B. Lobodov District Center of Prevention and Treatment
Alcoholism has been the traditional problem in Russia for centuries. The current situation is far from ideal (2.2 million alcoholics, 700,000 alcohol-related deaths, 160,000 diagnosed with psychosis annually); however, the attention of society has recently shifted toward illicit drugs. Some researchers estimate that there are 4 million to 6 million regular users, whereas among young Russians, lifetime prevalence of illicit drug use is up to 40 percent. The healthcare system appears to be completely unprepared to intervene. The first problem is the absence of reliable data as well as tools for collecting the data. According to official statistics, Russia has 448,100 regular drug users and addicts. However, even health authorities admit that these data should be multiplied by 10 in order to approximate real figures. The main cause of the current situation is the traditional approach to the problem; in Russia, addiction is still treated as mostly a medical problem. That is why the main emphasis in treatment has shifted toward a short-term (1 or 2 months) inpatient program and subsequent outpatient psychological consulting. Social workers or psychologists specializing in long-term programs do not exist. The result of this approach is the cumbersome system of medical institutions with huge numbers of specialists. According to official data, Russia has 16,000 beds in 162 large clinics, 203 dispensaries, and 2,060 district narcologist offices with about 5,300 physicians, specializing in the treatment of addiction. In 2002, these resources treated 390,000 patients with alcoholism, 160,000 with alcohol psychosis, and 97,500 drug addicts. However, the absence of an effective treatment model resulted in the relative ineffectiveness of treatment. According to official data, only 5 to 7 percent of patients achieved 1year of remission. A possible way to improve the situation is the creation of centers of treatment and prevention. Recently, about 256 centers have opened in large cities. The aim of these centers is to create an effective treatment model through an optimal balance of prevention, treatment, and subsequent social rehabilitation.