Substance Use Disorder

Substance use disorder is an addiction where the person experiences discomfort or withdrawal symptoms when they are unable to use the substance. Their lives are dominated by getting and using the substance. These can be legal (alcohol) or illegal (poppy husk). When a person is using substances in a dependent fashion, they continue to use them despite evidence that using substances is having a negative impact on their:

Physical health e.g. developing infections, liver damage from drinking

Psychological health e.g. depression, irritability, anger, insomnia

Social health e.g. poor pro-social support, limited progress in education and employment avenues

• Profound craving for the substance rather than dealing with other things
• More often intoxicated, or appears to be under the influence of something
• Anxious, depressed or shows symptoms of other mental health problems.
• Unable to say ‘no’ and has a strong desire for the substance
• Using more and more of the substance to get the same effect
• Secretive and evasive
• Angry if confronted about their substance use

• Tired, irritable and looks dishevelled
• Less interested in everyday things
• Involved in criminal activity

Alcohol is the commonest substance that is misused. Other than this, poppy husk has been used very commonly by individuals until recently. Other opiate drugs include opium, heroin and some medical drugs such as tablets and cough syrups that contain codeine. Cannabis is another commonly used substance. Stimulants such as cocaine and amphetamines and hallucinogens such as LSD are other drugs that are misused by younger adults.

Many individuals start to use drugs for experimenting with friends and recreationally. Some of these individuals are able to restrict their drug use to occasional use but large numbers start to experience negative feelings when they do not use the substance. Gradually the amount of substance used increases up to a point where the person becomes dependent. Once addicted, the individual has less control over their behaviour and is unable to stop on their own. They require professional help, and sometimes to be admitted in hospital for detoxification and rehabilitation. During treatment, techniques to remain well after discharge are taught and discussed.

• Get to know the addiction: Drug and alcohol abuse has alarming effects on the nervous system. Drug addiction should be viewed as a chronic disease and not a choice. However, the initial experimentation can be a decision but soon the user develops a dependence thus thinking the substance to be vital for their comfort and survival. This kind of understanding can go a long way in helping the family understand the addict and ensuring proper treatment.

• Set your boundaries: Family members must abstain from helping the addict financially. It is important to understand that such action would rather escalate the addiction. Chronically addicted individuals tend to use family and friends to their advantage to sustain the addiction. The family needs to put up a brave face and set boundaries for themselves and the addict.

• Do not enable: any behaviour that supports the addiction is called ‘enabling’. It can be financial help, hiding the addiction from authorities or making excuses.

• Consider professional help at the earliest: Counselling the people with drug addicted loved ones is also of utmost importance. Dealing with a drug addicted loved one can be a harrowing experience and thus requires a lot of patience, getting help from a psychologist in this kind of a scenario can be comforting.

• Confront the addict: Although difficult, but it can prove to an important step towards recovery. Voice your concern in a way that shows concern and not blames. However, if your loved one seems indifferent to the idea of treatment then an intervention may be considered.

At Mind plus we offer comprehensive biopsychosocial treatment for various types of drug addictions. With an experience of over two decades in this field, we are able to offer unmatched, evidence-based treatment for drug de-addiction. We use modern treatment modalities such as the SMART (Self-management and recovery training) philosophy – based on CBT in addiction. Besides the long term residential treatment wherein we focus on the resocialization we also provide outpatient drug treatment depending on the patient’s needs.

The treatment is started with a drug detox and medically managed withdrawal. But detoxification alone does not resolve the psychological, social and behavioural issues associated with drug addiction. Therefore it is followed by formal assessment and drug addiction treatment. We use the latest medication to ensure no discomfort during treatment and best chances of remaining well post discharge. We, therefore, provide the best substance abuse treatment in Ludhiana (Punjab) with the help of our able clinical team, consisting of psychiatrists and psychologists who have had extensive national and international training and experience.

With our comprehensive treatment, we ensure that we provide an individual with the best possible chance of developing the type of insight, motivation and ability to manage themselves in such a way that has perhaps not happened before, ensuring long term recovery, productivity and success in life.

I didn’t even know I was addicted. Until I tried to stop.

Drug Dependence: At the root of all, addiction is the pain

Mr Sanju is a 32-year-old married male from Himachal Pradesh who was brought to the clinic by his family. He is a Lawyer by profession.

Sanju’s family reported that he started consuming heroin when he was 25 years old. Since then his quantity has increased and during the time of admission, he was taking 2.5-3gms/day. From past, one year family has seen increased irritability and aggressive behaviour towards them, disturbances in sleep and appetite, severe withdrawal, severe craving and use of injectable. He also had a history of ADHD

Mr Sanju was not motivated to leave drugs and never felt the need for treatment. Initial few weeks of the treatment were spent educating him about drug dependence and doing Motivation enhancement therapy. Towards the end of the month, his involvement in the treatment became better. Relapse Prevention counselling and 12 step program for narcotics anonymous were initiated with him.

During the last phase of treatment home visits and exposure outings were done which yielded productive results. A patient was able to apply his learning in his outings. Now since pat 1.5 years he is maintaining abstinence and has been coming for regular follow-ups.