Drug counseling
Drug counseling is part of clinical psychology , medicine and social work . In response to the emergence of a drug scene in the Federal Republic of Germany (around 1969 ), so-called drug advice centers (Drobs) were created by various institutions (e.g. health and youth care authorities, the independent organizations) . The work of the drug counseling centers is aimed at those at risk of addiction, addicts and their relatives.
aims
From the point of view of society, the aim of drug counseling is positive socialization (socialization), i.e. a classification of people in the prevailing society .
The curious, consuming or affected person receives information about drugs and the dangers of consumption. The addict finds structures and support to (re) learn to be able to structure life as independently as possible on his or her own responsibility.
The main aim of low-threshold drug counseling is to counteract the impoverishment of drug addicts and to enable drug consumption, if it occurs, without unnecessary health risks (e.g. infection with hepatitis B, C or HIV).
deals
The areas of work of the drug counseling centers are: individual help, relatives work and prevention .
Rehabilitation and recuperation
In addiction therapy , recuperation stands for regaining access to the abilities inherent in oneself - in contrast to rehabilitation (German: "Reinstatement in the previous state"), which is about the restoration of a state before dependence.
Traditional drug help works with the so-called abstinence paradigm, which means that the goal is always a drug-free life and non-conspicuous socialization. Clients are supported in various ways (basic existential security, stabilization of the situation in life, counseling with the search for life alternatives, therapeutic discussions, etc.) in order to build up motivation for detoxification and therapy 'To accompany the former addict and to bring about a stabilization. The success rate of this approach, i.e. the proportion of drug addicts who actually live sustainably without addictive substances after a (successful) therapy, is still low, the relapse rate is around 60 to 80 percent. This can be attributed to various factors: In particular, the aftercare facilities are underdeveloped, as it is difficult to find adequate funding, i.e. many drug addicts are released after therapy without further or insufficient support into a life situation that they previously had through drug use Tried to cope - that must be almost unsuccessful. Returning to the same environment, to the scene, as there are usually the only remaining social contacts, quickly leads to a relapse into "old habits".
It should also be taken into account that the therapists are mostly released into precarious conditions, often not even an apartment has been obtained, work is nowadays hard to find for these, often poorly health, mostly underqualified people etc. This not only has the effect often necessary recourse to old acquaintances who are still on the scene, but also sets a vicious circle of uncertainty, dissatisfaction and hopelessness in motion.
It should not be forgotten that most illegal drugs, when appropriately misused, also cause immense psychological dependence, and the pressure of addiction is difficult to bear for many; Similar to alcoholics, these people also have a lifelong dependency. Often the basic causes that eventually led to drug abuse (psychological trauma) were not dealt with adequately during therapy, so that the “answer” to unconscious conflicts etc. is often to resort to drugs.
Abstinence and replacement therapy
The primary tasks of the drug counseling centers are the preparation for and placement in inpatient detoxification and withdrawal treatments, placement in a substitution program (with methadone - trade name Polamidon -, buprenorphine, etc.) as well as psychosocial support during treatment with substitutes.
In most European countries, in addition to absolutely abstinence-oriented drug counseling (often from the same providers), low-threshold offers were developed . In contact shops, emergency shelters, trendy get-togethers, etc., attempts are made to improve their living situation with clients without the high, often frustrating, abstinence requirement. These offers start with street work (looking for drug addicts in the scene) with the distribution of disposable syringes, usually include the possibility of personal hygiene, inexpensive food, accommodation, and free medical care or support the clarification of claims (ALG II, social allowance, pension).
Education and prevention
A theoretical approach has not yet been able to prevail. From ethnology it is known that the consumption of various drugs is or was firmly anchored in most cultures of the world, mostly served spiritual purposes and, where traditional forms of drug consumption are still established, dependence and abuse of the "addictive substances" are almost unknown are. The use of psychoactive substances is then considered an accepted part of human expression and behavior. The aim of drug counseling would therefore be to instruct people as early as possible on how to use stimulants independently and enjoyably, i.e. psychoactive substances (alcohol, nicotine, coffee, etc. are certainly also included here), i.e. it would be less of an aid than an aid Realize educational mission. At the same time, drug counseling centers have an immense political responsibility here (which they currently have - even if hardly realized), because a prerequisite for such a relaxed, culturally embedded drug use would be a fundamental change in public perception and discussion of the topic of "drugs", as well like the decriminalization of psychoactive substances and their users. This approach is called the acceptance concept in the literature. This approach is often used by low-threshold drug help institutions. The primary goal here is not to help the consumer to become “drug free”, but to offer him support in everyday life with his drug problem. The main focus here is the prevention of AIDS and hepatitis as well as social support.