How to kick the
drug habit for good
An animated discussion on self-control and inner strength is under way in an air-conditioned cottage tucked away inside a plush south Delhi farm. The group includes people from the US, Canada, Oman as well as from Southeast Asia. All have one thing in common: They were, till recently, "narcotics-induced psychotics".
The intense group discussion among the participants, who till recently were hooked to marijuana or cannabis, followed weeks of detoxification and psychiatric treatment and was part of their social rehabilitation process. Soon they would leave Delhi for their homes, but not before having spent anything like Rs 2 to 3 lakh ($3,500-5,400) for a three-month work-up at the Tulasi Health Care centre that has two centres in Mehrauli and Mandi in south Delhi. "In Bangkok, a 28-day treatment programme costs $10,000," says Gorav Gupta, senior psychiatrist and the force behind Tulasi.
This is a form of medical tourism too, but the problem of drug de-addiction is one that runs deep in India. As per the 2006 report of the National Survey on Extent, Pattern and Trends of Drug Abuse in India, an estimated 75 million Indians are drug addicts. In Delhi, there are about two dozen rehabilitation centres for narcotics-induced psychosis, as drug dependence patients are referred to, including both in government and private hospitals and NGO-run centres. Poor quality rehabilitation after medical treatment in the government sector has, however, created a huge demand for private initiatives.
"Social rehabilitation is our USP. The government hospitals and centres offer medical treatment but leave a lot on the individual to re-integrate with society," said Gupta, adding that they treat drug-dependence as a brain disease. Other private centres and hospitals, like Apollo, are also sought after and are showing the way forward.
Ruchika Kumari, an administrator with a private de-addiction centre in south Delhi, revealed that most patients under their care were aged between 20 and 35 years. "For a patient who consumes heroin or cannabis worth Rs 1,000-1,500 a day, a private hospitalís rehabilitation package is not unaffordable," she said.
Tiharís set up
Elite centres like Tulasi, which also get high-end patients from Delhi as well as other states, cater to a fraction of the segment. At the other end of the spectrum are the inmates of Delhi's Tihar jail.
About 8-10 per cent of Tihar's 12,000 inmates are addicts. Tihar Jail boasts of, perhaps, the cityís biggest de-addiction set-up with 150 beds. At any given time about 1,000 drug-dependent inmates are being treated.
"Till the time the patient is in jail, we help him emerge out of the problem. But once his term ends, we canít control the rehabilitation process or prevent a relapse," said Sunil Gupta, the spokesperson for Tihar jail.
The Tihar Jail de-addiction facility, which achieved an ISO 9001:2000 quality certification in 2009, is among the best in the city but not open to private people.
So the poor have to go to government hospitals. Said a de-addiction specialist from Ram Manohar Lohia Hospital, who did not want to be named: "The poor people come to government hospitals. The rich who want to maintain secrecy about their de-addiction prefer the high-end private facilities."
Interestingly, there are very few cocaine users among narcotics-induced psychosis patients in Delhi's rehabilitation centres.
"Cocaine is a costly narcotic. People who can afford it can even afford to sustain the abuse for long," said Anuj Wadhera, a Delhi-based detoxification and rehabilitation expert. Gorav Gupta, who also runs an OPD for poor narcotics-dependent patients from a centre in central Delhi, said that he uses medical intervention along with psychotherapy.
The treatment includes group and individual counselling ó coupled with group interactions through activities like table tennis, badminton, recreation and family counselling. "Our focus is to heal their minds and help get over social stigma and trauma," he said.
"We don't treat them as drug addicts. For us, they are like any patient suffering from a brain ailment," said Gorav Gupta.
According to a 2007 manual prepared by the drug dependence treatment centre at the All India Institute of Medical Sciences (AIIMS), a majority of heroin addicts relapse within the first year of treatment, most within the first three months.
"This is why rehabilitation is significant and private centres stand out by checking relapse," said Wadhera.