Attempts to combine drug therapy and psychotherapeutic effects can be found in the distant past. Already in the oldest source about healing methods - the Egyptian Ebers papyrus (XVI century BC) it is said that when taking medicinal infusions internally, it is necessary to pronounce a spell addressed to the gods and spirits: “Help! Go and drive out what is in my heart and my members.” Spells are beneficial when accompanied by medicines, and medicines are beneficial when accompanied by spells” [1, p. 20]. In the history of narcology, one can find quite a few different options for combining medications with psychotherapeutic effects. So, for example, in the tradition of ancient Russian Christian healing, we find the following advice for treating drunkenness: “Pour one spoonful of thyme into 500 milliliters of boiling water, boil for 10-15 minutes, leave, strain. 100-150 grams of broth and one spoon of vodka (do not mix) say three times: “Lord Jesus Christ, Son of God, have mercy on the servant of God (name). Oh, almighty, sweetest Jesus, have mercy on the sinful servant of God (name), heal from ulcers, from wine, debauchery and foul language. His soul plunged into the abyss of every fall. Lord, there is no sin that he has not drunk away. Lord, seek the slave (name) in the groans of a depraved world. He serves and works day and night for the flattering Satan. Lord, save his soul so that it does not perish in the abyss of sins from wine, debauchery and foul language. Amen!" [2, p. 123]. The creation of drugs that are narcotic antagonists has made it possible to form, as we think, one of the most promising areas in narcology - drug antagonist therapy. Drug-antagonistic pharmacotherapy for opioid addiction was proposed by Wickler, who based this therapy on the behavioral mechanism of “attenuation” (B. Tai and J. Blaine, 1997). Narcotic antagonists deprive the addict of receiving the expected psycho-physiological effects from drugs, thereby eliminating the possibility of reinforcing drug-taking behavior. The consequence of this is that taking drugs for a drug addict loses its meaning and this behavior falls out of the repertoire of his possible reactions. It should be noted, however, that in life, in order to change undesirable behavior, an undesirable habit, mechanisms of negative or positive reinforcement are often used. In addiction medicine, preference is still given to the mechanism of negative reinforcement. This mechanism, which is quite effectively used in aversive therapy, undoubtedly has its advantages. However, the “non-reinforcement” (“attenuation”) mechanism used in antagonistic drug therapy has its advantages. The main one is that aversive therapy is usually perceived by the patient as violence, punishment, struggle, confrontation, humiliation of one’s “I”. Consequently, the personality tries to counteract and fight the changes imposed on it, resulting from aversive therapy. Naturally, the use of the “non-reinforcement” mechanism is more acceptable to the individual. However, as practice shows, the effectiveness of narcotic antagonistic therapy is quite low, sometimes it lags behind aversive therapy. I think some clarifications need to be made here. When we talk about drug antagonist therapy, we mean Naltrexone therapy. Naltrexone is known to have better pharmacological properties than other narcotic antagonists and is better suited for narcotic antagonist therapy. In addition, our practical experience is related to the use of this particular drug. Experts believe that the main reason for the low effectiveness of Naltrexone therapy is that patients do not follow the course of treatment to the end (the so-called “noncompliance”). For example, according to one study of 252 heroin addicts who were treated with naltrexone, only 5% of them continued to take the drug.after 2 months (B. Tai and J. Blaine, 1997). Experts often point out the need to use psychotherapy, psychological counseling together with pharmacotherapy in the treatment of drug addiction. The role of psychotherapy and psychological counseling to solve the problem of noncompliance (patients do not follow the intended treatment program) is often noted. However, we believe that narcologists, psychotherapists, and psychologists who work in medical institutions are usually biologically and behavioristically oriented, and they often underestimate the importance of the versatility of personality and the influence of various individual and socio-psychological determinants on the patient. Of course, there is a second extreme, when psychologically, sociologically or spiritually oriented psychotherapists sin one-sidedly and underestimate the influence of biological and behavioral factors. Taking into account a number of advantages and disadvantages of the approaches known to us, we tried to develop our own model of a combination of narcotic antagonistic (Naltrexone) therapy and special psychotherapy for those suffering from opioid addiction. The main goal of this model is to eliminate psychological dependence on drugs. The theoretical basis for it was the psychological theory of attitude of the school of D. Uznadze. Our model tries to eliminate psychological dependence by developing an anti-drug attitude in the addict. In the theory of attitude of D. Uznadze, as is known, “attitude” is, in general terms, characterized as: 1) an unconscious readiness, a program of an individual to carry out a certain activity in a specific situation; 2) the readiness of the individual, which is formed on the basis of the interaction of internal (need) and external (situation) factors; 3) the holistic psychophysiological state of the individual, its modification in a specific situation; 4) the basis, mechanism of any activity (mental and behavioral) of the individual. Using the concept of attitude in our model, we have expanded the understanding of its content, or more precisely, the understanding of its structure. The structural elements of the anti-drug attitude, in our opinion, are: 1. Motivation of the individual (the individual must not only have the desire to quit taking drugs, but must also understand why, for what purpose and why she needs it; and she must also realize that she has the strength necessary for this, she can do it); 2. Environment, situation (to form an anti-drug attitude, it is necessary to determine in what situations it should manifest itself); 3. Behavior (in specific situations, what behavior should the anti-drug attitude be implemented in); 4. Emotions (on the one hand, negative emotions must be associated with drugs; and on the other hand, for positive emotions associated with taking drugs, it is necessary to find other, substitute, non-drug sources);5. Memory (in critical situations in relation to taking drugs, a person should have emotionally negatively colored memories; as well as memories associated with resisting and overcoming the temptation to take drugs);6. Habits, fixed psychological attitudes, reflexes associated with drug use (they need to be transformed, eliminated);7. Cognitive formations and processes (this refers to certain beliefs, ideas, attitudes, and personal thinking characteristics that support either a drug or anti-drug attitude; in addition to psychotherapeutic work with cognitive formations and thinking processes, it is necessary to help the patient understand the causes and influencing factors of drug use; and it is also important so that the patient understands, on the one hand, what psychological meaning drug use has for him, and on the other hand, getting rid of them, living without drugs);8. “I”-formation of the personality (“I”-concept, “I”-image and ideal-“I”);9. Personality characteristics: A) personality type – hysterical, psychasthenic, schizoid, etc.; B) motivational system of the individual (systematization according toA. Maslow) – 1) physiological needs; 2) security needs; 3) needs for social connections; 4) self-esteem needs; 5) self-actualization needs; C) social orientations of the individual – 1) everyday; 2) creative; 3) civil; 4) “actively tough” (the desire to subjugate others); 5) “passively compliant” (the desire to please strong and authoritative subjects of one’s social environment); 6) “storage”; 7) “market” (the desire to communicate with people of high prestige, high social position in society); 8) “hermit”; D) value orientations of the individual – 1) material level values; 2) vital level values; 3) values ​​of interpersonal communication; 4) values ​​of the mental (cognitive) level; 5) values ​​of the social level (social status in society); 6) values ​​of the “spiritual” level (values ​​of a religious, moral, social, philosophical order);10. Personal lifestyle;11. Self-realization of the individual (in what does the individual find self-realization);12. Time continuum of the individual (the individual’s view of his past, present and future);13. Personal goals and plans;14. Religious consciousness of an individual (if it is developed, it can be used as a powerful support for an anti-drug attitude);15. Personal resources;16. Psychodynamic factors (meaning resistance to treatment (change), negative transference to the psychotherapist, doing something to spite someone, unconscious complexes of the patient, etc.);17. Factors that can cause relapse and means of neutralizing them; 18. The significance of drug-antagonistic therapy and this psychotherapy for a specific individual;19. Current psychological problems of the individual (in the process of psychotherapy, the patient should be assisted in solving these problems); 20. The psychological worldview of a person, the psychological meaning of her life, her existential status (for what, for what, in the name of what does a particular person live). These structural components of the anti-drug attitude have become psychotherapeutic targets in our psychotherapeutic model. This model actually aims to change, so to speak, the drug-fixed attitude (the attitude of psychological dependence) to a fixed anti-drug attitude. It should be noted here that there is no need to always carry out psychotherapeutic work with all the noted components of the anti-drug attitude. The main thing is to identify the key components of the attitude of psychological dependence on drugs and by changing them, a corresponding transformation of other components of the attitude can be achieved, i.e. to form an anti-drug attitude. Our model of combining Naltrexone therapy with psychotherapeutic work on the formation of an anti-drug attitude of the individual, in general terms, can be represented as follows: 1. The beginning of psychotherapeutic work on the formation of an anti-drug attitude should precede Naltrexone therapy. Psychotherapeutic work should begin already during the detoxification period; 2. Psychotherapeutic work should continue until the patient himself is convinced that the anti-drug attitude has been formed and is working (for example, in situations that previously provoked a relapse in the patient, he now behaves differently, in accordance with the anti-drug attitude; the presence of an anti-drug attitude the patient can also be identified using certain psychological experiments or provocative tests); 3. Stages of psychotherapeutic work: 3.1. Establishing a certain psychotherapeutic relationship between the psychotherapist and the patient (this is the most important point, without such a relationship it is unlikely that the desired results can be expected); 3.2. Psychological preparation of the patient to work on the formation of an anti-drug attitude; 3.3. Identifying and working with key components of the patient’s anti-drug attitude at a conscious level; 3.4. Psychological preparation of the patient to work on the formation of an anti-drug attitude towardssubconscious level; 3.5. Psychotherapeutic work on the anti-drug attitude at the subconscious level; 3.6. Work on the manifestation of an anti-drug attitude;4. The goal of psychotherapeutic work is to eliminate the individual’s psychological dependence on drugs;5. The main task of psychotherapeutic work is to form a strong, anti-drug attitude;6. Psychotherapeutic targets are key components of the anti-drug attitude;7. Basic principles:7.1. Bio-psycho-socio-spiritual determinism of personality. Based on this principle, we believe that the ideal option for getting rid of psychological dependence on drugs is the formation of appropriate protection at all noted determining levels. At the biological level, such protection is provided by drug therapy, primarily Naltrexone therapy, as well as physical therapy. At the psychological level, this is the formation of the aforementioned anti-drug attitude of the individual. At the social level, in order to protect the patient from narcopathogenic factors, one can use his inclusion in certain groups and communities. We advise our patients to take courses in psychorehabilitation programs, become a member of Narcotics Anonymous and attend its events. On a spiritual level, the religious consciousness of an individual can be used to counteract narcopathogenic forces. We usually advise our Christian patients to turn to a preacher, confess to him, repent, use appropriate prayers and take a vow not to take drugs before the priest in the temple. Also, the patient can live for some time in a monastery for former drug addicts. As practice shows, to stop drug use, sometimes it is enough to achieve certain changes at only one of the noted levels. 7.2. The principle of attitude - it assumes that the basis of psychological dependence on drugs and the corresponding behavior of the drug addict is a certain psychological attitude of the individual. And if we want the addict to get rid of drug addiction and corresponding behavior, we must help him form a strong anti-drug attitude.7.3. The principle of the structural-system approach. This principle implies the fact that an attitude, like a personality as a whole, is a structural-system formation with its own characteristics and patterns. This must be taken into account during psychotherapy.7.4. The principle of the differential approach. Each personality is individual and therefore during psychotherapy it is necessary to take into account its clinical, individual and socio-psychological characteristics.7.5. The principle of complementarity of different psychotherapeutic approaches. These or those psychotherapeutic approaches, despite their sometimes contradictory nature, in essence they complement each other. Therefore, when solving a specific problem, a psychotherapist must choose and use those ideas, those methods of different psychotherapeutic approaches that will help him solve the specific problem facing him. 7.6. The principle of creativity. Any psychotherapeutic schemes, including the model we propose, are only supports for psychotherapy. One should always creatively adapt certain therapeutic regimens and models to a specific patient.7.7. The principle of establishing a psychotherapeutic relationship with a patient. In general, by psychotherapeutic relationship we understand the relationship of cooperation between the patient and the psychotherapist on the path to the psychotherapeutic goal. Without such relationships, we believe, it is hardly possible to carry out effective psychotherapy.7.8. The principle of determinism of conscious and unconscious mental phenomena. Both specialists and non-professionals often forget or underestimate the fact that personality is influenced by both conscious and unconscious mental phenomena. This leads to problems in solving psychotherapeutic problems.7.9. The principle of coordinated psychotherapeutic influence on the conscious and subconscious, 1997.