A STUDY OF ATTITUDES OF ADDICTION TREATMENT SPECIALISTS AND RESIDENTS OF MOSCOW TO INVOLUNTARY COMMITMENT OF HEROIN ADDICTS DURING WITHDRAWAL SYNDROME
In the scientific literature, there is a discussion about the nature of drug cravings in withdrawal syndrome: some specialists consider it to be compulsive drug seeking, others as delusion, which may be a legal cause for civil commitment. Our purpose was to study perception of the issue of involuntary civil commitment of heroin addicts. Materials and methods: in-depth interviews with 9 addiction treatment specialists from various inpatient facilities of Moscow were conducted as well as quantitative internet surveys of 50 respondents. Results: there was no consensus among addiction treatment specialists on the issue of perception of drug craving during withdrawal period. Some addiction specialists considered addiction an obsessive urge, others believed it to be a psychotic disorder. Despite the fact that some physicians considered drug craving as a delusion or a dominant idea, all respondents noted that involuntary civil commitment to treatment is unacceptable, based on the requirements of current Russian legislation. Almost all addiction treatment specialists faced situations when patients refused treatment. In this case, physicians organized their work with patients who wished to be discharged, based on personal experience and preferences, without consulting lawyers. Some physicians noted legal defenselessness of their profession. Most doctors believed that a special law is needed regulating civil commitment of drug addicts suffering from withdrawal syndrome. Others believed that the adoption of one law could not solve the problem. In the course of a quantitative survey of respondents about the need for involuntary hospitalization of a drug addict 74% of the respondents supported the idea of involuntary civil commitment to treatment. 76% of the respondents believed that a drug addict should be involuntarily kept in hospital in cases if he or she wanted to be discharged, thus demonstrating respondents' awareness of the contradiction between the rights and freedoms of an individual and involuntary treatment as an important condition for curing heroin addicts. 38% of the respondents noted the possibility for criminal prosecution of a doctor who used involuntary hospitalization of a drug addict.