Alcoholism has been a significant problem at all times and remains relevant to this day. Alcohol addiction treatment- the process is long and complex, it is much easier to eradicate a bad habit at the initial stages of formation. This requires prevention of drunkenness and alcoholism among the entire population, especially among children. It should be carried out at the state level and within each family.
Prevention of alcohol dependence is the most effective method of combating alcoholism and drunkenness. Alcoholism prevention measures include state, public, socio-economic, medical and sanitary, pedagogical and psychological activities. The prevention of alcoholism among the population is divided into several stages:
- primary prevention of alcoholism;
- secondary prevention of alcoholism;
- tertiary prevention of alcoholism.
Primary prevention of alcoholism is aimed at people who have not previously tried alcohol: children, adolescents and young people. Prevention of alcoholism among adolescents and minors is aimed at reducing the number of people who may be interested in alcohol, at maintaining or strengthening the health of children. Prevention of alcoholism in adolescents should be carried out both at school and at home in the family. In school institutions, it is necessary to regularly conduct prevention of alcoholism among students, which is an explanatory conversation about the dangers and consequences of alcohol, debunking myths about alcohol.
Adults should carry out alcoholism prevention not only at school, but also in the family. Parents should tell their children in detail about the dangers of alcoholism, convince them that it is not fashionable and not prestigious, and what it can threaten. Prevention of alcohol dependence in adolescents should include a psychological aspect and a physical one, from an early age the child needs to instill a love for sports and an active lifestyle. The state should also take an active part in the prevention of alcoholism among young people. It is a set of measures aimed at reducing alcohol advertising, supporting social programs, establishing strict laws in the fight against alcoholism.
Secondary prevention of alcoholism are intended for people who have already drunk alcoholic beverages or for those who have the first. They consist of explanatory talks about the dangers and dangers of alcoholism, reduction of commercials on television and in the city.
Activities for tertiary prevention of alcoholism are intended for people suffering from severe alcohol dependence and are of a medical nature. This prevention has two directions. The first is intended so that the patient does not drink in the future, or to eliminate the consequences of drinking alcohol, to help the patient in the fight against alcohol addiction. The second direction of the tertiary prevention of alcoholism is aimed at preventing new relapses in patients who have recovered and are recovering.
Another method of preventing alcoholism is to nurture a protective barrier against failure and social behavior. A person with a developed personality, spiritual principles, resistant to stress and disappointment, less prone to depression and the formation of alcoholism... It should be told how to deal with life obstacles and difficulties, to form a strong character in a child and adolescent. In school institutions, talk in detail about the harmful effects of alcohol, the consequences of alcoholism and ways to avoid it.
Prevention of alcohol dependence should include a positive attitude and the upbringing of an optimistic personality. Alcohol addicts should be tuned in to a positive outcome, tell them what opportunities he refuses. Such a person must understand and want to, begin to lead a healthy lifestyle, fight his addiction. In the early stages of alcoholism treatment the patient should be encouraged and supported... At the state level, it is necessary to form the desire to stop drinking alcohol. Develop various social projects, recreation programs and leisure activities for people.
Alcoholism treatment
Treatment of alcoholism is a complex of medical preparations, psychological assistance and its prevention. Alcohol dependence can be treated with various methods, including hypnosis, insertion of special substances to form a persistent aversion to alcohol, detoxification of the whole body, and restoration of the patient's health. For more severe forms of the disease, treatment includes rehabilitation methods to prevent a new relapse.
Alcohol rehabilitation assistance
After alcohol addiction treatment, it is extremely important to follow preventive measures. The patient is advised to give up alcohol for a long time, and best of all - forever. Alcoholism is not immediately cured in a short period of time. It may take years until the addicted person is completely cured and recovered. To stay sober, you must adhere to special prevention programs.
There are several types of alcohol prevention rehabilitation programs. Each treatment program differs from another, but conditionally they can be divided into the following:
- Detoxification of the body- represents the passage of patients detoxification, cleansing the body and a course of therapy. If the refusal of alcohol proceeds with consequences, the patient has diseases of other organs, he is provided with medical assistance. The detoxification course lasts for a week, then the patient can go home. Then he is offered other programs for the prevention of alcoholism, aimed at strengthening the strong-willed spirit.
- Hospital-based rehabilitation programs... Such programs usually include patient detoxification and group psychotherapy. Behavioral therapy programs that produce alcohol aversion and cravings can be used. After this course, the patient may be offered assistance c.
- Alcoholism prevention programs based on a social model. They differ from hospital programs in that the patient undergoes rehabilitation at home, he is provided with medical and psychological assistance. The patient may have access to drugs that help in the acute phase of treatment - detoxification. But the main focus of such a program is the formation of normal social behavior and good interaction with other people.
- Outpatient counseling is another method of preventing alcoholism, which can be carried out before and after alcohol dependence treatment. It includes sessions of individual psychotherapy or in a group. After treatment, the patient needs to learn to rebuild his life and communicate with people. The doctor tells how you need to gradually recover in society, to establish relationships with members of your family. A person quits drinking and does not know what to do with his free time. To do this, you can find a new job, hobbies and interest in other activities. It is extremely important to forget about alcohol addiction, as there is a risk of replacing one addiction with another, more severe form, for example, drugs. Psychological therapy will help you cope with the feeling of being unnecessary and find your place in society.
- Alcoholics Anonymous program was invented in the United States and has helped millions of people cope with alcohol addiction. This program is currently supported by millions of active participants around the world and is recognized as the most effective on the path to a permanent lifestyle without alcohol. Its essence lies in the fact that each participant tells his story of addiction, and how it ended. Conversations are conducted in a calm and anonymous environment, and participants do not need to be named. No one judges the narrator, does not give advice, just listens and supports. The task of the psychologist is to keep people in this program in order to protect them from possible breakdowns and binges. Each time, useful psychological practices are carried out, contributing to the restoration of personality and the growth of resistance against alcohol dependence.
It should be remembered that the treatment and prevention of alcoholism should be carried out with the full support of the patient's family and friends, since it is difficult for him alone to cope with this serious illness. You need to be patient, as the process of complete recovery can take from several months to several years.
Collapse
Such a social disease as alcoholism is very dangerous for the patient himself, his family, and environment. Modern statistics on this score are extremely disappointing - every year several hundred thousand people die from alcohol, while the contingent of the sick is getting younger. Alcohol affects not only young people, but also adolescents, for this reason, much attention should be paid not only to treatment, but also to the prevention of alcoholism, which makes it possible to prevent the development of this phenomenon.
Alcoholism statistics in the Russian Federation
According to statistics, alcohol affects about 60% of adolescents and young people, most of whom come from disadvantaged families. The remaining 40% of drunkards become such because of disorder, not knowing what to do with themselves. All this leads to the fact that drunkenness is becoming a disease of young people - more and more often not only students or graduates of schools begin to drink, but also students of the middle classes. As a result, a young body becomes susceptible to various diseases, a drunkard who started drinking at such an early age acquires a whole bunch of diseases by the age of 20, by the age of 30 it suffers from problems with the gastrointestinal tract and the cardiovascular system, by the age of 40 cirrhosis or cancer can be diagnosed ...
Studies show that several hundred thousand people die from alcohol every year, many alcoholics do not live to old age. For this reason, it is not treatment that comes first, but prevention, which helps prevent the further development of the spread of this harmful phenomenon.
Mortality statistics from alcoholism
Treatment should be comprehensive and include preventive measures for those who quit drinking. Only in this case will the common struggle be effective and bring real results.
Alcoholism Prevention Day
Day of Prevention of Alcoholism is celebrated on July 7, it is held as part of the general fight against such a social phenomenon as drunkenness, and is aimed at promoting the refusal of alcohol. The need for such measures has arisen for a long time, because according to studies, approximately 39% of adolescents already drink beer at school, of which 12% do it a couple of times a week! The percentage of those who have tasted spirits is less, it is 2%, but even this number is critical, because we are talking about children. This brings to the fore the prevention measures that will help reduce the addiction rate.
Types of prevention
Briefly, preventive measures include:
- primary for the general familiar with the problem, psychological assistance;
- secondary, used for those who have already given up alcohol or want to do it on their own;
- prevention for men and women;
- activities aimed at prevention among children, adolescents, students.
Primary prevention
Such measures are aimed at general acquaintance with the problem and show such dangerous consequences of drunkenness:
- problems with work, in the family;
- mental disorders, illness;
- development of addiction, job loss;
- serious health complications leading to death.
At this stage, it is necessary to show how harmful such a habit is, in most cases, with a well-designed strategy, drunkards with an initial stage of alcoholism try to cope with their craving for alcohol on their own.
Secondary prevention
Secondary prevention of alcoholism, the memo on which includes the main measures to prevent the development of drunkenness, is aimed at psychological assistance. The perception of the surrounding reality and the existing problem for any alcoholic is distorted. He believes that there is no problem at all, and prohibitive measures in this case will act as an activator to worsen the situation. Binges will become more frequent and prolonged, the behavior of the drunkard will gradually become completely uncontrollable. It is for this reason that the following secondary prevention measures are recommended:
- psychological counseling and work with the patient, his family;
- participating in group therapy with ex-alcoholics who can talk about how they coped with the situation;
- psychological trainings, human involvement in social activities;
- social and psychological assistance.
The main thing is the need to identify the cause, the exclusion of the factor, which became the impetus for alcoholism. Often the person himself cannot understand what was the impetus for all the frequent hard drinking, he needs outside help, the participation of all members of his family in this.
Prevention of alcoholism among adults
The prevention of alcohol consumption among adults is a complex task that requires a competent program design. It should take into account the main audience - former drunkards, treated, men or women. Most often these are consultation conversations, promotion of a healthy lifestyle, and limiting the sale of alcohol. During the work, one should immediately determine the social group, identify the round problems that are the cause of alcoholism, determine the range of measures that are most effective for the treatment of drunkenness.
Social prevention among all groups of the population is of great importance, this is social regulation of alcohol consumption, legislative restrictions on the sale and consumption of alcohol. The most effective will be government programs that include:
- limiting the sale of alcohol;
- increased control of product quality (according to statistics, most of the alcohol poisoning occurs precisely on low-quality, falsified alcohol);
- prohibition of drinking alcohol in public places;
- a ban on the sale of products to adolescents;
- events, the main purpose of which is to promote a healthy lifestyle, improve the quality of life.
It must be borne in mind that addiction by itself will not go away, the desire of the person himself is necessary. It is better to act not by the method of strict prohibitions, but to combine them with the conviction of the dangers of alcohol.
Prevention among men
The prevention of alcoholism among the male population is becoming relevant for almost all age categories - from adolescents to the elderly. We must immediately take into account that such a disease cannot be partially cured; in many cases, the patient returns to his addiction again, believing that he is okay. For this reason, well-designed prevention should be aimed not at treatment, but at the prevention of drunkenness.
An alcoholism prevention program can include the following activities:
Group therapy is one of the most effective techniques
Prevention among women
Prevention of female alcoholism is one of the most difficult, due to various reasons. Unfortunately, in recent years there has been an increase in registered cases when women of any age become susceptible to this disease, the reasons are very different, but most often it is unsettled, lack of normal work, unfavorable social environment. For this reason, preventive measures should include the following steps:
- identification of all potential drunkards with conducting conversations, determining the reasons for addiction to alcohol;
- carrying out various events at the state level related to promoting a healthy lifestyle, focusing on family values;
- it is necessary to involve the media, TV in the activity;
- prevention in work collectives, censure, introduction of administrative responsibility;
- limited sale of alcohol.
The church also talks a lot about the dangers of alcohol, these are programs and rehabilitation centers, assistance to women in difficult situations, large, dysfunctional families. Such prevention of drunkenness helps to restore traditional family values, to help women suffering from alcoholism to get rid of this addictive and dangerous habit.
Prevention of alcoholism among middle school students
Prevention of alcoholism among adolescents shows children the need to combat this addiction. The program is age-appropriate, it should include visual examples, videos in a form that is comfortable for adolescents. A feature of the events is a rather skeptical attitude towards them among the children themselves. Therefore, simple lectures or lessons will not be effective; prevention should be built on a different principle.
The main thing is the correct construction of the child's day, the principle of full-time employment of the day. To do this, you should work out a schedule for every day, and the lessons must be diluted with interesting courses or circles, visits to sports sections, and hikes. Under such conditions, the child simply will not have time for alcohol. But when planning the day, you need to take into account the child's age and interests. In this case, prevention will be effective, the teenager will no longer have any interest in such addictions as alcohol in the future.
Prevention of adolescent alcoholism
For adolescents from disadvantaged families, you should create comfortable conditions for classes, hobbies, show that giving up alcohol can make life full and bright.
Prevention of alcoholism among senior schoolchildren and students
Working with high school students and college students is much more difficult. The established independent opinion and social environment are of great importance here. Here, general employment also comes to the rescue, but instead of teaching lectures, interesting educational programs should be organized, visits to profiling circles before entering universities, not only trips will be interesting for students, but also the first tests of work in their future specialty, conducted in a friendly atmosphere. The teenager needs to be interested, in this case he simply will not have time for alcohol.
Summing up
Alcohol prevention interventions are an important part of the overall fight against alcohol abuse. It is necessary to start prevention not only among adults, but also among children and adolescents, which will make such measures effective. The peculiarities of prevention among adolescents can be found in the video.
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Alcoholism is a chronic progressive pathology, a type of drug addiction, which is characterized by physical and psychological attachment to alcohol (ethyl alcohol).
Chronic alcoholism is characterized by uncontrolled use of alcoholic beverages, an increase in the amount of dosage required for intoxication, withdrawal symptoms, destruction of internal organs, and memory lapses.
Prevention of alcoholism is an important component of any civilized society, prevention of alcoholism is always socio-political in nature and is carried out at the state level.
The main active element of all alcoholic beverages is ethanol, due to its pharmacological properties it is quickly absorbed into the gastrointestinal tract, through the intestinal walls it penetrates into the blood vessels and reaches the head through the blood, where it enters into communication with the nerve fibers of the brain.
The emergence of addiction occurs due to the effect of ethanol on the neurochemical systems of the brain. The substance affects the synthesis mechanism of neurotransmitters (adrenaline, norepinephrine, dopamine), which directly or indirectly increase the activity of the endocrine glands.
Features of the interaction of ethanol with the body:
- the concentration of ethyl alcohol in the blood reaches a maximum within 40-80 minutes after drinking alcohol-containing beverages;
- ethanol is excreted from the body unchanged by the lungs, kidneys, and external secretion glands;
- biological transformation (metabolism) of the element is performed by the liver. In a healthy organism, the process of decay and elimination of ethanol is carried out in 24 hours;
- the oxidation of ethyl alcohol in healthy people reaches a rate of 0.1 g of an element per 1 kg of body weight per hour;
- about 10% of ethanol is excreted by the renal and pulmonary systems (through respiration).
Important! "The natural defense of the body against ethyl alcohol poisoning is the urge to vomit, which atrophies during the development of the disease."
Classification of factors in the development of addiction
The overall focus depends on social, physiological and mental factors.
Social factor:
- alcoholization of the population is directly related to an increase in the standard of living;
- feast traditions;
- drinking relatives, friends;
- difference from generally accepted standards (homosexuality, congenital or acquired pathologies).
Physiological factor:
- hereditary genes that have mutated during evolution;
- body susceptibility;
- predisposition to alcoholism.
Psychosomatic factor:
- since ethanol stimulates the central nervous system, alcohol appears to be a kind of antidepressant;
- alcoholic beverages (wine) have been used by humans since ancient times and still exist in religious rites (with the exception of some religions);
- some psychosomatic pathologies provoke the development of addiction.
Stages of alcoholism progression
The disease begins gradually, in several stages, with an increase in the degree of regression to ethyl alcohol, a decrease in the ability to control alcohol consumed and the occurrence of diseases caused by constant poisoning of the body.
The progressive disease of alcoholism is characterized by three forms.
Initial, or neurasthenic
At the neurasthenic stage, the patient often has an overwhelming need for alcohol. If it is not possible to drink alcohol, then the desire temporarily disappears.
When alcohol is consumed, the control of the amount of consumed drinks is significantly reduced, irritability, aggression, and temporary memory loss occur.
The criticism of alcohol disappears, and there is an excuse for drinking. Over time, the first stage passes into the second.
Average, or drug addict
This period is marked by increased tolerance for alcohol consumption. A person completely loses control over the amount of alcoholic drinks drunk. There is a biological dependence on ethanol, a hangover syndrome appears, which is accompanied by headaches and tremors.
To calm this condition, the alcoholic begins to use alcohol to alleviate it, and this is how a relationship arises - a multi-day binge. Abrupt interruption of alcohol consumption without professional help can lead to various complications: hallucinations, delusional psychosis, encephalopathy or pathological intoxication.
Initial, or encephalopathic
The desire to drink alcohol increases, but the amount of drinks consumed decreases sharply, the body needs a minimum dosage to get into the desired condition. Mental disorders lead to complete or partial amnesia, degradation in the psychological, physical and social terms increases. The patient is constantly experiencing a craving for alcohol, drinks until the body is completely exhausted.
Alcoholism treatment
Important! “Treatment of the disease can be carried out only if one wishes to defeat the harmful addiction. Violent treatment does not lead to positive results, and the patient continues to drink alcohol. "
Treatment is carried out in several stages and includes:
- Aversive therapy is a drug-based method of stopping alcoholism and subsequent rehabilitation of the pathological condition caused by alcohol poisoning. During therapy, patients may experience fear of death due to the toxic combination of alcohol and the administered drug. If alcohol is taken during the rehabilitation period with aversive therapy, then irreversible pathological changes in the body may occur, leading to a lethal outcome.
- Psychological impact - reinforcing ways of instilling a negative attitude towards alcoholism after aversive therapy. With positive factors, the patient can form a clear position in life that he can cope with emerging problems without the use of alcoholic beverages.
- Social adaptation is the restoration of the patient as a person and integration into social life.
- Detoxification of the body is the shortest way to get rid of hard drinking: intravenous infusion of medications to correct the physiological state with a sharp interruption in the consumption of alcoholic beverages. This method relieves and prevents withdrawal symptoms.
After detoxification, therapeutic treatment is given to prevent relapse, but long-term use of rehabilitative drugs can worsen the alcoholic's physical condition.
Complex methods involve the combination of two or more methods of therapy. As a rule, this is medical, social and psychological rehabilitation of the patient.
Prevention
The prevention of drunkenness and alcoholism is diverse in its form and focus:
- Primary prevention of alcoholism is the promotion of information about the harmful effects of alcoholic beverages and the fatal consequences associated with drinking alcohol. Social and social orientation, stimulating the development of interest in a healthy lifestyle, agitation for sports, active recreation. Preventive guidance is provided by medical professionals, educators and psychologists.
- Secondary prevention work is focused on those involved in alcohol dependence. The effectiveness of this method increases with the participation of relatives, friends, employees, etc. Prevention is expressed in conducting conversations with the patient and preventing situations that can provoke an alcoholic breakdown.
- Chronic alcoholism and its prevention consists in the rehabilitation of people with possible degeneration and personality degradation, but with a desire to get rid of the addiction. The main methods are to hold Alcoholics Anonymous meetings, provide mutual assistance and support, and restore social status.
Preventive prevention measures in children
A special degree of danger is the emergence of alcoholism in children and adolescents. The reasons can be dysfunctional families, wrong ideals, alcoholic environment. The main preventive measures are aimed at preventing the development of alcoholism.
Prevention consists in holding special events in children's institutions, attracting children to spending time in sports, educational and thematic sections.
The main role in the organization of children's leisure is played by the state and municipal institutions through the creation and development of entertainment complexes, sports clubs, theaters and stadiums.
Social prevention of alcoholism
Prevention involves restrictive measures for the sale, consumption and promotion of alcoholic beverages at the legislative level:
- a ban on the purchase of alcohol for children under 18;
- fixing the time period for the sale of alcoholic beverages in retail outlets;
- prohibition of alcohol consumption in public places.
Important! "Government measures are particularly effective when involving public scrutiny."
Conclusion
Alcohol abuse leads to alcoholism, but this does not mean that any use of alcohol will lead to illness. ...
Anti-alcohol education, being an integral part of educational work aimed at the formation of a socially positively oriented personality, includes, first of all, sanitary and hygienic education and the formation of teetotal attitudes (Yu.P. Lisitsyn, N. Ya. Kopyt, 1983; A.N. Mayurov , 1987).
The main tasks of sanitary and hygienic anti-alcohol education: 1) improving health literacy
and the culture of the population; 2) promotion of a healthy lifestyle; 3) eradication of unhealthy habits.
Experience shows that not only adolescents, but also their parents know little about the harm that alcohol brings to the developing body. Research conducted by R.V. Kochetkova (1984) through an anonymous survey of the population of one of the large cities of Russia showed that 9.7% of schoolchildren do not know at all that alcohol has harmful properties, 10.7% approve alcohol consumption by parents on weekends, and 74.8% on holidays; 53.6% of urban residents do not know about the inadmissibility of alcohol consumption by minors, and 13.8% of parents allow occasional drinking of adolescents under 16 years of age. These studies illustrate the flaws in anti-alcohol propaganda.
Teenagers and their parents need to explain in an accessible form that alcohol is not a “food product” and an integral attribute of many traditions, but above all a substance with a pronounced narcotic effect. He, like drugs, has a destructive effect on the entire body, and, first of all, on the brain cells. Alcohol is a universal remedy that can deprive a person of his mind. If the degradation of personality in an adult who abuses alcohol occurs on average after 10-15 years, then in a teenager - after 3-4 years.
Anti-alcohol propaganda among adolescents should also emphasize that chronic alcohol poisoning negatively affects the sexual and reproductive functions of men and women. IV Strelchuk (1974) on a large clinical material showed that sexual dysfunctions are observed in more than 30% of men suffering from alcoholism. Studies have shown that the earlier a teenager begins to drink and the more severe the stage of alcoholism, the greater the severity and irreversibility of the sexual dysfunctions that arise in him (A. Nokhurov, 1978).
The most terrible consequence of drunkenness and alcoholism is handicapped children born to parents who abuse alcohol. Some children have a nerve
but mental disorders may not appear immediately, but only after they reach adolescence and adolescence.
There is a misconception that inferior children are born only when they are conceived while intoxicated. Chronic alcohol intoxication is no less dangerous than acute intoxication, especially when you consider that alcohol is retained in the tissues of the body for an average of 10-15 days (GI Ezrielev, 1975).
Speaking about the psychological aspects of anti-alcohol propaganda, it should be noted that one-sided "intimidation" of adolescents by the harmful influence of alcohol on the body most often does not give the desired effect. This happens, firstly, because the liver of an alcoholic or even an ugly embryo, depicted on a colorful poster, appears to a teenager as a distant abstraction that has no direct relation to him. Second, psychologists know that negative stimuli alone cannot long-term and effectively define complex life behaviors. We need positive elements, perspectives, goals, motives, for the sake of which it is necessary to resist the temptation to drink with peers in “good company”.
In anti-alcohol propaganda, it is important not only to clearly show why drinking is bad, it is even more important to prove the benefits of not drinking alcohol. And here, just declarative statements and imperative statements are not enough. We need specific examples that are accessible to the adolescent's perception and understanding, confirming and illustrating the position that being sober is more interesting and more useful than being drunk.
The strategy of anti-alcohol propaganda among adolescents and their parents should be based on the principle of completely prohibiting adolescents from drinking alcoholic beverages. Numerous observations show that the foundations of drunkenness as a stereotype of behavior are laid precisely in adolescence and, faster than in adults, lead to the formation of alcoholism (N.E.Butorina et al., 1978, MD Pyatov, N.G. Shuisky, 1983 ; V. T. Kondratenko, 1986).
The legal basis for anti-alcohol propaganda among parents should be a law providing for the responsibility of adults for involving children and adolescents in drunkenness.
One of the ways to form teetotal attitudes among children and adolescents is the system of anti-alcohol education at school, which is now given state significance. The basis of anti-alcohol education and education at school is:
Anti-alcohol education as an integral system of anti-alcohol education, which should be carried out throughout all the years of study and aimed at forming in the minds of children and adolescents an intolerant attitude towards any manifestation of drunkenness and alcoholism;
Gradual, taking into account the age and psychological characteristics of students, the disclosure of the negative impact of alcohol on human health and the life of society as a whole;
Carrying out anti-alcohol work in schools mainly by teachers with the invitation to read individual lectures of specialists (doctors, lawyers, sociologists, etc.);
Extension of anti-alcohol education to the parents of students.
Work with parents should be differentiated (for parents of younger, older students). Experience has shown that this kind of propaganda is best done at parent-teacher meetings.
The problem of anti-alcohol education of students of vocational schools, secondary specialized educational institutions, students, working youth of industrial and agricultural enterprises is no less urgent. Experience shows that anti-alcohol work among this contingent of young people, like in no other special groups, should be complex and differentiated.
When planning and conducting anti-alcohol education activities, it should be remembered that adolescents are very observant, receptive and prone to
to imitation. In this case, the subject for imitation is most often not the declarative-imperative assertions that "it is harmful to drink, it is harmful", but the way of life, actions, behavior of adults.
However, the problem of drunkenness is still far from its final solution.
No less formidable phenomenon, especially among adolescents, is becoming increasingly growing in recent years, drug addiction and substance abuse. In a number of regions of the country, the use of drugs, psychotropic drugs, inhalation of ether-containing and other "intoxicating" chemicals are widespread. It is not uncommon for "sniffers" to gather in groups and older adolescents pass on their "experience" to younger ones.
The age of exposure to toxic and narcotic substances averages 14.2 and 14.6 years, respectively (A.A. Rean et al., 2002).
According to the statistics of the Ministry of Internal Affairs of Russia, in 2000 there was a slight decrease in the number of adolescents registered with the internal affairs bodies for non-medical use of narcotic drugs: from 21.1 thousand in 1998 to 15.4 thousand in 2000.
However, the official chronicles, according to many experts, do not reflect the real state of child and adolescent alcoholism and drug addiction. According to experts, the real number of adolescents suffering from drug addiction and substance abuse is 6-10 times higher than the number actually registered, and the number of people who occasionally use drugs or toxic substances is on average 5.6 times higher (Children's Health of Russia, 1999 ).
This is largely due to the fact that a significant part of adolescents who use narcotic or toxic drugs live in single-parent or dysfunctional families, where parents often do not give their consent to the examination or treatment of the child.
Turning to individual studies reveals different realities. Thus, the data of sociological studies conducted in many cities of Russia showed that at least every fifth teenager aged 14-20 years already
tried drugs. In some regions this figure is even higher, in St. Petersburg, for example, this figure is 36% (E. V. Mironova, 2000). i
An analysis of the responses of 1,640 adolescents aged 10 to 17 about their drug awareness showed that the main source of information in all age groups of students is the mass media. With age, there is a decrease in the fear of drugs, the number of adolescents who have tried drugs increases. All interviewed adolescents are sufficiently aware of the main list of drugs: from 10-12 names in the 5th grade, up to 15-16 in the 8th grade, and up to 20-25 in the 11th grade. At the same time, teachers can name only 3-5 names of drugs (L. M. Shipitsyna, 2000).
The prevalence of drug addiction and substance abuse among children and adolescents at risk, especially among street children, is extremely high. Thus, according to the data obtained by examining the contingent of children admitted to the Center for Temporary Isolation for Juvenile Offenders (TsVINP), it was found that about 25% of Moscow "street" adolescents take drugs daily. This is not only about those adolescents who occasionally "indulge" in drugs, but also about drug addicts. At the same time, a significant part of them are heroin addicts who, as a rule, use syringes of "collective" use. Hence the rapid spread of AIDS in such an environment. In the last two years, according to the TsVINP, there has been a twofold increase in HIV-infected among street children every year. During 1999, about 20 cases of infection of adolescents out of a total of 6043 admitted to this center were registered at the Center for HIV and AIDS. Knowing the total number of street children passing through Moscow annually, this figure should be increased fivefold, having received at least a hundred HIV-infected street children and adolescents at the beginning of 2000 (Materials of the press conference, 2000).
It should also be noted that alcoholization and drug addiction in adolescents is, as a rule, in conjunction with early criminalization, a. also with various forms of deviant behavior and
mental disorders. For example, about 40 % adolescents with delinquent behaviors combined with alcoholism, toxicity and drug addiction are currently admitted to psychiatric clinics (Psychological and Pedagogical Aspects, 2000).
In terms of the number of serious complications and deaths, the use of drugs and toxic substances significantly exceeds drunkenness. Prevention and fight against this formidable social phenomenon requires close attention and efforts not only of doctors, but also of the broadest strata of society.
As you know, the best psychological protective factor is teaching social skills and abilities. Based on the fact that weak resistance to the negative influences of the immediate environment goes back mainly to inadequate social skills and ability to solve problems, a large number of prospective studies of primary prevention have been carried out, allowing, through a program implemented in the primary grades of school, to prevent or reduce the consumption of alcohol, tobacco and drugs. Important exercise and training content is: a solid knowledge of the cons of drinking alcohol and exercises to instill skills in their use; training in the ability to say "no" in situations where a teenager is offered alcoholic beverages; collecting positive arguments for avoiding alcohol and knowing the benefits of a sober life. The reports of the effectiveness of such programs in primary prevention (Elhckson & Bell, 1990; Botvm, Baker, Dusenbury, Tortu & Botvm, 1990) support the assumption that well-developed social skills are the best defense against alcohol and tobacco use, as well as against the urge to try drugs.
The most effective program for the prevention of substance dependence is currently considered to be the life skills development (LFF) program. The goal of the program is to instill healthy lifestyle skills, adequate stereotypes of behavior and aversion to substance abuse (V.D. Mendelevich, 2001).
The tasks of the program include:
1) development of social and personal competence of adolescents;
2) development of skills of self-defense and prevention of problems.
The solution to each of these tasks involves the formation of certain socio-psychological skills:
Teaching the skills of effective communication, critical thinking, decision-making, development of adequate self-esteem;
Teaching the ability to “stand up for oneself”, avoid situations of unjustified risk, make rational, healthy life choices;
Mastering the skills of regulating emotions, managing stress reactions, resolving conflicts.
In the previous sections of this chapter, it is shown that one of the important directions in the fight against alcoholism is the timely identification and registration of not only alcoholic patients, but also the contingent of persons threatened in relation to alcoholism - drunkards (without signs of alcoholic illness) who commit while intoxicated antisocial actions, and the implementation of a set of measures of medical and social impact in relation to them. The need for active and complete identification of alcohol abusers (drunkards and alcoholics), the application of differentiated measures of influence to them requires further coordination of efforts of health authorities and institutions, administrative bodies and the public, the creation of a more harmonious system that ensures organizational interconnection and continuity in the work of the main links of the struggle with alcoholism and drunkenness.
The regulations on the narcological dispensary and the narcological office (narcological center), approved in recent years by the USSR Ministry of Health, as well as guidelines and instructions for identifying alcohol abusers and organizing the treatment of alcoholics, provide for the interrelated activities of drug treatment institutions of the USSR Ministry of Health and the USSR Ministry of Internal Affairs and create the basis for further improvement of the system of drug treatment assistance to the population. Unfortunately, even the most advanced system of drug treatment, providing timely and complete identification of the contingent of alcohol abusers, still does not solve the problem of combating alcoholism. It only creates a favorable basis for an offensive and decisive struggle against this negative phenomenon.
An important strategic direction in the fight against alcoholism is the implementation of large-scale measures aimed at primary prevention of alcoholism, taking into account the specific factors that determine the genesis of alcohol abuse (see chapter VI).
The prevention of alcoholism, as shown in Scheme 2, includes three main areas: broad educational work with the population, sanitary and hygienic education of the population, and the formation of temperament attitudes in the younger generation. Let us dwell briefly on each of these areas.
Extensive educational work among the population should provide for a further increase in the cultural level, the formation of anti-alcohol public opinion and the organization of cultural leisure of the population, especially young people.
Research in recent years suggests that the majority of alcohol abusers have a relatively low level of education and culture; alcohol abuse is promoted by shortcomings in the organization of cultural leisure for young people and other groups of the population, the absence in many work collectives of an atmosphere of intolerance towards alcohol abusers, and a condescending attitude towards drunkards.
According to our data, as we noted above, there is a significant correlation (inverse) between education and the prevalence of alcohol abuse. Over 75% of alcohol abusers had a low cultural level; they spent a significant part of their free time with drinking companions.
The growth of the material well-being of the population under the conditions of developed socialism, as G. G. Zaigraev rightly notes, does not in itself cause adequate changes in the consciousness and behavior of people. It is necessary that the created favorable material, cultural and living conditions are simultaneously supplemented with a set of measures to form anti-alcohol attitudes among the population. Ensuring the all-round and harmonious development of the personality of the Soviet person is inextricably linked with the upbringing of socially positive moral attitudes in the working people, with the creation in collectives of a healthy moral and psychological climate, an atmosphere of intolerance towards drunkards and drunkenness as a social evil, with an increase in the role of leadership in the formation of anti-alcohol public opinion.
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