Rehabilitation center For Chronic Mental Illness | Mental Health Fellowship

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TREATMENT OF ALCOHOLISM / SUBSTANCE USE DISORDER

Substance dependence can simply be defined as a pattern of harmful use of any substance for mood-altering purposes. Illegal drugs are not the only substances that can be abused. Alcohol, prescription and over-the-counter medications, inhalants and solvents, and even coffee and cigarettes, can all be used to harmful excess. Theoretically, almost any substance can be abused.

Addiction is a complex but treatable disease that affects brain function and behaviour. No signal treatment is appropriate for everyone

The best way to treat people who are addicted to substance is:-

  • Medications
  • Behavioural therapy
  • Combined medication and behavioural therapy
  • Support groups like AA and NA

People trying to recover from substance abuse and addiction are often doing so with altered brains, strong substance-related memories and diminished impulse control.

Accompanied by intense substance craving these brain changes can leave people vulnerable to relapse even after years of being abstinent.

As a chronic recurring illness, addiction may require repeated treatments until abstinence is achieved. Like other diseases, substance addiction can be effectively treated and managed, leading to a healthy and productive life.

To achieve long-term recovery, treatment must address specific, individual patient needs and must take the whole person into account.

MEDICAL TREATMENT

Treatment during the detoxification period is generally symptomatic so as to relieve the withdrawals and craving. Replacements like benzodiazepines and morphine group of medicines are used. It is recommended that detox should be medically supervised ,at times patients can also develop serious complications.

Most people with severe addiction are polysubstance users and require treatment for all the substances abused. Even combined alcohol and tobacco use has proven amenable to concurrent treatment for both substances.

PSYCHOTHERAPY

Behavioural therapies can also help people improve communication, relationship, and parenting skills, as well as family dynamics. Some of the more established behavioural treatments, such as contingency management and cognitive behavioural therapy, are also being adapted for group setting to improve efficiency and cost-effectiveness. However, individual treatment outcomes depend on the extent and nature of the patient’s problems, the appropriateness of treatment and related services used to address those problems, and the quality of interaction between the patient and his or her treatment providers.

For the addicted patient, lapses to substance abuse do not indicate failure – rather, they signify that treatment needs to be reinstated or adjusted, or that alternate treatment is needed. Trying to locate appropriate treatment for a loved one, especially finding a program tailored to an individual’s particular needs, can be a difficult process.

Cognitive behaviour therapy is based on the idea that feelings and behaviours are caused by a person’s thoughts, not on outside stimuli like people, situations and events. People may not be able to change their circumstances, but they can change how they think about them and therefore change how they feel and behave, according to cognitive-behaviour therapists. In the treatment for alcohol and drug dependence, the goal of cognitive behavioural therapy is to teach the person to recognize situations in which they are most likely to drink or use drugs, avoid these circumstances if possible, and cope with other problems and behaviours which may lead to their substance abuse. To treat alcohol and drug-dependence individuals, cognitive behaviour therapy has two main components: functional analysis and skills training.

Functional Analysis: Working together, the therapist and the patient try to identify the thoughts, feelings and circumstances of the patient before and after they drank or used drugs. This helps the patient determine the risks that are likely to lead to a relapse. Functional analysis can also give the person insight into why they drink or use drugs in the first place and identify situations in which the person has coping difficulties.

Skills Training: If someone is at the point where they need professional treatment for their alcohol or drug dependence, chances are they are using alcohol or drugs as their main means of coping with their problems. The goal of cognitive behaviour therapy is to get the person to learn or relearn better coping skills. The therapist tries to help the individual unlearn old habits and learn to develop healthier skills and habits. The main goal of cognitive behaviour therapy is to educate the alcohol or drug-dependent person to change the way they think about their substance abuse and to learn new ways to cope with the situations and circumstances that led to their drinking or drugging episodes in the past.

ALCOHOLICS ANONYMOUS

Alcoholics Anonymous (AA), the first twelve-step fellowship, was founded in 1935 by Bill Wilson and Dr. Bob Smith.

“Each group has but one primary purpose — to carry its message to the alcoholic who still suffers.” Consequently, drug addicts who do not suffer from the specifics of alcoholism involved in AA hoping for recovery unless they have a desire to stop drinking or drugging. The reason for such emphasis on alcoholism as the problem is to overcome denial and distraction. A Twelve-Step Program is a set of guiding principles outlining a course of action for recovery from addiction, compulsion, or other behavioural problems.

The process involves the following:-

  • admitting that one cannot control one’s addiction or compulsion;
  • recognizing a higher power that can give strength;
  • examining past errors with the help of a sponsor (experienced member);
  • making amends for these errors;
  • learning to live a new life with a new code of behaviour;
  • Helping others who suffer from the same addictions or compulsions.

Intervention at TULASI is a multi pronged approach; Treatment module is divided into 3 broad categories Medical Intervention, Psychotherapy, Behaviour Modification and Support groups like A.A., N.A., and ALANON.

We believe in making a difference and that can only come about if we enable these individuals and their families to get empowered. In the process, we don’t only involve patients but also try our best to involve the family members as well.

Efforts are to make the treatment as smooth as possible, however the nature of illness can only be dealt with some amount of discipline.

We enforce rules, regulation and discipline on the client so as to achieve his goals at earliest.

In Tulasi, we intensively focus on how we can educate every individual, to develop and build an insight about their illness.

We have treated patients from different backgrounds and different countries, hence the program we have here is appreciated worldwide.

This approach has led to the recovery success rate of 50% to 60%.

POINTS TO REMEMBER

  • Treatment needs to be readily available.
  • Effective treatment attends to multiple needs of the individual, not just his or her substance abuse.
  • Remaining in treatment for an adequate period of time is critical. Counselling—individual and/or group—and other behavioural therapies are the most commonly used forms of substance abuse treatment.
  • Behavioural therapies vary in their focus and may involve addressing a patient’s motivation to change, providing incentives for abstinence, building skills to resist substance use, replacing substance-using activities with constructive and rewarding activities, improving problem solving skills, and facilitating better interpersonal relationships.
  • Medications are an important element of treatment for many patients, especially when combined with counselling and other behavioural therapies.
  • An individual’s treatment and services plan must be assessed continually and modified as necessary to ensure that it meets his or her changing needs.
  • Many substance-addicted individuals also have other mental disorders.
  • Medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change long-term substance abuse.
  • Treatment does not need to be voluntary to be effective. Substance use during treatment must be monitored continuously, as lapses during treatment do occur.
  • Research has shown that long-term substance abuse results in changes in their brain that persist long after a person stops using substances.
  • These substance-induced changes in brain function can have many behavioural consequences, including an inability to exert control over the impulse to use substances despite adverse consequences – the defining characteristic of addiction.
  • Substance treatment is intended to help addicted individuals stop compulsive substance seeking and use.
  • For many, treatment is a long-term process that involves multiple intervention and regular monitoring.
  • Specific needs may relate to age, race, culture, sexual orientation, gender, pregnancy, other substance use, co morbid conditions (e.g., depression, HIV), parenting, housing, and employment, as well as physical and sexual abuse history.

Tulasi Home – Schedule

7:00 AM                            –         Bed Tea

7:00 AM – 8:30 AM            –         Bath and Getting ready

8:30 AM – 9:30 AM            –         Breakfast (first females, then males)

10:00 AM – 12:30 AM        –         Group Sessions (Combined)

  • Morning Prayer and Meditation,
  • Newspaper Reading,
  • CRT Session – Jumbled Words are given to sort, crosswords, fixed word finding from the newspaper, story telling, themes are given to make stories, tambola sessions, etc.

12:30 – 1:00 PM                –         Lunchtime for Females

1:00 – 1:30 PM                  –         Lunchtime for Males

1:30 – 2:30 PM                  –         Staff Lunchtime

2:30 – 3:45 PM                  –         Game Sessions

                                                  Outdoor Games like badminton, cricket, etc.

(those who don’t play are allowed  TV time or else are involved in indoor games like Ludo).

3:45 – 4:15 PM                  –         Tea Time

4:15 – 5:00 PM                  –         Relaxation Time

5:00 PM                            –         Fruits are given

5:00 – 6:00 PM                  –         Individual Sessions with Psychologists.

6:00 – 9:00 PM                  –         TV / Entertainment Time (prolongable till 9:30 PM)

7:00 – 7:30 PM                  –         Dinnertime for Females

7:30 – 8:00 PM                  –         Dinnertime for Males

8:00 – 8:30 PM                  –         Staff Dinnertime

8:30 PM                            –         Medicine Time

9:00 PM                            –         Bedtime

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