping. Success after adequate detoxification is highly dependent on the living conditions of the patient. Isolation - not the best way, but be aware that alcoholics frequently marry alcoholics. Employers often go towards trying to cure an alcoholic, a policy of tolerance toward drinking. Attractive model for alcoholics is controlled drinking. If this is possible, it is only after a period of abstinence, when the patient is able to assess the impact of drinking bouts. For those who drink a long time, years and whose brain is struck by the influence of alcohol, just as it is described Korsakov, abstinence is an absolute requirement. There is evidence that cognitive impairment caused by alcohol, may to some extent offset by a period of abstinence, especially if it lasts more than two years. References 1. Latcham R. W. Gamma GT and MCV: their usefulness in the assessment of in-patient alcoholics. Br J Psychiatry, 1986, 149: 353-356. 2. Lamy J., Baglin M-C, Aron E, Weill J. Diminution de la gamma GT serique des cirrhotiques a las suit de sevrage. Clinica Chimica acta, 1975, 60: 97-101. 3. McCrady B. S, Stout R., Noel N., et al. Effects of three types of spuose-involved behavioural alcoholism treatment. Pr J Addict, 1991; 86: 1415-1424. 4. Mattick R. P., Heather N. Developments in cognitive and behavioural approaches to substance misuse. Curr Opin Psychiatry 1993; 6: 424-429. 5. Orford J, Edwards G. Alcoholism. Maudesley Monographs no 26. London: Oxford University Press, 1977.
The principal questions of the anti-drug prevention among children
M. Vedischeva, Ph.D., LN Rybakov, MD, MG Tsetlin, MD, Ph.D. Institute of Addictions Ministry of Health, Moscow Vposlednie 10-15 years in the Russian Federation is rapidly growing number of consumers of alcohol, drugs and other psychoactive substances (PAS). In this case, there is a clear trend towards the rejuvenation of the contingent addicted patients, to an increasing reduction in the age of first samples. In the sample of surfactants, "experiments" with them involved children 8-10 years (and even younger). By the age of 12 know the taste of alcohol for more than 50% of children, and to 14 years about 15% of teenagers have tried any drugs or substances for abuse. Among the newly diagnosed, primary patient drug treatment service with a diagnosis of "substance abuse" children and adolescents make up about half the total. There is every reason to believe that this situation will continue, at least in the near future. It should be borne in mind that children and teenagers is particularly high risk probability of a rapid transition from a random, episodic, "search" to re-use of surfactants, and then systematically receive them, and the danger of the formation of clinical drug treatment patterns of diseases, malignant course of disease with early personal degradation, increasing desotsializitsiey often disability of patients with high early of their mortality.
Wednesday, 22 June 2011
Poor absorption in such patients requires intramuscular injection of drugs. Need to constantly cheer patients, and to spend with them advocacy. Only a small proportion of heavy alcohol bind morning anxiety or irritability, depressed mood, night sweats and diarrhea, decrease in vitality with alcohol. However, if the patient is convinced that the cause of all trouble is alcohol, it becomes a powerful incentive for abstinence. When the general practitioner encounters a patient does not consent to treatment, then it turns into a difficult situation. Under the "Act on Mental Health" subject alcoholics with psychosis, alcohol dependence, according to this document is not in itself a mental disorder. Detoxification patients in some district hospitals conducted in the general wards, and in others - in mental health. And the hospital staff and primary care teams may consider re-introduction of drugs meaningless, but if the quality of life of the alcoholic improved at least in the short term, such treatment can be justified. In addition, many patients are ashamed of their drinking and drinking to get rid of feelings of guilt, staff should try not to exacerbate this condition. After detoxification the patient receives various forms of assistance that allows him to engage in the healing process and watching him. The atmosphere of Alcoholics Anonymous is not for everyone, but some get it the necessary support to successfully get rid of the addiction. Other alcoholics suitable alternative voluntary organizations, some of these societies, such as Alanon, support family members of alcoholics. Many voluntary organizations work together with government agencies. In the anti-alcohol team includes psychologists, who help patients solve their problems by using special techniques such as cognitive therapy of individual patients [3, 4]. Work in groups with a discussion of alternative approaches to receive alcohol, an explanation of how alcohol acts on the body, training, helping patients cope with anxiety and anger - all of these functions take on a variety of services, sometimes in conjunction with the local psychiatric ward. Antialcoholic agent disulfiram may be effective in the right mood, but impulsive drunks, relatives who helped introduce the medicine. Akamprozat relatively new GABA agonist, will remove the urge to drink from the drinker constantly, but small doses, but is ineffective against those who drink a lot in a short period of time. Investigation of Orford and Edwards shows that the results in the group of heavy alcohol, within six weeks of receiving treatment in Modesli, did not differ from that of a similar group, where only one was carried out corresponding to the conversation. While it is necessary to point out that for each individual patient treatment must be selected individually .