Tuesday, 25 February 2020 | 09:34:31
Almost 70% of addicts to alcohol and other psychoactive substances are comorbid, that is, they have a concomitant mental or physical illness. This was made clear at a workshop of psychiatrists on comorbid conditions, which was held at the National Center of Public Health and Analyses (NCPHA).
The existence of serious clinical and organizational problems in the treatment of addictions and their accompanying mental illnesses is reported by Tsveta Raycheva, MD, Head of the Department “Addictions”
"Genetics has discovered genes that determine both the risk of addiction and other mental disorders. Therefore, addictions should be viewed first and foremost as a medical problem, as a genetically determined disease ”, said in his presentation Assoc. Prof. Kaloyan Stoychev, MD - Head of the 2nd Psychiatric Clinic for General Psychiatry and Addictions at the University Hospital“ Dr. Stranski ”, Pleven.
In the discussion, psychiatrists warned that Bulgaria was not responding satisfactorily neither for medical needs nor for psychosocial ones related to rehabilitation, social reintegration, support for finding a job, etc. "I have seen colleagues in general medicine view these patients as mostly psychiatric and refuse to treat their physical illnesses - gastroenterological, neurological and others. And in many cases, somatic comorbidity is more serious. It can be seen as well that psychiatrists themselves refuse to treat mental illness with concomitant addiction”, said Assoc. Prof. Kaloyan Stoychev.
"Patients treated in so-called 'private' methadone programs pay for the treatment themselves, and only methadone is provided by the state. At the same time, over 50% of them are health insured. There is also a group of patients (between 10% and 20%) in severe financial, financial and social situations who often abuse their prescribed methadone, selling it partially to secure the means to continue their treatment. These are patients without health insurance who are virtually detached from the healthcare system. These circumstances make it difficult to treat their comorbidities”, explained Dr. Kemal Mutishev, a psychiatrist in a methadone program at the State Psychiatric Hospital for the Treatment of Drug Addiction and Alcoholism in Sofia.
Psychiatrists agreed on the need to improve the standards of treatment for addicted and psychiatric patients. Therefore, proposals to be included in the
draft of a new standard on psychiatry are forthcoming.