Drug Rehabilitation Centers rescue and reconstruct the lives of drug abuse or
substance abuse victims who, if ignored, plummet to the horrors of living hell.
Kamalesh Jayakar, Director and Dr. Pradeep Rangasamy, Psychiatrist at Serene
Life Hospital, Chennai, India, speak to Medindia on the different facets of
addiction and recovery program.
: Treatment for addiction is customized irrespective of the
person's sex. Girls and women have the same symptoms that of boys and men
but the symptoms differ based on the nature of the drug to which a person is
Withdrawal symptoms of alcohol are delirium, seizures, tremors,
deprived sleep and loss of appetite. As for heroin, a cold turkey sensation,
hair raising, profuse crying, consistent secretions through the nose, sweating,
and frequent urinating are indicators. Cannabis gives the sensation of bugs
crawling under the skin and the person exhibits psychotic behavior such as
hallucinations. Onset of addiction is probably due to explorative personality
where curiosity gets the better of the person to try drugs, or through peer
pressure when a 'friend' may invite to smoke a joint, or the pleasure aspect of
drugs offering an illusion of momentary 'happiness'. Eventually a person
becomes dependent on the substances to run their daily lives, and develops
withdrawal symptoms in their absence.
"Most patients think it is a habit and do not know it is a
disorder. Addiction is a disease," says Dr. Pradeep Rangasamy. A person becomes
an addict where alcohol or narcotics enter the blood stream through the
arteries or veins and even reach the brain, eventually affecting every part of
the person's body making it completely dependent on alcohol or drugs. Drugs
offer a person temporary relief from all withdrawal symptoms such as tremors,
cravings for drugs, sleep disturbances, poor appetite, especially if the person
has been addicted for a prolonged period.
So, when a person seeks help,
his physical fitness and mental condition are assessed before admitting him to
the rehabilitation facility. A person with mild liver disease with no internal
bleeding can be treated at the rehabilitation center; however, in cases of
serious medical complications such as liver sclerosis, a person is referred to
hospitals to have the condition treated before they can avail treatment for
Once admitted to a rehab center, an inmate goes through
three phases of treatment: the Detoxification phase, the Withdrawal Management
or De-addiction phase and finally the Relapse Management phase.
Detoxification phase, medication administered by the medical practitioner
addresses the symptomatic emergences, such as reduce his craving for drugs,
ease and eventually stop tremors, enable better sleep, stimulate healthy
appetite, induce relaxation and stabilize his mood. In the De-addiction phase,
the anti-craving medications reduce the craving for addictive substances, and
in the final Relapse Management phase, psychosocial workers play a vital role
in preventing the relapse of a recovering person. Post discharge if addictive
substances are available easily, then change of place could reduce the risk of
: During the recovery period, a person is required to stay in the
facility for 21 days. The initial phase of the treatment is for the first 15
days; however, relapse management is introduced by the second week. The
treatment continues even after the person is discharged from the center. During
residence, very few people get violent and those are the ones who lack
motivation, get deliriums and are unwillingly admitted into the program. In a
state of delirium, the person is unaware of his environment, his talk or his
actions; under such circumstances physical and chemical restraint is used.
Sedation (chemical restraint) reduces violent behavior and dissolves his
delirium. The person is then taken to a dark place to calm down.
Sessions: Inmates get together in Group Therapy Sessions, which are
directed towards sharing their problems and empathize with each other.
Group therapies are effective in helping patients handle their own psychological
problem and are taught to tackle external cues from the environment. External
cues include the sight of an alcoholic shop or talking to a former 'friend',
which seduces a recovering person to return to deteriorating habits. So their
thoughts are modified which will prevent the person from relapsing. During
their stay, inmates are discouraged from becoming friends with each other,
because the chances of relapse are different from one person to another. People
are motivated to say 'No' to addictive substances, but the level of motivation
is not same.
It is more often than not that peer pressure lands most of
them at a rehab center in the first place. Hence, the success rate is 60 to
65%. As for families, they get support through counseling and have their
depressive concerns addressed. Once convinced addiction is a disorder and they
can get help, families are at considerable peace.
Social stigma towards drug addiction forces families
to lock away people, flog them and abandon them to psychological deterioration.
Sadly, a person a young as 8 years old is vulnerable
to addiction. But qualitative treatment is available which costs about Rupees
20,000/- a month, considering the expense for food, price of medicines and
remuneration for medical assistance. For people from economically challenged
families, a trust provides financial assistance where the cost is reduced to
Rupees 12,000 to 14,000 a month. Hence Kamalesh Jayakar, Director of Serene
Life hospital asserts, "Family plays an important role during relapse
management. The recovery process is a team effort including the doctor,
counselors, person concerned and their family. Words like druggie or drunkard
hurts a person's self-esteem deeply. So we treat them with respect, kindness
and care. The gratitude of the person and his family at the end of the program
is truly rewarding."