START OF THE DRUG ADDICTION TREATMENT

TV Interview with Dr Bolbukh from Special hospital for addiction diseases Dr Vorobiev)

 

TV reporter: When the patient turns to you for help, how does the treatment start?

 

Dr Igor Bolbukh: There are multiple versions of the treatment and at the some initial conversation, the consultation with the patient we estimate his case, the consequences, seriousness of his drug use, his motivation for the treatment, the situation at home, help from family, and find a variant that would be liable from medical point of view and cab also fit into the plans of the patient. When we agree on the variations of treatment, usually it goes stage-by-stage,

 

We usually start with detoxification. This is a very important stage of the treatment, because if a man regularly takes some substance, cleansing the substance is very stressful and it is dangerous situation. Now there are a lot of methods to make this agonizing process painless. We are introducing those methods into our program and patients say that they passed quickly and did not feel a crisis. “I did not even notice (withdrawal symptoms), I slept well, maybe a little sleepier due to therapy, but there was no pain, there was no trouble.” Then we move on to the next phase of treatment.

 

The next stage is the most important. It’s the treatment of psychological addiction.

There are methods that can, at the start, help a man to “extinguish the fire” in his head, to get back to normal thinking ability. Often, the patient says, “When I have cravings for drug it is literally the first thing in the morning.” He did not get out of bed, still have not totally woken up and he already has a navigation system in his head  telling him where to get the money, where to get heroin. He is constantly making combinations in his head. That is why there is a part of the treatment called information therapy, therapy with the unit that regulates the balance of endorphins and ultimately it can get the patient out of this obsession, mania, and the patient says, “Okay, I have noticed a difference. I don’t wake up early with this craving; now I get up, I am interested in the news, what interested me is the breakfast.. “Some of these appear to be ordinary, normal, physiological needs. And when a man comes out of this phase, when he has strong motivation, then we do psychotherapy, then we plan activities how to live without drugs.

 

TV reporter: How do the devices you mentioned help the patients? How do they work?

 

Dr Igor Bolbukh: There are different techniques. There are devices that stimulate and our natural structure, brain structures that are responsible for the exchange of endorphins, to stabilize his mental condition. It is the ninth generation apparatus and the first time we’ve seen in Switzerland. One patient from Austria was hooked on heavy substance morphine sulfate, supstidol. When we asked are colleagues: “What is your plan, how long you plan to keep the patient on this treatment?”, They said that 5 days would be enough. We were skeptical, however, as we have seen, the patient connected to a machine said that he felt good, that device does not bother him, it somehow does change much in his condition. “I feel good, I was already in crisis, i started sneezing, felt discomfort in the body, now I feel good.” He went to sleep. The next day we saw that he had breakfast normally. Only on his third day he was a bit cold, vomited, but there was no drama, he said that it was awkward, but durable. On the fourth day, oddly enough, he was literally different, refreshed, he was in good mood, we had breakfast together. He said: “I already feel that everything is back. Today I feel good. “On Saturday, which was his sixth day, he went with his friend with the car, he was driving home. So, it’s really quite an advanced technique. In addition to this device there are more different devices for information therapy, audiovisual stimulation etc. I think that these devices mean a lot for the treatment.

 

TV reporter: Does that one treatment leads to healing, or is it necessary to repeat it from time to time?

 

Dr Igor Bolbukh: Healing depends on numerous factors. You cannot turn on the device on a patient and say: “Ok, you are cured.” No. It is necessary first to implement the stage of detoxification, solve the physical crisis. Some mental instability will follow, which is also necessary to heal. When you pass this phase, it is necessary to ensure that this state that is reached, good physical and mental, would be protected from some stress, nervousness, contacts with bad crowd. Therefore psychotherapy is necessary, pharmacological blockade is necessary, and therefore requires full cooperation of the patient, the hospital and relatives. And this phase lasts another year and it gives me the opportunity to be confident that the patient gets used to the sober life, and relatives can also see that month by month he returns to his normal state.

 

TV reporter: From your experience, what is the percentage of those who were cured? Can you really cure drug addiction?

 

Dr Igor Bolbukh: It can be cured, without question. Healing is possible, and evidence that there  are many people that do not take drugs for  8, 10, 12 years. But once again I say that the result depends on several factors and the patient’s will and his cooperation.

 

TV reporter: Unfortunately, there are probably some cases of patients that did not complete their treatment which are causing relapses. There are probably a few of these cases?

 

Dr Igor Bolbukh:

Yes, statistically these cases are less than 10%. And there are factors that we strive to completely analyze and dispose of in some way, to build such a construction that these negative factors would not influence the relapse. What are the main reasons for relapse? It is consuming some other types of psychoactive substances. After some time, it is difficult to convince the patient that it is necessary to leave the alcohol and marijuana. They say: “I’ve had a problem with heroin, I’m not an alcoholic, and marijuana is not a drug at all!” But consuming psychoactive substances provokes memories to narcotics, provoking instability in mental state. A second factor that provokes relapse is recurrent contact with old friends, and the patient says, “I know this man my whole life, it does not matter that he takes substance, I need him, we are in good relationship.” But this man, if he is your good friend, he does not want something bad to you consciously, but that fact that he is under the influence of substances, has a negative impact on you. And the third factor is boredom. After some time, the patient expects that it is enough that he stops using, lays in bed and immediately expects money, girls, Mercedes, and everything else. However, a few weeks pass, and he sees that there is nothing, Wait another week and his sober life will start to be boring. Therefore, it is also necessary to organize your life. Of course, it is necessary to have time for work and for sport, for everything else. No one can non-stop live in some “holiday euphoria”.