Interview with Nelly Klimchenko, the Leading Doctor of the "Polynar" Centre

In an interview for magazine "Leaders of Ukraine" the Leading Doctor of Medical Centre "Polynar" told us about the problems of alcoholic and narcotic dependence under her vision.

As a rule, "habitual drunkard' or drug addict's representation of his or her disease does not depicts the actual situation - they see only the top of the iceberg: "... well, yesterday I drunk too much, no stopping" or: "... I know everything about drugs - it is bad, so I will always have enough time to give up with it, I"ll start since Monday". But why there was no stopping and why Monday does not come at all - our patients do not think of that. And to know that and to realize are quite different things. "Drug addiction, alcoholism and any other kind of addiction should be treated by searches for the sense of life", Dr. Klimchenko thinks. That is our clinic where a patient first of all is rendered assistance in understanding his or her dependence and then in starting to get rid of it.

— Dependence of psychoactive substances (alcoholism, drug addiction, toxicomania) is a family disease. First of all, in 50% cases it is inherited genetically, secondly, even if there is only one habitual drunkard or drug addict in the family, all the other members of the family suffer psychologically. And the toxic emotion and intoxication by something in metabolism of a human body result in practically identical destructions.

— Why are there so many people, who are ready to pay, and do pay for alcohol and drugs at a price of their life?

— Our disease is characterized by a fatal uniqueness. Having been following up our patients for 30 years already, I can see the same scenario - unwillingness to acknowledge yourself staying in one boat with colleagues by misfortune. It is a distorting mirror: "look at him, he's worse than I am?! Indeed, that is he who is a drunkard, not me, I just had overdrunk". This uniqueness is dangerous, because it does not allow the patient to see the reality of his or her state. And the main medicine for our patients is his or her awareness of everything happened to him ot her, courage to accept it and to change and as a result to ask for help. Chemical addiction as disease "sits on two chairs" - these are biochemical or metabolic disorders - disease of disadaptation and psychological ones - replenishment of resource deficiency and failure in this world. Alcohol and drugs are great deceivers, they give our patients what each of them wants. "An alcoholic is a man, enveloped in flame and running to the sea. He drowns in the sea ". The flame means the feelings he cannot avoid: it is a wish to escape responsibility for his life and everything that happens in it. It is absence of tolerance in achieving the aims he set for himself; it is alexithymia - inability to expess feelings. It is a feeling of emptiness of own life. My patients try to delete or imagine these emotional experiences by means of alcohol and drugs. Not without reason their diseases are related to the sphere of narcology. In the basis of the name of this medical discipline lies the same word as in the basis of anaesthesia - narcosis. Drug addiction is a spiritual anaesthesia. But spiritual anaesthesia may result in a spiritual death.

— In what way is it possible to help these patients? In what degree the doctor is important for them?

— A doctor is a medication that as any medicine must be addressed and dosed properly. Overdose transforms medication into poison. For our patients the important thing is professional maturity which predetermines integrity of physician's personality and ability of activity without a projection. For this purpose, it is very important for all those who try to help our patients (I know it by my own experience) to overcome their own paternalism and to adopt the old postulate: a physician has no right to wish a patient more health than he or she wishes. To eliminate the internal itch and to stop saving and pursuing. And then, the patient wll have a chance for internal development. The sense of life of a concrete person is revealed, but not thought of. The sense exists not by itself, but in this or that situation for a concrete person. It is unique. The task for a physician is not to stick the sense to a patient, but only to help in finding it. If a person forgets about the purpose and is interested in means, he will have a "neurosis of the day-off" - a feeling of emptiness of own life. The victims of such a state drink much in order to escape the horror of this emptiness. Our patients are psychologically immature persons, and it is necessary to explain to them riches of the world values and to help them to create flexibility and ability to change to another valuable group, if their interest to the real one is lost. As a matter of fact, a person must be polyaddictive.

— At present, they say a lot and even predeterminedly of genetic predisposition to development of chemical addiction. What do you think of that?

— I think that I am very lucky in my life. In 1976 I came to narcology, not having even the slightest idea what alcoholism or drug addiction is. They seemed not exist in our country, as a fact. In 1978 I had the primary specialization in narcology. And my first teacher in those times explained to us, that there is more philosophy in this disease than materialism, that it is a family disease, that it is a disease of natural selection. Alcoholism and drug addiction are not a punishment, they are like a test of a family. It is normal for us, people, to mature spiritually and emotionally when we experience problems, pain, troubles. When we learn to make decisions and take responsibility. I remember an episode from film "Blame Klava K. in my death...". The main character of the film, a 3-rd class pupil, fell in love with Klava from the same class. He could not achieve her attention. And then he told everything to his father and the reply to his question "what should I do, Dad?" was "To suffer". Our patients were not allowed to suffer; they were accustomed to get anaesthesia at the early stage. Recently I have read in one book, that the case when parents do not let the child suffer from pain and trouble is considered a child abuse. A personality is comprised of scars. And genetics is a a probability, it is a predisposition. The main thing is that the values in your life will become the same values for your child. A price of life for a person must not be at the level of a wineglass, or "pills". If a man has a reason, he will stand it. I got education in Russia and willy-nilly rather often I visit my mates in Moscow, continue working together with the group of scientists from Saint Petersburg in new trends in a narcology. So, independent studies carried out in Saint Petersburg showed that in truly sober families there was not any drug addict.

— How many years can a person live with this disease?

— For today, chemical addiction according to the amount of the lives taken away is called the third disease of civilization, but I consider it the second one; oncology takes the first place. The cause of death from cardiovacular insufficiency in 80% cases is alcohol or drugs. Simply nobody raises a problem to trace, what the reason of myocardial infarction or fatal disorder in the heart rate was. A drug or alcohol is a not battery which you inserted to yourself, then ran and took it out and had no consequences. All these feelings are at the account of patient's health. In course of time the form of psychoactive substance consumption changes, the dose becomes greater, so as to result in euphoria required by the body. Soon the moment comes when cachexia occurs. Alcoholics die quietly in a young age. They do not simply wake up or suffer painfully from a stroke or cirrhosis after 55 years.

— As far as I understand, treatment of diseases is medication, droppers, and you say "...family, spirituality, sense", but what to do with the body, it hurts, isn't it?

— One of my patients (and most of them are strong people with a high intellect) said a surprising thing: "religion exists for those, who do not want to appear in the hell". Spirituality is for those, who have already visited the hell and do not want to return back there". I feel a wonderful sense of spiritual satisfaction, watching the recovery of patients. Recovery not by the body - nowadays there exist enough methods of treatment of metabolic disorders that occur in our patients. Programs to withdraw from hard drinking, removal of "withdrawal pain" for drug addicts and reduction of biochemical attraction to alcohol and drugs, powerful recovery amineacid programs, neuropeptides, informational medical technologies, medications for prolongated blocking action of the drug - all that we have in our clinic - this is my professional honour - quality of treatment, but all that is a body. And how can a man understand what should he be instead of being as he is? Goete gave the answer: "By thinking - never, only by acting! Try to discharge your duties and soon you will learn who you are. And then what is your duty? Demands of every day!". When my patients at last begin to be indeed in the process of self-recovery, they need help at all levels. Their bodies are sick, their feelings and mind are confused, and they are in the state of spiritual bankruptcy. They begin to search for a way to themselves. Their painful roundabout way of a dependent behaviour results in their own wisdom, and this is the recovery. Sometimes recovery lasts for alll the remaining period of life. The main thing is not to tell the lie to the patient. "If we treat people as though they already are like they might be potentially, we help them to become like that. For someone the years they spent for "spiritual anaesthesia" and forgot what they actually are, then become a background for a rebirth. And this background leads someone away to self-torture and as a result of that -a relapse of the disease.

— So, what kind of the problem is chemical addiction: is it a medical or psychological problem?

— You know, taking into account the trends which have been developing within the rehabilitation programs to withdraw from chemical addiction, we can say about multidimensionality of the approach to this problem - it is both psychological and social, medical and biological, spiritual and so on problem. The biopsychosocial approach is the only possible one in treatment of these diseases.

— Many people think that alcohol helps to take off stress, to relax. Some people go to the cinema, go in for sports, others think that alcohol and drugs provide them with repose of life problems.

— Our body lives due to metabolism and the head lives with symbols. The statement that a wineglass or drug takes off stress is an erroneous symbol in the bad head. And a wineglass of С2H5OH, and drug (depending on the kind), have a chemical formula which after entering the biochemical laboratory of the body causes a biochemical response, for example - acetic aldehyde which is the reason of severe hangover, and in the prospect - hepatic cirrhosis. Can that be a removal of stress? This statement is "clothes of the naked king".

— All we see in the streets, in houses, shelters for the abandoned children and in narcological departments makes ask a question, what should we do?

— The image of a not drinking, sporting, clean, nice smelling, finely dressed, business-like, competent person begins to appear in public conscience. He does not drink! And it does not warp already, and does not cause suspicions, like "sewn", "coded", "suffers from something", "scum, probably". Our consciousness is already ready to escape from dangerous symbols, and successes in narcology allow a body to get rid of biochemical captivity. The "POLYNAR" Clinic is established for me by my former patient. This fact confirms that chemical addiction is not a doom.