The Role of Drug De-addiction Centres in Manipur
- Part 2 -

Dr Jayenta Kumar *

Once these intake formalities are complete the clients starts the treatment phases.

Treatment process if of three phases :

• Detoxification stages: Where the client is relieve of his withdrawal symptoms which normally last for 7 to 10 days.
• De-Addiction Stages: Where the behavioural correction therapy is done. This stages last for 20 days after the detoxification is complete.
• Follow-up stages: This is follow-up of the client for integration in the family and community. This could last even up to 2 years time after discharge.

Detoxification stage:

• Medication for detoxification : Here the medical team slowly relieves the clients of his withdraw symptoms by giving detoxification drugs which normally last for 5 to 7 days. His order associated other health problems are also taken care off.
• Motivational Counselling : During this period also motivation counselling about the benefit of the treatment course is initiated. Old clients could also play a role in the process as a role mode!

De-Addiction stages:

Here the behaviour correctional treatment starts which consist of various inputs:

• Re-educative sessions: Here the clients are given classes on life skills and moral value of life which was completing missing during his drugging period. Skills on developing self esteem, anger management, communication, positive attitude etc. are taught which was completely missing in the client.
• Yoga and meditation: Here the clients are prepared for physical and mental tranquillity which is very important. It gives mental relieve to the clients which he was not having mental peace for a long time.
• Self-assessment: Here the clients take up assessment bout themselves for self realization. He slowly realizes who is he and its consequences which he never thought off when he was in drugging. Unless the clients realizes and accepts that he has a problem we cannot go for the solution.
• Individual Counselling: Here the clients are helped to explore and overcome their problems within their own limitations. He is given lot of options to choose and also choose the correct one and how he can implement the option. Many counselling session will be done during the treatment period.
• Recreation: Here the clients are given an opportunity to rejoice their feelings and emotions through games, music, movie, television etc. Movie of their choice are shown once in a week. They are allowed to choose the movie as a sign of reorganization.
• Group therapy: Here the clients given counselling in group according to their common interest and topic and share amongst themselves problems and helping to find solutions together. Of late group therapy has found to be very effective.
• NA/AA meetings: Here the clients are helped to attain spiritual and moral awakening.
• Relapse Prevention planning (RPP): Here the clients are given classes on the causes of relapse and given an opportunity to plan how to prevent it so that he can attain whole person recovery. The cause of relapse of a particular client is identified and the group help him to overcome it in future.

This is done mainly for clients who come after relapse. -

• Role model therapy: Here the old clients are given an opportunity to share their feelings with the inmates and thereby serves as a role models. This raise the self esteem both for the old clients as well as the clients under the treatment programme.
However some clients who are not confident of their behaviour problem could be given extended care treatment which could last even up to one month. But this not for all cases.

Extended-Care phase:

• Linkage with community: Here the clients are introduced to the community though interactions with community leaders and participation in community events/occasions which is organized by the centre.
• Assist staffs at treatment centre: Here the clients are given the opportunity to assist the staffs at treatment centre as extended care clients and develop a work culture. He could also assist in the centre programme like group therapy, client management etc assigned time to time.

For the families:

Involving the families as a part of the treatment programme is very important.

• Family Educational programmes: Here the family are invited for sensitization on the problem of drug abuse and its addition and their roles in the treatment of the dug abusers. This is done once or twice in a month depending on the needs.
• Family individual counselling: Here the nearest individual family member of the client is given counselling to support in the client's recovery and recognize the warning signs and symptoms of relapse. He/She will become the main caretaker of the client after discharge and become the communication link between the centre and home about the status of the client.
• Family/spouses Group therapy: Her the family members are invited in groups for discussion to sort out ways and means to support their wards to attain whole person recovery.

To community:

• Sensitization programmes: Here the community is given awareness on various aspects of drug abuse and the disease concept of addiction, and means to prevent it. Community is motivated to actively participate in drug treatment programme by supporting drug user in the community to come for treatment change their attitude towards them and involves them in community works. Normally at least one community meeting is held in a month.
• Advocacy meetings: Here the community people are invited for meetings to advocate the programmes so that they understand their roles in Drug abuse prevention and further create an enabling environment to support the drug abuse prevention programme and the client's smooth recovery.

Follow -up strategies:

This is few effective if the clients is within the reach of the treatment staffs. However, this may not be possible if the clients is coming from a far distance. In such cases the clients is referred to the nearest drug centre for follow up.

• Centre visit of clients: Here the clients visit the treatment centre even after the allotted treatment period to extend them counselling support and assess their recovery.
• Re-union of discharged clients: Here the discharged clients invited for a get-together to celebrate their successful recovery, encourage them to become role models for those who currently undergoing treatment.
• Visit at Self-Help Groups of recovering addicts: Here the clients attend recovery-based self-help groups meetings like NA/AA to strengthen their recovery through sharing of experiences and attain sustainability of their recovery. There are various such self help group in many district of Manipur and they are advised to attend the nearest one of their choice.
• Home visit, telephone and letters: Staffs of the centre make home visit and met the client and family once in a month or so depending on the need. Other mean of communication very effective nowadays is the mobile communication. Here the clients are communicated to congratulate on their successful recovery and asses the means to attain recovery. If there are relapse sign he is make to take professional help immediately.
• Recovery Hang-out junction: It is a place where the clients visit to gain care and support and hang-out with their recovering friends. The centre encourage to develop hangout area of recovery people wherever possible.
• Drop-in Centre for recovering addicts: Here the recovering clients visits for assessing various services like health care, counselling, recovery based self-help group meetings and recreation etc.

Conclusion: Drug treatment programme is never a one person affair or a one time event. It is a continuous process involving the clients, family, community, civil societies on a long term basis.

There is never a case like cured or gone case. Clients who are clean for a long time could have change of relapse if he continues to violate the values and principles of recovery and even the most chronic drug addict which has relapse several time still has chance of recovery.

Drug treatment is a difficult process but not impossible. Since drug treatment is a behaviour correction therapy, it is very related to the socio cultural setup of the people and place and hence there could be lot of local variation and they should be respected.

(Concluded)

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* Dr Jayenta Kumar ((Director RRTC NE I)) wrote this article for The Sangai Express. This article was webcasted on June 21, 2009.

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