Scientific substantiation of the principles of pharmaceutical correction of polydrug abuse based on forensic pharmacy

The dissertation is devoted to the scientific substantiation of organizational and legal, forensic and legal principles of pharmaceutical correction of polydrug abuse as a result of the simultaneous and consistent use of psychoactive substances of different classification and legal groups by studying regulatory, clinical and pharmacological, classification and legal, nomenclature and legal, marketing, pharmacoeconomic characteristics of medicines for the pharmacotherapy of polydrug abuse on the principles of forensic pharmacy and pharmaceutical law.

The dissertation analyzes the current state of the problem of polydrug abuse in the world and in Ukraine from the theoretical point of view. Studied the state of formation, development and distribution of polydrug abuse. Highlighted the cooperation of Ukraine with the states of the world in the area of counteraction to polydrug abuse. Described the existing methods of pharmacotherapy of polydrug abuse.

Firstly proposed forensic and pharmaceutical studies of the psychoactive alcohol-containing liquids circulation. Proved that among the psychoactive substances the main factors of the formation and development of polydrug abuse are psychoactive alcohol-containing liquids and their combinations at the same time (psychoactive drugs, psychoactive alcoholic drugs, alcoholic beverages, beer).

For the first time proposed the classification, the stages of the circulation and systematization according to the strength levels of ethanol for psychoactive alcoholcontaining liquids and psychoactive alcoholic drugs. Given the typical scheme of a succession of addicts in the formation and development of polydrug abuse due to the combined use of psychoactive alcohol-containing liquids in the order of their strength in increasing is given: alcoholic beverages, beer, psychoactive alcoholic drugs (tinctures), psychoactive drugs (codefemol) and psychoactive substances of classification and legal groups (narcotics, psychotropic substances, precursors, tobacco). Substantiated that polydrug abuse arises from the combined use of the psychoactive substances of different classification and legal groups, psychoactive drugs, psychoactive alcoholic drugs of the I, II and III levels of ethanol strength, psychoactive alcohol-containing liquids.

Generalized the forensic and pharmaceutical practice concerning criminal and administrative consequences of polydrug abuse. Noted that the falsification of alcohol-containing liquids poses a threat to the life and health of the population, causes significant losses to legal producers of pharmaceutical products and acts as a factor in the formation and development of polydrug abuse.

The results of the conducted questionnaire of consumers of psychoactive alcohol-containing liquids with the help of the advanced test "AUDIT" allowed to reveal the fact of dependence on beer among respondents of male at the age of 14–35 years (100.0%). The obtained results of the statistical (correlation) analysis confirmed by the presence of a pronounced positive correlation between the level of sales of beer with the general level of criminal offenses, including the most offense crimes against life and health, against property; the presence of a positive correlation between the level of illness, diseases of the central nervous system in general with the general level of criminal offenses, including moderate gravity, crimes against life and health, against property, as well as the level of sales of various alcoholic beverages.

Researched the circulation of psychoactive alcoholic drugs in communal healthcare institutions at the regional level. For the first time, a regional list of psychoactive alcohol drugs for procurement for budget funds (28 items) created for communal healthcare establishments. Installed by means of content analysis and a questionnaire survey of doctors, a significant proportion of International nonproprietary names from the regional list are represented by five psychoactive alcoholic drugs (96% ethyl alcohol, tincture of vestibule, valerian, calendula, Zelenina drops); 6 domestic producers; in the dosage form – solutions (89.2%), tinctures (42.2%), drops (12.3%); registered in Ukraine in 2013 and 2015 years.

Given the characterization of comorbid disorders with polydrugs abuse. Provided grouping, systematization of medicines included to the State formulary of Ukraine for clinical and pharmacological groups for six years and lists of medicines for pharmaceutical correction for polydrug abuse with the use of normative and legal, comparative, documentary methods of analysis taken into account for the results of a questionnaire survey of doctors and pharmacists. Researched the pharmacoeconomic characteristics (ABC/VEN-analysis) of medicines. Carried out the parameters of the control regime of extemporal medicinal products and phytopreparations for the pharmaceutical correction for polydrug abuse patients. Worked out the normative practice on the development of organizational and legal measures to counter the proliferation of polydrug abuse and justified the principles of the pharmaceutical correction.

The scientific novelty of the obtained results is the complex theoretical substantiation of the principles of pharmaceutical correction of polydrug abuse on the principles of forensic pharmacy and pharmaceutical law, with the further development and implementation of scientific and methodological recommendations and information letters on innovations in the field of health care.

Developed the most important results characterizing the scientific novelty and revealing the content of the dissertation study are that for the first time 3 methods for illumination and solving the problem of polydrug abuse. Analyzed the indicators (5 indicators of the circulation of psychoactive alcohol-containing liquids, 12 indicators of crime, 4 indicators of morbidity) of correlation relations between risk factors in the formation of polydrug abuse in four regions and in general in Ukraine. Prepared the lists of psychoactive alcohol drugs for procurement for budget funds and medicines for pharmacotherapy polynarcomania at the regional level are prepared. The conceptual principles of pharmaceutical correction of polynucleotide based on 13 vectors (organizational-legal, forensic-pharmaceutical, pharmacoeconomic, etc.).

The scientific novelty and theoretical value of the results of the dissertation research and scientific developments are protected by two certificates of the State Service of Intellectual Property of Ukraine and one informational letter on innovations in the field of health care of Ukraine.

The practical significance of the results obtained is to develop a scientific and methodical basis for substantiating the principles of pharmaceutical correction of polydrug abuse. The obtained research results are implemented into the practical activities of research institutions, medical health care facilities, pharmacies of various forms of ownership, including with extemporaneous manufacture of medicines, as well as in the educational process of higher pharmaceutical and medical educational institutions in the preparation of students, undergraduates, graduate students, cadets and researchers. Received in total 26 implementation acts.

Social orientation and significance of theoretical and practical definitions of the dissertation research confirmed by the certificates of the State Service of Intellectual Property of Ukraine, methodical recommendations, manuals, methodologies, schemes, achievements of normative practice, information letter on innovations in the field of health care of Ukraine.