Medical-social ways of solution of the problem of children’s and teenagers’addiction to psychoactive substances
The modern sights on a problem of rehabilitation of young people from dependence on psychoactive substances are covered. Analysis of publications according to this problem is carried out in the way of creative contribution to development of the national adapted modern forms and methods of rehabilitation from toxicomania and drug addiction among children and teenagers. The prevalence of drug addiction among youth in recent decades assumed an alarming scale. Thus, according to the Ministry of Internal Affairs of Ukraine data, 150 thousand drug addicts were registered in 2012, 80 % of them were young people. The consumption of psychoactive substances (PS) by inhalation (smoking tobacco, hemp, inhalation of volatile solvents - means of household and industrial chemicals) is the most frequent phenomenon among teenagers. Factors and causes of initiation and mechanisms of formation of dependent forms of behavior, ways of their reliable therapy, prevention and rehabilitation are insufficiently clarified until now. The goal of this research was to study the main rehabilitation programs used in the treatment of teenagers addicted to usage of psychoactive substances. The work is based on the analysis of publications devoted to the problem of psychoactive substance addiction among children and teenagers and questions of their rehabilitation. At the core of M.M. Kabanov’s rehabilitation program (1998) there are four basic principles: partnership of the physician and the patient; multiplicity of efforts; unity of psychosocial and biological methods of impact and their gradation. Rehabilitation of juveniles’ dependent forms of behavior by Y. Valentik, N.V. Vostroknutov et al. (2002) should be based on a number of key principles: voluntary agreement of the teenager to stop the usage of psychoactive substances, to follow systematic rehabilitation measures and programs, their stages, to have positive orientation, responsibility, inclusion of a family environment in the rehabilitation ("co-therapeutists"). Bab’uk I.A., Sosin I.K. (2004) indicate the need for establishing the system of governmental and commercial rehabilitation centers for juveniles in Ukraine. Among the main approaches to their construction authors identify multidisciplinarity of treatment and rehabilitation work, where the guarantee of quality is provided by the efforts of specialists of different professions (psychologist, expert in narcology, psychotherapist, psychiatrist, sociologist, pedagogue), combined in a working group that would ensure implementation of medical-social programs. The system of national rehabilitation of teenagers by V.S. Bitensky et al. (1991) includes the creation of groups modeled on Alcoholics Anonymous. Other authors (A.V. Pogosov, A.V. Kozyreva, 2002) questioned the possibility of the successful adaptation and usage of foreign models of programs for the rehabilitation of children and adolescents in the CIS countries, as these programs are based on hard mode with the authoritarianism that is problematic for this group of patients. In the scheme of rehabilitation program by P.D. Shabanov and O. Stackelberg (2000) the focus is on active participation of the patient in the process, the preferred forms of work with teenagers are ambulatory forms; minimal usage of pharmacological agents; emphasis is on rehabilitation in the group with the active participation of not only the doctor psychologist, but also the surrounding, rehabilitation is carried out continuously and not only in the form of personal contact with the doctor, but also other forms of interaction with the patient by the phone, in the form of written messages, etc. Integrated analysis of numerous publications on this issue will facilitate the development of nationally adapted modern forms and methods of rehabilitation from drug addiction among children and teenagers.