Comorbidity of Opioid and HIV Infection Dependence in the Republic of Kazakhstan
The problem of narcotic consumption and narcotic dependence has become especially timely in the Republic of Kazakhstan, as it is one of the priority problems threatening national safety. Modern narcotic situation is characterized by high tempo of morbidity growth. During the last 15 years morbidity increased more than 20 times (from 3.5 to 70.2 for 1000 population).
Because of its geographical position, being not far from the states with narcotic threat, the Republic of Kazakhstan has become one of the main channels of Central and Asian transit of strong so called “severe” narcotics (raw opium, heroin). It is well known that the growth of narcomania is contributed by the “precipitation” of narcotics in transit countries; it creates conditions for the involvement of a big number of narcomans into the narcotic consumption.
During the last years the most widely spread in the Republic of Kazakhstan narcotics taking into consideration in-patient medical aid, are opium narcotics: heroin (84.4%), opium (90%), other opiates (1.6%). Ninety percent of narcotic consumption is injection narcotics.
The growth of injection narcomania is directly connected with the progressive spread of HIV infection. Infection by the human immune deficit virus is taking place during the intravenous injection of narcotics in 60-80% of cases more often in heroin dependent patients. Interinfluence of injection narcomania and HIV infection gives an opportunity to speak about their comorbidity. The comorbid HIV infection changes the basic clinical manifestations of opioid dependency, causing polymorphic psychopathologic symptoms such as severe asthenia, acute and prolonged depressive reactions with the risk of suicide development, behavioral disturbances, and narcotic and HIV encephalopathies.
Lyudmila Yu. Bespalova
Kazakh Association of Psychiatrists