Background. In drug addiction treatment, the diagnostic process is based on the chemical toxicological determination of the intoxication substrate or its metabolite. Laboratory monitoring and prediction issues that could form the basis of secondary prevention remain unresolved. Specific nervous tissue proteins are considered to be the most promising laboratory markers of drug pathology.Objective — to determine some potential biomarkers of protein-chemical nature in the plasma of patients with drug dependence syndrome.Methods. The study was conducted according to the design of an observational clinical trial at the Narcological Dispensary of Krasnodar Krai in the period from 07.2021 to 07.2022. The main group (group 2) included 31 patients diagnosed with substance dependence syndrome. The control group (group 1, n = 15) consisted of healthy subjects submitted to occupational medical examinations. During the detoxification-stabilization therapy and rehabilitation, 5 proteins were determined in the plasma: brainand glial-derived neurotrophic factors, neuron-specific enolase, alpha-synuclein and calcium-binding protein S100B. Statistical analysis of the data involved the Mann-Whitney test for comparing the values of the control and experimental groups and the Wilcoxon test for comparing the values of one group obtained at different stages of observation. The calculations were carried out using StatPlus version 7 (AnalystSoft Inc., USA).Results. A total of 31 patients were included in the main group, 18 of them were followed up with a diagnosis of opioid dependence syndrome (n = 11) or psychostimulant dependence syndrome (n = 7). Patients dropped out of the study due to their refusal to participate in the study or undergo rehabilitation, or due to relapse of the disease. When admitted to the hospital, patients indicated a 45% decrease in brain-derived neurotrophic factor in the plasma ( p < 0.001), and a 3.9-fold decrease after rehabilitation course ( p < 0.001). Glial-derived neurotrophic factor in the plasma exceeded the controls 1.9 times ( p < 0.001) upon admission to hospital, but rapidly returned to normal values thereafter. Level of neuron-specific enolase in the plasma was also poor, 36% lower than the controls ( p <0.001), but approached the control values by the end of rehabilitation.Conclusion. The study obtained data indicating the changes in neurotrophic factors in the blood plasma of patients with opioid or psychostimulant dependence. The rehabilitation period was marked by a relatively rapid improving level of neurotrophins; however, brain-derived neurotrophic factor remained reduced despite the successful treatment, which may indicate the irreversible changes.

Background. The population prevalence of alcohol abuse-associated drug-related diseases bears high social impact. This indicator holds special value both as a potential indirect estimator of the quality of life, availability and efficiency of drug addiction treatment, a well as parameter for qualitative prognostic models of social and economic development. The burden of alcohol-associated drug diseases is typically ambiguous in prevalence estimation, both across Russian Federation and worldwide.Objectives. A study of the alcohol abuse-associated drug-related morbidity prevalence in Krasnodar Krai for period 2000–2020.Methods. A retrospective descriptive study included legal-paper data of the “Information on Drug-Related Disorders” federal statistics survey (Form 11) of Krasnodar Krai, years 2000-2020, describing the re-registration rate of alcohol use-associated drug disorders. The inclusion criterion was an established drug-related disease among all age cohorts. The main study indicators were regional prevalence values of alcoholic psychosis, alcohol dependence syndrome and harmful alcohol use relative to gender, area and age.Results. Prevalence trends in alcohol use-related drug pathology were more favourable in Krasnodar Krai over Southern Federal District and country-wide. The decline rate among males was significantly higher (22.1-fold) vs. the female population (3.0-fold). The prevalence of alcohol use-related drug pathology remained higher in urban vs. rural areas, with higher rural vs. urban decline rates. Over the entire study period, the 40–59 years-age population was leading by the incidence of overall alcohol use-related drug pathology and, separately, of alcoholic psychosis and alcohol dependence syndrome. Highest harmful alcohol use values were registered for 20–39-year population.Conclusion. The revealed dynamics of legal-registered alcoholic drug pathology prevalence has a multifactorial origin. The changes are conditioned by improvement in the narcological aid institutional regulation within the state guarantee programme, federal and regional preventive measures, current progress in drug therapy, regional demography, as well as underreporting of alcohol-associated drug diseases due to a missing strict vertical statistic registration at the level of any-type medical institutions.

Цель исследования-анализ отдаленных результатов лечения алкогольной зависимости по программе «Точка трезвости». Материал и методы. Проанализированы результаты терапии 104 пациентов, которые проходили лечение за 2 года и более до проведения настоящего исследования. Результаты и заключение. Установлена высокая эффективность комплексного лечения с применением пролонгированного инъекционного налтрексона. Ремиссия более 1 года была у 64,4% пациентов, ремиссия свыше 2 лет-у 45,2% больных. Отмечено улучшение показателей социального и семейного статуса пациентов. Ключевые слова: алкогольная зависимость, инъекционный пролонгированный налтрексон, длительная ремиссия, социальная адаптация. Objective. To analyze the long-term results of the «Point of Sobriety» program in patients with alcohol dependence. Material and methods. It was analyzed the results of treatment of 104 patients treated 2 or more years before the current study. Results and conclusion. The high efficacy of complex treatment with naltrexone injections was demonstrated. Remission during more than 1 year was achieved in 64.4% of patients, more than 2 years in 45.2%. Most patients reported improvement in social and family status.

Background: Despite the positive dynamics in this scientific area, the prevalence of drug pathology in Russia and other countries of the world remains unfavorable. Determination of laboratory markers of pathobiochemical processes which are characteristic to the patients with substance use disorder is promising from the standpoint of monitoring the course of the disease and evaluating the effectiveness of therapy.Objective: To determine the characteristic changes in oxidative homeostasis of patients with addiction to psychostimulants and opioids at the rehabilitation and anti‑relapse stage.Material and methods: The study was performed with the participation of 20 relatively healthy male volunteers and 18 male patients with addiction to opioids or psychostimulants who then became participants of the rehabilitation and anti‑relapse course of treatment. Changes in oxidative stress markers during rehabilitation and anti‑relapse treatment were studied.Results: In comparison to the control values at the initial stage of the study, patients of the main group demonstrated decreased values of the iron‑reducing ability of blood plasma – by 25%, as well as those of the sorption radical ability of blood plasma – by 30%; the content of thiol groups of blood plasma proteins decreased by 24% while the concentration of glutathione in erythrocyte suspension lowered by 26%. The level of TBA‑reactive products in erythrocyte suspension corresponded to the control level. The performed rehabilitation manipulations contributed to the partial normalization of oxidative homeostasis, which was confirmed by a statistically significant increase in the ability of radical sorption of blood plasma by 20% and the concentration of reduced glutathione in erythrocyte suspension by 28% in comparison to the initial values of the corresponding parameters in patients of the 2nd group. The TBA‑reactive products remained within the control values.Conclusion: The studied markers are suitable for monitoring the state of oxidative homeostasis in patients with opioid or psychostimulant addiction, the imbalance of which at the end of the rehabilitation and anti‑relapse stage also indicates the prospects for strengthening the antioxidant component as part of drug or nutritional correction.

Кафедра фармацевтической и токсикологической химии (зав.-д.фарм.н., проф. Д.С. Лазарян) Пятигорского медико-фар ма цевтического института Волгоградского государственного медицинского университета Минздрава России, Пятигорск, Россия, 357500; 2 химико-токсикологическая лаборатория Наркологического диспансера Минздрава Краснодарского края (гл. врач-Д.А. Любченко), Краснодар, Россия, 350080; 3 кафедра фармакологии с курсом клинической фармакологии (зав.-д.м.н., доц. А.В. Воронков) Пятигорского медико-фар ма цевтического института Волгоградского государственного медицинского университета Минздрава России, Пятигорск, Россия, 357500 В настоящее время довольно часто при неврологических и психических расстройствах назначают атипичные нейролептики. Среди них широко распространен алимемазин, который имеет достаточно широкий спектр действия. Известны случаи отравления алимемазином, иногда с летальным исходом. Цель исследования-определение алимемазина в биологических жидкостях при острых отравлениях лабораторных животных. Использовали крыс линии Wistar с массой тела 200 г. Изолирование алимемазина из биологических жидкостей (плазма крови, моча) проводили с помощью жидкость-жидкостной экстракции по разработанным нами методикам. Обнаружение и количественное определение алимемазина осуществляли с помощью ВЭЖХ и ВЭЖХ/МС. Описана методика изолирования алимемазина из мочи и плазмы крови. Полученные данные свидетельствуют о том, что максимальное количество вещества в извлечении из плазмы крови удается обнаружить спустя 1 ч при введении лабораторным животным токсической дозы препарата, через 2 ч-при введении терапевтической дозы; в извлечении из мочи-через 3 ч при введении терапевтической дозы. Разработанные методики изолирования алимемазина из биологических жидкостей могут быть включены в схему химико-токсикологического анализа алимемазина. Ключевые слова: атипичные нейролептики, алимемазин, биологические жидкости, острое отравление. The development of the methods for the extraction, identification, and quantitative determination of alimemazine in the biological fluids from the laboratory animals under the acute poisoning conditions