Stages of recovery from. Stages of bio-psycho-social recovery (recovery) for patients with addiction. Life without chemicals

Cancer, or a malignant tumor, develops in the body as a result of the appearance of atypical cells that divide at an uncontrolled high speed. This leads to an increase in the tumor, its growth through the tissue, right up to the blood vessels. Here the cells easily enter the general bloodstream and spread throughout the body, settling in the most distant organs. Secondary formations occur - metastases.

Statistics

Treatment of cancer in the metastatic stage most often becomes ineffective. Positive results are possible here too, but this requires a fanatical desire to survive. If hundreds of thousands of people get sick with cancer every year, then there are dozens of cases of healing at the last stage over 50 years.

Stages of cancer

Stage zero is diagnosed (the most successful for complete cure) and the next 4 stages. With each formation, it reaches a certain size and has its own rate of spread.

The last stage becomes the most severe; not only the sources of the tumor are damaged, but also neighboring distant organs. Signs of stage 4 are:

• a state of fever with a high constant temperature;
• oppressive constant pain that is not relieved by analgesics;
• weakness and fatigue, in which the patient constantly feels drowsy;
• exhaustion and loss of appetite;
• the appearance of bleeding and disruption of the functioning of the main body systems - gastrointestinal tract, urinary, pulmonary.

The size of the tumor is relegated to the background, the condition is determined by metastases. They cause damage to the brain, lungs, liver and bones.

Can surgery help?

The patient’s recovery depends entirely on the extent of the process. Surgeons have 2 ways to influence the process:

1. Antiblastic - complete excision of the tumor.
2. Ablastics is a principle aimed at preventing recurrence and spread of a tumor by excision of the lesion along with lymph nodes and vessels as a single block, within healthy tissue.

In the initial stages, radical treatment is most effective - more than 90%. At stage 4, it is impossible to wait for this; the process is irreversible, because the organ itself is infiltratively destroyed, and there are multiple metastases.

Only complete removal of the tumor and metastases can provide a cure for stage 4. Sometimes this is possible. The surgeon may remove more adjacent tissue and structures, such as during a mastectomy. But more often, the isolation of mutated masses becomes impossible and only part of the pathological neoplasm is excised.

The main method of treatment for stage 4 is palliative therapy. It only helps to eliminate the symptoms and alleviate the patient’s condition. It includes chemotherapy, immunotherapy, radiation therapy, and radiotherapy, which are very effective for certain tumors. Inoperable forms are removed only for health reasons: elimination of intestinal obstruction, urinary retention, bleeding.

Stage 4 therapy

The basic principles of treatment are as follows:

1. Immunotherapy is the use of cytokines and monoclonal antibodies that enhance the body's defenses to combat abnormal cells. The integrity of healthy tissue is not compromised and there are no side effects. Drugs are selected individually. The disadvantage is the duration of treatment to achieve results.
2. Radiotherapy or radiation therapy is mainly used for bone cancer. Gamma rays destroy atypical cells in the active reproduction stage.
3. Proton radiation therapy has a great advantage: the flow of protons is very targeted and practically does not affect healthy tissue.
4. Chemotherapy is almost always used to slow the growth of a tumor, especially a bone tumor. This is treatment with cytostatics.

Innovative methods:

1. Laser therapy is layer-by-layer dissection of the tumor with simultaneous tissue coagulation. This stops the spread of cancer cells.
2. Cryotherapy - a freezing source (nitrous oxide) is brought to the tumor and exposed to a critically low temperature.
3. Also, the tumor can be influenced by a targeted high-power current.

Cases of self-healing from cancer

The phenomenon of self-healing is called Peregrine syndrome. Such cases of spontaneous recovery are described in the literature. This regression occurs without the intervention of doctors. It can be complete or partial.

The name is given because in the 13th century there lived a saint named Peregrin. At a young age, he was diagnosed with a large bone tumor. He treated himself only with prayers and according to church documents, and died at the age of 80, having been cured of a tumor.

Today's situation

It is such that, according to scientists, a cure for cancer will not be created for at least the next 20 years. The patient's immunity is of great importance. Traditional treatments and the psychological state of the patient are also important.

Although it is difficult to talk about it, a person can be crushed by his diagnosis. Based on research since 1960, lists of cured cancer patients whose diagnosis was confirmed histologically have been published:

1. In the first place among such cases is kidney cancer such as hypernephroma. About 70 cases of recovery were noted.
2. In second place is blood cancer (leukemia) - 53 patients were cured.
3. Neuroblastoma is in third place - 41 cases.
4. Retinoblastoma - 33 cases.
5. 22 women were cured of breast cancer without doctors.
6. 16 men experienced self-regression of testicular cancer.
7. 69 cases of healing have been described for melanoma.

All other cases of healing are less than 10, so we cannot talk about this as a pattern. Theoretically, this could have been a medical error. There have been no cases of recovery from stage 4 esophageal cancer, for example.

Stomach cancer

At stage 4, palliative chemotherapy is used. Sometimes a gastroenterostomy can be performed urgently to restore the movement of food through the gastrointestinal tract. Cases of cure for stage 4 stomach cancer are known. Such examples are especially frequent in patients treated in Japan according to the Nishi system.

Esophageal carcinoma

Stage 4 esophageal cancer is severe and cannot be treated in any way, even in emergency situations. No cases of cure were recorded. Palliative therapy only eliminates symptoms without addressing their source at all. Treatment can only prolong life for a while and make it acceptable by reducing constant pain.

Reliably known cases of cure

The most famous case of recovery from stage 4 cancer is the illness and recovery of cyclist Lance Armstrong. He was diagnosed with terminal testicular cancer in 1996. After 2 years, he turned out to be healthy and returned to big-time sports.

Cases of cure for stage 4 cancer due to the so-called placebo effect have been recorded. The patient, not knowing his diagnosis, is treated for other pathologies and recovers. For example, the following case of a patient’s recovery is described. An oncologist professor from Moscow University consulted patients in Kazakhstan in the 70s. At the appointment, one of the patients was diagnosed with an inoperable form of laryngeal cancer. The specialist prescribed the usual symptomatic treatment without naming a diagnosis. Five years later, the same patient came to the professor to thank him, being completely healthy.

This is also evidenced by a review of one case: while the woman did not know her diagnosis, she was treated in gynecology for inflammation of the uterus. Then she was transferred to oncology and given a card with a diagnosis. When she read the “verdict,” she gave up and died at home a week and a half later.

A case of recovery of a woman at stage 4 of cancer, when she did not know her diagnosis, is also described. During the first operation, cutting into the abdominal cavity, the tumor was not touched; multiple organ damage was noted. The woman did not know her diagnosis and lived another 5 years. She went to the doctors about appendicitis, but she did not have a tumor.

A living example of a case of recovery from stage 4 stomach cancer is the life of yachtsman Jason MacDonald, who was given a 3-month life prognosis. After listening to the doctors' verdict, he set off alone around the world on a yacht. He was cured by completely new living conditions - the harsh sea, simple rough food and the absence of excesses.

No matter how strange it may sound, cancer is curable - the story of the cure of stage 4 cancer of the American film star Michael Douglas proves this. His throat cancer reached stage 3 or even 4, but he was able to pull through thanks to the support of his loved ones.

The materials of the oncology center “European Cancer Treatment Clinic in Moscow” describe a case of recovery of patient Alexey, who was also diagnosed with stage 4 intestinal cancer. He simply trusted his treating oncologist Andrei Pylev and did not go to Israel, returning his tickets. He performed several surgeries and 6 courses of chemotherapy. I literally forced myself to move and take care of work and family. The morale was terrible. When all the metastases were localized in one lobe of the liver, another operation was performed - a two-stage liver resection. He agreed to it with a slim chance. He had nothing to lose. Alexei's story of curing stage 4 cancer proves that cancer is curable. He completely broke out of the palliative! This is a completely different format when the tumor is gone altogether. The attending surgeon Andrei Pylev speaks about this.

There are real cases of cure for stage 4 cancer. The popular detective author Daria Dontsova was diagnosed with stage 4 breast cancer. The professor predicted she would have only 3 months to live. Dontsova herself recalls that she simply told herself that this could not happen, because she has 3 children, a mother, cats and dogs. The writer was determined to win. She underwent not only surgery, but also radiation and chemotherapy.

The artist Yulia Volkova was cured of stage 4 cancer, who learned about her diagnosis in 2012. She did not want to discuss this with anyone. She underwent a series of operations and only admitted it publicly a few years later. As a result of the operation, she lost her voice and could only whisper. She underwent 3 more operations to restore ligaments in Germany and Korea. Now Julia even performs sometimes.

Another story of recovery from stage 4 cancer. Kylie Minogue, a singer from Australia, was diagnosed with breast cancer while touring Europe in 2005 at the age of 36. The star immediately underwent surgery and chemotherapy for 8 months. Kylie Minogue forced herself to fight, although it seemed as if the ground had disappeared from under her feet.

The life of the famous TV presenter Yuri Nikolaev, who struggled with intestinal cancer for several years and won, proves that curing stage 4 cancer with metastases is possible. But this pathology is practically incurable. Yuri Nikolaev said that the world around him immediately turned black overnight, but he managed to overcome despair. He underwent a number of operations and other measures that were part of the course of therapy.

A real cure for stage 4 cancer occurred with Sharon Osbourne, the wife of the famous rock musician Ozzy Osbourne. Having colon cancer, she had her mammary glands preventively removed in 2012.

An example of a cure for stage 4 cancer with metastases is the disease and recovery of Laima Vaikule. In 1991, while touring America, she was diagnosed with terminal breast cancer. There was little chance of recovery. After her recovery, she said that the diagnosis forced her to reconsider her views on life. The star had a difficult character, was harsh, rude and did not like many people. After treatment, the singer changed dramatically in character and attitude towards others.

Rod Stewart experienced a miraculous recovery from stage 4 cancer. The British singer was operated on for thyroid cancer in July 2000 and underwent chemotherapy several times. In January 2001 he was completely cured and is still alive. Then Rod looked at his condition as a sign from above, and completely reconsidered his life.

Another example of recovery is Canadian runner Terry Fox. At the age of 19, he lost his leg due to cancer, but was cured thanks to his belief in victory and a few years later he ran across the country with a prosthesis, raising funds for cancer research.

Other celebrities who beat cancer: singer Anastasia, Angelina Jolie, Christina Applegate, Hugh Jackman, I. Kobzon - fought cancer for 13 years, Michael Hall, Vladimir Pozner, Cynthia Nixon, Vladimir Levkin from the group "Na-Na", Boris Korchevnikov, Andrey Gaidulyan, Valentin Yudashkin, Emmanuel Vitorgan.

And how many people have recovered, whose names are not so famous!

What does human life consist of?

A person can replenish his energy from 3 sources: nutrition, light (environment) and thoughts. In the absence of 1 source or its decrease, the other 2 usually compensate for it. This can explain all the many cases where a grandfather or grandmother smoked until the age of 90 and did not develop lung cancer. Either an uncle or an aunt ate butter with spoons, ate pork and fatty sausage all their lives, drank alcohol and lived to a ripe old age. But in such cases they never talk about how these people lived in general and what they always did right. Maybe they lived in nature. They smoked, but were frugal in their eating, active, kind to others, had a positive mindset, went to church and prayed a lot. Or, when they got sick, they changed their behavior dramatically and compensated for lost sources of nutrition.

Dr. Le Shan believes that it is a person’s internal state that influences the incidence of cancer. If for some reason he stops seeing meaning in his life, then the body reacts to this with cancer. This is especially typical for active people who, due to certain circumstances, suddenly “folded their wings.”

These facts convinced the doctor that cancer is a turning point in a person’s life, his last warning that everything needs to change. He wrote his book on this topic with numerous examples of healing.

Doctor Bernie Siegel shares the same opinion in his books. It often happens that a person only needs to be reminded of the proximity of death so that this spurs him to think and do everything differently, simply because “there will be no more time,” he is running out of time.

Today's workaholics often suppress their desire for happiness. Why is there so much talk about positivity? Because negativity has very low vibrations that destroy the body. We must not forget about ourselves and put everything on the altar for our children, husband, etc. Do you know what has been noticed: women who are overly protective of their children are more likely to develop breast cancer than other women their age.

Miracles are possible, but they must be accompanied by a fanatical desire to survive. At stage 4 there is too little time and energy left to think. You can't waste a single day. If you believe in the power of the Almighty, then pray fervently and sincerely.

Stages of recovery Stages of recovery used in a rehabilitation program. The separation of stages helps to improve the assessment of the patient’s condition by workers and by the patient himself in the recovery process. So that there is no confusion. The stages of rehabilitation may differ from the stage of recovery.

Stage 1 “Transition”.

First stage includes work on recognizing powerlessness over the problem of alcoholism and drug addiction, recognizing the loss of control over the problem.

Many, even admitting their powerlessness over the problem, try to control their use by reducing the dose, setting the time and timing of possible use. Even when entering rehabilitation, the addict is motivated not by complete recovery and stable remission, but by reducing the dose for further use.

This stage ends with the recognition of powerlessness over alcohol and drugs, and the lack of desire to control drug use. An addict who seeks help does not always have an idea why he lost control, why drug use cannot be stopped, and why all attempts to overcome cravings ended in failure. Our task is to help in realizing the problem and accepting it as something that has already happened. In AA communities, these symptoms are called fatigue fatigue. It is important for us that sobriety is not just a healing of wounds, but a way of life.

Stage 2. "Stabilization"

Stabilization. Healing from damage caused by use.

During the second stage - stabilization— we already understand that we have big problems with mind-altering substances, and that we need to completely stop using them, but we are not yet able to do this. During stabilization we are recovering physically from the effects of drug use. Withdrawal syndrome lasts individually for each person; for some it may take a month, and for others much longer. This period is the most difficult, as there is a struggle with oneself, how to resist the first glass or injection.

At this stage, after the body has recovered from withdrawal, addicts experience mental distress and emotional mood swings. This stage is one of the most important in the rehabilitation process, for which maximum resources are involved. Work with psychologists, group therapy, and occupational therapy.

Stage 3 Early recovery

The third stage is early recovery: this is a time of internal change. At this stage, we learn to live in society and feel comfortable abstaining from psychoactive substances. The craving for alcohol and drug use weakens, and we delve into the problem that led us to addiction and how it affected us.

We learn to overcome feelings of shame, guilt and remorse. The task of this stage learn to cope with your problems without turning to drugs. Early recovery ends when we are ready to begin applying what we have learned to improve other areas of our lives.

Stage 4. Average recovery

During mid-recovery, the fourth stage, we learn how to repair past damage and find balance in life.

We learn that full recovery means “applying these principles (the sober living skills we learned in early recovery) in all we do” (in the real world of everyday life). During the period of average recovery, repairing relationships with people becomes a priority. We overestimate our significant relationships, particularly with family and friends, as well as our careers. If we find ourselves unhappy in any of these areas, we accept it and plan to do something about it. In AA terms this is called “making amends.” We realize that we have harmed other people. We want to take responsibility and do everything we can to make amends. Average recovery ends when we achieve a balanced and stable life.

Stage 5 (not for everyone)

During the fifth stage - “late recovery”. Our task is to focus the children’s attention on overcoming obstacles to a new “sober” life, which have been formed since childhood. Long before a person became addicted. Many drug addicts come from dysfunctional families. (Families where parents did not fulfill their parental responsibilities).

Due to the lack of proper upbringing, the child was not able to acquire the standard skills in order to be happy. The purpose of the center, if necessary, is to show a person about possible adult problems caused by growing up in a dysfunctional family, and to help to recover in this area, to resolve current problems, despite the obstacles caused by the way the parents raised them.

Stage 6: Maintenance

The final part of recovery is “maintenance.” Those undergoing a course of recovery from drugs or alcohol receive the necessary information on how to move on with their lives, how to overcome obstacles and maintain sobriety. At the final part of the recovery process, the addict’s task is to put all the information received into practice. Constantly working on oneself and current problems makes it possible to become more resistant to the problems of alcoholism and drug addiction, and the ability to self-develop in society.

STAGES OF RECOVERY table

Stages of recovery	Main theme
Transition	Stop trying to control your alcohol or drug use.
Stabilization	Healing from damage caused by use
Early recovery	Internal changes (changes in thoughts, feelings and actions related to alcohol and drug use).
Average recovery	External changes (correction of lifestyle disorders caused by addiction and development of a balanced lifestyle).
Late recovery	Outgrowing the limitations of childhood
Maintenance	Living a balanced life and continuing to grow and develop

Additional: growing up in a dysfunctional family This is a small society in which strict parenting is encouraged, strict rules and destructive behavior are encouraged. In such a family there is no respect, no recognition of merit, no encouragement of the individual. The final part. Socialization. We hold various events that help you plunge into real life without drinking alcohol and drugs; Below is a video of an excerpt from the event at the New Hope Center now called “Helping Hand.”

The concept of treating chemical dependencies (alcoholism, drug addiction) from the point of view of a psycho-social approach. The difference between treatment and recovery. Stages of recovery. Beginning recovery and taking responsibility for it.

1. Recovery from chemical dependency

Recovery from chemical dependence (treatment of alcoholism or drug addiction) is the restoration of one’s psychological and social sphere to a level where there is no need to use surfactants to solve psychological and social problems.

Unlike physical illnesses, where treatment depends more on the doctor, in the psycho-social sphere, recovery depends more on independent efforts. This is why addiction treatment usually uses the term recovery rather than treatment.

Recovery begins with refusing to blame for your illness and trying to control it, stopping using (or accepting medical help if you can’t stop using yourself and the withdrawal syndrome is too severe - detoxification), and taking responsibility for your recovery.

The goal of recovery: restoration of one’s psychological and social life to the level as if the person was developing normally without drug use (simpler: the goal of recovery is a normal psychological and social life corresponding to the person’s age). A synonym for recovery is personal development. Quitting use is not the goal of recovery - it is just the first necessary step in recovery.

Achieving the goal of recovery requires a long time - at least 5-6 years. This period should not be frightened, since the improvement in life will occur gradually throughout the entire period of recovery.

Recovery itself involves working independently on yourself and your social relationships and accepting help. In most cases, assistance in recovery is necessary.

2. Stages of recovery

The recovery process can be divided into 6 stages, each of which has its own goals, objectives and methods of recovery. What a person does for his recovery changes from stage to stage, he does not do the same thing all the time.

Stage (goals)	Psycho- (psyche) (tasks)	Socio- (environment) (tasks)
1st – Accepting responsibility for recovery. Stopping use, gaining sobriety. Objectives: recognize due to use; b) recognize the loss of dose and situational control; c) recognize the presence of problems in oneself, and not in others; d) recognize the need for recovery; e) learn abstinence skills and create a sobriety support system. Duration from 3 months to a year. Help: rehabilitation, self-help groups, addiction counselors, social workers, narcologist.	Working with denial, working with cravings, working with relapse prevention, reading literature on addiction.	Refusal from the drug-using environment, moving away from the codependent environment, attending self-help groups, outpatient rehabilitation programs or inpatient rehabilitation.
2nd – stopping compulsion Goals: restoration of basic sober living skills. Help: mutual help groups for codependents, mutual help groups for addicts, personal growth trainings, therapeutic groups for addicts, psychologist - addiction specialist.	Restoring ways to control the psyche. Elaboration of using experience.	Finding a job compatible with recovery, setting boundaries with codependents, seeking help in restoring the basic skills of a sober life (special trainings, therapy groups for addicts, groups for codependents, a specialized psychologist).
3rd – Emotional stabilization Resolving major intrapersonal and social conflicts. Help: therapeutic groups with independent people, psychotherapist, family psychologist, mutual help groups for dependent and independent people, advanced training courses or new education.	Resolving intrapersonal conflicts at the “here and now” level	Restoration of normal relationships in the family, new friends and restoration of relationships with old friends, the emergence of a hobby, normal sober recreation, review of the goals of one’s social development, work, career, learning a new specialty.
4th – Social stabilization Solving childhood problems, social development. Help: psychotherapist working with childhood, therapeutic groups for independent people,	Working with childhood	New level of personal relationships, career growth, improvement of professional skills
5th – Personal identification Goal: harmonious psychological and social life psychotherapy, training from “successful” people in life	Global goals in life	Leadership training in various areas of life
6th – Moral stabilization Goal: finding meaning philosophical, spiritual and other worldview teachings	Finding the meaning of life	Activities for the benefit of humanity, teaching students

3. Beginning of recovery

The decision to enter recovery can be one of the most important in an addict's life. Recovery is the main task of the addict in the first year of sobriety; all other tasks are adjusted to the recovery, and if it doesn’t work out, then they are sacrificed.

Recovery is a change in your entire life, both external (environment, connections, relationships, etc.) and internal (worldview, habits, emotions, etc.).

To begin recovery, you must acknowledge: 1.) the problems that abuse has brought you; 2.) recognize the loss of control over use (dose, situational, problem-free use); 3.) recognize the presence of problems in oneself and in the environment; 4.) recognize the need for recovery (long-term efforts to change yourself and your life).

To begin recovery, you need to stop using, find a recovery support system, perform recovery activities, and observe restrictions.

For the first stage (taking responsibility for recovery) you need:

Recovery support system: in mild cases (not severe alcoholism) self-help groups (preferably 90 days of continuous attendance at AA/NA or other groups); in cases of moderate severity (stage 2 chronic alcoholism, non-injection drug addiction) outpatient rehabilitation, hospital stay for up to 3 months; in severe cases (injection drug addiction, alcoholism transitional from stage 2 to stage 3) hospital stay from 6 months to a year.

Recovery activities: special tasks on awareness of the disease, reading special literature on addiction, a diary of self-analysis and a diary of feelings, planning and analysis of the day, prevention of relapse and PAS, communication with other recovering people on the topic of recovery. It is enough to devote an hour to two hours a day to self-practice recovery activities.

Limitations: Avoid any situations that promote cravings.

It is advisable that someone “supervises” your recovery: for example, in AA/NA there are sponsors for this, and these could also be: an addiction consultant, a psychologist specializing in addictions, a social worker working with addictions.

Assignments for the topic “The Concept of Recovery”:

1. Why (describe your five most serious problems due to your use) and Why (describe five positive goals you want to achieve as a result of recovery) are you deciding to enter recovery?
2. What in your life today is preventing you from starting your full recovery (family, children, work, friends, some unresolved problems, etc.)? Why do you put these moments in your life today more important than recovery? How will it all end if you continue to prioritize things in your life over recovery (meaning you will likely end up relapsing and continuing your abuse)? Explain why you need to put your recovery first? How can you do this?
3. Write a short story on the topic “What do I want my sober psychological state and social life to look like in five years.” Alternatively, you can describe a day in your sober life in five years (how you want it to be).
4. What are you willing to do to avoid death from addiction and achieve a normal sober life? Describe specifically how much time per day to devote to independent work, what exactly to do, how much time to attend groups, who you are willing to work with personally, etc.

Although the nature of alcoholism has been well studied by specialists, it is difficult to treat for at least two reasons.

1. This is a disease in which there is no criticism of its presence or it is very superficial, despite the obvious harmful consequences. After all, craving for alcohol is one of the main signs of alcohol addiction. Therefore, very often patients do not want to be treated.
2. There is no universal “pill” for alcoholism, similar to, for example, insulin, which saves the lives of diabetics.

Think about the terrible numbers of official statistics on alcoholism in the Russian Federation:

• the presence of 5% of alcoholics and 10-11% of drunkards only according to state medicine, and how many people receive drug treatment in commercial medical centers on anonymous terms in order to avoid drug registration?
• How many people, in principle, do not seek such help for various reasons (fear of losing their job, ending up in a mental hospital, homeless people, and so on)?

In fact, the statistics of drunkenness and alcoholism are at least two times higher in sad terms. This means that every tenth resident of our country has serious problems with alcohol, and every fifth will develop them in the near future.

Alcoholism

This is a serious disease, and its treatment is difficult work. But recovery is possible and even inevitable if all instructions are followed and the need for treatment is realized by the patient himself and his immediate environment. True treatment for alcohol addiction is impossible without creating changes in the psychological, social and spiritual spheres of the patient, which requires the help of all his loved ones to create motivation and conscious activity, although medications for alcohol addiction also play an important role.

Picture of addiction

Most alcoholics behave in approximately the same way at the beginning:

At first they drink only on major holidays with friends, and allow themselves too much after persistent persuasion, then they become “friends” by the presence of a bottle and persuasion is no longer needed, after which they themselves are the initiators of various events, but certainly with drinking.

Reasons to drink

there are a wide variety of:

• salary,
• prepaid expense,
• end of the working week,
• chance meeting,
• business trip,
• the need to relax.

Such a person’s social circle includes new people and they, as a rule, like to drink; sober friends first fade into the background, and then are completely forgotten. Such a person no longer expects to communicate with friends without alcohol.

He may say that he drinks out of necessity, “it’s inconvenient to refuse,” “I need to treat him,” “tradition,” without noticing and not wanting to admit that there are more and more such reasons, unjustified reasons.

While waiting for a drink, a person’s behavior changes. A drinker or drinker noticeably perks up, becomes more cheerful, fusses more, trying to finish things off as quickly as possible in order to sit down at the table and drink quickly. There is only an approving attitude towards everything that is or may be connected with the consumption of alcoholic beverages.

Alcohol addiction

Such a person jealously protects his drinking buddies. He not only does not recognize them as alcoholics, but on the contrary finds many positive qualities in them. What prevents this is perceived from the negative side. Even a novice alcoholic hates talking to others about his regular abuse, defending his “rights” to drink in every possible way.

The feeling of coziness and comfort comes to him precisely in a state of intoxication. In a sober state, a drinker always lacks something, he is not at ease.

“Facts” about the benefits of alcohol are invented and presented as evidence: doctors recommend it in small doses, it relieves feelings of fatigue and emotional stress, increases performance, and so on. Such a person cannot be convinced that alcohol does more harm than good. There is a restructuring of life values ​​and moral principles. Everything that promotes drinking is assessed only positively, and everything that hinders it is assessed sharply negatively.

Work, family, children, family responsibilities interfere with drinking and become a burden. Each dose of alcoholic drinks affects and gives euphoria only for a certain period of time, so you have to drink more often.

For an alcoholic, the taste and even the type of alcohol are not important; the strength of the alcohol consumed is much more important. Even slight intoxication creates an irresistible attraction that an alcoholic, unlike a drunkard, cannot control.

This alcoholic craving usually arises only from a certain triggering intoxication, for which a certain dose of alcohol is needed, and everyone has their own portion. Almost every alcoholic assures that he “knows his limits,” but once he starts drinking, he can’t stop.

Symptoms

• Nausea and vomiting disappear when taking excessive doses of alcohol. The amount of alcohol consumed increases by 2-5 times. Drinking sessions are becoming more frequent. A hangover syndrome (alcohol withdrawal) occurs. It is different from a simple hangover after drinking too much alcohol. Weakness and malaise in this case are transformed into complete weakness.
• The symptom of shaking hands is replaced by tremors of the whole body. In alcoholics with a hangover, headaches, unlike a simple hangover, do not develop as often. It can occur due to head injuries or exacerbation of hypertension. Another symptom is prolonged insomnia, with characteristic manifestations in the form of nightmares and sweating.
• Hangover syndrome is dangerous because the consequences of chronic alcohol intoxication manifest themselves in damage to all organs and systems without exception. This is evidenced by exacerbations of existing diseases or even the emergence of new ones (pancreatitis, pneumonia and others).

Attention!!!

Severe alcohol withdrawal is often the “turning point” when an alcoholic can be persuaded to seek medical help for the first time. If a person feels comfortable, at best he will say that “we’ll go get checked someday” or refuse the conversation altogether.

The influence of addiction.

Let's try to see how much time a day it takes us to perform certain ordinary daily duties?

Let's say I draw this approximate picture:

• work (plus travel to work) - 10 hours,
• sleep - 8 hours, household chores (cooking, shopping, raising children) - 3 hours,
• leisure (TV, computer, reading) - 3 hours.

Total -24 hours. How does an alcoholic's time management change? Addiction “eats up” more and more time that a sober person devotes to doing important things. Behavior at home, work, and relationships with loved ones suffer. Even an alcoholic’s sleep may be longer, but it is physically incomplete and more reminiscent of anesthesia. That is, alcoholism impoverishes the usual role repertoire in all spheres of life, from the most subtle (leisure time and communication within the family), then work (where a person is increasingly either hungover or drunk) and ending with the most biological (sleep, sex , food).

That is, a person has a lot of sober and independent time. An alcoholic practically does not have it. Moreover, his roles are mixed - he allows himself to go to work drunk, and does housework as frivolously as if he were spending his leisure time. After all, a sober person at work doesn’t love, for example, his cat? And for a patient with alcoholism it turns out something like this. In the stage of mental dependence (the beginning of the formation of alcoholism), the patient does not yet develop work-related problems, since he can abstain from drinking at work. But he is always looking forward to the evening when no one will interfere with his drinking. But in the family, problems already arise when every evening you have to see a constantly drunk husband or wife. In patients suffering from alcoholism, the psyche gradually begins to change, everything goes backwards.

In the first place is alcohol and everything connected with it. For example, a patient works as expected all week and looks forward to the weekend. But not to go fishing or to the country, to spend more time with my wife and children, to do household chores, but to indulge in alcoholic libations! With the onset of the first day of the work week - Monday, an alcoholic in an absolutely broken state goes to work, already dreaming of an evening when he can get over his hangover, and on the weekend again “have a blast.” What does this mean? Yes, that only one “drip” is good for breaking a binge and relieving a hangover. But for real recovery from alcoholism, anti-alcohol treatment in the form of “filing” and “coding” is not enough. Due to the fact that the goals and objectives in the life of a patient with alcoholism are violated and disintegrate in all areas of spending time, a mandatory condition for recovery will be undergoing rehabilitation with psychotherapy and developing sober leisure skills. Preferably with the help of loved ones. Even if a person has completed a short course of withdrawal from hard drinking (for example, in a hospital) and received anti-alcohol treatment for a specified period, his condition is very unstable. Addiction penetrates deeply into the psyche and continues to lie dormant there. Part of the psyche becomes “empty” for a long time, “dead” - having not yet learned to live soberly. Therefore, many who have undergone such treatment for a long time complain of a feeling of melancholy, emptiness, and loss of meaning in life. If a person does not work on himself at this time, he feels that he has received only “hopeless sobriety,” and this is a sure path to a breakdown.

Even if a person tries to formally continue a sober life, he will perceive the usual home and work environment as a depressing routine and desire inside for his treatment to be “appreciated” by others as some kind of feat, and immediately. He can also perceive any approval at this time as recognition of his own “heroism”, consider that he has “already recovered” and try to “thank” himself a little with alcohol. And with established alcoholism, the transition to “cultural drinking” is impossible in principle, and everything usually ends in an even more severe binge and a feeling of greater emptiness after leaving it.

Attention!!!

The “point” of detoxification and prescription of anti-alcohol treatment is a convenient moment to obtain consent from the patient for the need for further psychotherapeutic and rehabilitation work, and regular visits to the doctor. Therefore, specialists in “helping professions” (psychotherapists and psychologists) begin to work with patients even during the “dig out” after heavy drinking. At the same time, you can use 100% the property of alcoholics, which is more developed in them than in mentally healthy people: due to the constant chaos of life, alcoholics have better short-term planning skills. But they require skillful external leadership.

Funnel of addiction.

This is a loop, a “vicious circle” of breakdowns and exits from binge drinking, with which the biography of most alcoholics is so rich. Why does this happen and what can be done about it? We understood from the previous chapters that alcohol affects all components of a person’s life without exception - physical, mental, social, spiritual. This already speaks to the need for comprehensive treatment, and not just a “drip” or “filing” as a way to recover from alcoholism.

The first use of alcohol by a person does not yet indicate the development of addiction, but shows us the person’s psychological readiness for regular alcohol consumption. Then comes the so-called “deaf period” with a gradual increase in quantity and dosage. This first forms a psychological dependence (craving), and then a physical one (hangover).

Problems appear (physical, psychological, social, spiritual) on an increasing scale. But, as we understand, there is also the opportunity to seek medical help. And here there is one important secret of recovery. According to experts, about 50% of patients agree to maintain sobriety after withdrawal from binge drinking. Of these, approximately 35% agree to undergo discharge or outpatient anti-alcohol treatment (various options for “filing” and “coding”) Of these people, only 1% agree with the need to work with people in “helping professions” and undergo it. Their remissions are the longest and most persistent compared to those who are going to rely on “willpower”, which is overestimated in our society, or hope for the miracle of “coding”.

For the last two categories, the picture is much more predictable. After some time, such a person tells himself and others that he is “already healthy” (and many people around him believe). Then he tries to allow himself to drink “culturally” or “under special circumstances” (which is basically impossible). He does not undergo psychotherapeutic work and evaluates many, in principle, ordinary life events as reasons worthy of drinking alcohol.

He has not been involved in rehabilitation and does not quite know how a sober life is led (he has very simplified ideas about it). He does not understand that life goals should not be replaced (even with the help of sobriety), but rather realized, and does not have a long-term plan for their implementation. As a result, it usually ends in a more severe breakdown, prolonged binge drinking and yet another expensive treatment.

Attention!!!

In order to treat alcoholism with the least losses, it is best to stop the “funnel of addiction” either at the “deaf stage” (domestic drunkenness without the development of addiction, measures are mainly educational), or at the stage of the first problems arising after the elimination of binge drinking (referring the person to psychotherapy and rehabilitation measures) .

Stages of recovery.

Recovery begins with the start of treatment. A few words about the treatment of alcoholism in a clinical setting. If the patient retains sufficient intellectual abilities, successful treatment of alcoholism is possible on an outpatient basis, without hospitalization. However, the risk of loss of mental potential and personality destruction due to alcoholism is very high, and if possible, it is always better to begin treatment in a specialized drug treatment hospital. After all, even among normal, healthy people, not everyone is able to find creativity in themselves and develop it. Family plays a huge role in recovery. Often the patient’s relatives are sure that only a doctor should be involved in treatment. However, as experience shows, family and friends surrounding an alcoholic are codependent people. These people should also actively

participate in the treatment process, read the necessary literature, communicate with psychologists, understand the symptoms of the disease and support the patient during treatment. Quite often it happens that even after successful completion of treatment, the family treats him as an alcoholic. It is important that changes on a subconscious level occur not only in the person who has given up, but also in his loved ones. Otherwise, old habits will contribute to a breakdown. It is necessary to understand that alcoholism is a chronic disease, therefore it will not completely disappear, but will exist either in the form of exacerbations or remissions. The attitude and willpower after successful treatment allow the patient to remain in a state of remission indefinitely.

Inpatient treatment for alcoholism has the following advantages:

• isolation of the patient from most external factors influencing the treatment process.
• depriving the patient of the opportunity to obtain alcohol.
• providing a full range of necessary medical care.
• continuous monitoring of the patient’s condition to make the necessary adjustments to treatment.

In an inpatient setting, it is possible to carry out all the necessary diagnostic procedures for a complete examination of the patient’s condition. Based on them, the most appropriate individual course of treatment is selected. The procedures for anti-alcohol therapy are fully controlled, and if necessary, the course of treatment is adjusted. Inpatient treatment is extremely necessary in severe cases. These include, for example, the presence of third or second degree alcoholism in the patient, and the identification of serious concomitant diseases.

Delirium tremens and other manifestations of conditions close to critical also require treatment in a hospital. It is inpatient treatment that can guarantee the safest passage of the most painful stage of giving up alcohol, while the period of overcoming the consequences of binge drinking (withdrawal) is reduced, and you can begin treatment measures faster. This enhances the effectiveness of the treatment course. Despite the achieved reduction in treatment time, the required stay in a hospital for alcohol dependent patients cannot be less than 5 - 7 days. Naturally, increasing the duration of inpatient treatment increases its effectiveness and has a beneficial effect on the patient’s condition. To overcome the consequences of heavy drinking, the necessary detoxification procedures are carried out.

Typically, for alcohol addicts in a hospital setting, 2-3 droppers are prescribed daily. At the first opportunity, a set of tests is carried out. First of all, they check the liver, kidneys, and cardiovascular system.

Blood tests are prescribed - general, biochemical, urinalysis. The patient and his relatives undergo the necessary additional consultations with

Doctors - specialists. A psychiatrist - narcologist, based on the obtained “picture” of addiction, prescribes and implements a treatment program together with the patient, involves a psychologist (psychotherapist) in the treatment process, issues instructions and recommendations for the patient’s loved ones. Specialists provide assistance to the patient in independently understanding the causes the occurrence of the disease, actively involve the addict in the processes of resolving these problems. For this purpose, individual and group motivational classes are conducted. This significantly increases the patient’s conscious ability to resist addiction, and the effectiveness of anti-alcohol therapy increases.

After completing a course of inpatient treatment, the patient is not left alone with his problems. The attending physician directs him to comply with the rehabilitation therapy program and draws up anti-relapse instructions for relatives to prevent a possible breakdown, and a mandatory consultation plan is drawn up.

Treatment of alcoholism in a hospital setting lays a solid foundation for successfully overcoming harmful cravings, and creates the prerequisites for the establishment of an unlimited period of sobriety. After undergoing inpatient treatment, the patient himself and his family and friends can receive the necessary consultations from a narcologist, psychotherapist, and, if necessary, receive help in a critical situation or psychological support.

Very often in our country, the measure of recovery from alcoholism is compliance with sobriety for a period of one year. And the most common way of prescribing anti-alcohol treatment is also for one year. Is it correct?

There are a lot of such patients; without conducting sobriety tests, you can with a high probability tell how the events of their life will develop further. At the beginning, such “simply coded” patients feel fear of alcohol. This atmosphere restrains the patient and his body gradually begins to recover. Patients feel much better. Numerous days of sobriety do not pass in vain - performance improves. The approval of others causes the return of abilities lost due to abuse.

Acquaintances, observing such a person sober, wanting to provide him with support, often praise him. The “former” alcoholic cannot help but like this and becomes his vital necessity. In reality, this achievement of his in the struggle for sobriety is nothing special; the immediate superior can only note that now the patient can “work like everyone else.” But especially at first, everyone claims that this is good, because before this was impossible. They nobly strive to demonstrate to the alcoholic that he can experience the life of a full-fledged person. This is undoubtedly correct. That is, in such a patient the fear of drinking alcohol is deeply hidden, it is turned into feelings of rejection, disgust, hatred, thanks to this the patient’s well-being and attitude towards others are at their best. This combination creates the illusion of “flight.” Those who have embarked on the path of sobriety often recall the feeling of joy of their first months without alcohol. At this time, “forgotten” mental sensations appeared again, headaches stopped bothering them, blood pressure normalized, and what they used to consider incurable disappeared.

And most importantly, control of sobriety allowed me to restore self-respect. Relationships in the family and at work have changed for the better. It’s strange and sad, but these positive aspects of the struggle for sobriety in life provoke breakdowns. The fact is that a person who has fallen into the insidious network of alcohol addiction develops an altered value system. Such a person will never be able to fully receive joy from what he has and has achieved - he will always be missing something in everything. Can you guess what? That's right, sensations that sobriety cannot give...

If a patient strives to learn the science of sobriety and works on himself, seeks help, searches for his spiritual path, participates in rehabilitation programs - he knows this, and with this knowledge he is armed and reliably protected from breakdowns. But, think about it, how many of the millions who come to a narcologist for one year of sobriety do this? The prices for alcoholism treatment procedures are not scary. They filed, coded, the relatives and the patient himself calmed down, a year will pass (or maybe even less) - the period of sobriety will end...

So what is next?

That is, in the treatment of alcoholism, at least 6 stages of recovery of varying quality can be distinguished:

1. “transition”, recognition of alcohol problems, willingness to seek medical help.
2. physical stabilization (from 3 to 10 days from the start of treatment).
3. early recovery (3-6 months of sobriety) - unstable stabilization.
4. average recovery (up to 18 months of abstinence) - restoration of mental and social functions impaired by alcohol.
5. late recovery (from 3 to 5 years of sobriety) - stable remission.
6. spiritual growth and purification (lifelong). That is, in the proper treatment of alcohol addiction, we slowly and gradually move from physical to mental, then to social and spiritual growth.

Attention!!!

Achieving any of these stages already contributes to a person’s recovery from alcohol addiction. Do not be overly afraid of relapses - this is the nature of all chronic diseases. A patient with alcoholism is not “crazy” from an everyday point of view, and with modern medical capabilities, even in difficult cases, achieving the highest stage of recovery is a completely realistic, although not the most quickly achievable goal.

In the development of the disease, four periods (stages) are usually distinguished: latent, prodromal, peak period of illness and the outcome, or period of end of the disease. Such periodization developed in the past during the clinical analysis of acute infectious diseases (typhoid fever, scarlet fever, etc.). Other diseases (cardiovascular, endocrine, tumors) develop according to different patterns, and therefore the given periodization is not very applicable to them. HELL. Ado distinguishes three stages of disease development: the onset, the stage of the disease itself, and the outcome.

Latent period (in relation to infectious diseases - incubation period) lasts from the moment of exposure to the cause until the appearance of the first clinical signs of the disease. This period can be short, as with the action of chemical warfare agents, and very long, as with leprosy (several years). During this period, the body’s defenses are mobilized, aimed at compensating for possible violations, at destroying pathogenic agents or at removing them from the body. It is important to know the features of the latent period when carrying out preventive measures (isolation in case of infection), as well as for treatment, which is often effective only in this period (rabies).

Prodromal period- this is the period of time from the first signs of the disease to the full manifestation of its symptoms. Sometimes this period manifests itself clearly (lobar pneumonia, dysentery), in other cases it is characterized by the presence of weak but clear signs of the disease. With mountain sickness, for example, this is causeless fun (euphoria), with measles - Velsky-Koplik-Filatov spots, etc. Velsky-Filatov-Koplik spots are found most often on the mucous membrane of the cheeks against the small molars, less often - on the mucous membrane lips, gums, sometimes on the conjunctiva of the eyes. Each of these spots appears in the form of a small, poppy seed-sized, whitish papule, surrounded by a narrow border of hyperemia (vascular network).

These spots, located in groups and sometimes in great abundance, do not merge with each other. They sit quite firmly on their base and cannot be removed with a tampon. The Velsky-Filatov-Koplik symptom lasts 2-3 days; it can often be detected on the 1st and even 2nd day of the rash. All this is important for differential diagnosis. At the same time, identifying the prodromal period in many chronic diseases is often difficult.

The period of pronounced manifestations, or the height of the disease, is characterized by the full development of the clinical picture: convulsions with insufficiency of the parathyroid glands, leukopenia with radiation sickness, a typical triad (hyperglycemia, glycosuria, polyuria) with diabetes mellitus. The duration of this period for a number of diseases (lobar pneumonia, measles) is determined relatively easily. In chronic diseases with their slow progression, the change of periods is elusive. In diseases such as tuberculosis and syphilis, the asymptomatic course of the process alternates with its exacerbation, and new exacerbations are sometimes noticeably different from the primary manifestations of the disease.

Outcome of the disease. The following outcomes of the disease are observed: recovery (complete and incomplete), relapse, transition to a chronic form, death.

Recovery- a process that leads to the elimination of disorders caused by the disease and the restoration of normal relations between the body and the environment, in humans - primarily to the restoration of working capacity.

Recovery can be complete or incomplete. Complete recovery is a condition in which all traces of the disease disappear and the body completely restores its adaptive capabilities. Recovery does not always mean returning to your original state. As a result of the disease, changes in various systems, including the immune system, may appear and persist in the future.

With incomplete recovery, the consequences of the disease are expressed. They remain for a long time or even forever (fusion of the pleura, narrowing of the mitral orifice). The difference between complete and incomplete recovery is relative. Recovery can be almost complete, despite a persistent anatomical defect (for example, the absence of one kidney, if the second fully compensates for its function). One should not think that recovery begins after the previous stages of the disease have passed. The healing process begins from the moment the disease occurs.

The idea of ​​the mechanisms of recovery is formed on the basis of the general position that illness is the unity of two opposing phenomena - the actual pathological one and the protective-compensatory one. The predominance of one of them decides the outcome of the disease. Recovery occurs when the complex of adaptive reactions is strong enough to compensate for possible disturbances. Recovery mechanisms are divided into urgent (emergency) and long-term.

Urgent ones include such reflex protective reactions as changes in respiratory rate and heart rate, the release of adrenaline and glucocorticoids during stress reactions, as well as all those mechanisms that are aimed at maintaining the constancy of the internal environment (pH, blood glucose, blood pressure, etc.). d.). Long-term reactions develop somewhat later and last throughout the disease. This is primarily the inclusion of backup capabilities of functional systems. Diabetes mellitus does not occur when even 3/4 of the pancreatic islets is lost. A person can live with one lung, one kidney. A healthy heart can perform five times more work under stress than at rest.

Enhanced function increases not only as a result of the inclusion of previously non-working structural and functional units of organs (for example, nephrons), but also as a result of an increase in the intensity of their work, which in turn causes activation of plastic processes and an increase in organ mass (hypertrophy) to a level when the load for each functioning unit does not exceed normal.

The activation of compensatory mechanisms, as well as the cessation of their activity, depends primarily on the nervous system.

The sequence of stages of compensation can be traced using the example of lameness when one leg is damaged:

1) signaling of imbalance from the vestibulocochlear organ;

2) restructuring the work of motor centers and muscle groups in order to maintain balance and the ability to move;

3) caused by a stable anatomical defect, constant combinations of afferentations entering the higher parts of the central nervous system, and the formation of temporary connections that provide optimal compensation, i.e., the ability to walk with minimal lameness.

Relapse- a new manifestation of the disease after its apparent or incomplete cessation, for example, the resumption of attacks of malaria after a more or less long interval. Recurrences of pneumonia, colitis, etc. are observed.

Transition to chronic form means that the disease progresses slowly, with long periods remission(months and even years). Remission(from Latin remissio - reduction, weakening), a period of chronic disease in a person or animal, characterized by a weakening or disappearance of its signs. This course of the disease is determined by the virulence of the pathogen and mainly by the reactivity of the body. Thus, in old age, many diseases become chronic (chronic pneumonia, chronic colitis).

Terminal states- the gradual cessation of life even with seemingly instantaneous death. This means that death is a process, and in this process several stages (terminal states) can be distinguished: preagony, agony, clinical and biological death.

Preagonia can be of varying duration (hours, days). During this period, shortness of breath, a decrease in blood pressure (up to 7.8 kPa - 60 mm Hg and below), and tachycardia are observed. The person experiences a blackout of consciousness. Gradually the pre-agony turns into agony.

Agony (from the Greek agon - struggle) is characterized by a gradual shutdown of all body functions and at the same time extreme tension of protective mechanisms that are no longer useful (convulsions, terminal breathing). The duration of the agony is 2-4 minutes, sometimes more.

Clinical death they call this state when all visible signs of life have already disappeared (breathing and heart function have stopped, but metabolism, although minimal, still continues). At this stage, life can be restored. That is why the stage of clinical death attracts special attention from clinicians and experimenters.

Biological death characterized by irreversible changes in the body.

Experiments on animals, primarily on dogs, made it possible to study in detail the functional, biochemical and morphological changes at all stages of dying.

Dying represents the disintegration of the integrity of the organism. It ceases to be a self-regulating system. In this case, the systems that unite the body into a single whole are first destroyed, primarily the nervous system. At the same time, lower levels of regulation are preserved to some extent. In turn, there is a certain order of dying of various parts of the nervous system. The cerebral cortex is most sensitive to hypoxia. In case of asphyxia or acute blood loss, activation of neurons is first observed. In this regard, motor agitation occurs, breathing and heart rate increase, and blood pressure increases.

Then inhibition occurs in the cortex, which has a protective significance, since for some time it can save cells from death. With further dying, the process of excitation, and then inhibition and exhaustion, spreads lower, to the stem part of the brain and to the reticular pharmacy. These phylogenetically more ancient parts of the brain are the most resistant to oxygen starvation (the centers of the medulla oblongata can tolerate hypoxia for 40 minutes).

Changes in other organs and systems occur in the same sequence. With fatal blood loss, for example, within the first minute breathing sharply deepens and becomes more frequent. Then its rhythm is disrupted, the breaths become either very deep or superficial. Finally, the excitation of the respiratory center reaches a maximum, which is manifested by especially deep breathing, which has a pronounced inspiratory character. After this, breathing weakens or even stops. This terminal pause lasts 30-60 s. Then breathing temporarily resumes, acquiring the character of rare, first deep, and then increasingly shallow sighs. Together with the respiratory center, the vasomotor center is activated. Vascular tone increases, heart contractions intensify, but soon stop and vascular tone decreases.

It is important to note that after the heart stops working, the system that generates excitation continues to function for quite a long time. On the ECG, biocurrents are observed within 30-60 minutes after the disappearance of the pulse.

In the process of dying, characteristic metabolic changes occur, mainly due to ever-deepening oxygen starvation. Oxidative metabolic pathways are blocked, and the body obtains energy through glycolysis. The inclusion of this ancient type of metabolism has a compensatory value, but its low efficiency inevitably leads to decompensation, aggravated by acidosis. Clinical death occurs. Breathing and blood circulation stop, reflexes disappear, but metabolism, although at a very low level, still continues. This is enough to maintain the “minimal life” of nerve cells. This is precisely what explains the reversibility of the process of clinical death, i.e., revival is possible during this period.

The question of the time period during which resuscitation is possible and advisable is very important. After all, revival is justified only if mental activity is restored. V.A. Negovsky and other researchers argue that positive results can be achieved no later than 5-6 minutes after the onset of clinical death. If the dying process continues for a long time, leading to depletion of creatine phosphate and ATP reserves, then the period of clinical death is even shorter. On the contrary, with hypothermia, revival is possible even an hour after the onset of clinical death. In the laboratory of N. N. Sirotinin, it was shown that a dog can be revived 20 minutes after death as a result of bleeding, followed by a complete restoration of mental activity. It should, however, be borne in mind that hypoxia causes greater changes in the human brain than in the brain of animals.

Resuscitation, or revitalization, of the body includes a number of measures that are aimed primarily at restoring blood circulation and breathing: cardiac massage, artificial ventilation, cardiac defibrillation. The latter event requires the availability of appropriate equipment and can be carried out under special conditions.