The head of the department of drug addiction and substance abuse at the Russian National Research Medical University INOPR told socialbites.ca that the current treatment strategy for alcohol dependence is not delivering meaningful results. NI Pirogov, psychiatrist-narcologist Lev Blagov, makes the case for a shift in approach.
“The traditional narcology model treats intoxication itself, focusing on stopping the immediate drinking episode. Clinically this is not a cure, but a temporary correction. It fails to address the underlying disease,” the expert notes.
Today many clinics rely on detoxification methods and motivational conversations with patients. Yet such steps often do not lead to lasting recovery or improved quality of life for individuals struggling with alcohol use disorder.
Blagov uses a striking image to illustrate the issue. A plane cannot be captured with a net while it is taking off; in a similar way, focusing solely on detox is like trying to catch the problem after it has begun. He points out that detoxification may show a result, but it does not tackle the root cause of the disorder. In the field of clinical addiction science, intoxication is viewed as a symptom of a broader disease. In his words, a person is not ill because they drink; they drink because they are ill.
He argues that treatment must progress along different stages. First, the patient should be guided into clinical remission, establishing a stable period without active symptoms. Next comes supportive care and relapse prevention, built through pharmacology and psychotherapy to form a protective framework around the patient. This foundation is crucial for lasting recovery and reduces the risk of future relapse.
The third stage, reparative treatment, focuses on psychological rehabilitation and social reintegration. The aim is to help the patient rejoin everyday life and participate fully in society. Implementing this approach requires rigorous scientific research and practical application. Blagov advocates for establishing a dedicated clinical institute for addiction in Russia as a foundational step toward building an integrated scientific and practical system.
These ideas reflect a broader agenda for improving outcomes in alcohol use disorder, including the development of standardized protocols, better access to multidisciplinary care, and ongoing monitoring of recovery progress. The emphasis is on moving beyond merely stopping drinking to rebuilding health, functionality, and social connection for individuals in Canada, the United States, and beyond.
Previously, experts discussed why early intervention for alcohol dependence should be mandatory, highlighting the potential to prevent the progression of the disease and reduce long-term harm. The evolving view now favors early, comprehensive, and coordinated care that addresses physical health, mental well-being, and social factors to support sustained recovery. Attribution: Source included for context is the Russian National Research Medical University INOPR and associated clinical experts.