The role of existential reference points in complex treatment of opioid dependence and relapse prevention
DOI:
https://doi.org/10.33910/2687-1270-2026-7-2-241-253Keywords:
existential reference points, meaningful values, motivation, personality, personality structure, opioid dependence, persons with drug dependence, relapse preventionAbstract
The study aims to clarify existential reference points in individuals who use opioid drugs. The study involved 30 men and 15 women aged 23 to 38 who had been using opioid drugs for 3 to 12 years, and 20 men and 10 women aged 21 to 39 who do not use opioid drugs. The study revealed direct and inverse correlations between life goals and value orientations. Thus, the direct correlation between life goals and self-acceptance suggests a relationship between a person’s goal-setting and their ability to accept themselves despite their weaknesses and to grow. The more self-actualized a person is, the more goals they have in life. This makes sense because the life goal is determined by the values that a person chooses to prioritize. The inverse correlations between life goals and values such as ‘honesty’ and ‘effectiveness in business’ indicate that the respondents’ answers were not sincere. Additionally, there are inverse correlations between life goals and values such as ‘self-respect’, ‘knowledge’, and ‘self-confidence’. This suggests that excessive self-esteem, overconfidence, and an overestimation of one’s own abilities and capabilities can hinder the development of meaningful values for the future. It has been established that life goals in patients suffering from opioid dependence have features that differ from those of healthy individuals. In the personality structure of a person with drug dependence, there is a destruction of the systems of psychophysiological self-regulation, a decrease in emotional and volitional control, and a destruction of the meaning sphere.
References
ЛИТЕРАТУРА
Адамьянц, Т. З. (2019) На пути к целостной «картине мира» (к проблеме социализации и адаптации современной молодежи). Мир психологии, № 2 (98), с. 230–238.
Анохина, И. П. (2008) Основные биологические механизмы алкогольной и наркотической зависимости. В кн.: Н. Н. Иванец, И. П. Анохина, М. А. Винникова (ред.). Наркология: национальное руководство. М.: ГЭОТАР-Медиа, с. 42–51.
Асадуллин, А. Р., Галеева, Е. Х., Лисовская, С. Б. (2017) Систематизация синтетических «дизайнерских» наркотических средств и новых потенциально опасных психоактивных веществ. Наркология, т. 16, № 3, с. 94–100.
Барлоу, Д. (2008) Клиническое руководство по психическим расстройствам. СПб.: Питер, 912 с.
Гиппенрейтер, Ю. Б. (2025) Введение в общую психологию. М.: АСТ, 352 с.
Завалько, Г. А. (2023) Виктор Франкл и проблема смысла жизни. Альтернативы, № 2, с. 143–157.
Змановская, Е. В., Рыбников, В. Ю. (2009) Девиантное поведение личности и группы. СПб.: Питер, 352 с.
Илюк, Р. Д., Ильюшкина, Е. В., Святенко, В. С. и др. (2016) Сравнительное исследование социально- психологических, поведенческих и клинических характеристик опиоидзависимых с ВИЧ-позитивным и ВИЧ-негативным статусами. Сообщение 2: Сравнительный анализ личностных характеристик, показателей агрессии и гнева, копинг-стратегий, смысложизненных ориентаций, стигматизации, качества жизни. Обозрение психиатрии и медицинской психологии имени В. М. Бехтерева, № 4, с. 25–41.
Карелин, А. А. (2007) Психологические тесты. М.: Владос, 312 с.
Кибитов, А. О., Анохина, И. П. (2016) Генетические основы этиологии и патогенеза болезней зависимости от психоактивных веществ. Наркология, т. 15, № 6 (174), с. 84–101.
Кокин, В. И. (2011) Личность наркомана: проблемы отчуждения (социально-философский аспект). Отечественный журнал социальной работы, № 1 (44), с. 69–77.
Колотилин, М. Г. (2014) Сравнительный анализ клинико-психопатологических расстройств и качества жизни при формировании опиоидной наркомании для разработки дифференцированных подходов к терапии. Диссертация на соискание ученой степени кандидата медицинских наук. М., Национальный научный центр наркологии, 146 с.
Колчев, А. И., Зун, С. А., Баразенко, К. В. и др. (2020) Ранняя диагностика отклоняющегося поведения у лиц допризывного возраста. Известия Российской военно-медицинской академии, т. 39, № S3–4, с. 9–14.
Коробко, Е. В. (2020) Тема целостного человека: понятие смысла жизни и самоубийства в философии и медицине. В кн.: Размышления о Человеке. Волгоград: Изд-во ВолгГМУ, с. 70–77.
Леонтьев, Д. А. (2006) Тест смысложизненных ориентаций (СЖО). М.: Смысл, 18 с.
Москаленко, В. Д. (2014) Зависимость: семейная болезнь. М.: Изд-во Института консультирования и системных решений, 352 с.
Осин, Е. Н., Кошелева, Н. В. (2020) Тест смысложизненных ориентаций: новые данные о структуре и валидности. Вопросы психологии, № 6, с. 150–163.
Проценко, Е. Н. (2006) Наркотики и наркомания. Надежда в беде. М.: Триада, 260 с.
Рогов, Е. И. (2008) Настольная книга практического психолога. М.: АСТ Хранитель, СПб.: Сова, 672 с.
Фастовцов, Г. А., Игумнов, С. А., Искандаров, Р. Р. и др. (2025) Профилактика употребления психоактивных веществ в свете междисциплинарных исследований: парадоксы, уроки истории, пенитенциарные решения. Вопросы наркологии, т. 37, № 3, с. 60–75.
Фролов, И. Т. (2001) Философский словарь. М.: Республика, 719 с.
Шамрей, В. К., Лыткин, В. М., Баразенко, К. В., Зун, С. А. (2023) О динамике развития проблемы посттравматического стрессового расстройства. Медико-биологические и социально-психологические проблемы безопасности в чрезвычайных ситуациях, № 1, с. 68–77. https://doi.org/10.25016/2541-7487-2023-0-1-68-77
Bruneau, A., Frimerman, L., Verner, M. et al. (2021) Day-to-day opioid withdrawal symptoms, psychological distress, and opioid craving in patients with chronic pain prescribed opioid therapy. Drug Alcohol Dependence, vol. 225, article 108787. https://doi.org/10.1016/j.drugalcdep.2021.108787
Cheetham, A., Allen, N. B., Yücel, M., Lubman, D. I. (2010) The role of affective dysregulation in drug addiction. Clinical Psychology Review, vol. 30, no. 6, pp. 621–634. https://doi.org/10.1016/j.cpr.2010.04.005
Crumbaugh, J. C.; Maholick, L. T. (1964) An experimental study in existentialism: the psychometric approach to Frankl’s concept of noogenic neurosis. Journal of Clinical Psychology, vol. 20, pp. 200–207. https://doi.org/10.1002/1097-4679(196404)20:2%3C200::AID-JCLP2270200203%3E3.0.CO;2-U
Deriu, V., Altavilla, D., Adornetti, I. et al. (2014) Narrative identity in addictive disorders: a conceptual review. Frontiers in Psychology, vol. 15, article 1409217. https://doi.org/10.3389/fpsyg.2024.1409217
Earp, B. D., Skorburg, J. A., Everett, J. A. C., Savulescu, J. (2019) Addiction, identity, morality. AJOB Empirical Bioethics, vol. 10, no. 2, pp. 136–153. https://doi.org/10.1080/23294515.2019.1590480
Fattore, L., Diana, M. (2016) Drug addiction: An affective-cognitive disorder in need of a cure. Neuroscience and BioBehavioral Reviews, vol. 65, pp. 341–361. https://doi.org/10.1016/j.neubiorev.2016.04.006
Feng, Y., He, X., Yang, Y. et al. (2012) Current research on opioid receptor function. Current Drug Targets, vol. 13, no. 2, pp. 230–246. https://doi.org/10.2174/138945012799201612
Frankl, V. E. (1972) The feeling of meaninglessness: A challenge to psychotherapy. American Journal of Psychoanalysis, vol. 32, no. 1, pp. 85–89. https://doi.org/10.1007/BF01872487
Garland, E. L., Bryan, C. J., Kreighbaum, L. et al. (2018) Prescription opioid misusing chronic pain patients exhibit dysregulated context-dependent associations: Investigating associative learning in addiction with the cue-primed reactivity task. Drug Alcohol Dependence, vol. 187, pp. 13–21. https://doi.org/10.1016/j.drugalcdep.2018.02.014
Gordon, A. (2008) Comorbidity of mental disorders and substance use: A brief guide for the primary care clinician. Adelaide: Department of Health and Ageing Publ., 142 p.
Jelen, L. A., Young, A. H., Mehta, M. A. (2024) Opioid mechanisms and the treatment of depression. In: M. Browning, P. J. Cowen, T. Sharp (eds.). Emerging Neurobiology of Antidepressant Treatments. Current Topics in Behavioral Neurosciences. Vol. 66. Cham: Springer Publ., pp. 67–99.
Kacinko, S. L, Papsun, D. M. (2019) The evolving landscape of designer drugs. Methods in Molecular Biology, vol. 1872, pp. 129–135. https://doi.org/10.1007/978-1-4939-8823-5_13
Kleiman, M. A. R., Caulkins, J. P., Hawken, A. (2011) Drugs and drug policy: What everyone needs to know. Oxford: Oxford University Press, 256 p.
Koob, G. F. (2020) Neurobiology of opioid addiction: opponent process, hyperkatifeia, and negative reinforcement. Biological Psychiatry, vol. 87, no. 1, pp. 44–53. https://doi.org/10.1016/j.biopsych.2019.05.023
Koob, G. F. (2021) Drug addiction: hyperkatifeia/negative reinforcement as a framework for medications development. Pharmacological Reviews, vol. 73, no. 1, pp. 163–201. https://doi.org/10.1124/pharmrev.120.000083
Melin, Y., Eklund, M., Lindgren, B. M. (2017) Experiences of living with opioid dependence: An interview study among individuals participating in medication-assisted treatment. Issues in Mental Health Nursing, vol. 38, no. 1, pp. 9–17. https://doi.org/10.1080/01612840.2016.1235638
Monroe, S. C., Radke, A. K. (2023) Opioid withdrawal: Role in addiction and neural mechanisms. Psychopharmacology (Berlin), vol. 240, no. 7, pp. 1417–1433. https://doi.org/10.1007/s00213-023-06370-2
Nakamoto, K., Tokuyama, S. (2023) Stress-induced changes in the endogenous opioid system cause dysfunction of pain and emotion regulation. International Journal of Molecular Sciences, vol. 24, no. 14, article 11713. https://doi.org/10.3390/ijms241411713
Nelson, E. C., Agrawal, A., Heath, A. C. et al. (2016) Evidence of CNIH3 involvement in opioid dependence. Molecular Psychiatry, vol. 21, no. 5, pp. 608–614. https://doi.org/10.1038/mp.2015.102
Pergolizzi, J. V. Jr., Raffa, R. B., Rosenblatt, M. H. (2020) Opioid withdrawal symptoms, a consequence of chronic opioid use and opioid use disorder: Current understanding and approaches to management. Journal of Clinical Pharmacology and Therapeutics, vol. 45, no. 5, pp. 892–903. https://doi.org/10.1111/jcpt.13114
Tamama, K. (2021) Synthetic drugs of abuse. Advances in Clinical Chemistry, vol. 103, pp. 191–214. https://doi.org/10.1016/bs.acc.2020.10.001
REFERENCES
Adamyants, T. Z. (2019) On the way to a holistic “worldview” (on the problem of socialization and adaptation of modern youth). The World of Psychology, no. 2 (98), рp. 230–238. (In Russian)
Anokhina, I. P. (2008) Basic biological mechanisms of alcohol and drug dependence. In.: N. N. Ivanets, I. P. Anokhina, M. A. Vinnikova (eds.). Addiction: National leadership. Moscow: GEOTAR-Media Publ., pp. 42–51. (In Russian)
Asadullin, A. P., Galeeva, E. Kh., Lisovskaya, S. B. (2017) Systematization to classification “designer” drugs and potentially hazardous chemicals, with a brief overview of the problem. Narkologiya, vol. 16, no. 3, pp. 94–100. (In Russian)
Barlow, D. (2008) Clinical manual of mental disorders. Saint Petersburg: Piter Publ., 912 p. (In Russian)
Bruneau, A., Frimerman, L., Verner, M. et al. (2021) Day-to-day opioid withdrawal symptoms, psychological distress, and opioid craving in patients with chronic pain prescribed opioid therapy. Drug Alcohol Dependence, vol. 225, article 108787. https://doi.org/10.1016/j.drugalcdep.2021.108787 (In English)
Cheetham, A., Allen, N. B., Yücel, M., Lubman, D. I. (2010) The role of affective dysregulation in drug addiction. Clinical Psychology Review, vol. 30, no. 6, pp. 621–634. https://doi.org/10.1016/j.cpr.2010.04.005 (In English)
Crumbaugh, J. C.; Maholick, L. T. (1964) An experimental study in existentialism: the psychometric approach to Frankl’s concept of noogenic neurosis. Journal of Clinical Psychology, vol. 20, pp. 200–207. https://doi.org/10.1002/1097-4679(196404)20:2%3C200::AID-JCLP2270200203%3E3.0.CO;2-U (In English)
Deriu, V., Altavilla, D., Adornetti, I. et al. (2014) Narrative identity in addictive disorders: a conceptual review. Frontiers in Psychology, vol. 15, article 1409217. https://doi.org/10.3389/fpsyg.2024.1409217 (In English)
Earp, B. D., Skorburg, J. A., Everett, J. A. C., Savulescu, J. (2019) Addiction, identity, morality. AJOB Empirical Bioethics, vol. 10, no. 2, pp. 136–153. https://doi.org/10.1080/23294515.2019.1590480 (In English)
Fastovtsov, G. A., Igumnov, S. A., Iskandarov, R. R. et al. (2025) Prevention of psychoactive substance use in the light of interdisciplinary research: Paradoxes, lessons from history, penitentiary solutions. Journal of Addiction Problems, vol. 37, no. 3, pp. 60–75. (In Russian)
Fattore, L., Diana, M. (2016) Drug addiction: An affective-cognitive disorder in need of a cure. Neuroscience and BioBehavioral Reviews, vol. 65, pp. 341–361. https://doi.org/10.1016/j.neubiorev.2016.04.006 (In English)
Feng, Y., He, X., Yang, Y. et al. (2012) Current research on opioid receptor function. Current Drug Targets, vol. 13, no. 2, pp. 230–246. https://doi.org/10.2174/138945012799201612 (In English)
Frankl, V. E. (1972) The feeling of meaninglessness: A challenge to psychotherapy. American Journal of Psychoanalysis, vol. 32, no. 1, pp. 85–89. https://doi.org/10.1007/BF01872487 (In English)
Frolov, I. T. (2001) Philosophical dictionary. Moscow: Respublika Publ., 719 p. (In Russian)
Garland, E. L., Bryan, C. J., Kreighbaum, L. et al. (2018) Prescription opioid misusing chronic pain patients exhibit dysregulated context-dependent associations: Investigating associative learning in addiction with the cue-primed reactivity task. Drug Alcohol Dependence, vol. 187, pp. 13–21. https://doi.org/10.1016/j.drugalcdep.2018.02.014 (In English)
Gippenreiter, Yu. B. (2025) Introduction to general psychology. Moscow: AST Publ., 352 p. (In Russian)
Gordon, A. (2008) Comorbidity of mental disorders and substance use: A brief guide for the primary care clinician. Adelaide: Department of Health and Ageing Publ., 142 p. (In English)
Ilyuk, R. D., Il’yushkina, E. V., Svyatenko, V. S. et al. (2016) A comparative study of the psychosocial, behavioral, and clinical characteristics of HIV-positive and HIV-negative opioid users part 2 comparative analysis of personal characteristics, indicators of aggression, anger, coping strategies, stigma, quality and purpose of life. V. M. Bekhterev Review of Psychiatry and Medical Psychology, no. 4, pp. 25–41. (In Russian)
Jelen, L. A., Young, A. H., Mehta, M. A. (2024) Opioid mechanisms and the treatment of depression. In: M. Browning, P. J. Cowen, T. Sharp (eds.). Emerging Neurobiology of Antidepressant Treatments. Current Topics in Behavioral Neurosciences. Vol. 66. Cham: Springer Publ., pp. 67–99. (In English)
Kacinko, S. L, Papsun, D. M. (2019) The evolving landscape of designer drugs. Methods in Molecular Biology, vol. 1872, pp. 129–135. https://doi.org/10.1007/978-1-4939-8823-5_13 (In English)
Karelin, A. A. (2007) Psychological tests. Moscow: Vlados Publ., 312 p. (In Russian)
Kibitov, A. O., Anokhina, I. P. (2016) The genetic basis of etiology and pathogenesis of substance dependence. Narkologiya, vol. 15, no. 6, pp. 84–101. (In Russian)
Kleiman, M. A. R., Caulkins, J. P., Hawken, A. (2011) Drugs and drug policy: What everyone needs to know. Oxford: Oxford University Press, 256 p. (In English)
Kokin, V. I. (2011) Identity of the addict: problems of alienation (socio-philosophical aspect). Otechestvennyj zhurnal sotsial’noy raboty, no. 1 (44), pp. 69–77. (In Russian)
Kolchev, A. I., Zun, S. A., Barazenko, K. V. et al. (2020) Early diagnosis of deviant behavior in individuals. Russian Military Medical Academy Reports, vol. 39, no. S3–4, pp. 9–14. (In Russian)
Kolotilin, M. G. (2014) Comparative analysis of clinical and psychopathological disorders and quality of life in the formation of opioid addiction for the development of differentiated approaches to therapy. PhD dissertation (Medicine). Moscow, National Scientific Center for Addiction, 146 p. (In Russian)
Koob, G. F. (2020) Neurobiology of opioid addiction: opponent process, hyperkatifeia, and negative reinforcement. Biological Psychiatry, vol. 87, no. 1, pp. 44–53. https://doi.org/10.1016/j.biopsych.2019.05.023
Koob, G. F. (2021) Drug addiction: hyperkatifeia/negative reinforcement as a framework for medications development. Pharmacological Reviews, vol. 73, no. 1, pp. 163–201. https://doi.org/10.1124/pharmrev.120.000083 (In English)
Korobko, E. V. (2020) Theme of human wholeness: concept of sense of life and suicide in philosophy and medicine. In: Reflections on the Human. Volgograd: Volgograd State Medical University Publ., pp. 70–77. (In Russian)
Leont’ev, D. A. (2006) Test of meaningful orientations (MFO). Moscow: Smysl Publ., 18 p. (In Russian)
Melin, Y., Eklund, M., Lindgren, B. M. (2017) Experiences of living with opioid dependence: An interview study among individuals participating in medication-assisted treatment. Issues in Mental Health Nursing, vol. 38, no. 1, pp. 9–17. https://doi.org/10.1080/01612840.2016.1235638 (In English)
Monroe, S. C., Radke, A. K. (2023) Opioid withdrawal: Role in addiction and neural mechanisms. Psychopharmacology (Berlin), vol. 240, no. 7, pp. 1417–1433. https://doi.org/10.1007/s00213-023-06370-2 (In English)
Moskalenko, V. D. (2014) Addiction: Family illness. Moscow: Institute for Counseling and Systems Solutions Publ., 352 p. (In Russian)
Nakamoto, K., Tokuyama, S. (2023) Stress-induced changes in the endogenous opioid system cause dysfunction of pain and emotion regulation. International Journal of Molecular Sciences, vol. 24, no. 14, article 11713. https://doi.org/10.3390/ijms241411713 (In English)
Nelson, E. C., Agrawal, A., Heath, A. C. et al. (2016) Evidence of CNIH3 involvement in opioid dependence. Molecular Psychiatry, vol. 21, no. 5, pp. 608–614. https://doi.org/10.1038/mp.2015.102 (In English)
Osin, E. N., Kosheleva, N. V. (2020) Test of life orientation: New data on structure and validity. Voprosy psikhologii, no. 6, pp. 150–163. (In Russian)
Pergolizzi, J. V. Jr., Raffa, R. B., Rosenblatt, M. H. (2020) Opioid withdrawal symptoms, a consequence of chronic opioid use and opioid use disorder: Current understanding and approaches to management. Journal of Clinical Pharmacology and Therapeutics, vol. 45, no. 5, pp. 892–903. https://doi.org/10.1111/jcpt.13114 (In English)
Protsenko, E. N. (2006) Narkotiki i narkomaniya. Nadezhda v bede [Drugs and drug addiction. Hope in trouble]. Moscow: Triada Publ., 260 p. (In Russian)
Rogov, E. I. (2008) Practical Psychologist’s Handbook. Moscow: AST Khranitel Publ., Saint Petersburg: Sova Publ., 672 p. (In Russian)
Shamrey, V. K., Lytkin, V. M., Barazenko, K. V., Zun, S. A. (2023) PTSD development and dynamics. Medicо- Biological and Socio-Psychological Problems of Safety in Emergency Situations, no. 1, pp. 68–77. https://doi.org//10.25016/2541-7487-2023-0-1-68-77 (In Russian)
Tamama, K. (2021) Synthetic drugs of abuse. Advances in Clinical Chemistry, vol. 103, pp. 191–214. https://doi.org//10.1016/bs.acc.2020.10.001 (In English)
Zaval’ko, G. A. (2023) Viktor Frankl and the problem of meaning. Alternatives, no. 2, pp. 143–157. (In Russian)
Zmanovskaya, E. V., Rybnikov, V. Yu. (2009) Deviant behavior of personality and group. Saint Petersburg: Piter Publ., 352 p. (In Russian)
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Leonid S. Shpilenya, Alexander I. Kolchev, Vasiliy Ya. Apchel, Kirill V. Barazenko, Ekaterina A. Nikitina
This work is licensed under a Creative Commons Attribution 4.0 International License.
The work is provided under the terms of the Public Offer and of Creative Commons public license Creative Commons Attribution 4.0 International (CC BY 4.0).
This license permits an unlimited number of users to copy and redistribute the material in any medium or format, and to remix, transform, and build upon the material for any purpose, including commercial use.
This license retains copyright for the authors but allows others to freely distribute, use, and adapt the work, on the mandatory condition that appropriate credit is given. Users must provide a correct link to the original publication in our journal, cite the authors' names, and indicate if any changes were made.
Copyright remains with the authors. The CC BY 4.0 license does not transfer rights to third parties but rather grants users prior permission for use, provided the attribution condition is met. Any use of the work will be governed by the terms of this license.
