Thursday, August 11 2005 15:33 Hrs (IST) - World Time -

Part I - Drug addiction and rehabilitation

Out of mind, out of trouble. To reach that out of mind stage, we take the help of various forms of physical and mental drugs. Drug addiction is not an immediate problem for those who are addicted but a torture to their family, friends and well-wishers. Drug addiction is a complex disorder characterized by compulsive and often-uncontrollable drug craving, seeking and use that persist even in the face of extremely negative consequences. Once the habit is acquired, there remains a vestige of innocence, belief that one can stop using at will. This belief produces an immediate gratification of the desire to be in control. Short periods of sobriety are often easy to achieve. Good long-term outcome is a non-trivial treatment objective.

Drug addiction

The path to drug addiction begins with the act of taking drugs. Over time, a person's ability to choose not to take drugs can become compromised. Drug seeking becomes compulsive, in large part, as a result of the effects of prolonged drug use on brain functioning and thus, on behavior.

Individuals progress through drug addiction treatment at various speeds, so there is no predetermined length of treatment. However, research has shown unequivocally that good outcomes are contingent on adequate lengths of treatment. Generally, for residential or outpatient treatment, participation for less than 90 days is of limited or no effectiveness and treatments lasting significantly longer often are indicated. For methadone maintenance, 12 months of treatment is the minimum and some opiate-addicted individuals will continue to benefit from methadone maintenance treatment over a period of years.

Drug rehabilitation

Perhaps, rehabilitation of drug addicts is a difficult aspect of the problem. In India, the rehabilitative approach through compulsory treatment in penal institutions is neither feasible nor practicable. The problem needs family as well as community support. Community support includes educational, religious and social welfare organisation. These organisation have a vital part to play for the identification, referral and mobilisation of rehabilitative resources.

Drug addict rehabilitation has been a traditional responsibility of the family on the social group to which they belonged. However, with the change of various socio-cultural structures, there has been an increasing demand on the Government to provide them with adequate facilities for the treatment.

Usually, drug addicts have been treated through the general health services, on a voluntary basis. Apart of that many hospitals, as part of their psychiatry department, have recognised that drug addict is a psycho-social-medical problem and as such needs to be tackled in the entirety of the life situation of the addict.

The main thrust of these programmes is to promote and strengthen the contacts of the addict with his family and community and to win over the confidence of the community to gain better support and cooperation in the rehabilitation of the drug addicts. The de-addiction centers, run by Non-Governmental Organisations, employ various systems of medicine like Allopathy, Homeopathy, Ayurveda, Naturopathy, Yoga and the like, coupled with a combination of different psychotherapies. Of course, there is a need to evaluate the comparative efficacy of these systems, so as to evolve a composite model or treatment of drug addicts.

There has been a significant escalation in the use, abuse and problems related to alcohol and drugs in India. The De-Addiction Unit at the National Institute of Mental Health and Neurosciences, Bangalore, has been playing a pivotal role in the treatment of patients. In 1998, the NIMHANS De-Addiction Centre was recognised as the Regional Centre for the Southern Region by the Ministry of Health and Family Welfare, Government of India. The e-mail id for the De-Addiction Centre is: deaddiction@nimhans.kar.nic.in