Chemical addiction. Conception of illness
Chemical addiction is a complicated medical problem, in the basis of which lies «drug addiction» behavior as manifestation of the dependence that already exists, and not its before-nosologic period. Numerous concomitant or pathologic manifestations which are a result of addictive behaviour - toxicological, neurological, somatic, psychological, social, etc. – should be considered in a certain hierarchy. Psychological and toxicological approaches, which are dominant at present in attempts to comprehend narcological pathology, produce attitude towards our patients as to a person with a normal mind in general, but simply got into an unfavorable toxicological situation. Logically speaking, actually it is sufficient to sober a patient up or to relieve withdrawal pain, then to talk to him with arguments about his wrong belief, to overcome his psychological defence, - and he will give up his drug addiction at once. With such approach chemical addiction is interpreted not as disease, but as some toxicologically specified «bad habit».
In our clinic the conception of such a problem as chemical addiction is not considered as a result of «neuromediatory wreck» (catecholamine theory of chemical addiction evolution), as a pathology related to «epileptization», severe organics which is realized as paroxism. We realize that a backbone psychopathological syndrome – drugs dominant – is in the base of the dependence. The drug dominant can be marked as a pathological functional structure (system), the basis of which is comprised of specific and nonspecific psychopathological phenomena, characterizing pathology of consciousness, emotional, volitional, intellectual-mnestical and other spheres of psychical activity within the framework of specific disorders of thinking, which results in the steady forms of improper drugs addictive behavior.
The addictive behavior is not a consequence of bad mood, not contribution to fashion or «requirements of subculture». It is not conditioned by communicative problems and other features of the nature and personality, it is not a psychological defence, not a «psychological adaptation» to social medium, - it is a disease that does not «pay attention» to these explanations in the period of manifestation, and it has a psychopathology in its basis.
Psychopathology is a show of psychical disease, finally, it is a steady and programmed response (according to a certain disease scenario) of the body to a pathogenic factor, realized as a model of ill, improper behavior, provided with certain symptomatics. Our experience shows that such a clinical interpretation of the essence of chemical addiction syndrome reflects the problem and is important at working out the program for providing medical care to our patients not only at the first stage (relief of withdrawal pain), but at the stage of restoration therapy as well.
There is no fatality in the problem of any chemical addiction, the problem is in understanding, approaches and rendering assistance.
