From the author: Today there are many rehabilitation centers for chemically dependent people... without a rehabilitation program. This means the absence of a clear, well-founded set of assistance to an addict in solving his personal problems, based on a system of knowledge about addiction as a disease, and (most importantly!) on the personal active participation of the addict and his family in the recovery program. Reflections on the topic... Committed There are no universal specific recommendations that can fit absolutely any situation. Each situation is unique in its own way, a differentiated approach is required. However, there are three universal fundamental principles that have proven their absolute efficiency: UNRELEVANT HONESTY, to everyone around and to oneself, OPENNESS, to people and to hearing new things, without prejudice, and READINESS to take action. to difficult decisions, to working on oneself. This applies both to addicts themselves, and to relatives of addicts, as a vector, as a direction of work on oneself, and to those who are engaged in rehabilitation, as an unconditional requirement, a basis in their work. Today it exists many rehabilitation centers for chemically dependent people... without a rehabilitation program. This means the absence of a clear, well-founded set of assistance to an addict in solving his personal problems, based on a system of knowledge about addiction as a disease, and (most importantly!) on the personal active participation of the addict and his family in the recovery program. Recovery from addiction is a process which you need to do all your life in order to live soberly and prosperously. A rehabilitation center allows you to establish this process, provides “starting conditions”, which the addict himself then develops and strengthens in his life after the center. It is impossible to recover, but recovering throughout your life, living prosperously and fruitfully, is not only possible, but it is the only way out for an addicted person. This solution must be adequate, otherwise addiction will kill a person. Relatives of addicts who send their problematic relatives to rehabilitation centers without trying to figure it out, consult with specialists, consider options, and now, often without the consent of the addict himself, have very strong arguments for this. They are always similar: “He will be sober for a while (in isolation), “He may die soon and there will be no time to sort things out (and negotiate with him),” “He will at least see that it is possible to be sober.” It is precisely such relatives who often defend in the media the “honor” of centers that turn out to be scammers; funds that turned out to be criminal; people who enriched themselves at their expense and harmed their sick relatives. They say: “At least we lived for ourselves for a few months”, “It’s not so important that they don’t have a professional help system, he (she) was sober”, “We no longer knew how to cope with him, we were already afraid for ourselves ", "He remained alive, but he could have died during these months." This is the best argument. But what is a “rehabilitation period” without a rehabilitation program for an addict? What happens to him, to the relatives themselves, what are the consequences FOR EVERYONE? In Addictology and effective rehabilitation programs, the possibility of an addict beginning to recover is closely associated with the concept of “rock bottom” (in addictionology - “motivational crisis”). Only by reaching his “bottom” can an addict come to a sincere desire to quit using and become ready to change his life. “Bottom” is not so much external - one person, having lost everything, with rotting limbs, wants to continue using; and the other is threatened with deprivation of parental rights, and he is already beginning to wonder how much is internal. This is an awareness of the aimlessness, hopelessness and hopelessness of one’s life, and internal, emotional, mental pain, such that it is better to endure withdrawal than to endure this internal pain. However, this internal crisis occurs because external life is increasingly collapsing: friends, family, trust of relatives, status, money, opportunities and all other external resources disappear.There is a bitter joke in Alcoholics Anonymous: “Alcohol is the best solvent, it dissolves everything: money, health, work, family, friends, etc.” Relatives and those around them could help to realize this, but the loved one refuses to understand, and then “it’s easier to send them out of sight.” Finding yourself in a Center where there is no system of consistent and comprehensive solutions to personal problems based on knowledge of the disease of addiction, and where its active position, the addict gets the opportunity to avoid meeting the “bottom”. He finds himself in a place where he gets a break, reduces the dose, gains trust from society, becomes more sophisticated in lying to himself and others (this is inevitable without systematic daily work on himself), and the main thing is that the addict again acquires the illusion that he is capable of managing his life by trusting his usual forms of survival. This illusion is the most terrible deception of addiction, which forces a person to follow the obsession of his mind and will with addiction, and destroy his life and everything around him for decades. While this illusion of control is alive, the addict has no choice, he will use. At the same time, the disease itself - incurable, progressive, fatal, according to WHO definition) - is covered with temporary external well-being, becoming invisible, imperceptible... The World Health Organization, the majority of specialists around the world, recognized the disease of addiction as progressive! It develops and destroys a person more and more if there is no treatment. This disease is also chronic, incurable, in the medical sense: even if there is treatment, and addiction does not destroy a person, it remains with him, regardless of whether the addicted person uses psychoactive substances or not. This disease, like many other chronic, progressive, fatal diseases, can be lived with. To do this, first of all, we must not forget that this disease exists; someone who forgets about diabetes, say, can die from his forgetfulness. And knowing that a person is sick requires certain restrictions and certain regular daily efforts (actions). This, in fact, is called a recovery system, therapy or treatment (although the latter term is not correct). Having learned that a loved one has cancer or diabetes, or open tuberculosis, we begin to look for methods of treatment, realizing at the same time that “not all yoghurts are equally healthy”, which is “useless”, in this case, is not the same as “harmless”. Therefore, we are careful and attentive in choosing treatment. But with addicts this is not so obvious! Moreover, another problem arises here. If relatives turn to an adequate specialist, they hear from him information that is very unpleasant for them. This “terrible truth” is that the whole family is sick and every family member is sick. And if on the websites of “Rehabilitation Centers Without Rehabilitation” you can still read that a relative’s addiction affects family members, and they supposedly get sick from it, and this is called “codependency,” then a real specialist will take away this convenient straw, explaining that everything is wrong Just. The addict became the way he became not only because of genes and certainly not from “bad companies,” but also because he grew up in a “codependent family” with many dysfunctions. Those who have come to solve a problem with an addicted relative must, in addition to helping him, urgently take care of their recovery and solve THEIR personal problems. And here the relatives turn on the same psychological defense mechanisms, the same denial as the addicts. It’s easier for an addict to point out what’s wrong with his life: he smells bad, he breaks the law, he lets people down, he doesn’t feel well in the morning. But it is much harder for a codependent person to accept that he is sick. Therefore, it is easier to send the “culprit” out of sight. And so, they come to the rescue of sick relatives and those who do not want to face their dependent problems.all sorts of proposals for pastime called “rehabilitation”, but not presupposing an adequate system for working with the disease. Some even propose to forcibly take the addict to such a center. These include religious centers, where the basis is the imposition of religious ritual behavior and worldview, and commercial centers, where, at the expense of patients’ relatives, closed conditions for “correct life” are created, like a commune (often with harmful practices such as NLP, kundalini, pseudo-spiritual and pseudo-psychotherapeutic practices), and “murky” communities in the outback (taiga, villages, Cossack settlements with corporal punishment, etc.). These can be medical centers, where doctors can “load” an addict with medications for a long time, suppressing his desire to use drugs, but where nothing is provided for adequate rehabilitation, and all kinds of local and foreign “occupational therapy” centers, where patients work all day long in a special production, without changing oneself internally. There are many Centers and organizations that claim a recovery system, but immediately talk about the Black Sea coast (or Bali, Thailand, or Israel), sanatorium conditions, single rooms, medical support, etc. Such tempting offers in the advertisement can immediately let me tell you that this is not rehabilitation! Creating ideally comfortable conditions for “doing nothing” has nothing to do with addiction therapy; as well as monastic life itself, round-the-clock work, medication assistance (which is needed only for detoxification or in case of a “double diagnosis” - the presence of mental illness, but this is not the treatment of addiction). None of this, in and of itself, is treatment for addiction or recovery from it. The transformation of addicts into athletes (especially if these are aggressive sports), and humiliation with beatings - even more so. The addict, “rested” in the next “center”, remains faithful to all his usual “forms of survival” (destructive, in fact) and old life attitudes: lies, irresponsibility, manipulation, disorderly and irresponsible relationships, antisocial behavior and so on. He can compulsively play sports, get carried away by pseudo-spiritual practices, plunge fanatically into religious life, or join in the same violent activities that were carried out against him (as if to help). But, firstly, all this only seems better “than he would use,” and secondly, over time, the vast majority of such addicts will almost inevitably return to using chemical substances. Why? Because the disease was not treated! It’s not difficult to stop using (especially in a closed place), but in order to live soberly and prosperously, you need to constantly work on yourself, it takes a lot of effort for INNER changes. And since the addiction progresses, then, having relapsed, the addict very quickly reaches the level of destruction of all spheres (mental, social and biological) at which he stopped, and begins a rapid fall below, destroying everything and everyone around. There are some criteria for the initial assessment of rehabilitation centers :1. All activities of the center, fund and any organization involved in helping addicts must be completely transparent and reflected on the website. It is necessary to see who the founders and management are. The website should have a section with specific individuals, with a description of their competence, with contacts and the address of the organization. It is advisable to find patient reviews on the Internet and see if there are any scandalous stories with the name of this center or foundation. Read on the website what is offered as a recovery program, and discuss this with a doctor from a drug treatment clinic, for example, yes, and with an addicted relative who is invited to go there. You need to go for an initial consultation and form your own opinion about the people offering you help. If the rehabilitation is long (longer than a month and a half), then the relatives must be able to visit the center, and the opportunity to receive fromyour dependent close feedback on the activities of the center, at least once a week, especially if the Center is located in another city or country. 2. You can immediately delete from the lists organizations that offer only medicinal (drug) treatment. This is not enough to treat addiction (but medical assistance is often needed to alleviate the condition and prevent complications). If they promise that the addict will leave the Center “cured” (recovered, independent, etc.) - don’t waste your time. Addiction is incurable and recovery is a lifelong process. If relatives are not offered to join the program in the form of consultations and theoretical classes, these are not professionals. 3. Today in Russia there are the following effective forms of rehabilitation: “Minnesota model”, using the philosophy of the “12-step program”, psychological assistance, individual counseling, group therapy and much more; this is an intensive, most often quite short-term program, most often in a hospital; “Therapeutic communities”, in which there is addiction therapy, “peer counseling” (recovering addicts, having been trained, work in the center), as well as elements of the “12 step program”, a large the scope of various group work formats, including “mutual help therapy”, and much more; This is, most often, a long-term program of up to six months (sometimes more) taking place in an inpatient setting, with a strict system of rules; Outpatient rehabilitation programs, with individual counseling, individual written assignments, group work and a clear focus on client participation in self-help groups of the Anonymous Fellowship. Of course, It is necessary for the Center to have professionals - certified psychotherapists, psychologists, as well as “peer consultants” - addicts who have been successfully recovering for some time and have been trained to help other addicts. Having assessed the Center at least according to such simple criteria, You can hope for a change in the situation as a result of turning to them for help, if you meet one more absolute condition: DO NOT AGREE TO TAKING AND HOLDING A DEPENDENT IN THE CENTER AGAINST HIS WILL If you were offered this and called it treatment, rehabilitation, they claim that’s what they say! help an addict, then these people are charlatans and criminals, they will profit from your misfortune and cause harm! The only thing for which violence can be used is for safety (and this will definitely not be a treatment for him, but will only be forced isolation), and the only ones who can use violence are state authorized bodies. But the main thing in any therapy remains the solution of one’s personal problems, that is, your own recovery. For relatives of addicts, this is also not a dacha, where relatives like to go, sending the addict “to at least some Center.” These are, first of all, the Al-Anon and Nar-Anon communities, where they will be helped to see their “bottom”, which is so difficult to comprehend (see the websites of these communities, there is also literature). PS Now separately about the forced placement in the Center This step , of course, caused by fear for oneself, the inadequacy of the addict, and the fatigue of relatives. But still, this is a step away from solving both the addict’s problems and his own personal problems. Firstly, in such a situation, the addict does not reach the necessary “bottom”, which means he does not recognize addiction as the source of his problems, does not face reality, the truth About Me. Therefore, the addict does not solve his problems, blocks help, and does not learn responsibility for himself, his behavior and his life. Experts who justify such measures are mistaken or disingenuous. A psychotherapist cannot force goodness. Even in cases where addiction treatment begins in prison, therapy begins only with the patient’s readiness, with his voluntary decision. Recovery programs are structured in such a way that the patient works all the time on his motivation. Secondly, the family did not come to this situation “from scratch.” For a long time, relatives unknowingly"