Zdrav Var 2006; 45: 1-3
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@IVLJENJE JE RADOST, NE LE U@ITEK
Marko Kol{ek1
Uvodnik
Ta {tevilka Zdravstvenega varstva je namenjena zasvojenostim. Uporabljam izraz »zasvojenost«, ~eprav mnogi uporabljajo izraz »odvisnost«. Pove namre~ ve~ in pu{~a manj dvoma o samem pojavu. Ljudje smo namre~ fiziolo{ko povsem odvisni od mnogih stvari (ne pa zasvojeni), v~asih tudi od ljudi (npr. dojen~ek). Bivanjsko smo odvisni od hrane, teko~ine, kisika in {e marsi~esa - brez vsega tega umremo. Bolnik s sladkorno boleznijo tipa 1 je odvisen od inzulina - brez njega ne bi pre‘ivel, ne moremo pa re~i, da je zasvojen z inzulinom. Nekateri primerjajo zdravljenje z inzulinom dajanju metadona ljudem, odvisnim od opiatov, kar je v osnovi zgre{ena primerjava. Pri vseh zasvojenostih gre za povsem nekaj drugega. Nih~e ne umre, ~e ne more zadovoljiti hrepenenja po tistem, s ~imer je zasvojen (je nekaj malega izjem, npr. mo‘ni smrtni zapleti pri deliriumu tremensu). Zasvojenost je motnja, bolezen mo‘ganov, za katero so nekateri bolj dovzetni od drugih zaradi genetskih, osebnostnih, socialnih, kulturnih ali drugih vzrokov, ve~inoma gre za preplet ve~ dejavnikov, ki jih lahko zdru‘imo v znano trojico: ~lovek - okolje-agens. Zakaj so ljudje v tiso~letjih uporabljali razli~ne snovi, za katere so iz izku{enj, zapisov modrecev ali pa izro~ila lahko vedeli, da jim povzro~ijo lahko te‘ave in jih lahko zasvojijo? Zakaj so se ohranjale, ~eprav so mnogim ljudem zmanj{ale mo‘nost za pre‘ivetje? Zakaj ljudje sploh i{~ejo snovi, ki vplivajo na njihovo po~utje, do‘ivljanje? Pa saj ne gre samo za psihotropne snovi, kajti nekatere zasvoji hrana ali dolo~ene dejavnosti (npr. ra~unalni{ke igrice, gledanje TV, igre na sre~o, nakupovanje), na nek na~in so nekateri lahko zasvojeni celo z odnosom do so~loveka. V maternici dobi ~lovek ponavadi vse, kar potrebuje. Vse se zgodi samo od sebe - brez njegovega truda. Ko pa se rodi ~lovek, naenkrat niso ve~ izpolnjene osnovne potrebe. Sedaj se mora sam potruditi in pokazati, da je la~en, ‘ejen, moker, utrujen, osamljen. ^e mu v dru‘ini ljube~e izpolnjujejo njegove potrebe, otrok pridobiva zaupanje do sveta, do drugih ljudi in do sebe. Odvisnost od ljubezni star{ev in od stvari, potrebnih za ‘ivljenje, lahko z leti spontano preide v spoznanje, da je s trudom in ljubeznijo ‘ivljenje lepo, hkrati pa v spoznanje, da na svetu nisi sam in da zaradi tega obstajajo omejitve. Prvotna sebi~nost, ki je v zgodnjem otro{tvu potrebna
za pre‘ivetje, lahko postopoma preide v duhovno rast, ko prevlada svobodno odlo~anje o zadovoljitvi potreb (ali odlo‘iti zadovoljitev ali celo ne izpolniti potrebo, ~e v tem vidi smisel) in ob~utek za so~loveka, razumevanje in sprejemanje drugih. Tako lahko star{i prenesejo na otroka radost in veselje do ‘ivljenja samega in do ‘ivljenja z drugimi ljudmi. Vsa ‘iva bitja imamo v genih zapisano ‘ivljenje in tudi smrt. A smrt pride vedno {ele po ‘ivljenju. Bistvo ‘ivljenja je ‘iveti, kot je zapisal Sre~ko Kosovel. Veselje do ‘ivljenja je »biti«, ne imeti (1). ^e si to, kar si s svojim bivanjem, ne pa to, kar ima{, si v bistvu svoboden. Ljudje v nacisti~nih koncentracijskih tabori{~ih niso imeli ni~esar, a so vsi hoteli ‘iveti - hoteli so »biti«, izpolniti svoj smisel. Kljub vsemu trpljenju so bili mnogi globoko v sebi radostni, kljub vsemu so videli smisel ‘ivljenja in so svojo radostnost izra‘ali na razli~ne na~ine (2). Kot ugotavlja Viktor Frankl, je velika te‘ava sedanje dru‘be pomanjkanje smisla, kar {tevilne posameznike vodi do bega od aktivnosti za samouresni~itev v pravo nasprotje ~lovekovega bistva - v potro{ni{tvo, pridobitni{tvo s kopi~enjem materialnih dobrin in v iskanje kratkotrajnih u‘itkov, kar ne prina{a umirjenosti in pravega zadovoljstva. Zadovoljitev vseh ~lovekovih individualnih potreb in {tevilnih umetno ustvarjenih potreb ne izpolnjuje smisla ~lovekovega bivanja, ampak nasprotno, vodi do bivanjske praznine, kar so mnogi misleci ugotavljali ‘e v preteklosti (3). Pomanjkanje smisla pa je dobra osnova za razvoj razli~nih zasvojenosti. Kot je zapisal biv{i »zasvojenec«: »Ko sem imel vse, nisem imel ni~esar - v meni je bila praznina. Droga je izpolnitev praznine. Samo, da te uni~i.« (4)
Kdor ne nosi v sebi radosti ‘ivljenja, kdor i{~e le na~in za doseganje individualnih ciljev in golo zadovoljevanje potreb, ne more biti sre~en. Nejc Zaplotnik (5) je zapisal: »Kdor i{~e cilj, bo ostal prazen, ko ga bo dosegel, kdor pa najde pot, bo cilj vedno nosil v sebi«. @ivljenje ni cilj, ampak pot - ni u‘itek, ampak radost. Danes se poudarja individualnost, tekmovalnost, komercialna miselnost, koristolovstvo, pohlep, pozablja pa se, da je ~lovek odnosno bitje; vse se spreminja v porabni{ko blago, celo odnosi med ljudmi. Zanemarja se kakovost medsebojnih odnosov, solidarnost, sodo‘ivljanje -empatija, ljubezen, ki temelji na dajanju, ne na
1Medicinska fakulteta, Katedra za dru‘insko medicino, Poljanski nasip 58, 1000 Ljubljana Kontaktni naslov: e-po{ta: marko.kolsek@mf.uni-lj.si
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Zdrav Var 2006; 45
posedovanju. Tako prihaja do motenj v do‘ivljanju samega sebe, soljudi, narave, dela, dru‘be, kulture in lastnega smisla (6).
@e otroci se danes bolj kot kdaj koli prej u~ijo, kako se izogniti naporom, odtujujejo se dejavnim oblikam pre‘ivljanja prostega ~asa, neposrednemu dru‘enju z vrstniki in ustvarjalnemu ‘ivljenju s posedanjem pred TV sprejemniki, videokasetami, ra~unalniki, z iskanjem kratkotrajnih u‘itkov in se nau~ijo osnovnih vzorcev vedenja, ki lahko vodijo v zasvojenost (7). Izgublja se u~enje s pridobivanjem lastnih izku{enj in z izmenjavo izku{enj z drugimi (vrstniki in odraslimi), zaradi ~esar se zmanj{uje njihova sposobnost za konstruktivno re{evanje te‘av, s katerimi se sre~ujejo v ‘ivljenju.
^loveku lahko raznovrstne te‘ave zbujajo ob~utke tesnobe, skrbi, ‘alost, bole~ino, utrujenost, osamljenost, nesprejetost, ob~utke krivde, sramu in strahu. Vse to je neke vrste alarm, ki nas opozarja, da je nekaj narobe (8). Brez alarma bi imel posameznik kakor tudi skupine manj mo‘nosti za pre‘ivetje. Po naravni poti te alarme izklapljamo z odstranitvijo njihovega vzroka, kar ponavadi zahteva trud, nekatere pa lahko samo ubla‘imo z aktivnostjo ali preseganjem samega sebe. Ljudje so ‘e v davnini ugotovili, da lahko te ob~utke in do‘ivljanja vsaj za~asno ubla‘ijo tudi na druga~en na~in - z umikom v »drug svet« s pomo~jo razli~nih psihotropnih snovi. ^e ~lovek za bla‘enje takih ob~utkov ve~krat uporabi tak{ne umike, je vse ve~ mo‘nosti, da naravni na~ini »izklaplanja alarmov« postajajo vse manj u~inkoviti. Z drugimi besedami: vse tisto, kar drugim ljudem prina{a zadovoljstvo, pomiritev in notranje ravnovesje, postopoma postaja neu~inkovito in za vsa neprijetna ob~utja vse bolj ostaja ena sama pot pomiritve - tak{na ali druga~na droga. Tu pride do izraza sedanja »instant« civilizacija, ki nam vsiljuje u‘iva{tvo, ideologijo zabave, pasivnost, skrb za »fasado« brez klju~nega bogatenja vsebine ter nam ponuja hitre odgovore in re{itve za »vse« te‘ave. To se lepo navezuje na dana{njo zmedo v sistemu vrednot v dru‘bi, na {tevilne razpadajo~e dru‘ine, odtujenost od soljudi, negotovost glede prihodnosti. V tem svetu se mnogi mladi ne znajdejo, ne uspejo izraziti radosti ‘ivljenja in svoje volje do ‘ivljenja, ne najdejo lastne potrditve, svojega mesta med drugimi, ne najdejo bli‘ine, mo‘nosti za konstruktivno in ustvarjalno iskanje novih spoznanj. Tako jim pride prav instant ponudba vseh mogo~ih ma{il in nadomestkov, ki jih odtujujejo od stvarnost. To je zanje dolgoro~no {e bolj pogubno, kot je za starej{e odrasle, saj pride do motnje osebnostne rasti, {e preden so sploh dozoreli (9). Droge so le ena od oblik tovrstne ponudbe in so po rezultatih
raziskav med mladimi pravzaprav lahko dostopne vsem, kljub zakonskim omejitvam. [tevilni ukrepi, ki so jih do sedaj izvajale razli~ne dr‘ave, za zmanj{evanje rabe razli~nih drog, niso bili zelo u~inkoviti. Odkar je Slovenija samostojna dr‘ava v ta namen {e ni {iroko zastavila nobenega programa, ~eprav strokovnjaki ‘e kar nekaj let opozarjajo, da se raba drog in nekemi~nih omam hitro pove~uje, kar je razvidno tudi iz prispevkov v tej {tevilki Zdravstvenega varstva. Prej bi lahko rekli obratno: da z dru‘benoekonomskimi spremembami v zadnjih 15 letih celo spodbujamo {irjenje razli~nih omamljanj. V {tevilnih filmih in oddajah na TV bolj ali manj prikrito prikazujejo in reklamirajo alkohol (zadnji primer v oddaji Bar) in druge droge, a nih~e ni~ ne re~e. Ljudi brezobzirno privabljajo z u‘iva{tvom pa z nasiljem, z brezosebno spolnostjo zaradi dobi~ka. Mirno sprejemamo industrijo plehke zabave, mno‘i~ni konformizem, cenene alkoholne pija~e, prosta{tvo. Biv{i »zasvojenec« tak{no stanje komentira takole: »Za to dru‘bo je to o~itno normalno. Za dobi~ek je ta dru‘ba pripravljena tako zlorabljati lastne otroke; ko pa zaneti ogenj, pa uprizarja ga{enje - ~ista zlaganost...« (4). Ob tak{ni dostopnosti in tako {iroki rabi alkohola in tobaka ter raznoterih nekemi~nih oblik umika je bolestno govoriti {e o legalizaciji nekaterih prepovedanih drog. @e tako je ilegalna ponudba prepovedanih drog veliko preob{irna; legalizacija bi zagotovo ne zmanj{ala njihove rabe med mladimi. Tako se je treba vpra{ati, kaj je cilj tak{nih te‘enj.
Torej, kak{na naj bi bila pot, ~e resni~no ‘elimo zmanj{ati rabo tak{ne ali druga~ne omame? Odgovor ni preprost, prav tako tudi ni mogo~e pri~akovati hitrih rezultatov.
Dolgoro~no je lahko uspe{na le naj{ir{a dolgotrajna dru‘bena akcija, ki bo vklju~ila vse segmente dru‘be. Usmerjena bo morala biti na vsa tri podro~ja, ki vplivajo na odlo~itev posameznika: na ~loveka, okolje in agense. O ~loveku, njegovi vzgoji, pogojih za samouresni~evanje je bilo napisanega ‘e veliko, udejanjenega pa bistveno manj. Vloga zdrave dru‘ine je pri tem nenadomestljiva, prav tako lahko {ola oz. celoten sistem izobra‘evanja prispeva veliko z vzgojo za zdravje, tako da bi mladina znala do‘ivljati radost ‘ivljenja in uskladiti ljubezni do sebe, do drugih in do smisla ‘ivljenja (10). Vsi ostali segmenti dru‘be tudi prispevajo k oblikovanju ~loveka, poleg tega pa vplivajo na okolje. Vplivajo npr. na stali{~a do raznovrstnega omamljanja in z njim povezanega vedenja (npr. pijanost v dru‘bi pri nas ne velja za sporno, neredko prav nasprotno - za za‘eleno), na ‘ivljenjske pogoje, pogoje dela, na razli~ne prepre~evalne dejavnosti omamljanja
Kol{ek M. @ivljenje je radost, ne le u`itek
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(primarne, sekundarne in terciarne prevencije) itd. Uspe{no lahko dru‘ba vpliva na same agense, v tem primeru na droge, ~e le ho~e. Z ustrezno zakonodajo, s celovito nacionalno politiko (za alkohol, tobak, prepovedane droge in nekemi~ne zasvojenosti) in seveda njenim resni~nim izvajanjem lahko bistveno omeji dostopnost na ve~ razli~nih na~inov, kar se je doslej ‘e izkazalo za u~inkovito (11), pri ~emer je treba prepre~iti kakr{no koli morebitno vpletenost javnih delavcev v dobi~ke od prometa z drogami. Nenazadnje je treba v ta kompleksni program vklju~iti civilno dru‘bo z razli~nimi skupinami in dejavnike v vseh lokalnih skupnostih, saj si je dolgoro~no te‘ko predstavljati uspeh brez njihovega trajnega dejavnega sodelovanja. Sedanji ukrepi se vse preve~ usmerjajo v zmanj{evanje {kode - kot je zapisal biv{i zasvojenec (4): »S tem, da ti dajo metadon, drogo, in si tako zagotovijo, da bo manj vlomov, tatvin, manj kriminala, manj oku‘b, te {e niso re{ili; {e manj se ti ljubi spreminjati ‘ivljenje.« Bistveno ve~ bi bilo treba narediti za ustvarjanje bolj{ih pogojev za ustrezno odlo~anje posameznika v dana{nji tako raznovrstni in protislovni ponudbi ‘ivljenjskih izbir, v kateri se {e zelo kriti~en ~lovek te‘ko znajde (9). ^eprav na koncu koncev je vsak sam odgovoren za svoja dejanja in tudi za nedejanja. ^e pa je nekdo ‘e zasvojen , saj on ni ve~ on: »Otrok ni ve~ va{ otrok, partner ni ve~ va{ partner. Droga (alkohol, loterija, internet, ...) ga je ukradla - v njem ni ve~ ~ustev, ljubezni, v njem je samo {e tak{en ali druga~en zadetek.« (4) Zato potrebuje pomo~, da se lahko odlo~i, ali bo nadaljeval
po starem ali pa bo sprejel pomo~ in se re{il; ali bo namesto umika v trenuten u‘itek oziroma tak{no ali druga~no omamo, izbral »trpljenje odvajanja« zaradi @ivljenja, ki vklju~uje oziroma obsega njega samega, soljudi in naravo, in dal temu trpljenju smisel, da bo na{el svojo pot.
Literatura
1.   Fromm E. Imati ali biti? Zagreb: Naprijed, 1986.
2.   Frankl V. Psiholog v tabori{~u smrti. Celje: Mohorjeva dru‘ba, 1983.
3.   Gasset JO. Upor mno‘ic. Ljubljana: Slovenska matica, 1985.
4.   Gr‘an K. V svetu omame (Droga na Slovenskem). Ljubljana: Dru‘ina, 1999.
5.   Zaplotnik N. Pot. Ljubljana: Cankarjeva zalo‘ba, 1981.
6.   Ramov{ J. Do‘ivljanje, temeljno ~lovekovo duhovno dogajanje. Ljubljana: Zalo‘ni{tvo slovenske knjige, 1990.
7.   Auer V. Droge in odvisnost. Ormo‘: Samozalo‘ba, Ibidem, 2001.
8.   Jakopi~ J. Delo z odvisnimi od alkohola je pogosto (navidezno ali pa tudi zares) strokovno napa~no. In: ^eba{ek-Travnik Z, Radovanovi~ M. (Eds) Medicina odvisnosti. Zbornik prispevkov 1. slovenske konference o medicini odvisnosti, oktober 1996, Ljubljana. Ljubljana: Republi{ki strokovni kolegij za psihiatrijo, Delovna skupina za odvisnost od alkohola, 1996: 91-111.
9.   Rugelj J. Pot samouresni~itve. Ljubljana: samozalo‘ba: Slovensko dru{tvo terapevtov za alkoholizem, druge odvisnosti in pomo~ ljudem v stiski, 2000.
10. Duval LA. Otrok, ki se je igral z luno. Koper: Ognji{~e, 1985.
11. Babor T, Caetano R, Casswell S, Edwards G, Giesbrecht N, Graham K et al. Alcohol: No Ordinary Commodity: Research and Public Policy. Oxford, UK, etc.: Oxford University Press, 2003.
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Zdrav Var 2006; 45: 4-6
LIFE IS JOY, NOT MERE PLEASURE
Marko Kol{ek1
Editorial
This issue of Zdravstveno varstvo is dedicated to the problem of addiction. I deliberately chose the term »addiction« instead of the more widely used »dependence«. The word »addiction« tells us more about this phenomenon, and raises less doubt about its true meaning. Humans are physiologically dependent on -rather than addicted to - many things, even on people (e.g. a baby). We are vitally dependent on food, fresh water, oxygen and many other things. When deprived of them for long enough we will die. Patients with Type 1 diabetes are dependent on insulin. They depend on insulin injections to stay alive, but they are not addicts. Insulin therapy has been compared to methadone maintenance treatment in opiate addicts, yet this comparison is entirely wrong. The nature of addiction disorders is completely different. People do not die if they cannot satisfy their urge for a stimulant (there are only a few exceptions, e.g. delirium tremens). Addiction is a brain disorder that some people are more liable to develop because of their personality traits, and genetic, social, cultural and other causes. Generally, several factors intervene in the phenomenon of addiction; they consitute a well-known triad, involving man, environment and addictive agent. Why have addictive substances been used over so many centuries despite their traditionally known harmful effects and addictive properties, described in detail by sages and old scripts? Why have so many people continued to take addictive substances even if they reduced their chance of survival? People become addicted not only to psychoactive substances but also to food or certain activities (playing computer games, watching TC, gambling, shopping); and even to relationships.
While in the mother’s womb, the baby usually gets all he needs . Everything runs smoothly and no effort is required. After the birth the baby has to show that he is hungry, thirsty, wet , tired or lonely if he wants his basic needs to be met. Children whose needs are met promptly and lovingly develop a sense of basic trust in the world, people and themselves. Dependence on the parents’ affection and on other vital things may spontaneously grew into something more: into awareness that love and comittment make the life beautiful, and that we must accept limitations because
we are not alone in the world. In the process of spiritual growth the original egotism, required for survival in the early childhood is gradually replaced by the freedom of choice between fulfillment, delayed fullfilment and even non-fulfillment of one’s needs. One develops empathy and understanding, and accepts other human beings. Parents can thus instil in their children the love of life and the joy of sharing life with other people. Life and death are written in the genes of all living creatures. Ye t death comes at the end of one’s life, therefore the essence of life is to live, as wrote the Slovene poet Srecko Kosovel . The joy of life is in »being« and not in »having« (1). If our life is defined by what we are rather than by what we have, we are free. Prisoners in concentration camps had nothing left but a strong will to live »to be« and to find fulfillment. Despite the great suffering many of them experienced joy in the depth of their heart, they found the meaning of life and expressed their joy in many different ways (2). According to Viktor Frankl, the sense of meaningless is one of the important problems facing the modern society. Many individuals abandon all endeavours to find hapiness in self-fulfillment and opt for its very contrast - life of unbrideled consumerism, characterized by excessive accumulation of material goods and search for transitory pleasure, which brings no peace of mind and no sense of satisfaction. Satisfying all individual and all artificially created needs cannot give meaning to one’s life, on the contrary, it may lead to hollowness of existence (3).
The sense of meaninglessness is an excellent breeding ground for the development of various addictions. A former addict said: »When I had everything I had nothing - I felt empty inside. I filled my emptiness with drugs. But … they destroy you« (4).
People who lead an existence devoid of meaning and joy, satisfying only their personal needs and pursuing only their own pleasure, are not happy. Nejc Zaplotnik (5) wrote: »Those engaged in pursuit of goals will remain empty, but those who have found the path will always carry the goal within themselves«. Life is not an aim but a path - it is not filled with pleasure but with joy . Today, individualism, competitiveness, comercialism, egotism and greed feature most highly on the list of favoured attributes, everything is changed into
1 University of Ljubljana, Medical Faculty, Department of Family Medicine, Poljanski nasip 58, 1000 Ljubljana Correspondence to: e-mail: marko.kolsek@mf.uni-lj.si
Kol{ek M. Life is joy, not mere pleasure
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consumable goods, even interpersonal relationships. The quality of relationships with other people, empathy and love - a gifting rather than a possessing love - are neglected nowadays. This leads to disturbances in perceiving and relating to self, other people, nature, work, society , culture and sense of being (6). Today, children learn very early how to avoid getting involved in real-life activities. Instead of socializing with their peers and adopting healthy and creative lifestyles, they spend their leisure time watching TV and videotapes, sitting long hours at the computer or seeking shortlived pleasures (7). They avoid learning from their own experience or through interaction with their peers or adults, which reduces their ability to tackle problems encountered in their daily life in a constructive way.
There are a variety of problems that make one feel anxious, worried, sad, tired, lonely, unaccepted, guilty, ashamed or afraid. These feelings alert us to the fact that something went wrong (8). Without these warning signs people would have had lesse chance to survive. One’s alarm system can be turned off in a natural way by eliminating the causes of alarm, which tends to be a demanding task. Unpleasant feelings can also be attenuated by involvement in various activities and by making effort to surpass oneself. Yet, since the earliest days of mankind people have known other means that allowed them temporarily to forget their problems and escape into a different world: psychoactive substances. Frequent use of this way of escape to alleviate unpleasant feelings gradually reduces the effectiveness of the natural ways available to turn off the alarm system. In other words: all activities that bring personal satisfaction and help restore inner balance to other people become increasingly less effective, and the only solution left is to resort to psychoactive substances. The modern materialistic civilisation imposes its »instant« ideology on people by encouraging constant quest for pleasure and fun, conditioning people into passivity, advertising outer form rather than self-enhancement and self-enrichment, and by offering instant answers to »all« problems. This model is reflected in a confused system of values, as well as in family disintegration, interpersonal alienation and feelings of uncertainty about future. Many young people feel lost in this society, they lack skills to express joy and willingness to live fully, and they fail to find their own place in the world. They fail to get closer to and to interact with others to be able to explore new possibilities for acquiring experience and new skills in a constructive and creative way. At this point they risk to get trapped in a world offering a vast array of substitutes and instant
solutions, a world that promotes one’s escape from the reality. In the long run, young people seem to be in greater peril than adults, because their personality growth is hindered before they have reached maturity (9). Drugs are only one of the substitutes available, and research has shown that they are readily accessible despite legal restrictions. Measures taken by different countries to reduce the use of various drugs have mostly proved ineffective. Since 1991 when Slovenia gained independence, no large-scale programme has been conducted, despite many warnings voiced by experts that the use of addictive chemical and non-chemical substances has been increasing at a rapid rate. Papers published in this issue of Zdravstveno Varstvo clearly attest to this situation. In fact, the socio-economic changes that have occurred over the past 15 years have even encouraged addictive behaviour in the population. Films and TV shows more or less overtly advertise the use of alcohol and other drugs, and nobody seem to react. For the sake of pure profit they relentlessly lure people by representations of pleasure, violence and detached sexuality. We readily accept this industry of amusement without any artistic merit, mass conformism, cheap alcoholic beverages and vulgarity. A former addict commented: »This situation seems to be normal for our society, which is prepared to abuse its own children to make profit. Once the fire is lighted, they pretend they are busy putting the flames out. Pure hypocrisy….« (4). Considering the present ready accessibility and wide use of alcohol, tobacco and various non-chemical means of escape, it is unethical to support legalization of some illicit drugs. Currently, the availability of illicit drugs on the black market is far too extensive, and drug legalization would certainly not curb drug usage among young people. Here the question arises: what are the real aims pursued?
What is then the most effective method for decreasing the use of drugs of various kinds? There is no clear, straightforward answer to this question, and it would be unrealistic to expect results overnight. In the long run good results are obtainable by a sustained, large-scale social action, which would include all segments of the society. The activities should be primarily focused on three areas that influence one’s decisions about drug use: man, environment, agent. A lot has been written about the man, education and conditions for one’s self-realization, yet very little has been accomplished in this area. A healthy family plays an irreplacable role here. School and the whole educational system can contribute largely to this goal by equipping young people with skills necessary to
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Zdrav Var 2006; 45
experience joy of living and to develop a healthy balance between self-love, love for others and love of the sense of life (10). Other segments of the society are also involved in one’s personality formation and exert effects on the environment. They have impact on how people perceive the use of drugs and what attitude they take to drug-related behaviour (e.g. in Slovenia drunkenness is socially acceptable, even more, people are frequently encouraged to get drunk). Also they affect one’s living and working conditions, as well as various drug prevention programmes, both primary, secondary and tertiary By adopting appropriate legislative measures and comprehensive national strategies concerning alcohol, tobacco and illicit drug use and non-chemical addictions, and by strictly implementing the adopted policies, the society can restrict drug accessibility in different ways. The interventions have proved very effective (11), yet care should be taken that people working in this field do not take profit out of illegal drug trade. Civil society with its institutions as well as various local community factors should be encouraged to take part in this complex programme, because its success vitally depends on sustained action and cooperation of all these partners.
Most current policies on drugs are directed towards reducing harmful consequences of drug use. A former addict said: »The idea behind giving you methadone, just another drug, is to reduce the rate of burglaries, thefts, criminal acts and infections - yet you are far from being saved and you have even less motivation to change your life.«(4). Greater efforts will have to be taken to create an environment that would favour proper life choices to be made amid a number of different and often opposing options available that are baffling even to mature individuals (9). The final responsibility for the choices made always lies with each of us individually. An addict is no longer the person he/she used to be.
»Your child is no longer your child, and your partner is no longer the partner you knew. They have been stolen by the drug (alcohol, gambling, the Internet)- they are now bereft of emotions, of love - all they crave is a fix of any kind« (4). These persons need help to choose between two options: to either continue taking drugs, or to accept help and save their life - to escape in a world of transitory »high« sensations, or to take a decision to go through the painful drug withdrawal for the sake of Life, which encompases their own self, other people and nature, makes sense of their suffering during withdrawal, and helps them find their own path to normal life.
References
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2.   Frankl V. Psiholog v tabori{~u smrti. Celje: Mohorjeva dru‘ba, 1983.
3.   Gasset JO. Upor mno‘ic. Ljubljana: Slovenska matica, 1985.
4.   Gr‘an K. V svetu omame (Droga na Slovenskem). Ljubljana: Dru‘ina, 1999.
5.   Zaplotnik N. Pot. Ljubljana: Cankarjeva zalo‘ba, 1981.
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9.   Rugelj J. Pot samouresni~itve. Ljubljana: samozalo‘ba: Slovensko dru{tvo terapevtov za alkoholizem, druge odvisnosti in pomo~ ljudem v stiski, 2000.
10. Duval LA. Otrok, ki se je igral z luno. Koper: Ognji{~e, 1985.
11. Babor T, Caetano R, Casswell S, Edwards G, Giesbrecht N, Graham K et al. Alcohol: No Ordinary Commodity: Research and Public Policy. Oxford, UK, etc.: Oxford University Press, 2003.