Chapter I. Psychology of drug addiction: current state of the problem. Deep causes of drug addiction (transpersonal view)

4.1. Psychology of drug addicts

Very often, drug addicts satisfy themselves with things that they essentially do not need. They are content with things that are easier to achieve. What don’t they do to keep themselves occupied?! But they don’t feel any clear needs that they need it. Therefore, many are engaged in an unloved profession, doing an unloved business (“Simply, the day passed without stress and overcoming, and it’s good”). For example, many alcoholics become security guards, etc. just to do nothing.

How can you help a drug addict, what should you do with him? In order to answer this question, it is necessary to understand why many people do not consume alcohol and drugs at all? Why do former alcoholics and drug addicts stop consuming? Everyone has different reasons and attitudes. For example, a drug addict may not consume due to a goal setting. In other words, she has set a goal not to consume for something (she wants, for example, to build a cottage, buy a car, etc.) In fact, such a person remains a drug addict, but does not consume yet. This is the target setting. What is a target setting? For example, a man is sitting in the bushes, he was told that a wolf will appear now, you must be careful. And suddenly a man appears, and he thought it was a wolf. His goal setting worked. And he killed him. He had no need to kill, he was simply given the goal of killing a wolf, and because of this attitude he killed a random person. A goal setting arises from a goal that others set for a person or that he sets for himself. Although a person may not have a need to realize this goal.

The semantic attitude of a drug addict is that he tells himself that there is no point in consuming a drug. In the first case, the goal is not to consume, but here there is no point in consuming. These are different things. “I’m sick, my heart is sick, I’m dying, now I’ll consume and die.” This means there is no point i.e. the semantic setting is triggered. He finds no meaning in consumption. This can also happen due to the fact that the person finds some different or new meanings - values that replace the values of the drug experience. In this case, what does the drug addict say? “I already feel good, I’m already happy, I sleep well (not like before), I live, I’m happy. The drug is too much for me. I'm feeling pretty good. Why should I still encourage myself? I live a great life, I have everything to enjoy life without artificial encouragement.”

Previously, it was believed that in order to cure a drug addicted person, it was necessary to create a semantic attitude that was opposed to the drug addicted person (an anti-attitude). Will he be happy about this, will he be glad about this, who knows? A person can create a counter-attitude (anti-installation). Will he enjoy life? After such courses, the drug addict walks around gloomy and has no mood to live, but there is indifference to the drug. This is a dangerous condition. And, in the end, relapses begin, because you can’t go far with one semantic attitude. Therefore, for effective treatment of drug addiction, it is necessary that the above conditions be met.

Example. Coding. Very often one hears that a given personality is encoded and therefore it is dangerous to consume. Actually, he is a drug addict and he wants to consume, but he can’t, otherwise it’s the end. Nowadays, the concept of coding has poisoned society so much that people often don't believe it. Usually, after coding, drug addicts and alcoholics begin to use again because long-term abstinence oppresses them.

The question arises: how can we create these substitute values for alcohol or drugs? We seem to have painted a picture of how to help a drug addict. It would seem that everything is very simple: pull all these settings, create them, and alcoholics and drug addicts will recover.

Example. Uncle Vanya took it and stopped drinking. And suddenly, spontaneously, without noticing it, he began to go fishing. This happens often. Alcoholics don't need to be taught what to do. They don't need to be taught hobbies. Without noticing it themselves, they often choose the hobby that they need, choose new activities for themselves, but only in accordance with alcoholic attitudes. They necessarily choose those hobbies that correspond to their alcoholic attitudes. And they will never choose hobbies that do not suit them. And it turns out that Uncle Vanya started going fishing. What does this mean? This suggests that fishing is a continuation of alcoholism, but without alcohol consumption, i.e. the personality remained alcoholic. Therefore, activities and hobbies are needed that would go against alcohol attitudes. Then the person would really get rid of alcoholic attitudes, i.e. from psychological dependence on alcohol. It wouldn't be helpful.

Are there any values or experiences that would go against alcohol attitudes? It turns out there is. It is necessary to completely reconsider the phenomenon of values. What is value? It turns out that value must be formed in a person.

Example. Let's take a breath now and hold it in our lungs. What are you starting to feel? That something that we do not see i.e. air suddenly becomes valuable. We're used to it, there's a lot of it, and that's normal. And, suddenly, you begin to feel that the air is great!

Thus, there is no need to look for some new values that are somewhere far away. The values are nearby, but they need to be discovered. We just need to create a new state for ourselves that changes the perception of what is nearby, to which we are accustomed, adapted and did not perceive before.

Example. Once, one man said to his friend the following phrase: “what a beautiful woman is coming,” and then, “oh, it turns out that this is my wife...”

We get used to it, adapt to beauty and don’t notice it. Thus, it is necessary to form values in a drug addicted person on a different basis, on the basis of depriving him of something, so that later his attitude towards previously lost values will change. It is most effective to work here in terms of life and death. When a person begins to understand that value is life in itself.

Example. When a person gets sick and recovers, for the first two days he is so happy. It turns out everything is so beautiful and great! Then he adapts to the values of a healthy person and his mood drops to its previous level.

Thus, the individual needs to know and take into account his adaptation mechanism and not let it dominate him. Therefore, if you add some values to a person by carrying out such a procedure so as not to allow him to adapt to the values of life, contrasting phenomena, comparing everything through the prism of life and death, then you can achieve effective rehabilitation of a drug addict or alcoholic.

Example. To eat deliciously, you need optimal fasting... And so, no matter what area we take (sex, study, communication, etc.), everywhere we need to be able to turn on the mechanism of this hunger, this appetite for life. Learn to approach ordinary and prosaic things in a new way. This is precisely what the work of teachers and psychologists should be aimed at. Thus, it is very important to form positive values of experience on simple values, simple objects, but which would be discovered anew. It is necessary to distinguish between understood values (known values) and experienced values.

Example. One girl decided to give birth. Why? But because it's time. Mother says it's time. Everyone says it's time. The girl understands this value, but does not worry about it. Thus, for her, childbirth and the unborn child become only an understandable value. She does not yet know what awaits her and, in essence, this is not a real value for her. Very often, many women do just that. My husband forces me to do it, saying it’s necessary. Let's have one more. The woman doesn't want to. For her, this is only an understood or known value, but not an experienced one. Isn't this the psychological reason for abortion? The woman does not want to give birth. Psychologically, he does not want to carry a child within himself. this person, but often does not realize it. Many women become drunkards on this basis.

And so it is everywhere. Many people live in a world of only understood values. These are unhappy people.... They reason like this: “This is good not because it feels good to me now, but because we were taught that it is good. Because others say it's good. Various books say that this is good.” Only later does he ask himself: “Did I need this?” It turns out THIS is not what we were promised.

Example. Another woman says to her friend: “I want to give birth to him and that’s all.” Although she is married. She is free. She will definitely give birth (despite the fact that she is married to someone else) and will love and be happy. And her friend answers her: “I lived right, but I wasn’t happy.”

Candidate drug addicts most often live in a world of understood values that do not please them. And that’s why they get bored in life. They do not know what the true values of experience are. Such a person lives and gets bored. Finds something to do, but the soul does not find any meaning in it. And suddenly, she discovers the value of the experience. This person was poured a glass of cognac and everything began to sparkle with new colors. This is truly the value of the experience. One boy said this after the first intoxication: “Everything else is bullshit.” Of course, not everyone reacts so violently to their first consumption. Those who have simply had wonderful experiences in life will never say that. A teenager who has lived in depression all the time will definitely make a discovery for himself out of intoxication.

A drug addict will never say: “I am a drug addict or an alcoholic.” They always disguise this by denying the addiction itself, saying “an alcoholic is someone who is standing in a gateway, and I’m wearing a tie, I’m an assistant professor.” Alas! Respectable people often suffer from drug addiction. It is from them that students need to be protected.

4.2. Cinema and drug reality

Let's give signs of the degrees of alcoholism and drug addiction (let's draw an analogy with going to the cinema):

1st degree. The personality is immersed in a positive virtual world and returns to the constant world, without losing the constant world. The constant world remains as before. The personality drinks periodically, but does not lose the constant world, it returns to where it came from. Therefore, a person can drink or not drink. May abstain. It's like going to the movies. He went in, paid the money, watched the film and left and doesn’t want to go to the cinema anymore.

2nd degree. The personality has been in a positive virtual reality, went to the constant one and again wants to go to the virtual, positive one. She is already dependent and cannot live without her. In other words, a person went to the cinema, came out, and cannot forget about the film. The next day he goes to the cinema again.

3rd degree. The person bought a ticket to the session and sat there all day without going outside. This is already a binge. The personality does not return to the original constant reality, but is constantly in a certain narcotic reality.

4.3. What bluffing techniques do drug addicts use?

A) Bluff by denial.. The personality states: “I am not an alcoholic, I am not a drug addict.” But someday he will hear that his wife and relatives still evaluate him differently. He is assessed as sick. This happens at some point and the person sees that he is not respected and not perceived as before. And he is becoming more and more convinced of this. And then he understands that there is no point in denying. Therefore, any drug addict will never tell the truth about himself, will create myths, and it will be more and more difficult for him to play the role of a teetotaler.

b) Bluff with aggression (defense with aggression).

A drug addict is aggressive and explains this aggression by saying that he is worried about you and is suffering. An alcoholic mother can tell her children: “I worry about you, I suffer for you, I am like this because I love you.” But in essence, the person worries about himself and betrays his aggression, supposedly because others are to blame, the world around him is to blame: salaries are not paid, prices are rising, etc. etc. Such a person attributes the reason for his aggression to other factors that have nothing to do with the true cause. The reason is in herself, she is sick. A drug addict often worries about himself because of his own dissatisfaction. Although he explains his aggression as worry for something else, for you, for the people, for happiness.

c) Bluff by intellectualization. Often a drug addict comes into a psychotherapist’s office and begins a whole theory. An alcoholic professor comes and starts saying how smart he is and knows everything. Why did you come then? He “knows everything!” He begins to speak and does not allow the psychotherapist himself to say a word. Such a person has his own theory, his own erudition, his own intelligence. As soon as the psychotherapist begins to take her to the heart, to the sore spot, to the essence, then such a person again retreats from the answer into his theories: “You know, I’ve read a lot of books about alcoholism and drug addiction, you probably haven’t read this.” A person may know the theory of alcoholism and drug addiction. They try to justify their drunkenness and that there is no need to do anything.

d) Bluff by omnipotence (defense by omnipotence). The drug addict claims that he can do anything, including quitting the drug. “Why do I need a psychotherapist. I'll quit on my own, I can do it. I can do everything. Look, I'm the director of the company. I have money. I generally strong man“I can do anything, and at the same time I can quit drugs.” But time shows that this is not in his power.

e) Bluff by regression (defense by regression). Very often, a drug addict pretends to be a child and shows his weaknesses, but in a fake way. Drug addicts are good players and deceivers, they can play, manipulate by pretending, showing their weaknesses and thus achieving their goals.

f) Contradiction. If you record on a tape recorder the speech of a drug addict asking him the same question only in different forms, then you will notice that he will answer the same question in different ways.

Substance abuse is international problem, from which almost every country on the globe suffers, including Russia. Systematic studies of drug addiction, widespread in a number of foreign countries, began in our country no more than 15 years ago. Numerous health problems, death, social problems The symptoms associated with this abuse are the result of a complex interaction between the substance, the individual, and the environment. The user develops a strong habit of psychoactive substances (dependence), as a result of which drug use becomes increasingly inevitable.

For a long time, the main attention of drug addiction researchers in our country was focused on the pharmacological effects of narcotic substances, the dynamics of physiological processes and the general state of health during the systematic use of psychoactive substances. Concentrating attention specifically on the medical and physiological aspect of drug addiction also determined the main approach to its treatment, which reduced the problem of drug addiction to physiological dependence and its relief. The problem of drug use should be considered not only as a physiological problem, but also as a problem of an individual who resorts to drugs in a specific social situation. In this case, preventive, therapeutic and rehabilitation work acquires new content, and therefore new opportunities. Practice shows that such an understanding of the problem complicates its solution, but significantly increases the indicators of delayed results.

The underestimation of psychological factors and psychological mechanisms in the emergence and dynamics of drug addiction is reflected in the position of official narcology, which understands drug addiction as a group of diseases caused by the systematic use of narcotic substances and manifested in changes in mental reactivity and physiological dependence, as well as in some other psychological and social phenomena. So, drug addiction is considered as a problem of an individual who takes drugs in a certain socio-cultural context. At the same time, society, the social and cultural environment, reacting to drug addiction, “embed” their reactions into the “drug addict” type of behavior. An analysis of the literature shows that different psychological trends have different points of view on the problem of drug addiction.

The main psychological approaches to the problem of drug addiction are grouped around the leading trends in psychology and the most developed theories.

BEHAVIORAL APPROACH. Proponents of this trend defend the idea of the continuous influence of his social environment on a person. Positive connections of a chronic drug addict with society are limited to contacts with members of the drug addict group. From the point of view of psychological structure, an addict belongs to a personality type that has little tolerance for pain and emotional stress. If he does not have close contacts with people similar to him, then he loses his sense of confidence. Due to the “defectiveness” of social development, the addict tries to avoid any form of responsibility, becomes unfriendly and distrustful of those whom he considers part of the threatening world. Therefore, the association of drug addicts into groups is one of the social needs inherent in drug addiction. The members of the group are united by the need to obtain the drug. There is no hierarchy in it, all its members have equal rights and practically no responsibilities towards each other. Once drawn into such a group, it is difficult for a drug addict to escape from there, since it offers him everything that he cannot get in the real world. In the drug group everyone is just like him, it’s easy and simple for him there. Having escaped from there, he finds himself seemingly in another world, where he encounters misunderstanding, condemnation, alienation, and aggressiveness not only of his family, but also of society as a whole. Society pushes away drug addicts, although it itself is largely responsible for the occurrence of this disease. Drug addicts try to unite in groups, and since the influence of the social environment on a person is great, they continue to kill themselves and others.

Sutherland suggested that behavioral disorders can be formed under the influence of other people, and depend on the frequency of contact with them. However, in some studies these results were not confirmed: there are teenagers who live in unfavorable material and family conditions, they have constant contact with drug addicts, but they, nevertheless, remain resistant to drug contamination and do not become drug addicts.

Let us also note the high efficiency of the behavior of a drug addict, behavior aimed at acquiring and using drugs: neither the law and the police, nor control from society and family, nor the lack of money and material resources, nor much else that could be an insurmountable obstacle for a person, suffering from drug addiction is not an obstacle for the drug addict. Moreover, this complex chain of behavioral acts and events always ends with positive reinforcement with a vividly experienced bodily component. Quitting the drug means giving up highly effective behavior in favor of acting in an unstructured, hostile environment, and with a low probability of success.

The view of drug addiction as a complex system of behavior of a drug addicted individual in a social environment poses an extremely difficult problem for the developers of rehabilitation programs: the formation of a behavior in a drug addict who is in remission that would provide him with greater efficiency in interacting with the world than “drug addict” behavior .

Thus, drug addiction can be considered as a highly adaptive behavior, the refusal of which is a maladaptive step associated with the risk of uncertainty and responsibility for oneself. At the same time, teetotal behavior does not guarantee a person either happiness or ease of existence, and drug use guarantees the addict the “disappearance” of the world with its problems. Moreover, the drug addict does not have a clear idea of the possibilities of action confirmed by the achievement of the necessary state, embodied in success. If the rehabilitation program does not give a clear answer to the question: “What in return?” - it is ineffective.

COGNITIVE APPROACH. The concept of locus of control has found the most widespread use in explaining the causes and consequences of drug addiction within the cognitive approach. So, according to Rutter, some people attribute their behavior to internal reasons, others explain it to external circumstances. Addicts attribute their behavior to external circumstances. They are convinced that they use drugs because of other people or because of chance. Therefore, one of the reasons why they cannot stop using drugs is the lack of internal control. This approach helps to reveal the complexity of interactions between a person and emerging situations. But its representatives, however, do not talk about why one is inclined to see the reason for his behavior in himself, and the other in others.

In addition, recent studies have shown that the question of the nature of the locus of control in drug addicts cannot be resolved so unambiguously and categorically.

Data regarding the specifics of cognitive processes in drug addicts can be considered more reliable and reliable. For example, it has been found that with opium addiction there is degradation of the imagination, emasculation of thinking, expansion of peripheral visual perception, and a decrease in adequacy in understanding the non-verbal behavior of other people.

PSYCHOANALYTICAL APPROACH. Psychoanalytic studies of drug addiction come down mainly to explaining the emergence of addiction as defects in psychosexual maturation, leading to oral dissatisfaction, which leads to oral fixation.

Another explanation of drug addiction within the framework of the psychoanalytic approach is fixation at the anal stage, or at the anal and oral stages of development simultaneously.

Based on such explanations, dependence is seen as a regression that can be stopped by eliminating this regression.

Since it can never be completely satisfied, the frustrated personality reacts with hostility, and if it withdraws into itself, this leads to mental destruction. For such people, the drug is a means of relieving frustration by inducing euphoria. The social stigma that accompanies drug use only increases hostility and simultaneously leads to increased feelings of guilt. A drug addict is an irresponsible person who is incapable of achieving success in any area of social or economic activity. His connections with the real world are broken, and protection from adverse influences is ineffective. Interested, “programmed” exclusively for the acquisition and use of drugs, they do not value relationships between people and are only interested in their own pleasure from the effects of these drugs. Inadequate connections with other people are a consequence of the defective “I” of the drug addict, for whom libido is a “blurred erotic concept.” Despite the fact that many psychoanalytic authors consider drug addiction as a kind of masturbation, a more thorough analysis indicates the presence of a deep intrapersonal conflict reaching the oral stage of psychosexual development. The essence of this regression is that the personality returns to that period of development when life was easier, there were no problems, fear, guilt. This regression may indicate a weakness of the self in the face of pain and frustration. It is interesting that these positions have hardly been criticized or edited in psychoanalysis, even though it has long been known: addiction is almost impossible to “cure” using psychoanalytic methods. We believe that the psychoanalytic approach to the treatment of mental addiction is ineffective precisely because drug addiction is not a direct result of parent-child relationships and childhood trauma. Drug addiction develops on the basis of mental stress that actually arises in adolescence in communication between an adult and a child and/or in the teenage environment. It is in the sphere of relationships, as we believe, that the ground for the development of drug addiction first arises. Thus, the psychoanalyst will work with "premise reasons,” but not with the reason itself. Real experience of working with drug addicts refutes the ambitions of psychoanalysts and requires the development of other methods of psychotherapy for addiction.

TRANSACT ANALYSIS. In E. Bern's theory we do not find a clear definition and understanding of the essence of drug addiction. According to his theory, normal personality development occurs when the essential aspects of Parent, Adult and Child are consistent with each other. These are people with good boundaries of Self, who may have serious internal conflicts, but who are able to balance Parent, Adult or Child so as to “allow” each to perform their functions. In this regard, many researchers suggest that in a drug addict one ego-state dominates, most likely it is the Child, or one ego-state is infected with another.

Drug addiction can also be viewed as a game in which each participant (this could be family members, surrounding people, “saving” organizations) takes a certain position. Game is, in essence, the artificiality of behavior, the impossibility of achieving spontaneity. When there is a lack of sincerity, some existing and familiar situations are played out. In the game, everyone seems to receive a certain benefit, but its participants in such conditions cannot develop, change, and therefore do not have the opportunity to solve this problem, to do what could lead to recovery. Such relationships record mental dependence on drugs. In this regard, let us note the thought of V.A., which is very productive for transactional analysis as a therapeutic direction. Petrovsky that “game acts as a way of self-knowledge, as a way of achieving spontaneity while simultaneously striving for sincerity and the impossibility of achieving it.”

Games can be considered part of broader and more complex transactional ensembles called scripts. Scenarios belong to the field of psychological transference phenomena, that is, they are derivatives, or more precisely, adaptations of infantile reactions and experiences. It is a complex combination of transactions that are cyclical in nature. Psychological analysis of scenarios shows the essence of such a complex phenomenon as codependency in the family of a drug addict. Despite the lack of a developed concept of drug addiction within the framework of transactional and structural analysis, there is every reason to note the high theoretical and practical potential of this area. In our work, we rely on the theory of personalization (A.V. Petrovsky, V.A. Petrovsky), the concept of maladaptive activity (V.A. Petrovsky) and the concept of ego states (E. Bern). The heuristic fruitfulness of these theories allowed us to develop a psychological model of the development of mental dependence in drug addiction, which will be presented below.

systematic approach. From the standpoint of a systems approach, drug addiction can be defined as a systemic complex that includes elements that are different in nature, level and dynamics. If we consider drug addiction from the point of view of systemic family psychotherapy, then it is a family disease, a “family problem.” The drug addict “involves” into the disease all the people close to him, who develop codependency. It, in turn, prevents an adequate perception of reality, distorts the nature of intrafamily interaction and, thus, fixes mental dependence. If an adult family member (father or mother) is addicted to psychoactive substances, then this has a detrimental effect on the child even before he himself begins to use them. A child growing up in such a family is an element of a dysfunctional system and is exposed to the entire complex of factors leading to the development of the disease. Growing up, he will transfer his experience into adulthood and, most likely, will become chemically dependent himself or connect his life with a chemically dependent person. Of course, the systems approach has significant prospects in the analysis of drug addiction as a complex and multi-level phenomenon. At the same time, we note that a systemic analysis of drug addiction inevitably leads to the realization that the factors in the formation and fixation of addiction to a narcotic substance are different both in the method of origin and functioning, and in their structural complexity and “direction”. It may well be that, according to V.A. Petrovsky, “drug addiction as a systemic phenomenon has nothing in common teleological grounds." This thought by V.A. Petrovsky is fully confirmed by the observation he made, according to which drug addiction “has no resulting therapy.” Thus, in the case of drug addiction, we are faced with a special kind of systems, the specific features of which are not reflected in studies on systemic issues.

In addition, we note that there are practically no serious systematic studies of youth drug addiction in our country.

Thus, within the framework of current trends in psychology, we do not find a single theory or concept that could fully explain the phenomena associated with drug use without resorting to borrowing from other theories, ignoring what is “stubbornly not explained” or using as starting points, statements that have no logical or theoretical justification.

The only conclusion that emerges from the analysis of existing points of view on drug addiction and is at least somehow capable of explaining the available data is paradoxical: drug addiction performs adaptive functions and has an adaptive meaning. In the absence of any developed psychological concept of drug addiction, empirical research deserves special attention. Largest quantity Psychological research on drug addiction is associated with the study of predisposition to substance abuse.

If we talk about predisposition or, more broadly, about the factors leading to the formation of drug addiction, then we can say that there are biological, social and psychological factors. A number of studies indicate that a hereditary burden of mental illness can act as a factor contributing to drug addiction.

The emergence and highly progressive course of drug addiction is also facilitated by:

pre-, peri-, postnatal pathology;

traumatic brain injuries, severe and long-term somatic diseases;

residual (residual) organic brain damage.

Delayed puberty, which is most often associated with constitutional slowing of development, has psychological consequences. The experience of falling behind one’s own age group in a number of ways is in itself traumatic for a teenager: a feeling of inferiority, a violation of identity, and dysmorphophobia may appear. Teenagers who mature early are, on average, more liked by others; they are more balanced and less timid. In contrast, those who mature late have more fears, anxieties, even malice; a lot of compensatory mechanisms are revealed.

Motif-forming factors are also of interest. E. Fromm considers drug use as a special case of the cult of consumerism among young people; therefore, the motive for taking up drugs is the desire to “consume happiness” as a commodity. A.E. Lichko and V.S. Bitensky used the classification of motives that V.Yu. Zavyalov developed for alcoholics, highlighting after him the following groups of motives:

1. Social and psychological motives:

motives determined by traditions and culture;

submissive motives, reflecting submission to the pressure of other people or a reference group;

pseudo-cultural, like a teenager’s desire to adapt to the “narcotic values” of a teenage group.

2. The need to change one’s own state of consciousness:

hedonic motives;

ataractic motives;

motives for hyperactivation of behavior.

3. Pathological motivation associated with the presence of withdrawal syndrome and pathological craving for drugs.

However, very often, using various methods, it is not motives that are determined, but motivation, that is, the subject’s explanation of the reasons for an action by pointing to circumstances that are socially acceptable for him and his reference group. Motives, as is known, may not be realized by the subject. In addition, significant distortions are possible during their verbalization. The works of V.V. Guldan, as well as studies carried out under the leadership of K.S. Lisetsky and S.V. Berezin, which use projective and psychosemantic methods, deserve attention.

A study of emotional relationships and the structure of ideas about drug addiction among Moscow schoolchildren aged 10-17 years showed that behavioral characteristics are closely related to the nature of the situation, gender, and age. The most unfavorable trends were:

the absence of internal prohibitions on substance abuse drugs, unlike drugs;

at the age of 12-13 years - dependence of behavior on the situation;

at the age of 14-15 years - risk-taking and increased activity;

at the age of 16-17 years - lack of inclusion in the situation of friends and family;

drug use as a way to organize interaction in a group.

The main motive for refusing to use drugs was not fear for health, but the lack of opportunity to get them.

An analysis of the literature has shown that various methods of presenting information about drug addiction that is undifferentiated in its content, used to prevent youth drug addiction, lead to mosaic, fragmentation, and contradictory ideas about drug addiction among adolescents and children. A sharply negative emotional attitude towards the “drug addict” stereotype very often coincides with an interest in using such substances. Some authors have discovered discrepancies in motivations and motives, which, in turn, are the result of a discrepancy between the rules, norms, prohibitions and realities of the youth subculture formally known to a teenager, which reflect the cognitive dissonance of schoolchildren’s ideas about the problem of drug addiction.

In 1991 V.V. Guldan conducted a comparative psychosemantic analysis of the motives for taking drugs and giving them up in adolescents. social behavior(main group) and school students (control group). If we compare the motives for taking drugs in the main and control groups, we can note that interest and curiosity in using drugs is inherent in both of them. Therefore, the question of the specificity of curiosity as a motive requires further study. All subjects use drugs to “get rid of troubles.” For the control group of subjects in a situation of possible drug use, the influence of peers turned out to be insignificant; for them, changes in consciousness with the help of drugs and the opportunity to experience pleasant sensations were more tempting. Antisocial adolescents are more susceptible to the influence of the peer group (namely, the influence of the elder in the group) when choosing behavior in favor of taking drugs.

An analysis of the literature shows that the motives for drug use and drug abstinence have not been sufficiently studied and are heterogeneous in content.

In this regard, it is necessary to mention studies of personal prerequisites and attempts to build a “specific profile” of a person predisposed to drug use. Research undertaken in this direction is very contradictory. Adolescence, as is known, is characterized as a crisis, and therefore vulnerable both from physiology and from social factors, in particular, family, school, and youth subculture. Problems in communication, instability of self-esteem, self-disorganization, lack of formality, high susceptibility to stress, as well as a high degree of propensity for various experiments (as a way of searching for something “of one’s own”), the desire to be accepted by any social group - all this is a background that increases the likelihood of a teenager using psychoactive substances.

The main reason for the significant vulnerability of adolescence is the instability of the self-concept. It has been shown that some specific features of the self-concept in adolescents can act as a factor in the formation of drug addiction.

As is known, the self-concept is formed under the influence of the social environment and predetermines the interaction of a teenager with him. Consequently, the more unstable the social factors, the less stable the adolescent self-concept. In addition, the most important aspect of the formation of a teenager’s “self-image” is body image; and, since the teenager’s body is constantly developing and changing, his “I” concept is developing and changing, and, consequently, the ways of interacting with the environment. The crisis and conflict nature of a teenager also lies in the fact that he feels the need not only to join a social group, but also the need to simultaneously separate himself from his usual social environment, even to resist it in the acquisition and disclosure of his “I” . It is obvious that the teenage “I” is an energetically powerful entity, requiring constant self-expression, release, but, at the same time, uncertain, very often filled with the content of the experience of other people: parents, older friends, others significant people. The contradiction between the potential possibility and the actual content of the activity gives rise to the adolescent’s internal tension, the resolution of which becomes more and more urgently necessary and vital with each passing minute. Very often the most in an efficient way Reducing tension, according to the teenager, is one or another form of deviant behavior, including behavior aimed at using psychoactive substances.

An analysis of the existing literature does not answer the question of what specific personality characteristics can be considered risk factors for initiation into drug use. Among the psychological factors that create conditions for adolescent substance abuse are: great value has troubles in the family. In addition, many studies show that a large number of adolescent drug addicts are raised in single-parent families. Trouble in the family serves as a background that most often pushes a teenager to participate in antisocial companies, especially with certain types of character accentuations. P.B. Gannushkin believes that a constitutional predisposition to drug addiction is most characteristic of epileptoid, unstable, cycloid and hysteroid types of accentuations. It was found that the risk of abuse is highest for the epileptoid and hysteroid type of accentuation. Hyperthymic people show interest in hallucinogens and inhalers, which can evoke bright, colorful images. In addition, they also tend to “try everything.” Teenagers with hysterical accentuation prefer a pleasant state or sedation caused by tranquilizers. With the schizoid type, there is a tendency to use opiates, that is, a desire to induce an emotionally pleasant state in oneself. But most authors came to the conclusion that the risk of drug and substance abuse is most typical for adolescents with epileptoid, unstable and hyperthymic accentuation. Unfortunately, we have to admit the fact that in most cases, the identification of adolescents who abuse psychoactive substances occurs late, when their behavior is already characterized by pathocharacterological reactions. This circumstance casts doubt on the reliability of the data that character accentuations are factors of predisposition to drug addiction, since the cause-and-effect relationship can be both direct and reverse: accentuations have a greater risk of starting to use drugs, but drug use also leads to significant impairments in life. behavior and character changes.

S.P. Genaylo, having conducted a clinical examination, found that drug addiction develops mainly in adolescence in individuals with pronounced tendencies towards self-affirmation and immediate fulfillment of their claims. At the same time, these are people with a reduced ability for long-term, purposeful activity, irritability, a tendency to excessive fantasy, demonstrative expression of feelings, imitation and lies. This gave the author reason to assume that they have an imbalance between needs and capabilities. And this, in turn, leads to a decrease in social adaptation and contributes to the formation of antisocial forms of behavior.

Thus, according to the assumption of S.P. Geneilo, the factor that increases the risk of drug addiction is a high level of intensity of needs and low level possibilities of satisfying them. Unfortunately, the qualitative content of needs, the frustration of which increases the risk of drug addiction, remains unclear. Let us also note one more very important circumstance. A significant number of studies of the causes of drug addiction are characterized by a traditional understanding of human behavior as a process aimed at satisfying a need or several needs. The discovery of a need or a class of needs, the dissatisfaction of which would act as a specific prerequisite for drug addiction, would mean, firstly, the presence of a teleological basis in drug addiction, and, secondly, the possibility of constructing a resulting therapy. However, as they show scientific research and analysis of clinical practice, drug addiction has neither a common teleological basis nor resulting therapy (V.A. Petrovsky).

We believe that the answer to the question of what constitutes the class of needs that underlie the formation of mental dependence is still missing precisely because the causes of anesthesia are associated with mental phenomena other than needs and need states. We believe that the decisive condition for the formation of mental dependence is the experience of “mogu” (V.A. Petrovsky), i.e. the experience of redundancy of possibilities for satisfying needs, and not the unsatisfied needs themselves as such. The experience of “I can” is fundamentally different from the experience of not being able to do something. I can - this is an excess of experiences, which are close to what S.L. Rubinstein denoted by the term “interest”, and V.A. Petrovsky denotes by the term “aspiration”. There are certain “I can”: I can demand (a drug), I can take it, I can use it in the company of friends. “I can” is characterized by a subjective feeling of overcoming obstacles: nothing prevents me from doing this. And then there is a feeling of grandiose possibilities - a resolution of generalized dissatisfaction. The desire of the subject to take advantage of growing opportunities is not exactly what is called in psychology by the term “need”; it is a different type of motivation. Let's look at the difference between motivations based on scarcity (needs) and motivations generated by experiences of excess using the following example. Affective need, i.e. the need to be accepted in a group is deficiency, this is the absence of a subjective experience of acceptance by others, significance for others, neediness by them, etc. The presence of such a need often pushes the subject to use drugs as a way of gaining the sympathy of the group. In turn, motivations based on redundancy (aspirations) arise when the subject experiences a feeling of freedom, namely, the freedom to take advantage of his opportunities, which pushes him forward, beyond his behavior. An example of this kind of state is bravado, which sometimes carries the subject far beyond the scope of behavior that would be in accordance with his needs. In bravado the subject experiences and enjoys an excess of my capabilities: I feel brave, risky, not limited. Such an experience of “I can”, motivating the subject’s activity in any area of relations or activity, reduces, or even completely removes, the severity of the experience of “I can’t” in all other areas of relations and activity. Perhaps that is why the drug is becoming an almost universal means of solving life’s problems.

Thus, in analyzing the development of mental dependence, we are forced to turn to both the “need” category and the “can” category, which denotes redundancy of capabilities and acts as a motivating force.

Of significant interest are works devoted to the study of traits characteristic of people who abuse drugs and alcohol. These include:

poor development of self-control and self-discipline;

emotional immaturity;

low resistance to all kinds of influences and inability to predict the consequences of actions and overcome difficulties;

deformed value system;

the tendency to react inadequately to frustrating circumstances, the inability to find a productive way out of a difficult traumatic situation;

painful impressionability, touchiness;

inability to adequately perceive situations related to the need to overcome life's difficulties, establish relationships with others and regulate one's behavior.

N.Yu. Maksimova suggests that the following reasons contribute to the actualization of adolescents’ psychological readiness to use drugs:

The inability of a teenager to find a productive way out of a situation of difficulty in meeting current, vital needs;

The lack of development and ineffectiveness of methods of psychological protection for a teenager, allowing him to at least temporarily relieve emotional stress;

The presence of a traumatic situation from which the teenager cannot find a way out.

Thus, the teenager finds himself helpless in the face of the negative states overwhelming him and resorts to changing his state chemically.

R. Dewc believes that a subject, using drugs, causing harm to himself, “comes under the control of a scheme with an inappropriate method of reinforcement - a narcotic substance.” The drug helps an insecure and fearful person free himself from fear and uncertainty.

It is noted that as a result of the development of drug addiction, personality begins to change. Internal conflicts intensify, and poor mental adaptation becomes more and more obvious. In the works of N.S. Kurek identified features of the emotional activity of drug addicts: a decrease in the adequacy of the perception of emotions in another person based on facial expressions, gestures and postures, a normal or increased level of emotional expression; leveling gender differences in the emotional sphere between boys and girls.

Thus, there is not only a violation of the emotional sphere of drug addicts, but, what is especially important from the point of view of studying the social behavior of drug addicts, disturbances in the expression and recognition of emotions.

Informal groups play a special role in introducing teenagers to drugs. Its influence on the personality of a teenager is very great. Constant disturbances in a teenager’s relationships with peers can be a subtle indicator of possible abnormalities in mental development. As a teenager grows up, the system of his relationships with peers has an increasing influence on his behavior and attitudes. The popularity of a child in a group is associated with a number of his individual characteristics: level of intellectual development; nice appearance; liveliness in communication; ability to establish friendly contacts; success in certain types of activities that are most significant for group members. Unpopularity and social rejection of a child can be harbingers of deviant behavior and mental disorders.

M.A. Alemaskin found that teenagers take the path of deviant behavior under the influence of older children.

It must be said that school as a social institution can also be a risk factor for drug addiction. It was found that instability of the teaching staff is most typical for schools that have the greatest number of problems among students. If school can really influence a teenager, it is important to know how to ensure that it influences for the better. Unfortunately, there is little reliable data regarding this issue. Hargraver, in a study of social relationships in secondary schools, drew attention to the consequences of rigid division of students into streams. In more successful groups there is a good relationship between teacher and pupils, and the latter tend to be committed to school and take their studies seriously. Teachers expect only bad things from children from the weaker group and, in addition, adolescents in such groups receive fewer positive emotions. These weaker groups essentially form a special subculture within which drug addiction can occur. The data from this study are in good agreement with the data of other authors. It seems that the distinction between strong and weak students most likely leads to the formation of deviant behavior in weak adolescents.

Of significant interest from the point of view of analyzing the causes of drug addiction is the question of stability (trans-situationalism) of human behavior. Polar points of view are expressed about the determination of human behavior with stable characterological characteristics, on the one hand, and situational factors, on the other.

According to a number of authors studying the problem of drug addiction, a productive approach is based on the use of the principle of complementarity of the interaction of trans-situational and situational factors, and in most cases the determining factors are personal, and situational factors play the role of a modulator (determining the variability of the manifestation of personal factors). In some cases, the hierarchy of factors may change. Exaggerating the role of situational factors in behavior (as is done by supporters of the behavioral approach) can lead to particularly negative consequences specifically in theoretical and practical assessments of drug addiction in adolescents. Considering situational factors as determinants (and not modulators) leads to the release of the individual from responsibility for his behavior.

Thus, risk factors for drug addiction should not be considered in isolation from each other. Their interaction plays a decisive role.

Analysis of research by domestic and foreign psychologists, as well as research conducted by us, allows us to formulate the following conclusions.

The available psychological data are heterogeneous and contradictory in nature, and the correlates of drug use are often confused with their causes.

Not a single concept of the emergence or formation of psychological dependence seems exhaustive and convincing.

The collision of an individual with circumstances that prevent the realization of his deep, basic tendencies in life determines a predisposition to drug abuse.

Drug abuse is a protective activity of the individual in the face of difficulties that interfere with the satisfaction of the most important and significant needs for him and has an adaptive meaning.

The motivation to use drugs can be not only the expectation of a reduction in the intensity of unmet needs, but also the expectation of an increase in the possibilities of action against the background of drug intoxication. We are talking about the attitude towards a drug as a means of increasing an individual’s capabilities in interacting with the world.

Of course, the above analysis is not exhaustive. However, it makes it possible to see the multidimensionality of the problem and the role of the mental factor in the dynamics of addiction. In this regard, effective treatment of drug addiction is possible if it is structured as a systemic intervention that can increase the individual’s ability to self-realize in a dynamic social environment.

The least studied aspect of drug addiction is the central component of addiction - mental dependence on the drug. In our opinion, this is explained by the following reasons. Firstly, long-term underestimation of mental factors of pathogenesis in drug addiction. Secondly, the lack of reliable and reliable data on the effectiveness of various methods of destroying mental dependence. Thirdly, the lack of development of a methodological basis for studying the structure, functions and dynamics of mental dependence on a narcotic substance.

However, it is obvious that all attempts at primary, secondary (rehabilitation) and tertiary prevention of drug addiction among young people will be ineffective without analyzing the central component of drug addiction - mental dependence.

Psychology and drug addiction clinic. Modern approaches to the rehabilitation of drug addicts.

(according to candidate of medical sciences S.V. Dvoryak, Ukraine)

Clinical forms of addiction differ only within the framework of the characteristics of the formation and course of physical dependence.

I draw your attention to two problems of alcoholism and drug addiction: the first is the stereotype of alcohol (drug) abuse, and the second is the syndrome of alcohol (drug) dependence. These are different problems, since, for example, alcohol dependence syndrome exists all the time, but a stereotype only exists when a person drinks alcohol. The same is true with drugs: the stereotype may change when the addict switches to something else, but he will still have the addiction syndrome, since he has a need to change his state of mind in any way, and if he does not find his drug, he will find another.

For example, having switched from opium to alcohol, a drug addict will not be able to consume it within the framework of a “normal” stereotype - he will quickly develop an increase in tolerance and get used to large doses, and he will end up with alcohol dependence, although this will be a relatively better option for him.

There are currently 6 main groups of drugs:

Opium preparations (opioids) - natural (heroin, codeine) and synthetic (eg, promedol). By action
Hypnotics (mainly barbiturates). In case of altered tolerance, they have an inverse (reverse) effect: they excite instead of calm. It is characteristic that when this drug is withdrawn, convulsive syndrome often occurs, for example, with drug addicts who are in prison.
Hypnotics often form the so-called. barbiturate encelopathy (“barbiture dries out the brain”). After repeated use of barbiturates, intelligence decreases, memory and intellectual acuity deteriorate, which is often not restored after getting rid of addiction - unlike opiates.
Sedatives (hypnotics) with altered tolerance cause a feeling of euphoria and intoxication.
The psyche of a drug addict is such that he receives pleasure from changes in consciousness that a healthy person does not receive. Drug addicts often experience a feeling of “rush” when taking sedatives, a desire to do something. Often they are already prepared by the very anticipation of the process, enhancing the effect with the “placebo” effect and the ritual load of the action - for example, a drug addict can get pleasure from an intravenous infusion.
Very often, drug addicts take hypnotics, sedatives and barbiturates in combinations, which, as a rule, enhance the effect much more than with simple arithmetic addition of the effects of these drugs (potentiation effect) - for example, young people prefer codeine with glutamide.
Psychostimulants (caffeine, tonin, phenamine or pervetin).
Pervitin is often homemade from ephedrine and used for intravenous injection. It increases the content of serotonin in the brain, which makes you not want to sleep, and doses can be repeated after 6-8 hours, which keeps a person in a state of constant high performance and euphoria, but subsequently serotonin and adrenaline seem to be washed out of their depots in the neurons of the brain and causes a coma, sometimes with cardiac arrest. It is interesting that this group of drugs does not cause withdrawal symptoms and does not seem to form physical dependence, although mental dependence is very strong. This also includes cocaine.
Psychostimulants, acting as a stimulant and eliminating inhibitory mechanisms, increase the risk of criminal acts and often lead to psychosis and schizophrenia.
Psychotomemetics (hallucinogens: LSD, psilocybin, femcyclidine or PCP - a synthetic cheap drug that is mixed in small proportions with expensive cocaine and produces the famous crack, so common in poor black neighborhoods of the USA, where blacks cannot afford pure cocaine).
Psychotomimetics are not addictive, but, like other drugs, they lead to a decrease in control and psychological dependence.
Cannabinol (marijuana, hashish, plan, anasha - a drug containing tetrahydrocannabinol, usually made from Indian or Chui hemp). It is considered a good alternative to alcohol and is allowed in many countries, because... does not entail pronounced antisocial behavior. Using the example of these countries, where there are no more drug addicts than in other countries, it is clear that the problem lies not in the availability of drugs, but in the formation of certain needs in people. Rather, on the contrary, an additional incentive for drug consumption is (especially for teenagers) the fact that it is prohibited.

Stereotypes of drug use vary. The worst option is the use of injectable drugs - heroin, morphine, in our country - homemade opiates, which are used mainly after extraction with acetone by heating without any additional purification, which leads to frequent infections when the infection enters a vein (vomiting, fever - at in the language of drug addicts - “shaken”), phlebitis, hepatitis and AIDS.

Therefore, one of the tasks of the fight against drug addiction is to transfer the drug addict to non-injection forms of addiction - for example, the world-famous "methadone programs" in Holland, where every registered drug addict can receive free methadone tablets daily - a synthetic drug similar in action to morphine, whose industrial production is very cheap. This eliminates the danger of AIDS and infectious diseases, the drug business is deprived of huge shadow income, and the drug addict himself is in plain sight all the time and is not forced to engage in antisocial actions to obtain money.

Methadone programs are a reflection of the existing concept of harm reduction - harm reduction. This concept is based on the already familiar idea that drug addiction, like alcoholism, is incurable, and therefore measures are necessary for those addicts who cannot withstand withdrawal symptoms for the rest of their lives.

It is believed that the degree of drug addiction can be assessed according to the following criteria:

The drug addict began to use more or less drugs over the past period (“before, you needed 5 wheels, now one is enough” - a positive change, because he needs less money, there is less chance of infection, there is less support for the drug business, etc.).
Does he use other stimulants in addition to the main drug (a combination is always worse - including for the health of the addict).
State of physical health: skin, teeth, nails, lungs, liver, central nervous system).
The presence of psychiatric complications (psychosis, intellectual disorders, obsessive fears, etc.).
Family and social indicators (does he get along with his family, does he live at home, is he divorced, does he have friends, etc.).
Relationships with the law (arrests, arrests, fines, convictions have a strong impact on the health of a drug addict - after temporary forced abstinence and severe stress, drug addicts increase their doses much more often).
Relationship with the employer (whether it works).

Preserved social connections, of course, make all attempts to help the addict more successful. If a drug addict has already lost his family, job, or former friends, then most often after rehabilitation he begins to take the drug again.

There is a myth in society about the absolute dangers of alcohol and drugs: “A person started drinking and became spoiled.” However, it is not the drug that creates the drug addict, but the personality - simply, when using the drug, those qualities that were inherent in this person before appear. In fact, the addict already begins to take drugs because he is an addicted person, and does not become addicted because he begins to take the drug. A drug is nothing more than a prosthesis to replace those personal qualities or mental states that the addict has not learned to develop on his own.

That is why it can be argued that all drug addicts have certain personal qualities, such as:

Vulnerability, touchiness. Low ability to accept, understand and express one’s feelings, unsuccessful attempts to control them and refusal to accept oneself as one is.
Low level of self-care, inability to take care of oneself.
Low levels of self-esteem alternating with high self-esteem (usually during or after drug use).
Relationship disturbances, low frustration tolerance, intolerance to refusals, negative responses, which most often provokes either a rude or conniving attitude of loved ones.

In total, this can be characterized as a feeling of uselessness, abandonment, guilt and hypertrophied responsibility for everything that happens around them.

Naturally, a modern rehabilitation program is formed from these provisions - the qualities that led to drug addiction must be eliminated in the process of counseling or group treatment.

In the process of communicating with a group, the main healing factor is the presence of an environment, a community in which a new personality is formed as a product of changes in interpersonal relationships. Typically, in self-help groups, the presence of a psychotherapist is not necessary or is limited to participation in the first sessions. Treatment is usually long-term and takes more than one year - there is an opinion that for every month that a person lives in a state of addiction, a year of conscious work on oneself is necessary. The environment is also therapeutic because it successfully snatches the drug addict from the influence of his subculture and refutes the myths that exist in the mind of the drug addict that a real, “cool” life is possible only for those who “understand the thrill”, that Once you become a drug addict, it is no longer possible to recover, etc. Group:

Gives hope.
Shows the addict that he is not alone in his problems - others have them too, and others cope with them.
The addict receives a large amount of information that inspires confidence. His defenses, denial, and mistrust are removed.
The addict learns altruism, which is just as contagious as selfishness. He sees people caring about him without any benefit for them. They are amazed and intrigued by this because they have never experienced anything like this.
In the programs of Narcotics Anonymous, God occupies a large place, thanks to whom their altruism becomes reasonable and justified, since he does something not so much for another as for God, without being offended that a particular person may not live up to his hopes. Thanks to God, relationships with others become not local, but total, all-encompassing - there is, as it were, a higher power that sees everything, counts it, connects it together and rewards. By understanding what is happening in the group in the context of the concept of God, the addict can get rid of such a deep-seated problem as fear, since fear is caused primarily by the unknown and incomprehensible.
The addict sees people who have had the same problems and dealt with them - he trusts them and understands that the same thing can happen to him.
The addict gains new social interaction skills. In a group context, expressing and accepting others' true feelings is encouraged, which is not typically done in families - especially with regard to positive feelings. It is considered wrong to tell a child how much he is loved, valued, valued - and even the relationships of adults wither without this nourishment. But the basic human need is love, and everyone strives to satisfy it first. By adopting the skills of new group relationships, addicts can transfer them into their environment, making the world a better place.
There appears group cohesion, cohesion, a “common language” of aphorisms, rules, signs, symbols, attitudes to problems, existential factors - attitudes to God, life, health, destiny, the meaning of life. Man is an open system, and as we change our attitude towards someone, someone changes their attitude towards us. Drug addicts who have undergone treatment say that they began to see fewer drug addicts around them and more good, normal people. Although today the most successful rehabilitation programs have an effectiveness of 25-30% due to the fact that drug addicts return to the same environment and not every one of them is strong enough to go so far in their changes as to pull this environment with them - this is not a reason to stop fighting for them and giving them hope for healing.

In conclusion, I want to say that the Odessa Steps Center has the status non-profit organization(note - they do not have the right to have money in their account, but must immediately spend it) and has a hospital, a day hospital and an outpatient department for working with alcoholics and drug addicts. Treatment is paid, but the service has a system of referrals to self-help groups operating in Odessa. A similar association in Kyiv is “Sociotherapy”, headed by Vievsky.

1.1. Drug addiction as a subject of psychological research

Substance abuse is an international problem that affects almost every country on the globe, including Russia. Systematic studies of drug addiction, widespread in a number of foreign countries, began in our country no more than 15 years ago. The numerous health, death, and social problems associated with this abuse are the result of a complex interaction between the substance, the individual, and the environment. The user develops a strong habit of psychoactive substances (dependence), as a result of which drug use becomes increasingly inevitable.

For a long time The main attention of drug addiction researchers in our country was focused on the pharmacological effects of narcotic substances, the dynamics of physiological processes and the general state of health during the systematic use of psychoactive substances. Concentration of attention specifically on the medical and physiological aspect of drug addiction also determined the main approach to its treatment, which reduced the problem of drug addiction to physiological dependence and its relief. The problem of drug use should be considered not only as a physiological problem, but also as a problem of an individual who resorts to drugs in a specific social situation. In this case, preventive, therapeutic and rehabilitation work acquires new content, and therefore new opportunities. Practice shows that such an understanding of the problem complicates its solution, but significantly increases the indicators of delayed results.

The main psychological approaches to the problem of drug addiction are grouped around the leading trends in psychology and the most developed theories.

COGNITIVE APPROACH. The most widespread concept in explaining the causes and consequences of drug addiction within the cognitive approach is the concept of locus of control. Thus, according to Rutter, some people attribute their behavior to internal reasons, others explain it to external circumstances. Addicts attribute their behavior to external circumstances. They are convinced that they use drugs because of other people or because of chance. Therefore, one of the reasons why they cannot stop using drugs is the lack of internal control. This approach helps to reveal the complexity of interactions between a person and emerging situations. But its representatives, however, do not talk about why one is inclined to see the reason for his behavior in himself, and the other in others.

In addition, recent studies have shown that the question of the nature of the locus of control in drug addicts cannot be resolved so unambiguously and categorically.

Another explanation of drug addiction within the framework of the psychoanalytic approach is fixation at the anal stage, or at the anal and oral stages of development simultaneously.

Based on such explanations, dependence is seen as a regression that can be stopped by eliminating this regression.

Since it can never be completely satisfied, the frustrated personality reacts with hostility, and if it withdraws into itself, this leads to mental destruction. For such people, the drug is a means of relieving frustration by inducing euphoria. The social stigma that accompanies drug use only increases hostility and simultaneously leads to increased feelings of guilt. A drug addict is an irresponsible person who is incapable of achieving success in any area of social or economic activity. His connections with the real world are broken, and protection from adverse influences is ineffective. Interested, “programmed” exclusively for the acquisition and use of drugs, they do not value relationships between people and are only interested in their own pleasure from the effects of these drugs. Inadequate connections with other people are a consequence of the inferior “I” of the drug addict, for whom libido is a “blurred erotic concept.” Despite the fact that many psychoanalytic authors consider drug addiction as a kind of masturbation, a more thorough analysis indicates the presence of a deep intrapersonal conflict that reaches the oral stage of psychosexual development. The essence of this regression is that the personality returns to that period of development when life was easier, there were no problems, fear, guilt. This regression may indicate a weakness of the self in the face of pain and frustration. It is interesting that these positions have hardly been criticized or edited in psychoanalysis, even though it has long been known that addiction is almost impossible to “cure” using psychoanalytic methods. We believe that the psychoanalytic approach to the treatment of mental addiction is ineffective precisely because drug addiction is not a direct result of parent-child relationships and childhood trauma. Drug addiction develops on the basis of mental stress that actually arises in adolescence in communication between an adult and a child and/or in the teenage environment. It is in the sphere of relationships, as we believe, that the ground for the development of drug addiction first arises. Thus, the psychoanalyst will work with the "premise of the cause", but not with the cause itself. Real experience of working with drug addicts refutes the ambitions of psychoanalysts and requires the development of other methods of psychotherapy for addiction.

Drug addiction can also be viewed as a game in which each participant (this could be family members, surrounding people, “saving” organizations) takes a certain position. The game is essentially, artificiality of behavior, impossibility of achieving spontaneity. When there is a lack of sincerity, some existing and familiar situations are played out. In the game, everyone seems to receive a certain benefit, but its participants in such conditions cannot develop, change, and therefore do not have the opportunity to solve this problem, to do what could lead to recovery. Such relationships record mental dependence on drugs. In this regard, let us note the thought of V.A., which is very productive for transactional analysis as a therapeutic direction. Petrovsky that “game acts as a way of self-knowledge, as a way of achieving spontaneity while simultaneously striving for sincerity and the impossibility of achieving it.”

SYSTEM APPROACH. From the standpoint of a systems approach, drug addiction can be defined as a systemic complex that includes elements that are different in nature, level and dynamics. If we consider drug addiction from the point of view of systemic family psychotherapy, then it is a family disease, a “family problem.” The drug addict “involves” into the disease all the people close to him, who develop codependency. It, in turn, prevents an adequate perception of reality, distorts the nature of intrafamily interaction and, thus, fixes mental dependence. If an adult family member (father or mother) is addicted to psychoactive substances, then this has a detrimental effect on the child even before he himself begins to use them. A child growing up in such a family is an element of a dysfunctional system and is exposed to the entire complex of factors leading to the development of the disease. Growing up, he will transfer his experience into adulthood and, most likely, will become chemically dependent himself or connect his life with a chemically dependent person. Of course, the systems approach has significant prospects in the analysis of drug addiction as a complex and multi-level phenomenon. At the same time, we note that a systemic analysis of drug addiction inevitably leads to the realization that the factors in the formation and fixation of addiction to a narcotic substance are different both in the method of origin and functioning, and in their structural complexity and “direction”. It may well be that, according to V.A. Petrovsky, “drug addiction as a systemic phenomenon does not have a common teleological basis.” This thought by V.A. Petrovsky is fully confirmed by the observation he made, according to which drug addiction “has no resulting therapy.” Thus, in the case of drug addiction, we are faced with a special kind of systems, the specific features of which are not reflected in studies on systemic issues.

In addition, we note that there are practically no serious systematic studies of youth drug addiction in our country.

Thus, within the framework of current trends in psychology, we do not find a single theory or concept that could fully explain the phenomena associated with drug use, without resorting to borrowing from other theories, ignoring what is “stubbornly not explained” or using as starting points, statements that have no logical or theoretical justification.

The only conclusion that emerges from the analysis of existing points of view on drug addiction and is at least somehow capable of explaining the available data is paradoxical: drug addiction performs adaptive functions and has an adaptive meaning. In the absence of any developed psychological concept of drug addiction, empirical research deserves special attention. The largest number of psychological studies of drug addiction are associated with the study of predisposition to substance abuse.

The emergence and highly progressive course of drug addiction is also facilitated by:

pre-, peri-, postnatal pathology;
traumatic brain injuries, severe and long-term somatic diseases;
residual (residual) organic brain damage.

1. Social and psychological motives:

motives determined by traditions and culture;
submissive motives, reflecting submission to the pressure of other people or a reference group;
pseudo-cultural, like a teenager’s desire to adapt to the “narcotic values” of a teenage group.

2. The need to change one’s own state of consciousness:

hedonic motives;
ataractic motives;
motives for hyperactivation of behavior.

3. Pathological motivation associated with the presence of withdrawal syndrome and pathological craving for drugs.

the absence of internal prohibitions on substance abuse drugs, unlike drugs;
at the age of 12-13 years - dependence of behavior on the situation;
at the age of 14-15 years - risk-taking and increased activity;
at the age of 16-17 years - lack of inclusion in the situation of friends and family;
drug use as a way to organize interaction in a group.

The main motive for refusing to use drugs was not fear for health, but the lack of opportunity to get them.

Analysis of the literature showed that various ways Presenting information about drug addiction that is undifferentiated in its content and is used to prevent youth drug addiction leads to mosaic, fragmentation, and contradictory ideas about drug addiction among adolescents and children. A sharply negative emotional attitude towards the “drug addict” stereotype very often coincides with an interest in the use of such substances. Some authors have discovered discrepancies in motivations and motives, which, in turn, are the result of a discrepancy between the rules, norms, prohibitions and realities of the youth subculture formally known to a teenager, which reflect the cognitive dissonance of schoolchildren’s ideas about the problem of drug addiction.

In 1991 V.V. Guldan conducted a comparative psychosemantic analysis of the motives for taking drugs and giving them up in adolescents with antisocial behavior (main group) and school students (control group). If we compare the motives for taking drugs in the main and control groups, we can note that interest and curiosity in using drugs is inherent in both of them. Therefore, the question of the specificity of curiosity as a motive requires further study. All subjects use drugs to “get rid of trouble.” For the control group of subjects in a situation of possible drug use, the influence of peers turned out to be insignificant; for them, changes in consciousness with the help of drugs and the opportunity to experience pleasant sensations were more tempting. Antisocial adolescents are more susceptible to the influence of the peer group (namely, the influence of the elder in the group) when choosing behavior in favor of taking drugs.

An analysis of the literature shows that the motives for drug use and drug cessation have not been sufficiently studied and are heterogeneous in content.

As is known, the self-concept is formed under the influence of the social environment and predetermines the interaction of a teenager with him. Consequently, the more unstable the social factors, the less stable the adolescent self-concept. In addition, the most important aspect of the formation of a teenager’s “self-image” is body image; and, since the teenager’s body is constantly developing and changing, his “I” concept is developing and changing, and, consequently, the ways of interacting with the environment. The crisis and conflict nature of a teenager also lies in the fact that he feels the need not only to join a social group, but also the need to simultaneously separate himself from his usual social environment, even to resist it in the acquisition and disclosure of his “I” . It is obvious that the teenage “I” is an energetically powerful entity that requires constant self-expression and release, but at the same time it is also uncertain, very often filled with the content of the experience of other people: parents, older friends, other significant people. The contradiction between the potential possibility and the actual content of the activity gives rise to the adolescent’s internal tension, the resolution of which becomes more and more urgently necessary and vital with each passing minute. Very often, the most effective way to reduce tension, in the opinion of a teenager, is one or another form of deviant behavior, including behavior aimed at using psychoactive substances.

An analysis of the existing literature does not answer the question of what specific personality characteristics can be considered risk factors for initiation into drug use. Among the psychological factors that create conditions for adolescent substance abuse, family dysfunction is of great importance. In addition, many studies show that a large number of adolescent drug addicts are raised in single-parent families. Trouble in the family serves as a background that most often pushes a teenager to participate in antisocial companies, especially with certain types of character accentuations. P.B. Gannushkin believes that a constitutional predisposition to drug addiction is most characteristic of epileptoid, unstable, cycloid and hysteroid types of accentuations. It was found that the risk of abuse is highest for the epileptoid and hysteroid type of accentuation. Hyperthymic people show interest in hallucinogens and inhalers, which can evoke bright, colorful images. In addition, they also tend to “try everything.” Teenagers with hysterical accentuation prefer a pleasant state or sedation caused by tranquilizers. With the schizoid type, there is a tendency to use opiates, that is, a desire to induce an emotionally pleasant state in oneself. But most authors came to the conclusion that the risk of drug and substance abuse is most typical for adolescents with epileptoid, unstable and hyperthymic accentuation. Unfortunately, we have to admit the fact that in most cases, identification of adolescents who abuse psychoactive substances occurs late, when their behavior is already characterized by pathocharacterological reactions. This circumstance casts doubt on the reliability of the data that character accentuations are factors of predisposition to drug addiction, since the cause-and-effect relationship can be both direct and reverse: accentuations have a greater risk of starting to use drugs, but drug use also leads to significant impairments in life. behavior and character changes.

Thus, according to the assumption of S.P. Geneilo, the factor that increases the risk of drug addiction is a high level of intensity of needs and a low level of possibility of satisfying them. Unfortunately, the qualitative content of needs, the frustration of which increases the risk of drug addiction, remains unclear. Let us also note one more very important circumstance. A significant number of studies of the causes of drug addiction are characterized by a traditional understanding of human behavior as a process aimed at satisfying a need or several needs. The discovery of a need or a class of needs, the dissatisfaction of which would act as a specific prerequisite for drug addiction, would mean, firstly, the presence of a teleological basis in drug addiction, and, secondly, the possibility of constructing a resulting therapy. However, as scientific research and analysis of clinical practice show, drug addiction has neither a common teleological basis nor resulting therapy (V.A. Petrovsky).

We believe that the answer to the question of what constitutes the class of needs that underlie the formation of mental dependence is still missing precisely because the causes of anesthesia are associated with mental phenomena other than needs and need states. We believe that the decisive condition for the formation of mental dependence is the experience of “mogu” (V.A. Petrovsky), i.e. the experience of redundancy of possibilities for satisfying needs, and not the unsatisfied needs themselves as such. The experience of “I can” is fundamentally different from the experience of not being able to do something. I can - this is an excess of experiences, which are close to what S.L. Rubinstein denoted by the term “interest”, and V.A. Petrovsky denotes by the term “aspiration”. There are certain “I can”: I can demand (a drug), I can take it, I can use it in the company of friends. “I can” is characterized by a subjective feeling of overcoming obstacles: nothing prevents me from doing this. And then there is a feeling of grandiose possibilities - a resolution of generalized dissatisfaction. The desire of the subject to take advantage of growing opportunities is not exactly what is called a “need” in psychology; it is a different type of motivation. Let's look at the difference between motivations based on scarcity (needs) and motivations generated by experiences of excess using the following example. Affective need, i.e. the need to be accepted in a group is a deficiency, a lack of subjective experience of being accepted by others, being significant to others, being needed by them, etc. The presence of such a need often pushes the subject to use drugs as a way of gaining the sympathy of the group. In turn, motivations based on redundancy (aspirations) arise when the subject experiences a feeling of freedom, namely, the freedom to take advantage of his capabilities, which pushes him forward, beyond the limits of his behavior. An example of this kind of state is bravado, which sometimes carries the subject far beyond the scope of behavior that would be in accordance with his needs. In bravado, the subject experiences and uses the excess of his capabilities: I feel brave, risky, not limited. Such an experience of “I can,” motivating the subject’s activity in any area of relations or activity, reduces, or even completely removes, the severity of the experience of “I can’t” in all other areas of relations and activity. Perhaps that is why the drug is becoming an almost universal means of solving life’s problems.

Of significant interest are works devoted to the study of traits characteristic of people who abuse drugs and alcohol. These include:

poor development of self-control and self-discipline;
emotional immaturity;
low resistance to all kinds of influences and inability to predict the consequences of actions and overcome difficulties;
deformed value system;
the tendency to react inadequately to frustrating circumstances, the inability to find a productive way out of a difficult traumatic situation;
painful impressionability, touchiness;
inability to adequately perceive situations related to the need to overcome life's difficulties, establish relationships with others and regulate one's behavior.

N.Yu. Maksimova suggests that the following reasons contribute to the actualization of adolescents’ psychological readiness to use drugs:

the inability of a teenager to find a productive way out of a situation of difficulty in meeting current, vital needs;
unformed and ineffective methods of psychological protection for a teenager, allowing him to at least temporarily relieve emotional stress;
the presence of a traumatic situation from which the teenager cannot find a way out.

Thus, the teenager finds himself helpless in the face of the negative states overwhelming him and resorts to changing his state chemically.

Special role An informal group plays a role in introducing teenagers to drugs. Its influence on the personality of a teenager is very great. Constant disturbances in a teenager’s relationships with peers can be a subtle indicator of possible abnormalities in mental development. As a teenager grows up, the system of his relationships with peers has an increasing influence on his behavior and attitudes. The popularity of a child in a group is associated with a number of his individual characteristics: level of intellectual development; pleasant appearance; liveliness in communication; ability to establish friendly contacts; success in certain types of activities that are most significant for group members. Unpopularity and social rejection of a child can be harbingers of deviant behavior and mental disorders.

M.A. Alemaskin found that teenagers take the path of deviant behavior under the influence of older children.

It must be said that school is like social institution may also be a risk factor for drug addiction. It was found that instability of the teaching staff is most typical for schools that have the greatest number of problems among students. If school can really influence a teenager, it is important to know how to ensure that it influences for the better. Unfortunately, there is little reliable data regarding this issue. Hargraver, in a study of social relationships in secondary schools, drew attention to the consequences of rigid division of students into streams. In more successful groups there is a good relationship between teacher and pupils, and the latter tend to be committed to school and take their studies seriously. Teachers expect only bad things from children from the weaker group and, in addition, adolescents in such groups receive fewer positive emotions. These weaker groups essentially form a special subculture within which drug addiction can occur. The data from this study are in good agreement with the data of other authors. It seems that the distinction between strong and weak students most likely leads to the formation of deviant behavior in weak adolescents.

Thus, risk factors for drug addiction should not be considered in isolation from each other. Their interaction plays a decisive role.

Analysis of research by domestic and foreign psychologists, as well as research conducted by us, allows us to formulate the following conclusions.

The available psychological data are heterogeneous and contradictory in nature, and the correlates of drug use are often confused with their causes.
Not a single concept of the emergence or formation of psychological dependence seems exhaustive and convincing.
The collision of an individual with circumstances that prevent the realization of his deep, basic tendencies in life determines a predisposition to drug abuse.
Drug abuse is a protective activity of the individual in the face of difficulties that interfere with the satisfaction of the most important and significant needs for him and has an adaptive meaning.
The motivation to use drugs can be not only the expectation of a reduction in the tension of unmet needs, but also the expectation of an increase in the possibilities of action against the background of drug intoxication. We are talking about the attitude towards a drug as a means of increasing an individual’s capabilities in interacting with the world.

Of course, the above analysis is not exhaustive. However, it makes it possible to see the multidimensionality of the problem and the role of the mental factor in the dynamics of addiction. Due to this, effective treatment drug addiction is possible if it is built as a systemic impact that can increase the individual’s opportunities for self-realization in a dynamic social environment.