Millions struggle with the grip of substance abuse, a condition that not only damages physical health but also wreaks havoc on mental well-being. Substance use disorders also co-occur at high prevalence with mental disorders, such as depression, bipolar disorder,attention-deficit hyperactivity disorder (ADHD), psychotic illness, borderline personality disorder, and antisocial personality disorder. (https://www.ncbi.nlm.nih.gov/books/NBK571451/)
The World Health Organization (WHO) estimates that approximately 35 million people globally suffer from drug use disorders (https://www.unodc.org/unodc/en/frontpage/2019/June/world-drug-report-2019_-35-million-people-worldwide-suffer-from-drug-use-disorders-while-only-1-in-7-people-receive-treatment.html)
Several factors contribute to the high rates of substance abuse in India:
- Socioeconomic disparities: Poverty, unemployment, and lack of educational opportunities can increase vulnerability to substance abuse.
- Cultural factors: Traditional practices and social pressures can normalize or even encourage substance use.
- Easy access to substances: The availability of substances, both legal and illegal, is a significant contributing factor.
- Lack of awareness and stigma: Limited knowledge about substance abuse and associated stigma can prevent people from seeking help.
The most commonly used substances in India include:
- Alcohol: Alcohol consumption is prevalent, with significant health and social consequences.
- Tobacco: Smoking and chewing tobacco are widespread, leading to various health problems. one in two males and one in ten females in India use tobacco in some form or the other (https://ntcp.mohfw.gov.in/assets/document/surveys-reports-publications/Global-Adult-Tobacco-Survey-India-2009-2010-Report.pdf)
- Opioids: The misuse of prescription opioids and illicit substances like heroin is a growing concern.
- Cannabis: The use of cannabis, both for recreational and medicinal purposes, is increasing.
- Inhalants: Volatile substances like glue, paint thinner, and gasoline are abused, particularly among young people.
Substance abuse manifests through various behavioral, emotional, and physical signs. Recognizing these early can help prevent long-term damage:
- Changes in behavior: This can include becoming withdrawn or secretive, neglecting responsibilities, or engaging in risky behaviors.
- Physical changes: This can include changes in appearance, weight loss or gain, or problems with sleep.
- Psychological changes: This can include mood swings, anxiety, depression, or paranoia.
- Tolerance: This is when a person needs to use more of a substance to get the same effect.
- Withdrawal: This is when a person experiences physical or psychological symptoms when they stop using a substance.
Substance abuse can have a devastating effect on mental health. It can lead to a number of mental health problems, including:
- Depression: Substance abuse can cause or worsen depression.
- Anxiety: Substance abuse can cause or worsen anxiety.
- Psychosis: Substance abuse can cause psychosis, which is a mental state characterized by delusions and hallucinations.
- Cognitive impairment: Substance abuse can impair cognitive function, making it difficult to concentrate, learn, and remember things.
Treatment and Prevention
(infographic- A flowchart showing the stages from detoxification to rehab, therapy, support groups, and medication.)
If you or someone you know is showing signs of substance abuse, it’s essential to seek help. Treatment options include:
- Detoxification and Rehabilitation
Detoxification, or “detox,” is the first critical step in the treatment process for substance abuse. It involves clearing the substance from the body and managing withdrawal symptoms in a medically supervised setting. Withdrawal can be severe, depending on the substance used and the duration of use, and may require medications to ensure safety. For example, detoxing from alcohol or opioids often necessitates medical supervision to manage symptoms like seizures, hallucinations, and intense cravings. Professional detox programs help manage withdrawal symptoms and guide recovery. - Rehabilitation is the next phase, focusing on treating the root causes of addiction through structured programs. These can be inpatient (residential) or outpatient, depending on the severity of the addiction and personal circumstances. Rehab combines individual therapy, group therapy, and holistic treatments (e.g., yoga, art therapy) to help individuals build coping mechanisms and a relapse prevention plan.
- Counseling and Therapy:
Psychological therapies address the mental and emotional aspects of addiction. Common methods include:
– Cognitive Behavioral Therapy (CBT): Helps individuals identify and alter unhealthy thought patterns related to addiction, teaching coping strategies and relapse prevention.
– Dialectical Behavior Therapy (DBT): Focuses on mindfulness, emotional regulation, and distress tolerance, particularly helpful for those with co-occurring disorders like trauma.
– Group Therapy: Provides a supportive environment where participants share experiences and learn from each other’s recovery journeys.
– Motivational Interviewing (MI): A client-centered approach that encourages individuals to explore their motivations for change and resolve ambivalence about recovery. - Support Groups: These are peer-led groups based on a 12-step program that promotes personal accountability, spirituality (though not necessarily religious), and community support. Meetings provide a safe space to share experiences, discuss challenges, and receive encouragement from those who have successfully navigated recovery. The peer-driven nature helps individuals remain engaged in sobriety, reducing feelings of isolation.
- Medication: Medications are often used alongside behavioral therapies to manage cravings, reduce withdrawal symptoms, and prevent relapse. These are administered under the supervision of healthcare professionals.
Remember, you are not alone. If you or someone you know is struggling with substance abuse, there is help available. Reach out to 1800-11-0031. You can also reach out to the following organizations for assistance:
- National Institute of Mental Health and Neurosciences (NIMHANS): https://nimhans.ac.in/
- National Health Mission (NHM): https://nhm.gov.in/
- Visit https://rehabs.asia/india/ to locate the center according to your area
