1. Robertas Obrikis Darius Jankauskas
EXAMINATION of NARCOTIC DRUGS and ETHYL ALCOHOL AMONG the SOLDIERS in LITHUANIA
Robertas Obrikis
Darius Jankauskas

2. Introduction
Life of Lithuanian people is changing as quickly as economics and social sphere. Very serious problem - using of narcotic drugs – today stands already beside other social habits – smoking and alcohol abuse. Today there are almost no problems to obtain narcotic drugs; illegal offer and supply of narcotic drugs increase, demand of narcotic drugs comes into existence.
Narcotic drugs could be described as natural or chemical substances, which are included in the approved lists of controlled substances of the Ministry of Health, using of which causes severe health disorder due to their harmful effect, evoking psychological and physical dependence or danger for human’s health.
Young people are very exposed at this point. They do not afraid to take risk and are curious, therefore they often start to prove and later – to use narcotic drugs or even become engaged in dangerous activity related with narcotic drugs. Examination executed in schools among pupils of age of years old has showed that number of children who smoke, use alcohol and narcotic drugs is increasing.

3. 35 years old and elder – 23,6% (966)
Statistics
Since 2001, patients who suffer from dependence have been registered in the medical care institutions of them are dependent on narcotic drugs.
Distribution of addicts according age:
till 14 years old – 0,1% (5)
15-19 years old – 11,3% (461)
20-24 years old – 28,0% (1142)
23-24 years old – 37,0% (1513)
35 years old and elder – 23,6% (966)
Distribution of addicts according gender and residence:
In town – 94,0% male – 81,5%
In village – 6,0% female – 18,5%
Majority of the soldiers in the Lithuanian army are young people and they cannot avoid problems typical to our society. For example, there is a department of narcotic drugs and alcohol control in USA army, which is responsible for executing examinations and inducts with harm of using alcohol and narcotic drugs. Examination in USA army is executed using general and selective methods. If the examination result is positive, a soldier could not serve for 6 months. Additional cure is set to him.

4. Research target
Trying to decrease using of narcotic drugs and alcohol in the country, it’s necessary to identify the persons using alcohol, narcotic and toxic drugs and medicinal substances.
Referring of epidemiologic examination executed among conscripts of Lithuanian army and soldiers of initial compulsatory army service, it was determined that a problem of using narcotic drugs and alcohol exists in some department of army. Using of the above mentioned substances menaces on physical and mental health of soldiers, could cause illness of dependence, due to which a soldier could not be able to carry our his commitments.
Using during psychological examination, laboratory blood and urine analysis and psychiatric testing, if necessary military medicinal committee determines if the conscripts have dependence on abuse of alcohol, narcotic drugs or other substances that have influence on psyche. If a dependence of alcohol or narcotic drugs is determined, a conscript is adjudged as unfit for army service.
The purpose of our research is to determine either soldiers have any possibilities and conditions to abuse the above mentioned substances and if they use them.

5. Research object Groups of tested soldiers Cases Per cents (%)
Supervision group 20
6,29
Randomly selected group
272
85,53
Symptomatically selected group 26
8,18
TOTAL
318
100
From 2002 until 2004 years neurological reactions as well as blood and urine toxicological analysis of 318 soldiers in Lithuania army have been evaluated. Soldiers belonging to supervision group have been tested first. These are persons, who either are under major risk of using narcotic drugs, or those who have some disorder because of using narcotic or psychoactive substances, but who were adjudged as proper to serve in the army.
Soldiers who have returned from short-term leave, public events, entertainment places (discos, cinemas, parties) organized outside the limits of the unit, have been randomly selected for testing.
Soldiers who have obvious drug dependence problems and also those with minimal, but already noticeable symptoms, have been tested by symptomatic method based on the suspicion of a medical officer of the subunit, and on noticing physical, emotional or psychological changes in the behavior of a soldier during practical training and in daily life.

6. Testing means identification either a person uses narcotic drugs and alcohol. It’s reliable medical method to determine which kind of substances are used.
According to the tenth revision of the International Statistical Classification of Diseases and Related Health Problems, the following groups of substances that affect psyche have been determinated during testing:
- ethyl alcohol
- opiates
- cannabinoids (marijuana, hashish, grass)
- tranquilizers and sedatives (tranquilizers, barbiturates)
- cocaine
- stimulants (amphetamine, extasy, ephedrine compounds)
- psychoactive substances and narcotics used simultaneously.

7. 100 ml of urine into special platic containers has been taken from persons in supervision and randomly selected groups. Preference was alloted to determination of narcotic drugs and medicines. Ethyl alcohol has been searched in all cases.
For persons, who were tested using symptomatical method, blood from elbow vein (vena ulnares), urine or both objects, depending on what substance was used (blood for determination of ethyl alcohol and its concentration; urine for determination of narcotic drugs and medicines), have been taken after evaluation of medical examination and neurological symptoms.

8. Research methods
Persons have been tested referring to approved order of physical examination for intoxication: appearance of exploratory, changes in behaviour, consciousness, orientation at the point of time and place, memory, speech, walking, coordination of movement, mime, neurological and somatic condition, vegetal reactions (breathing, pulse, blood pressure), subjective and objective information about using of alcohol and other intoxicating substances, results of additional tests and laboratory analyses.
Ethyl alcohol was identified by gas chromatography method using gas chromatograph Chrom-4.
Narcotic drugs have been identified by qualitatyve way, referring to the reccomended methods for testing of narcotic drugs in biological enviroment using screening methods of according to the United Nations International Drug Control Programme.

9. Research results and their consideration
318 soldiers have been tested during years. Average term of observation – 9 monts. 25 cases of using alcohol and narkotic drugs were determined (it composes 7,86 % of all exploratory).

10. Using methods of toxicological analysis it was determinated that 17 soldiers used ethyl alcohol, 5 soldiers – ethyl alcohol and heroine, 2 soldiers – amphetamine derivatives, 1 soldier – carbamazepine.

11. All exploratory have been divided into three groups.
Supervision group contained 20 persons. No facts of using ethyl alcohol and narcotic drugs were found during testing.
272 soldiers have been randomly selected for testing. 9 positive cases were found: 8 cases concerned ethyl alcohol and 1 using of medicine – carbamazepine (this medicine was not prescribed by doctor according to medicinal indications).
26 case was examined using symptomatic method; 16 results were positive:
2 persons used narcotic drugs only – amphetamine and metamphetamine (0,63 % of all exploratory);
intoxication during service was determined to 5 conscripts of initial compulsatory army service. While testing it was determined that they used ethyl alcohol and heroin simultaneously (1,57 % of all exploratory);
9 soldiers used ethyl alcohol only (2,83 % of all exploratory)
No cases of using of narcotic drugs have been found testing soldiers of professional service.

12. Taking all positive cases of using ethyl alcohol, subclinical drunkness (0,18 – 0,35 ‰) was determined in 12 cases, slight drunkness (0,64- 0,92 ‰) – in 6 cases, middle drunkness (2,19- 2,41 ‰) – in 3 cases and severe drunkness (2,53 ‰) – in 1 case.

13. Conclusions
Executed examination allows making the conclusion that the soldiers abused ethyl alcohol, narcotic drugs and psychoactive substances in separate cases only. The above-mentioned substances have been used once or twice and they did not cause permanent mental disorder or change in behaviour. As ethyl alcohol could be obtained easily, it was used most frequently (in 22 cases from 25). There are no conditions for such harmful habits in the army.