ABOUT THERAPEUTIC RELATIVISM IN ADDICTOLOGY

Abstract

The problem of off-label therapy of addictive disorders is analyzed in the article. It has been noted that such a practice became widespread due to the position of narcologists called "therapeutic relativism" according to which establishing a "nosological" diagnosis on ISD or DSM was not basic and significant for making a therapeutic decision. Significant is a determination of a psychopathologic syndrome / phenomenon level and existence of the patient's subjective inquiry. It is estimated that the doctor has the right to prescribe a therapy depending on "inquiry" of the person seeking for a medical attention not only in case of disorders detection, but also in cases of the preclinical states. The discussion history on the limits of addictive norm and pathology has counted more than thirty years when there was an opinion that addictive disorders represented the continuum built as disorders increase and excluded existence of differential criteria between the norm and pathology. The problem of diagnostics and therapy intensified with the introduction of ICD-10 which besides the dependence contained nosologically undetermined heading "harmful (with harmful consequences) use of surfactant" (F1x.1). The article makes a conclusion that off-label therapy in a modern addictology can be considered as justified, but only concerning drugs with the proved safe action profile and in case of unfailing adherence to the informed consent principle.