Chronic alcoholism treatment in custodial facilities: Ukraine's experience during independence

Introduction: Chronic alcoholism is a powerful catalyst for commission of many serious and particularly grave crimes - intentional homicide, bodily damage, robbery, plundering, traffic safety violations that led to fatalities. The vast majority of these offenders are sentenced to imprisonment. Although independent Ukraine refused their compulsory treatment, such experience, unfortunately, did not improve the situation. This will require finding new ways of solving the alcoholism problem that may be of interest to both post-Soviet countries and developed democracy countries. The aim of this research is to trace the evolution of chronic alcoholism treatment in Ukrainian penitentiary institutions, identify the causes of its poor effectiveness under the current approach, and suggest some ways to minimize the negative impact of this disease on a patient and society.

Material and methods: The study is grounded in dialectical, historical, comparative, analytical, synthetic, statistical, monographic, sociological (interview) and criminological mapping research methods. The calculations and mapping were done using Microsoft Word 2016, Adobe Photoshop CS6 and Quick Map 2.2. According to the General Prosecutor's Office of Ukraine, criminal intensity of perpetrators of alcohol intoxication was calculated, and due to the analysis of medical and technological documentation on standardization of medical assistance to alcoholics, the peculiarities of voluntary treatment principle of convicted persons were established. The study group consists of 50 medical professionals working in the medical units of penitentiary and civilian healthcare facilities.

Results: According to 3/4 of the surveyed experts, about 50% of convicts need treatment for alcoholism. The factors that influence the increase in concentration of such persons in penitentiary institutions are: prevalence of alcoholism in the whole country; alcohol illegal use in penitentiary institutions; detaining of large mass of household alcoholics in penitentiary; exclusively voluntary treatment and medico-social rehabilitation; lack of alternative treatment methods for alcoholism and consolidation of the lasting effect of this treatment; etc. The consequences of the above are often further decay of alcohol; involvement in this pernicious habit of new unstable persons, especially young convicts; lack of qualified medical care, even in urgent cases that threaten person's life; genetic addiction of subsequent generations; relapse and recurrence of criminal behavior; etc.

Conclusions: There is a need for immediate monitoring of people with chronic alcoholism and alternative treatment modalities, such as substance abuse replacement therapy; allocation of material resources for implementation of specific measures aimed at reducing the alcoholism level of convicts; immediate receipt of licenses by medical units of penitentiary institutions that do not have them, etc.