Category Archives: dependente


On the topic of alcohol culture in Romania* 

I have written a few words in preparation for this meeting and, with your permission, I would like to read them to you and then I invite you to respond and bring in your own experiences. As you can see, this is going to be an old fashioned presentation, with someone who speaks simple words and someone who listens and allows their mind to travel freely through the mind of the speaker and their own. The adding of technical so-called improvements has the effect of distracting the listener and give speech the uniformity of corporate communication. We are not corporations. We speak if we find an interested listener and then, in our turn, we listen when the listener has something to respond and we have dialogue. So, as they say, lend me your ear!

As I was considering the meaning of my presentation’s proposed title, “alcohol culture”, and not wanting to appeal to google for an easy fix, a definition or some handsome quote, I first looked around. I was in Krakow, Poland at the time and one of the things that I found interesting was the presence of 24 hour shops dedicated to selling alcohol in all strengths and sizes. ALKOHOLE 24H would be written in bright, glowing neon letters on almost every major street. I said to myself this is surely a very visible manifestation of alcohol culture in a society. So how about Romania, what do we have in this respect? As hard as I tried to find something that would be representative, maybe even symbolic for our relationship to alcohol (so maybe this could be a tentative definition for now – alcohol culture is the relationship that people in a society have with alcohol, alcohol use and alcohol users as well as with the negative consequences of alcohol use and abuse) I could not find anything. From the young people getting smashed with their friends in a club, to the urban man and his booze at the end of the day, relaxing him into a sort of a stupor that allows the mind to come down from the excitement and the stress of a day’s work, the blue collar worker meeting with friends for beer, sometimes during work hours when the friends are the coworkers, to the middle aged mother and wife drinking by herself, now not so much a mother because the children have gone and with them the major purpose of her life and the husband had been absent for years, the rural folks for whom the day starts with a shot of palinca and ends with one too, many others in-between, all proudly home made out of the best ecological fruits, ‘no additives’ they proudly boast to the visitor as if it’s some sort of a medicinal remedy – nothing seems to be quite able to capture some sort of specificity of my people’s relationship with alcohol. The neurologists say that alcohol does not have a specific target in the brain, that it rather permeates the whole brain, making the neurons’ membranes more fluid, more permeable. In the same way, alcohol permeates all walks of Romanian life.
So, at this time, empty-handed and out of ideas, I stopped looking out and started looking in. What was MY relationship with alcohol? What kind of history do I have? One’s experience can hardly be considered evidence for something larger, but when one doesn’t know, it feels good to return to something that is known, namely the lived, personal history. And while contemplating these issues, one thing came out to the fore with a force that surprised me with the intensity of a small revelation. It was about the first years of my life as a child in a family with two children in communist Romania in the 80’s. I was the eldest. And, for the first few years, I was completely in love with my father. He took me to the zoo, we would go out and eat steak together. When I was left in the care of my maternal grandparents who lived several hundred kilometers away, in a small village in the middle of the great Romanian planes of the South (a sort of Kansas, if you will), he would arrive in the morning unexpectedly and, to my delighted surprise, wake me up from my slumber with his spiky beard and his strong smell of tobacco. One of the first stories that include me (told by those present then, I have no memory of it myself) is about how there was a flood near my grandparents’ house and the bridge became impracticable, so my father had to get on a tractor to be able to make it to the outside world where a job awaited him. And I, a child of maybe 3 years old, running behind and crying, to the amused delight of the adult audience, “daddy runs away from me in a tractor!” At 4 or 5, I would wake up very early in the morning (despite the possibility of getting a later rise allowed by my mother’s working schedule that started later in the day), just to be able to hold his hand on our way, me to the kindergarten, him to his work that started at 7 am, in a communist factory now long closed, demolished and the land sold to corrupt politicians and their proxies. It would be cold, winter time, very dark, I could feel his big hand holding mine and I would sing from the top of my lungs “the night is made of silk” – “noaptea-i de matase”, a popular tune at the time, heard on one of the few TV programs of which we only had a couple of hours every week. I don’t think I ever felt so free and uninhibited as I did in those mornings. Then, when visiting his parents, he would amaze me with unimaginable superpowers, such as the possibility to step barefooted on a thistle so big and so thorny that I would be scared to even look at.
And then, all this stopped. He continued to be around for awhile, helping me with homework in school sometimes, but something started slowly growing and that something finished our relationship – my father started coming home drunk. There would be fights with my mother about the drinking and the money. He would get upset and raise his voice. Mother would raise her voice as well, then she would start crying, I felt sorry for her and started hating him for making her cry and making me miserable. I began to be able to identify the signs of alcohol intoxication – the red eyes, not quite sure in their tracking movements, a slight awkwardness in walking, a change in the tone of voice, not so self assured anymore and a tendency to let it all pass that was not goodness of the heart, but rather a wish to not be bothered. Surely, this is not the picture of the violent, alcoholic father, but violence has many ways of manifesting itself. I think I have lost my father to alcohol in a discretely violent way. Life was very hard in Romania, in the 80’s. Especially so for a man with family and children. The industry had started its collapse (it was the beginning of the end for the communist system) and oftentimes my father’s payment was cut short. We went through terrible shortages of food, electricity, even running water. I remember my father having to wake up at 3 in the morning, to be able to catch a winning place at the line for milk. More importantly, I think, there was a lack of hope – at a time when the world was preparing for the opening that was to come in 1989, Romania seemed to plunge deeper into darkness, a North-Korea of Eastern Europe.
And if you’re wondering, as they say in the books when they describe the natural evolution of alcohol abuse, spontaneous recovery is possible and that is what happened in his case, but only after several years of misery and lost time when I, a medical student by then, would be too busy, sometimes with my own alcohol abuse, to notice that he has changed. Then I moved to a different city and almost to a different world than his, a world with computers and internet and travels abroad that he cannot understand or relate to. Many of my patients have had similar histories of losing a parent, more often the father, to alcohol. Good men, loving fathers, devoted to their families, men who worked hard to build a career, to make their parents proud.

And so, with this inner exploration coming to an end, what do I have to say on the topic of Romanian alcohol culture? To me it has to do with family life and the disruption of relationships in the family. Romanian life, at least until the end of the communist period was very much a traditional, family-centered life. This was and it continues to be especially true in rural areas (both of my parents belong to a generation that was uprooted at an early age from their rural life and family and moved to the city, to work in the developing socialist society, at the beginning of the 50’s and 60’s). There continues to be a lot of disruption to life in the family – parents emigrating and leaving their children behind in the care of an aging grandparent incapable of being a substitute for the missing parents, confusion over values in life and that same feeling of hopelessness that never really left us. Sure, we have large amounts of television. Most goods are available, but not necessarily affordable. The ruthless rule of the almighty party system has been broken into smaller, but not necessarily kinder private or corporate masters. We are still the poorest nation in Europe. We are still struggling just to survive. And alcohol is here to help us ease the pain and forget for awhile the despair, the disappointment and the anger of the generations past and generations present.

I do not intend to suggest that this is more than a starting point, one of many, in a conversation about alcohol culture in my country. But it is important to consider that, beyond the globalization trends among the urban middle class, drinking in the same way their Western generational peers are drinking, there exists a background of drinking as remedy (‘no additives’, remember..!?) or drinking as therapy, maybe in the same way the North American Indians were drinking after their society collapsed and the white man moved in. Or the way the natives of South America chew coca leaves. It would surely explain why we seem to not be able to look at our relationship with alcohol from a critical point of view (Romania is probably the only country in Europe that does not have a government body set up to handle alcohol issues at a national level, especially from a health perspective). Or, in the words of Mrs. Zizi, my cleaning lady, a woman without a home of her own, without a job or a pension, without health insurance, who works just to make ends meet, a woman such as many women and men in the Romanian population, when I confront her about her smoking and heart problems, she says “please, doctor, why do you want to take away the only pleasure that I have left in this life?”. And I know it is not only the denial of the addicted, the resistance to change or the ambivalence manifested through exaggerations, for her and for many like her it is also the truth.

Thank you!

* presented in English at the ‘Empowerment’ Workshop, part of the ‘Power to Resist’ international project on alcohol abuse in Denmark, Sweden, UK, Spain and Romania, organised in Bucharest by ALIAT NGO on October 20th.

studiu

Primul studiu national  ce evalueaza serviciile de sanatate adresate persoanelor cu un consum problematic de alcool.

Aliat&AlcoHelp 2011 from etwa77

 


				
			
			

e aici.. (de la 1% la 12% in 2 ani)

la inceputul anilor 2000, posibilitatea izbucnirii si in romania a unei epidemii de hiv/sida de magnitudinea celor inregistrate deja in tarile fostei uniuni sovietice in randul consumatorilor de droguri a determinat o serie de institutii internationale sa finanteze servicii adresate acestora, in special consumatorilor care isi injectau substantele.. prima interventie de acest fel a apartinut aliat, sub forma centrului “risc minim” unde consumatorii primeau consiliere, erau indrumati spre spitale, testati pentru bolile cu transmitere prin seringa (hiv, hepatite), primeau seringi sterile si se colectau seringile folosite, potential infectate.

in 2009, finantatorii straini se retrageau, recomandand statului roman preluarea acestor servicii la bugetul de stat.. conform datelor publicate de compartimentul pentru monitorizarea si evaluarea infectiei cu hiv/sida in romania de pe langa institutul de boli infectioase “matei bals”, in 2009 doar 1.1% dintre persoanele infectate cu hiv/sida proveneau din randul consumatorilor de droguri..

ramas fara finantare si prigonit de noul management al spitalului “obregia”, centrul “risc minim” a fost inchis.. la fel alte programe similare care functionau in bucuresti.. in prezent, mai exista doar un singur astfel de program..

si, intre timp, au aparut etnobotanicele.. multi consumatori care isi injectau heroina au inceput sa-si injecteze noile substante, mai ieftine, mai eficiente, dar cu actiune mult mai scurta.. daca un consumator dependent de heroina se injecta de 2-4 ori pe zi, un consumator de etnobotanice ajunge sa se injecteze de cateva zeci de ori pe zi..

si ajungem in 2011.. la 30 iunie, compartimentul de pe langa spitalul “bals” publica datele disponibile la acea data.. imaginea dezastrului arata asa:

hiv romania

deci, din 2007 pana in 2009, procentul celor infectati se mentine in jur de 1%, in 2010 urca la 2.7%, iar in 2011 ajunge la 12%.. din surse neoficiale am aflat ca, pana in prezent, inca tot atatia consumatori de droguri cati au fost identificati la data publicarii datelor de mai sus (30 iunie) au fost diagnosticati cu hiv/sida

(cealalta categorie de populatie care prezinta o crestere a ratei de infectare sunt homosexualii.. de la 8% in 2009 la 16% in 2011. si aici, programele de prevenire lipsesc de cand finantatorii straini au parasit romania)

in 2010, scriam pe acelasi subiect, ingrijorat de cei 3%.. acum, cand cele mai negre temeri se confirma, ce mai e de spus.. despre diferenta intre costul unei seringi si costul unui tratament pe viata pentru sida?.. despre cum ministrul Bazac (Ferrari) a inaugurat in 2009 prima academie europeana de hiv?.. despre cum incet si cu incuviintarea partidului-stat, ong-urile romanesti mor si se scufunda in uitare?.. despre cum vom privatiza sistemul de sanatate?.. despre noile campanii tembele de prevenire in care tinerii sunt indemnati sa joace sah, in loc sa consume etnobotanice?.. sau poate despre teribilul sentiment de a-ti vedea munca de un deceniu si sanatatea unei intregi populatii rapuse de lacomia, incompetenta si prostia celor care ne conduc?..

citatul din goethe sub care se plaseaza informatiile oferite de compartimentul de monitorizare sida ale carui date le-am discutat aici este corect: “nimic nu este mai inspaimantator decat ignoranta activa”

cine “acceseaza” etnobotanicele?

inca o data, politicienii romani demonstreaza ca datele si cercetarile stiintifice nu contribuie la intemeierea pozitiilor publice pe care le sustin.

doamna Ecaterina Antonescu propune integrarea scolara ca modalitate de prevenire a consumului de droguri legale, ignorand o cercetare recenta care arata ca majoritatea consumatorilor sunt cu varste mult sub cea a mersului la facultate si deja integrati in mediul scolar.

ideea ca e de ajuns ca un tanar sa-si “vada de treaba”.. sa mearga la scoala, sa ia note bune, sa intre la facultate pentru a fi ferit de, cum spune doamna Andronescu, “accesarea” drogurilor e falsa.. motivatia pe care mi se pare ca o intuiesc este ca, astfel, noi.. parintii, profesorii, statul.. nu trebuie sa ne asumam nicio responsabilitate, nu trebuie sa schimbam nimic.. tot ce e nevoie e ca tanarul sa aiba responsabilitatea de a merge la scoala.. e alegerea lui (“alege viata” se repeta obsesiv in mesajele oficiale).

In fond e inca o dezertare a adultilor. Pentru ca intrebarea pe care nu ne-o punem este – cum se face si ce factori contribuie la situatia creata, aceea ca niste copii de sub 15 ani, din “familii bune”, cu situatie materiala satisfacatoare si acces la educatie ajung sa consume niste substante extrem de periculoase?

un fel de reclama..

etnobotanice..

Nu, asta n-o să se întîmple în nici un caz! rosti străinul cu o neclintită convingere.
— De ce, mă rog?
— Pentru că, urmă el, aţintindu-şi ochii îngustaţi spre cer, unde, presimţind răcoarea serii,
păsări întunecate însăilau neauzit bolta, pentru că Annuşka a şi cumpărat uleiul de floarea-
soarelui, şi nu numai că l-a cumpărat, dar l-a şi vărsat. Aşa că şedinţa nu va mai avea loc.
După aceste cuvinte, e de la sine înţeles că în umbra teilor se lăsă tăcerea.

“Nu, asta n-o să se întîmple în nici un caz! rosti străinul cu o neclintită convingere.

— De ce, mă rog?

— Pentru că, urmă el, aţintindu-şi ochii îngustaţi spre cer, unde, presimţind răcoarea serii, păsări întunecate însăilau neauzit bolta, pentru că Annuşka a şi cumpărat uleiul de floarea- soarelui, şi nu numai că l-a cumpărat, dar l-a şi vărsat. Aşa că şedinţa nu va mai avea loc. După aceste cuvinte, e de la sine înţeles că în umbra teilor se lăsă tăcerea.”

Maestrul si Margareta, Mihail Bulgakov

impresionanta desfasurare de forte la guvern.. ministrul sanatatii, politia, ministrul agriculturii (???) si premierul insusi s-au adunat sa gaseasca solutia care va interzice drogurile in Romania.. dar, ca la radio erevan, nu drogurile, doar etnobotanicele, si nu etnobotanicele, doar magazinele se vrea a fi inchise o data si pentru totdeauna..

prezenta ministrului agriculturii este probabil justificata de particula “botanice”, iar prezenta primului ministru este pentru “etno”, caci Romania a ramas o tara in care lucrurile se misca doar cand seful guvernului se implica in persoana..

in acest timp, niste oameni s-au adunat in piata sa strige “jos etnobotanicele!“..

si ma gandesc ca Annuska a varsat deja uleiul si accidentul este inevitabil.. exista o masa mare de oameni care traiesc la periferia societatii, in saracie si ghetouri, fara slujbe, dar cu obisnuinta de a se descurca ei cumva, dintre acestia multi au ajuns sa consume si sunt deja dependenti de aceste substante, exista un potential urias pentru noi substante de a fi sintetizate si facute accesibile prin cele mai diverse mijloace, interventiile de prevenire au ramas la nivelul “spune nu drogurilor” si “alege viata”,  avem mai multe locuri disponibile in puscarii decat in centre de tratament si autoritati neinformate si opace la posibilitatea de a solicita consultanta sau de a face si altceva in afara de a interzice si atat..

ce se va intampla cand tinerii vor continua sa consume, cumparandu-si plicurile pe internet sau de la coltul strazii? probabil ca se va spune “noi ne-am facut datoria, am inchis magazinele, daca astia continua sa consume inseamna ca sunt niste drogati nenorociti si la puscarie cu ei..!

intre timp, in uk, guvernul a solicitat si primit un raport stiintific despre caracteristicile, riscurile si masurile de luat in ce priveste canabinoizii sintetici cunoscuti sub numele de “spice”.. si nu, ministerul mirodeniilor nu a fost chemat la consultari.

betivii.. politistii..

“Daca pe mine ma intrebati, un punct de vedere personal, eu as vrea sa se faca disponibilizari in politia romana. Pentru ca este un moment extrem de prielnic de modernizare a politiei si de asanare a mediului politienesc. Avem suficienti politisti betivi, nenorociti.”

Liviu Popa, Inspector General al Inspectoratului General al Poliţiei Române

domnul Popa este, pe scara ierarhica, seful agentiei nationale antidrog, aflata in subordinea igpr.. pe site-ul acesteia sta scris: “România continuă să dezvolte, la nivel naţional şi local, un sistem integrat de servicii de prevenire şi tratament. Au fost create 47 de centre de prevenire, evaluare şi consiliere antidrog, câte unul în fiecare dintre cele 41 de judeţe din ţară şi şase în Bucureşti“.. angajatii din cele 47 de centre (peste 200) ar trebui sa se ocupe cu tratarea betivilor nenorociti de care vorbeste domnul Popa..

ma gandesc la cei cativa oameni buni pe care ii cunosc si lucreaza in ana.. ce zile triste au ajuns sa traiasca..!

AlcoHelp..

AlcoHelp a ajuns la 1000 de utilizatori.. cu o medie de peste 800 de vizitatori pe luna.

sunt peste 1500 de mesaje postate pe forum.

Mai multe, pe 15 decembrie, la o conferinta de presa.

dezastrul romania (II)

ultimele date de prevalenta comunicate de autoritatea europeana in domeniul drogurilor (am selectat grupa de varsta 15-34 de ani, pentru ca aceasta a fost cea mai expusa dupa 1989 la fenomenul aparitiei drogurilor):

15-34 (cel putin o data in viata) 15-34 (in ultimul an) 15-34 (in ultima luna)
RO UE RO UE RO UE
Cannabis 2.9% 31.6% 0.9% 12.6% 0.3% 6.9%
Ecstasy 0.6% 5.2% 0.2% 1.2%
Cocaina 0.1% 5.9% 0.1% 2.3% 0.0% 0.9%

spre comparatie, un studiu cu chestionare anonime realizat in 2009 de SNSPA in randul elevilor de clasa a 12-a (p. 21 in raport) releva urmatoarele:

– 10.7% au consumat cel putin o data in viata droguri ilegale

– dintre acestia, 1.4% au consumat heroina

– 23% dintre elevii consumatori au initiat consumul sub varsta de 15 ani

– 23.5% nu au declarat ce droguri au consumat

Studiul releva raspandirea la nivel national a fenomenului consumului de droguri in randul tinerilor: “Rezultatele acestui studiu indică faptul că, în cazul elevilor de clasa a XII-a, Bucureştiul nu mai este principalul oraş din România în care se consumă droguri, regiunea Bucureşti-Ilfov fiind pe locul trei în ceea ce priveşte procentul înregistrat.”

Concluzia mea: Romania apare constant in rapoartele internationale pe ultimul loc al prevalentei consumului de droguri in populatie, lucru care pare sa nu fie sustinut de studii independente. In plus, explozia fenomenului spice pare sa releve ca exista o masa mare de persoane dornice sa experimenteze cu substante psihoactive.

dezastrul Romania..

imaginea dezastrului:

HIV - 2010

o crestere cu 300% intr-un singur an a prevalentei HIV in randul consumatorilor de droguri injectabile (CDI) este un semnal de alarma foarte serios. O epidemie de HIV este iminenta.

alte date prezentate in ultimul raport al Agentiei Nationale Antidrog privind situatia drogurilor in Romania:

scaderea cererii de tratament cu 14%, in 2009 aflandu-se in tratament 1689 de persoane

aproape 5000 de persoane au fost cercetate penal in 2009, in crestere cu 11% fata de 2008 si cu 7% fata de 2007; dintre acestea, 976 au fost trimise in judecata (o crestere cu 9.5% fata de 2008 si cu 30% fata de 2007)

– 676 de persoane au fost condamnate, din care doar 14% sunt recidivisti (in procente, asta inseamna o crestere cu 50% fata de 2008 a numarului de persoane condamnate )

in 2009, au fost condamnate cu 81% mai multe persoane pentru infractiunea de detinere in vederea consumului propriu!

in primele 6 luni din 2010 s-au inregistrat 235 de cazuri de intoxicatie cu etnobotanice ajunse la camerele de urgenta ale spitalelor, fata de 86 in tot anul 2009

– pe piata drogurilor a crescut pretul pentru drogurile usoare (cannabis, ecstasy) si a scazut pretul pentru heroina

ALIAT este mentionat in raportul ANA cu 3 proiecte:

AlcoHelp – prevenire in randul populatiei la risc (persoane care fac abuz de alcool)

– Stiu ca Pot – prevenire generala a initierii consumului de droguri in randul elevilor de clasa a 9-a

– Risc Minim – prevenire HIV/SIDA in randul consumatorilor de droguri injectabile (proiect mult diminuat in urma incetarii fondurilor in vara lui 2010 si oprirea utilitatilor prin dispozitia managementului spitalului Obregia in septembrie). Risc Minim continua in regim de voluntariat, fara apa, caldura si lumina pana nu se va mai putea fizic..

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