Narrowly biological view on drug addiction leads to a dead end

Leonid Sauta is psychiatrist, president of Dnepropetrovsk Association of Help to Drug Addicts, one of the most authoritative specialists in psychiatry in Ukraine. He has been working for medicine for 26 years, and since 1983 he has been occupying himself with psychiatry. He was the first doctor in Ukraine who started to use psychotherapy oriented on person in individual and group forms. He is also professor of Dnepropetrovsk Medicine Academy and of Dnepropetrovsk State University. Leonid Sauta is also the author of Complex Programme of Treatment and Rehabilitation of Drug Addict and their Relatives, in which ex-patients deliberately participate as social workers. Leonid Sauta also leads Vybor (Choise) therapy community. PRAVDA.Ru correspondent Andrei Lubensky asked Leonid Sauta several questions. Question. Tell me, please, how the Association of Help to Drug Addicts was created?

Answer. The association is the result of state experiment in the field of treatment and rehabilitation of drag addicts and their relatives. In the early 1990s, it became clear that narrowly biological view on drag addiction leads to a dead end. Professionals understood that this phenomenon had social and psychological roots. The disease could not reduced only to pleasure experience of a person. In crisis society, an outwardly successful young person comes to drugs first of all through emotional deficit, while communicating with drug addicts’ subculture and narcotization become a kind of hypercompensation of this deficit. Basing on this view, a group of specialists headed by me worked out a rehabilitation programme using social and psychotherapy methods. We also used experience of the people who won this addiction. In 1992, we launched the programme in the framework of a state experiment. In a year, first results appeared and it became obvious that some problems (like new working places, consultative and club work) could be solved only by a public organization. So, in 1993, our association was founded, which united professionals, ex-patients, their relatives and other people who are interested in bettering the situation around drug addiction in Ukraine. The experiment was lasting to 1997. The results were presented in two world congresses of psychiatrists and turned out to be very convincing, though supporters of orthodox post-Soviet narcological system did their best to stop the experiment. This was why the experience received through the experiment was realized by the association and by Vybor rehabilitation centre. These two organizations started to work at creation and development of therapy association which is new for post-Soviet development of effective rehabilitation form.

Q. How looks now the situation with drag addiction’s spread in Dnepropetrovsk Region and in Ukraine?

A. What happens now in Ukraine, and, in particular, in Dnepropetrovsk, could be characterized only with one word – epidemic. Nobody knows the exact number of drug consumers. The real achievement of official narcology was the statement that all the figures should be multiplied by 10. According to our experience, drug feels self-assured almost in all spheres of human activity, while drug consumers became younger and now drug could be bought not only in some hang-outs, but in discos, colleges, clubs etc.

Q. From where is drug supplied to the region? Who supplies it, who sells it, who “roofs” this business? Is it known?

A. We are more interested in the reasons of stable demand for drug. Drug addict subculture was formed in the region in the 1960s. At that time, that was opiate drugs, while they were mainly obtained through trips for poppy-seeds. Recent years, stimulators, hallcinogenic drugs, heroin are spread. These drugs could be only bought. Now, youth is sure that “that” drugs were bad, while through expensive, “elite” drugs a young man could be higher than the “grey mass” and become near to youth elite.

Q. You think, the state’s efforts are enough, aimed at fight against drug addiction and narco-Mafia?

A. Now, in Ukraine, there is no consistent anti-drug policy. Separate chaotic activities could not be called “efforts.” For, drug addiction is an integral phenomenon, so an integral system should oppose it. We suppose, that even a partial solving of the problem in whole is better, than the full solving of its separate part.

Q. What do you thing about latest initiative of a Ukrainian party bloc to fight for drug legalization to supplement the budget?

A. I suppose, this initiative is the last link in the series of calls and speculations, whose main sense is: it is necessary to create good conditions for consuming drugs. Now, there is no “light” drugs for Ukraine. To legalize drug in a crisis country means to push its youth to drug addiction.

Q. Who works for your Association, what are forms and methods of the work?

A. Rehabilitation work is carried within the therapy community. Here, medicine is not used and there are no usual medical attributes. The main instrument of rehabilitation are specially formed surroundings. Psychiatrists work for the community while other workers are ex-patients. Among them, there is a psychologists, and 10 therapeutist instructors. The instructors are people from 20 to 40 years with different life experience. All of them decided to devote themselves to psychotherapy and combine their work with studying psychology. The centre receives 5 to 7 patients with whom doctor and 4 instructors work, while the psychologist and a specially prepared instructor daily work with the patients’ relatives. A short enough stationary stage (1.5-2 months) is replaced by a long enough dispensary period of work with the patient and his family. In the same way, Poltava section of our rehabilitation centre works. The staff is formed of ex-patients. The rehabilitation work is intended for a high level of moral maturity of the patient. In the association, there is the club of mothers including women who managed to help their children to overcome drug addiction. The chairman of the club, Nina Vesnina belongs to Women Association of Dnepropetrovsk Region. The members of the club participate in prophylactic work. Ex-patients also participate in prophylactic actions. A similar club was created this year in Poltava.

Q. Do state bodies or local self-government assist in your work?

A. We aim at cooperation with these structures, and sometimes we obtain it: we carried scale and serious prophylactic actions several times. In 1996, first regional conference took place: Model of Drug Addiction Prophylaxis: Strategy of Prevention and Reduction of Demand for Drug. Conception of Partnership and Role of Self (Mutual) Help. In 1997, an enlarged sitting of National Coordination Council on Fight against Drug Addiction by Ukrainian Cabinet was carried out. In 2002, Woman, Family, Society against Drug Addiction and AIDS science conference was carried out. Though, our initiatives are often not supported at all. Actually, the question could be formulated in another way: we do not aim at help, we aim at cooperation. The situation could be changed only through united efforts.

Q. Does the society understand how dangerous spread of drug addiction is? In my view, the society does not fully understand it. This is mostly connected with too small covering this problem by mass media. In newspapers and in TV, there is only information of “horror” character or some reports about 100-percent successful method of drug addiction cure.Both kinds of information hinder citizens from objective understanding the problem. Now, the main task is to form adequate view on the issue.

Q. Could the issue of drug addiction be won in a separate country?

A. Drug addiction is a kind of “shadow” of the society. One cannot win a victory in a fight with his shadow. The way lies in positive changes in the society.

Q. What could you advice the parents and relatives of drug addicts?

A. Work with relatives is a very important part of a drug addict’s rehabilitation. In our view, drug addiction is only a symptom of his family’s illness. That are relatives, who protect, hide from criminal liability, “treat” the drug addict. While they themselves have a feeling of fright, guilt, confusion, loneliness, shame, helplessness before the distress. They begin to search for a clinic, where for a pretty good sum “100-percent cure” is guaranteed without their participation. We are sure, a part cannot be corrected without correction of the whole. So, only that drug addicts can be our patients, whose relatives actively participate the psychotherapy groups. For relatives who do not have such a possibility, there are consultative points. Members of our Association write articles for Dnepropetrovsk newspapers about modern views on the issue of drug addiction and about their own experience of this addiction’s overcome. In 2000, the association edited the book Returned from Non-existence by Dnepropetrovsk journalist Tamara Nesterenko. The book contains the stories of the people who managed to win drug addiction thanks to the association’s specialists.

Q. What plans the association has for the nearest future and for prospect?

A. To continue to work. The main direction of the work is rehabilitation. Development of the therapy community. We also plan to perfect surroundings therapy, group psychotherapy on the base of eclectic method we use and to develop different forms of psychotherapy of addict family. By using experience we have, we intend to create working places for ex-patients. Second, scientific work. We intend to continue sociological research to study peculiarities of drug consumers’ families. We plan to participate in scientific conferences on the issue, to publish scientific articles, while for the prospect – to write a book containing our 10-year experience of therapy. Third is studying up-to-date methods of work by our doctors and psychologists. Preparing ex-patients and their relatives for prophylactic work. We worked out a programme of preparing teachers, school psychologists and persons working with youth for prophylactic work. We would like to realize this programme in Dnepropetrovsk and Poltava. Fourth, prophylactic sphere. We pay much attention to sport as a powerful mean of developing strong aspects of a personality. In 1995, Vybor football team was created of the players who won drug addiction. While participation in tournaments is a way to show possibilities to overpass drug addiction and an effective way of drug addiction’s prophylaxis. We plan to carry out Sport against Drug Addiction and AIDS regional football tournament. We also expect teams of the kind will participate in it. We also want to edict second volume of the Nesterenko book telling about life troubles the characters come into collision with during the post-rehabilitation period. We would like to shot a regular TV programme “The Truth and Myths about Drug Addiction.”

Leonid Sauta was interviewed by Andrei Lubensky PRAVDA.Ru

Translated by Vera Solovieva

Read the original in Russian: http://www.pravda.ru/main/2002/04/24/40249.html