Treatment of Brown Sugar (Heroin) addiction is beneficial for overall wellbeing of a family

Sunday, Sep 05, 2021 07:45 [IST]

Last Update: Sunday, Sep 05, 2021 02:16 [IST]

Treatment of Brown Sugar (Heroin) addiction is beneficial for overall wellbeing of a family

Dr SATISH RASAILY, MD, Psychiatry (RIMS), Postdoctoral Fellowship in Addiction Medicine (NIMHANS), C

Mr 34 year’s old married man, driver by profession was brought by family members (parents, brothers and wife) for weeks inpatients detoxification program at Center for Addiction Medicine, Sikkim in January 2021 for Brown Sugar dependence.
History reveals that Mr X  had been indulging in Brown Sugar ( BS) misuse since last 4 years neglecting his basic roles and responsibilities at home as a husband and father along with frequent problems at job. His mind used to be preoccupied with only arranging BS for use, repetitive using it to control painful withdrawal symptoms, & craving, and getting pleasure.   He always returned home very late every night and create lot of troubles with his wife and family. His 10-year-old daughter used to avoid him refusing to come near him.
Mr X insidiously increased his BS dose to more than 4-5 grams costing him more than Rs 10000 a day to maintain his addiction. Mr X emptied all his bank savings security and spent all his monthly earnings in buying drugs. He also suffered from overdose on several occasions at home which compelled his wife to seek help of our hospital.
Mr X was quite resistant in admitting his BS problem denying existence of any harms related to drug use.  With great difficulty, he accepted 10 days inpatient detoxification treatment along with individual counselling support. He was started on few medicines to manage withdrawal symptoms which was tapered gradually by 2 weeks. We offered him various treatment options to maintain abstinence period and prevent future relapses. Mr X made a personal decision choosing substitute medicine Addnok N. Mr X was subsequently discharged with Addnok N on by 12th day of admission and advised for regular follow up visit. Mr X has been visiting us every month since 8 months for Addnok prescription and counselling along with his wife.
Recenlty, I asked him how the treatment helped him. He answered that treatment has changed his lifestyle thereby significantly improving his relationship with his daughter, wife, parents and siblings. He no longer frequent with his peers who are still indulging in BS misuse.  He goes to job regularly and can focus in his work diligently. He spent most of his time with his daughter who has started interacting with him. He helped her daughter in doing homework and studies. He feels that his family have started trusting him now which he had lost previously due to frequent lying, and problems. He began saving money for his daughter education and security after quitting drugs. Previously, he used to spend approximately Rs 2 lakhs a month to buy drugs. Mr X thanked us for helping him to reclaim his health, relationships, respect, trust, financial health and life priorities.
Therapy/ counselling need long term investment by a therapist and patient. Therapy is not a one time quick fixed solution wherein you visit mental health professionals once or twice with expectation of magical and divine psychological intervention. Treatment of mental illness and drug addiction are more time consuming and challenging than any other medical services.
I have observed that there are many individuals, people and stakeholders actively pursuing the cause of mental health, drug addiction and suicide in the community.  But when it comes to seeking help for these diseases for themselves and family members, more than 90% of people engaged in such programs will try to hide their feelings, mental illness and addiction because of fear of discrimination and stigma. Most of the people involved with us in awareness programs will seek alternative therapy by visiting traditional and faith healers. Few of them will even suggest their friends and family afflicted with these diseases to overcome their mental illness, suicidal feelings and drug addiction by simply increasing their willpower. Most of them will even try to stop medicines prescribed by doctors to treat psychiatry illness and drug addiction based on their own reservation and assumptions about psychiatry medicines and treatment. Most of us will prefer to travel outside the State for psychiatry consultation.
Mental health and drug deaddiction treatment & services gets very limited priorities whatsoever in comparison to other health issues. The GDP spent on mental health and drug addiction is scanty. In fact most of the countries don't have a mental health policy, and suicide prevention policy and earmarked budget allocated for service development. If the trend of BS addiction continues amongst  adolescent, youths and productive age group population (15- 45 yrs), consider the damage and negative harms in our human resources, economy, and communities in the future. The problem with BS is "once you are addicted to it, you are probably addicted for life". Imagine the total number of people who will be using drugs after 10 years. New users will continue to add in already existing cohort of drug using population. Few years earlier, drug addiction used to be concentrated in urban population.
Unfortunately,  BS addiction is gradually engulfing our rural population which is a serious concern. Individuals and parents will have to resort to selling lands, gold, valuables and household items after exhausting bank savings. Children addicted to BS will blackmailed their parents for drugs money threatening to end their life if their demands are not met. Parents will have to share their Google pay, debit card and credit card with their adolescent son's and daughter's who will comfortably do online transactions to pay for drugs. Many women will have to pay hard earned money to maintain drug addiction of a husband apart from taking care of children and household needs. Road traffic accidents while driving under the influence of substance may become common. Crimes such as petty thefts, gang activities, drug peddling, burglary, shoplifting, robbery, assault, domestic abuse, violence and public order crime shall increase with increasing BS addiction in a community. Rate of depression, anxiety, psychosis, and suicide will skyrocket with increasing BS use. Many adolescent children and youths will drop-out from school and college without completing their studies due to BS addiction. Incidence of drug overdose deaths will rise killing many lives.
We can appreciate a fracture in a bone, but it's difficult to feel the pain of a loved ones suffering with fracture of a mind.
We get alarmed taking immediate action by visiting a doctor when our heart stops beating but we choose to suffer in silence when our mind stops working normally.
Stigma and discrimination are the biggest challenges in 21st century. We do have an adequate awareness on mental illness and drug addiction in our community. What we are lacking seriously is an awareness on seeking help of a doctor for these conditions because we are refusing to accept mental health and drug addiction as a medical illnesses.
I urged all the stakeholders, health workers, NGOs, organizations and individuals working in these field to generate awareness on medical treatment of mental illness, suicide and drug addiction to facilitate communities to seek proper help.
Don't hesitate to seek treatment for depression, anxiety, psychosis, suicidal feelings, and alcohol & drug addiction where-ever you feel comfortable. Psychiatry and drug deaddiction outpatients clinic are available both at Government Hospitals and private clinics.
Connecting with available services offers best hope for prevention of drug addiction, mental illnesses, depression and suicide. This is the most cost effective strategy in comparison to socio-economic intervention.
Seek help at Primary Health Center (PHC) counselors and District Counseling Center ( DCC) counselors & psychologists at Singtam, Namchi, Gyalshing & Mangan District Hospitals where mental health services have been made available negating need to travel to Gangtok & Siliguri.

Sikkim at a Glance

  • Area: 7096 Sq Kms
  • Capital: Gangtok
  • Altitude: 5,840 ft
  • Population: 6.10 Lakhs
  • Topography: Hilly terrain elevation from 600 to over 28,509 ft above sea level
  • Climate:
  • Summer: Min- 13°C - Max 21°C
  • Winter: Min- 0.48°C - Max 13°C
  • Rainfall: 325 cms per annum
  • Language Spoken: Nepali, Bhutia, Lepcha, Tibetan, English, Hindi