Drug abuse: Tendencies and ways to overcome it
p> Identification, Diagnosis, and Registration of Drug Users: The identified addicts may belong to different age and social groups;
their condition may have a different degree of narcotic neglect. This fact
may influence the choice, distribution and intensity of medical measures,
as well as their combination with other types of aid. Of particular importance is the early identification of addicts among
the young and the adolescents. A timely medical interference, caring
participation and influence of parents, relatives, teachers, police
officers, and the atmosphere of friendliness can stop the youngsters' slump
into illness. When the consumers of different drugs have been identified, it is
exigent to inform the police to enable it to find the sources of drugs and
trafficking channels and execute other preventive measures. Information is especially important if the drugs have been manufactured
illegally or their origins are unclear. The following list of measures can help identify the individuals who
misuse narcotic substances: medical check-ups of industrial labor staffs, school and college
students; medical check-ups of inmates in jails and penitentiaries; medical examination of the perpetrators of drug abuse for further
registration and treatment, including compulsory treatment; specialized testing of certain professionals (the military, pilots,
drivers of all means of transport, police officers) for the bodily presence
of narcotic substances; revealing the most dangerous forms of drug abuse that complicated
detoxification, revealing the cases of multiple drug misuse (the combined
use of more than one drug) and the cases of an intertwined abuse of drugs
and alcohol; identification of addicts who carry the HIV and other infectious
diseases, elimination of the consequences of infectious transmission; timely registration, treatment and rehabilitation of those who need it. Another way to improve the health servicing of drug abusers is to
organize: fundamental research; development of efficacious pharmaceutical
preparations and novel methods of treatment for different types of narcotic
dependence, their speedy translation into public health practices; large-
scale contribution to research from Russian and foreign scientists (the
Academy of Sciences, medical, pedagogical, psychological and other research
institutions, application of practices adopted abroad); accelerated training of highly qualified personnel (addictive
conditions psychiatrists, psychologists, educators, social workers) at
medical colleges and upper level courses, specialized training of medical
attendants, nurses and technicians. The study program should cover not only
the novel methods of treatment, but also the specifics of contacts with the
drug addicts and methods of readiness for treatment and prophylactic
practice; organization of new preventive-treatment/ registration clinics, out-
patient departments at industrial facilities and offices, emergency aid
centers and a wide publication of data on their mode of operation,
anonymous and commercial treatment centers for drug addicts; extensive adoption by drug-abuse monitoring services of the
achievements in the medical science, psychology, pedagogy, pharmacy, and
special-purpose technology; modernization of drug-abuse monitoring services, improvement of
material supplies and provision of the necessary personnel. The post-treatment rehabilitation measures should include: a) the
creation of purpose-oriented government-run and charity funds, ex-drug
abusers support funds and diverse forms of work with them; b) development
of rehabilitation methods based on the effective analysis of the existing
rehabilitation procedures and of qualification levels of the personnel; c)
psychological assistance to the former abusers' families, relatives, and
friends who must be taught the techniques of exerting favorable influence
on the patients. Equally important is the organization of other anti-narcotics efforts
taken by public health institutions. The health of the nation is an important element of the social and
economic development of a country. From this angle, the popularization of a
rational way of life, the cultivation of respect for human health as the
basic value of society ranks high among the priorities of medical
institutions. Publicizing Information Against Drugs: A skillful and persistent dissemination of knowledge about the
destructive impact of drugs and their detriment for the future generations
is a crucial activity of medical institutions in the struggle against
narcotics. It is advisable to find a particular audience and do masterly
presentations. Lectures and discussions are not the only means of knowledge
dissemination. Meetings with former drug addicts and presentations about
broken human lives have also proved productive. To increase the prophylactic effects of popularization, it would be
useful to train the instructors on the methods and tactics of campaigning
against narcotics, design a system of mass anti-narcotic education, based
on medical science, provide the necessary teaching aids, control and
stimulate this activity.
Organization of Control Over the Use of Narcotic Substances:
Public health institutions have responsibilities in exercising control
over narcotic substances under international conventions, treaties,
agreements and other forms of international cooperation in combating drug
abuse. As mentioned earlier, their primary responsibility is to control the
proper use of drugs, the correct taking of their stock, their storage,
distribution and removal. The issue of special prominence is the storage of
narcotic substances at medical institutions and warehouses and the
thwarting of attempts to misappropriate them. Inspections often expose
serious flaws in this field. To rule out a possible abuse, leakage or misappropriation of drugs, the
following list of measures is essential: guarding narcotic substance storage facilities, fitting them out with
new equipment and fire/break-in alarm systems connected to the central
control panel or to the 24-hour operational medical personnel or guards
mail; proper protection of the points where drugs are stored in small
quantities for distribution as administered by the physicians; tightened control over big-batch long-term storage facilities like the
warehouses of regional drug-store administrations, and strategic reserves
warehouses; regular inspections at narcotic drug warehouses; strict abidance by the rules of taking stock, storage and use of drugs
for medical purposes; a timely exchange of information with the police on the above issues
and cooperation in drawing up the lists of drug storage facilities. Experience suggests that a successful solution of the problem depends
on the depth of our insight into it. This is especially true of such a
complex issue as the treatment and rehabilitation of drug addicts
regardless of what stage they are at. That is why the fullest and the most
objective information is essential for the medical and other institutions
to organize a counter-offensive against drug abuse. With that goal in mind,
public health centers should adhere to the following organizational
guidelines: gathering and analysis of information on the conditions of drug
addicts, tendencies in and results of their treatment and rehabilitation,
and types and means of using drugs and the impact they have; interaction with other institutions and departments in concrete forms
of anti-narcotics activities in such large-scale operations as Poppy and
Doping, in check-ups and research; control surveys prepared by the narcology service. Organizational support for these guidelines could be achieved through: the establishment of a strict procedure for and the terms of turning
in, and registration of documents, supply of dependable information on the
actual situation with drugs and their sales and use for both medical and
non-medical purposes, on the individuals perpetrating misuse, supply of
other data essential for making specific decisions; cooperation with other departments in holding joint selective research
and express-tests to obtain reliable information on the actual levels of
drug abuse, the damage it inflicts, the effects of treatment and other
types of aid to the addicts; scheduled and unscheduled departmental and/or inter-departmental
inspections of how control over drugs is maintained, and how the rules of
their use and storage are observed; analysis and broad publicity of the achievements of medical staffs who
have a record of positive results in combating narcotics, as well as
provision of incentives. The scope of health institutions' duties also embraces revealing and
timely informing the relevant departments and the public at large on
dangerous tendencies in drug abuse, new varieties of stupefying substances,
the techniques of their manufacture and the means of use. The public health
system develops the adequate methods of prevention, treatment, and
counteraction. Par. 3. Enforcement of Legal Measures of Narcotics Counteraction The organization of legal enforcement of anti-narcotics measures falls
into three groups: 1) application of legal administrative and criminal legal norms
regulating the prevention and suppression of narcotics; 2) government legal
measures to set and refine law enforcement and other agencies combating
narcotics; 3) international anti-narcotics measures. Group One includes compulsory treatment of drug addicts and measures
against drug-related crimes. Compulsory treatment of drug addicts is a law-
enforcement measure aimed at cutting down the non-medical use of narcotic
substances. It can be administered by the court to an addict who evades
voluntary treatment or who continues misusing drugs after a course of
treatment. If an addict commits a crime, the court metes out punishment in
combination with compulsory treatment. Compulsory treatment of Drug Addicts:
Compulsory treatment is prescribed to all categories of abusers at medical
institutions with a specialized treatment procedure in the course of work
therapy. If criminal punishment is imposed, the treatment is executed at
the penitentiary during the term of imprisonment. Placement of drug addicts to mandatory treatment centers is in the
domain of responsibilities of police departments. This activity goes hand
in hand with the following organizational measures: identification of individuals perpetrating drugs abuse; administering a medical examination, and a compulsory visit to a
medical institution in case of a refusal to undergo the procedure
voluntarily; compulsory hospitalization for complete check-up upon conclusion of a
narcologist (psychiatrist specializing in addictive conditions -
translator's note). Notification is given to the prosecutor's office and,
if an underage addict is hospitalized, to his or her parents. timely and renewable registration of drug addicts at the drug-patient
monitoring clinics, and prophylactic registration of the individuals whose
misuse of drugs has not yet acquired the form of an illness; supervision over the daily way of life of the registered patients and
checking their attempts to skip compulsory treatment, imposition of other
measures of educational, medical and legal influence; issuance of documents for placing the addicts who avoid mandatory
treatment to rehabilitation and work-therapy clinics and specialized drug-
abuse Medicare centers; filing documents on treatment of evaders with the
courts; escorting of addicts to the places of mandatory treatment, registration
of individuals who were formerly sentenced for drug-related crimes or fell
under administrative liability for misuse of drugs; individual prophylactic measures against addicts to whom corrective
labor has been meted out without a term of imprisonment, or whose sentences
have been suspended or deferred; treatment of drug addicts at corrective labor institutions
simultaneously with serving a term, supervision over inmates' treatment and
behavior. Organizational Law Enforcement Measures against Drug-related Crimes: Other organizational law enforcement measures against narcotics-related
crimes are: locating the illegal plantations of narcotic-bearing crops and
identifying their growers, eradicating such plantations, securing
prohibitions to grow narcotic substance containing crops, making special
maps upon the inspections of gardens, private plots of land and wastelands,
cooperating with agriculture experts, army units and other departments
concerned, carrying out special task operations and disseminating
information on drugs. It is of paramount importance to reorganize the system of guarding
government-controlled plantations of hemp and the like crops or create such
a system in the places where it is absent. This measure is closely linked
to the development of advanced methods of crop guarding, especially, in
harvesting seasons. Work by shifts and material incentives may prove
effective. Good results can also be obtained through the improvement of
technical and chemical means of protection. To limit the access of the public at large to the areas of government-
sponsored drug- bearing crop plantations, it would stand to reason to
establish special passport and traffic control in such areas. Organization of Measures to Suppress Drug-dealing: The measures to suppress drug dealing are the most important issue at
present. Manufacture and trade in narcotics has become a branch of the
shadow economy. It is gaining momentum, creating production facilities and
channels of distribution. In a large number of cases the understaffed law
enforcement departments are unable to rebuff the onslaught of drug
manufacturers and offer sound alternatives to all aspects of drug abuse. The illegal production of drugs that spill over the state borders and
continents is at the top of the world community's agenda. Particular
significance is attached to the clandestine drug laboratories. In the wake of it, it is exigent to set up specialized police
departments, which will concentrate the officers of high professional
expertise, and to provide them with the necessary material and technical
support. Foreign experts believe tangible results in eradicating clandestine
laboratories can be achieved if police operations to uncover the channels
by which the raw materials arrive and the end product is dispatched are
synchronized with the efforts to block access to chemical substances and
equipment the manufacture of drugs requires. This, however, is not easy as
some drug synthesis components such as acetic anhydride, ether, benzene,
acetone are extensively used in the industrial sector. Their industrial
consumption is not controlled in practical terms since, in most countries,
legislation does not regulate the production, storage and use of these
chemicals. Experts in Germany propose in this connection that the laws against
drugs should extend to cover these chemicals too. But the output and
industrial use of the above substances is so massive that the attempts to
take them under control within the boundaries of a single country have
yielded no results while entailing substantial expenditure on organizing
the control service. Another measure suggested is marking the packing of chemical substances
with special marks that would help the police identify the country of
origin and the manufacturer. Such a step, however, is unproductive as in
most cases the police does not get a hold of packing of the chemicals which
had already been used. Experts consider as more promising the special laboratory tests of the
confiscated narcotic substances and chemicals used in the manufacture of
drugs. The tests can be more helpful in identifying the country of origin,
elucidating specific features of the technological process and other
fundamental properties of the chemicals. For instance, specialists of the German institute of criminology have
designed on the basis of the American and Swedish experience methods of
identifying the places of origin of heroin through chromatographic testing. Experts believe the most effective way to control the proliferation of
the substances used in drug manufacturing could be the marking of such
substances with dyes or radiation. The weak point of the method is a
possible impact the marking may have on the qualities of the chemicals and
the end products. Besides, it would contradict the legislation of many
countries and some international agreements. That is why the researchers of
anti-narcotic methods tend to pin hopes on the method of a different nature
- self-control. It encompasses a set of police-proposed measures that are
effectuated by the services directly involved in actions against illegal
manufacturing, trafficking and trade in drugs, as well as by all companies
and individuals who have a connection with the manufacturing, sales and use
of narcotics and auxiliary chemicals. According to this concept, the
producers, suppliers and consumers of chemicals report to the police all
suspicious purchases. The police, in its turn, work out detailed
recommendation and criteria for such cases. Examples of these criteria are
above-the- statistic-average size of a purchased batch of chemicals, a
request from a new client, etc. Such kind of reporting gives the police
more opportunities to locate illegal laboratories, channels of raw
materials supplies and dispatch of the end product.
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