natgillin/translations-raw huggingface dataset:
• increased numbers referred from the criminal justicesystem in some countries;
Noorukite (st alla 18aastaste isikute) ametlikukshoiatamiseks rakendatakse konkreetset menetlust.
• increased referrals from family and other social supportnetworks (family, friend, social services, school);
obleemidega klientidepuhul, nagu enamik kanepitarbijaid.
• an increased proportion of intensive (daily) cannabisuse, although daily users remain in the minority;
Liikmesriikideobleemidest teadlikud, jamitmed riigid teatasid oma Narkootikumide ja Narkomaania Euroopa Tgu teabekeskustearuannetes, et probleemsete kanepitarbijate japrobleemsete her kinnistamaks arusaama kanepi negatiivsest jaebaseaduslikust olemusest.
For the most part, those with a cannabis-related problemare treated alongside clients being treated for problem useof other illicit drugs, typically opioids.
kogustes kanepit. Sekkumise raames korraldatakse obleeme nendes prbaasil.
As many of thesespecialised drug treatment centres are configured to meetthe needs of an often chaotic and marginalised population,their suitability for those with less acute needs, such as mostcannabis users, is debatable.
Austria riiklikus aruandes soovitatakse, et juhul, kuihaiglaravi on vaja, peaks see toimuma pigem noorukite kohta ja kasvatuslikku teavet.
It is easier to designprogrammes specifically for cannabis users on anoutpatient basis.
Hollandis on traditsiooniks uimastiraviasutuses.
The Austrian national report suggests thatinpatient care, if required, should preferably take placewithin a generic adolescent psychiatry department ratherthan a specialist drug unit.
Liikmesriigid on esitanud andmeidmitmete uuenduste kohta kanepitarbijate ravis, mille hulkaoonilistele kirjeldas Hash & Weed Week(171 ); palju kanepit tarbivad probleemsete kanepitarbijate eneseabisait Internetis, mis
Conclusions increasing levels of social and educational problems insome countries, although data in this area are weak.
Järeldused sellest, et kanepi suitsetamise ja hingamisteede haigusteenevast murtervisele on kanepitarbimisest tingitud kahjude enemine laiemassees on ilmne, et paljudteadlikuma poliitilise arutelu seisukohast olulised eldes muude uimastite tarbijatele suunatud sekkumistega.
What is also apparent is that the availableevidence does not justify an alarmist position but nor is itcause for complacency.
obleemidega inimestele on
In considering the increase in treatment demands, itappears that changes in referral practice have an impact,and a substantial proportion of those referred appear not tobe intensive drug users. Nonetheless, in some countries atleast, a significant number of treatment demands come fromindividuals whose use of cannabis is intensive.
Inimeste osakaal, kellel on kanepiga seotud probleeme, ei aani, Saksamaa, Kreeka,Prantsusmaa, Holland, Austria, Rootsi ja Norra) pakuvad e mas noored mehed, tavaliselt ligikaudu 20aastased, ja riikides on kanepiprobleemide ravi integreeritud
People with cannabis-related problems constitute a nontrivial proportion of treatment demands in specialisedfacilities in some countries and form an important subgroup within the larger treatment population. Most areyoung males, typically around 20 years old, and moststarted using the drug at 16 or 17 years of age.
)ogrammide kohta on esitatud Euroopa Narkootikumide ja Narkomaania Seirekeskuse EDDRAandmebaasi veebisaidil (http://eddra.emcdda.eu.int/eddra/plsql/showQuest?Prog_ID=2091). ) http://eddra.emcdda.eu.int/eddra/plsql/showQuest?Prog_ID=385.
Annual report 2004: the state of the drugs problem in the European Union and Norway most affected are young and may be using the drugintensively during important developmental stages or whenthey are particularly vulnerable.
Aastaaruanne 2004: Narkoprobleemide olukord Euroopa Liidus ja Norras
Among sociallydisadvantaged families or communities, cannabisdependence or abuse may compound individuals’ problemsby harming education or employment opportunities.
Kanepiprobleemidega klientidel on muude uimastite olulisi erinevusi leida ka kanepitarbijate endi hulgas.
problems. General population survey data suggest that,compared with occasional use, intensive cannabis use isrelatively uncommon.
obleemid ei ole lihtsalt dujatest teeb seda kanepipr lahenduste leidmisega.
However, the widespread use ofcannabis means that considerable numbers of people maybe using the drug intensively — at least for some part oftheir life.
Olulisteks asjaoludeks on siinkohaltarbimissagedus, muude uimastite tarbimine kas praegu eristada kahesuguseid kliente: kanepipruuringu andmete kohaselt on intensiivne kanepi tarbimine
Estimates would suggest that intensive use may affectbetween 0.5%and 2%of the adult population and between1%and 3%of young adults.
• sotsiaalselt integr ganite, em noorte ooniliste saada selget pilti sellest, kui suur on probleemsete.
The prevalence among youngmales is likely to be substantially higher.
Kuigi k er ei tarbi muid uimasteid ja on ilmselt ainult juhuslikudkanepitarbijad.
It is difficult to drawfrom the survey evidence a clear picture of the number ofusers experiencing problems with or becoming dependenton cannabis.
obleem eriti teravalt puudutab, on nooruimastit intensiivselt oluliste ar kanepipr gmist:
In summary, there remains a critical need for research toprovide an understanding of the relationship betweendifferent patterns of cannabis use and the development ofproblems.
•kasvanud on perekonna ja muude sotsiaalsetegustike (perkool) poolt ravilesuunatute arv; kanepitarbimise harjumuste ja probleemide tekkimise vahel
The extent to which cannabis users experienceproblems and the nature of the problems that may be foundstill remain poorly understood.
• obleemide kanepitarbimine probleeme ja milline on nendeprobleemide olemus.
Methodological tools arerequired to assess problems at the population level.
Vaja on metodoloogilisiabivahendeid, et hinnata probleeme kogu rahvastiku tase, kuigi teave selle kohta on puudulik.
Suchinformation is a prerequisite to the development, targetingand implementation of effective public health responses tocannabis use in Europe.
vastaste rahvatervise edendamise meetmete ja oluline osa ravilesuunatutest on kliendid, kes ei tarbi eelduseks Euroopas.
Selectedissue 3Co-morbidity
Valikteema 3Kaasnev haigestumus
Aetiology
Haiguste põhjused
Determining the aetiology of comorbidity results in achicken and egg discussion: what came first?
Kaasneva haigestumuse põhjuste väljaselgitamine annabsarnase tulemuse kana ja muna teemaliste arutlustega:kumb oli enne?
Existingresearch about the causal relations between psychiatric andsubstance disorders is inconclusive.
Olemasolev andmestik vaimse tervisehäirete ja uimastitarbimisega seotud haiguste põhjuslikustseosest on ebapiisav.
The symptoms of mentaldisorder and addiction problems interact and mutuallyinfluence each other.
Vaimse häire ja sõltuvusprobleemidesümptomid mõjutavad üksteist vastastikku.
Research evidence indicates that psychiatric and personalitydisorders usually occur before substance use disorders, i.e.they increase individuals’ susceptibility to such problems(e.g. Kessler et al., 2001; Bakken et al., 2003); however,psychiatric disorders may also be aggravated by drug use(e.g. for depression: McIntosh and Ritson, 2001) or occurin parallel.
Tõendusmaterjal viitab sellele, et vaimse tervise häired jaisiksusehäired ilmnevad tavaliselt varem kuiuimastitarbimisega seotud häired, st need tõstavad indiviidivastuvõtlikkust selliste probleemide suhtes (nt Kessler jt,2001; Bakken jt, 2003); siiski võivad vaimse tervise häireduimastitarbimine puhul kas süveneda (nt depressioon: McIntosh ja Ritson, 2001) või esineda paralleelselt.
The co-occurrence of psychiatric illness and substancedisorders, commonly termed comorbidity or dualdiagnosis, is not a new phenomenon.
Vaimse tervise häired ja uimastitega seotud häiredeksisteerivad sageli koos; kõnealust nähtust nimetatakseüldiselt topeltdiagnoosiks ning see pole sugugi uus.
However, in recentyears the issue has gained momentum in the political andprofessional discussion as it has become apparent that alarge and probably growing number of people areaffected.
Siiski onselle küsimuse poliitiline ja professionaalne arutelu saanudviimaste aastate jooksul hoogu juurde, sest on selgunud, etsee puudutab suurt ja tõenäoliselt üha kasvavat hulkainimesi.
In this chapter the focus will be on the coexistenceof psychiatric and personality disorders and the use of illicitdrugs.
Käesolevas peatükis on tähelepanu keskpunktisvaimse tervise häirete ja isiksusehäirete eksisteerimine koosebaseaduslike uimastite tarbimisega.
In fact, it is often appropriate to speak aboutmultimorbidity, as affected individuals often also suffer fromsomatic illnesses, e.g. human immunodeficiency virus (HIV)or hepatitis C virus infection, as well as social disorders,such as family problems, unemployment, incarceration orhomelessness.
Tegelikult võib isegirääkida mitmete haiguste koosesinemisest, kuna inimesed,keda see puudutab, kannatavad sageli ka somaatilistehaiguste tõttu, näiteks inimese immuunpuudulikkuse viirus(HIV) või C-hepatiidi viirus, aga ka sotsiaalsete häirete tõttu,nagu perekondlikud probleemid, tööpuudus, vangistus võikodutus.
Care and treatment services are usuallyinadequately equipped to deal with the diagnostic andtreatment needs of this client group, disregarding and/orbeing incapable of coping with the totality of the client’sproblems.
Hooldus- ja raviteenused on selle klientidegrupivajaduste suhtes tavaliselt ebapiisavalt ette valmistatud,jättes tähelepanuta ja/või olles võimetud nägema klientideprobleeme tervikuna.
The result is frequently a ‘revolving door’situation, with individuals in great need of treatment beingreferred from one service to another while all the time theirsituation deteriorates.
Selle tulemuseks on sageli nnpöördukse-sündroom, kus tõsiselt ravi vajavaid inimesisuunatakse ühest asutusest teise, samal ajal kui nendeolukord ainult halveneb.
Note that the specific relationship between cannabis useand psychiatric disorders is considered in more depth in theselected issue on cannabis (p. 82).
Kanepi tarbimise ja vaimse tervise häirete vahelise seoseüle arutletakse pikemalt kanepiga seotud teemasidkäsitlevas peatükis (lk 82).
Drug use can also be perceived as a component orsymptom of a psychiatric or personality disorder and as anattempt to self-medicate (e.g. Williams et al., 1990; Murrayet al., 2003).
Uimastitarbimist võib vaadelda ka vaimse tervise häire võiisiksusehäire koostisosana või selle sümptomina, kuidsamas ka katsena ennast ise ravida (nt Williams jt, 1990;Murray jt, 2003).
The fact that substance use alleviatesdistressing symptoms encourages the development ofaddiction.
Tõsiasi, et uimastitarbimine kergendabmasenduse tundemärke, soodustab sõltuvuse tekkimist.
Once the drug use is discontinued, e.g. throughwithdrawal or substitution treatment, the symptoms mayreappear. Acute drug-induced psychoses occur particularlyin users of cocaine, amphetamines and hallucinogens andusually subside relatively quickly.
Kuilõpetada uimastitarbimine, näiteks läbi võõrutamise võiasendusravi, võivad masenduse tundemärgid tagasi tulla.Ägedad, uimastite poolt esile kutsutud psühhoosidesinevad eriti just kokaiini, amfetamiini jahallutsinogeenide tarbijate seas ja tavaliselt raugevadsuhteliselt kiiresti.
It may, however, be verydifficult to differentiate between symptoms due to substanceintoxication and unrelated psychotic episodes.
Siiski on vahel väga keeruline teha vahetuimastist tingitud mürgistussümptomite ja sellegamitteseotud psühhootiliste episoodide vahel.
Krausz (1996) suggests four categories of dual diagnosis:
Krausz (1996) osutab topeltdiagnoosi neljale kategooriale:
• a primary diagnosis of a mental illness, with asubsequent (dual) diagnosis of substance misuse thatadversely affects mental health;
•esmaseks diagnoosiks vaimuhaigus, teiseseks uimastitekuritarvitamine, mis mõjub halvasti vaimsele tervisele;
• a primary diagnosis of drug dependence withpsychiatric complications leading to mental illness;
•esmaseks diagnoosiks uimastisõltuvus, koospsühhiaatriliste komplikatsioonidega, mis viivadpsühhoosini;
• concurrent diagnoses of substance misuse andpsychiatric disorders;
•uimastite kuritarvitamise ja vaimse tervise häiretekonkureerivad diagnoosid;
• a dual diagnosis of substance misuse and mooddisorder, both resulting from an underlying traumaticexperience, for example post-traumatic stress disorder.
•uimastite kuritarvitamise ja meeleoluhäiretopeltdiagnoos, kusjuures mõlemad on saanud algusevarjatud traumaatilisest kogemusest, näitekstraumajärgsest stressireaktsioonist.
Co-morbidity, or dual diagnosis, is defined by the World Health Organization (WHO) as the ‘co-occurrence in thesame individual of a psychoactive substance use disorderand another psychiatric disorder’ (WHO, 1995).
Maailma Tervishoiuorganisatsioon määratleb kaasnevathaigestumust või topeltdiagnoosi järgmiselt:“psühhoaktiivsete ainetega seotud häire ja muu vaimsetervise häire koosesinemine ühel ja samal indiviidil“(Maailma Tervishoiuorganisatsioon, 1995).
Accordingto the United Nations Office on Drugs and Crime(UNODC), a person with dual diagnosis is a ‘persondiagnosed as having an alcohol or drug abuse problem inaddition to some other diagnosis, usually psychiatric, e.g.mood disorder, schizophrenia’ (UNODCCP, 2000).
ÜROUimastikontrolli ja Kriminaalpreventsiooni Büroo(UNODC) määratluse kohaselt on topeltdiagnoosigainimene: “isik, kellel on diagnoositud alkoholi või uimastitekuritarvitamine ja lisaks sellele veel mõni muu diagnoos,tavaliselt vaimse tervise häire, näiteks meeloluhäire,skisofreenia“ (ÜRO Uimastikontrolli ja Kriminaalpreventsiooni Büroo, 2000).
In otherwords, comorbidity in this context refers to the temporalcoexistence of two or more psychiatric or personalitydisorders, one of which is problematic substance use.
Teisisõnu, kaasnevhaigestumus viitab selles kontekstis kahe või enama vaimsetervise häire või isiksusehäire koosesinemisele, millest ükson probleemne uimastitarbimine.
Selected issue 3: Comorbidity
Valikteema 3: Kaasnev haigestumus
Similarly, the Swedish national report differentiates betweenpsychiatric patients suffering from comorbidity and drugdependent clients with personality disorders that areaggravated by drug use and which are not alwaysadequately diagnosed.
Samalaadselt eristab Rootsi riiklik aruanne eldati, et depr gatavalt suurenenud (Br eid, mida raskendabuimastitarbimine ja mida ei diagnoosita alati adekvaatselt.
It is possible thatsome individuals with depression may self-medicate withopiates and benzodiazepines: clients in treatmentprogrammes have lower depression scores than clients inlow-threshold services (Rooney et al., 1999) or at initiationof treatment (McIntosh and Ritson, 2001).
eid komplikatsioonidest,mis on spetsiifiliselt seotud just uimastite tarbimisega.ete hulka kuuluvad:
Disorders often foundamong drug users include:
Norras tehtud uurimus (n =2359) tuvastas, et suur hulk
• sleep disorders, resulting from depression, anxietydisorder or psychosis;
• ed, mis tulenevad depr es t ekondlikke probleeme. 70% on koolisobleeme,
Female drug userswith psychiatric comorbidity have often been the victims oftraumatic sexual abuse (e.g. Beutel, 1999).
Naissoost uimastitarbijate puhul, kellel esinebeid, on sageli tegemisttraumaatilise seksuaalse kuritarvitamise ohvritega (nt Beutel, 1999).
• pharmaco-psychoses induced by hallucinogenic drugsor amphetamines;
• segadusseisundid.
Except in some particularly aware and/orspecialised services, mental symptoms and disorders arerarely explored in drug treatment services.
Vete rutiinne hindamineei ole alati standardse diagnostilise protseduuri osaks, mis
Recent neuropsychological and neurobiological studies andthe advent of techniques that enable brain processes to bevisualised have made it possible to hypothesise about theinteractions between mental and physical trauma, braindevelopment, drug effects, stress and mental development.The reward system is essential in the development ofaddiction, and addiction is linked to structural changesandadaptation of the brain at micro and macro levels(Nestler,2001).
Hiljutised uurimused neur obioloogia toimuvaid pr engu,essi ja vaimse arengu vastastikuste valdavalt domineerib kliinilises pildis ja varjab muudatuste ja peaaju kohanemisega nii mikro- kuimakrotasandil (Nestler, 2001).
In addition, substance abuse cancause psychiatric symptoms that are barely distinguishablefrom those of psychiatric disorders (Berthel, 2003), whilesubstance withdrawal or acute intoxication can also mimicalmost any such disorder (Liappas, 2001).
Teised teooriad seostavad kindlaid uimasteid teatavate ete her essi, leevendada valusid ja gistusseisund samuti sarnanedaetele (Liappas, 2001).
Furthermore,depression and anxiety can be viewed as inherentsymptoms of the intoxication–withdrawal cycle; symptomsthat used to be alleviated by drugs become manifest in thecourse of abstinence or substitution treatment.
Veelgi enam, eeniliste depr ja piirialaste skisofrvaimuhaigusega patsiendid siiski ei tarbi heroiini. Kokaiiniessiivseid nartsissistlikel isiksustel ennast suur tagasi.
Cannabiscould relieve tension and ecstasy ease social inhibitions(Verheul, 2001; Berthel, 2003).
ecstasy vabastadasotsiaalsest pidurdatusest (Verheul, 2001; Berthel, 2003).
The 2002 Irish national report specifically examineddepression among drug users, based on the results ofseveral studies, and concluded that there is a strongassociation between problem drug use, in particular use ofopiates and benzodiazepines, and high rates of depression.German research into the relationship between substancedisorders, depression and suicide concluded that the risk ofsuicide is greatly increased in those with a depressive
ete kui uimastitarbimisega seotud prpalju standardiseeritud ja tunnustatud vahendeid samuti on olemas erinevaid vahendeid uimastitarbimise
The addiction severity index(ASI) is a multifunctional instrument that can be used indiagnosis, treatment planning and follow-up, and research.The ASI has the advantage of being multidimensional,measuring past and current problems in seven areas: healthstatus, employment and self-support, alcohol use, drug use,legal status, family and social relationships and psychiatricsymptoms (Krausz, 1999a; Öjehagen and Schaar, 2003). Itis standardised and has been translated from English into
2002. aasta Iirimaa riiklikus aruandes uuriti mitmeteessiooni uimastitarbijateeldusele, et on olemas tugev seosprge depressioonitasemevahel ja seda eriti just opiaatide ja bensodiasepiinide indikaator (ASI) on multifunktsionaalne vahend, mida saabelravis ete, depressiooni ja
The Spanish national report notes that the observedincrease in comorbidity might partly be due to an increasein dependence on psychostimulants.
Iirimaal kasvas ajavahemikul1990–2001 esmakordselt raviletulevate uimastitarbijate e (ADHD) (Eland ja Van de Glint,
Prevalence of comorbidity in treatment settings
Levimus inimeste arvu kasvust.
For reasonsdiscussed above, under-diagnosis is likely in many cases.
ja uimastiravil olevate statsionaarsete ja ambulatoorsete
In a review of different studies, Uchtenhagen and Zeiglgänsberger (2000) concluded that the most commonpsychiatric diagnosis among drug users is personalitydisorder, affecting 50–90%, followed by affective disorder(20–60%) and psychotic disorders (20%).
Tkaasneva haigestumuse levimuse kohta liikmesriikide ulemused, nii arvudeskui diagnooside seisukohast, varieeruvad suuruurimisaluste arvust ja valimist, valikumeetoditest, ete kohta uimastiraviasutustest.
Between 10 and50%of patients exhibit more than one psychiatric orpersonality comorbidity disorder.
Kuigi selles eldavad, annavad need aimu situatsioonist Euroopa eldasid teiste kasutatud vahendite kui ka diagnoosimise aja osas.
In a review of international studies on psychopathology indrug-dependent subjects, Fridell (1991, 1996) outlined aclinical picture of comorbidity in drug addiction that hasbeen confirmed by his own studies in Lund, Sweden. Threemain groups of disorders could be identified: personalitydisorders (65–85%), depression and anxiety states(30–50%), and psychoses (15%).
Kr dlev uurimus kliinilise pildi, mida on kinnitanud tema enda uuringudeteed (65%–85%), depressioon ja eldes Kreeka uimastitarbijatega oliete levimus Prantsusmaauimastitarbijate hulgas suurem (19% vs.7%), kusjuuresantisotsiaalsed isiksusemudelid olid enam levinud Kreekavalimis (20% vs. 7%).
The co-occurrence of anantisocial personality disorder was highest in male polysubstance abusers (Landheim et al., 2003).
V ed olid antisotsiaalne (23%),e (10%).
Prevalence — prisons and compulsory treatment
indiviidid on sellega seotud“ (Kokkevi ja Facy, 1995).
Irish data suggest that 48%of male and 75%of female prisoners are mentallydisturbed, while 72%of men and 83%of women in prisonreport lifetime experience of drug use (Hannon et al.,2000).
Paljud uimastite valdkonna asjatundjad leiavad, etetega on suur suur ainete kuritarvitajate (85% nendest olid heroiinitarbijad) japuhtalt alkohoolikute vahel.
The relapse rate among drug users who
V ete etega uurimisobjektide
)See EMCDDA Evaluation Instrument Bank (http://eib.emcdda.eu.int).
)Vt Euroopa Narkootikumide ja Narkomaania Seirekeskuse hindamisvahendite pank (http://eib.emcdda.eu.int).
Table 7: Prevalence of comorbidity in treatment settings in various countries of the EU
Tabel 7: Kaasneva haigestumuse levimus ravikeskkonnas Euroopa Liidu eri riikides
Prevalence of comorbidity (%)
Kaasneva haigestumuse levimus (%)
Admissions for drug problems (1996–99) database (
V uimastipr (1996–1999) andmebaas (
Personality disorders: 14%Depression: 7%Neurotic disorders: 6%Eating disorders: 5%
Resideeruvad patsiendid(2001–2002) ed: 14%depressioon: 7%neured: 6%ed: 5%
Opiate addicts
Ravikeskused
Stress and somatoform disorders: 43%Affective disorders: 32%Phobias: 32%Depressive episodes: 16%
) stred: 43%ed: 32%foobiad: 32%depressiooniepisoodid: 16%
Opioid-dependent men
Vangla ja raviteenistused
Kokkevi and Stefanis
Kokkevi ja Stefanis
Methadone service
Metadoonasendusravi
Borderline: 7%Antisocial disorders: 6%Social phobia: 6%Depression: 5%
) sotsiaalfoobia: 6%depressioon: 5%
Anxiety: 4%Depression: 3%Behavioural disorders: 3%Eating disorders: 2%
) revus: 4%depressioon: 3%ed: 3%ed: 2%
Mental health services
Vaimse tervise teenused
Lifelong drug users
Eluaegsed uimastite tarbijad
Patients previously in contact with psychiatric services excluding detoxification (1996–2002)
) raviga, v.a detoksikatsioon,kokku puutunud patsiendid(1996–2002)
Depression: 29%Social phobia: 29%Bipolar disorders: 24%Dysthymia: 22%
18–64 (1996) depressioon: 29%sotsiaalfoobia: 29%e: 24%
Obsessive–compulsive disorders: 73%Depression: 72%Somatisation: 60%Paranoid ideation: 58%
) depressioon: 72%somatisatsioon: 60%
Hospital patient discharge register
Patsientide haiglast
Paranoid ideation: 58%Psychotic disorders: 32%Mood disorders: 28%Neurotic disorders: 10%Personality disorders: 29%
Uimastiga seotudhaiglaraviperioodid (2002) egister neur ed: 32%ed: 28%ed: 10%ed: 29%
Patients on detoxication ward (1977–95)
Detoksikatsioonipatsiendid (1977–1995) depr e: 11%
Annual report 2004: the state of the drugs problem in the European Union and Norway have served prison sentences is high, and there isincreasing recognition that incarceration can contribute to aworsening of mental health problems.
Aastaaruanne 2004: Narkoprobleemide olukord Euroopa Liidus ja Norras gistusilminguid peetakse ekslikult eldes meestega, esinesnaiste hulgas oluliselt enam raskeid depressioone,kereid.
Of 46 substance-dependent girls incompulsory care for children and young people, two thirdshad psychiatric diagnoses or personality disorders (Janssonand Fridell, 2003).
omakor uimasteid kuritarvitavate meeste hulgas, kes tarbisid mitutuimastit (Landheim jt, 2003).
In Spain, for example, most psychiatric services exclude clientswith substance disorders and their staff members have noappropriate training.
Levimus – vanglad ja sundravi probleemsete uimastitarbijate puhul, kes tavaliselt ei saamingit uimastitega seotud ravi (Weaver jt, 2003). Need
Obstacles to the treatment of comorbidity
Iirimaa andmetel on 48% meesvangidest ja 75%etega, samal ajal on 72% kaasnevate haigustega patsientide juurtulemusi.