Fifteen years ago, Chennai had to rely on neighbouring metros such as Bengaluru to rehabilitate and reform the lives of drug addicts and alcoholics. But as the number of addiction cases increased, private rehabilitation centres mushroomed in the city. “There is a steep increase in people falling prey to alcoholism, drug abuse and other substances. We had admitted 111 cases in 2015-16 and 220 patients in 2016-17,” says Dr V Sunil Kumar, a clinical psychologist and founder of  Mindzone, a private de-addiction centre in Adyar.

However, while a barrage of information is available online when you search for de-addiction centres, they do little to address or dispel the confusion and common concerns that family members generally have in such cases. The common man still tends to shy away from sending a family member for rehabilitation in the fear that such centres resort to harsh treatment.  

It is high time that such myths and taboos are busted, and there is an objective assessment of when, how and where to seek help.  

Intervention

When should one intervene and take the step to rehabilitate a person? This is a persistent question that the family of an addict grapples with.

It is often easier to take the step when the actions of a person are constantly dictated by his addiction, robbing him of all sense of right or wrong.  In many cases, however, the victim or addict is a loving husband or mother or son, as soon as the influence of the substance wears off and it is then that decision-making becomes particularly tough. 

“It is time to intervene if they turn violent, depressed or abusive after the substance in-take.  Or if they rely on alcohol even to carry on with day-to-day activities and have unresolved coping issues with family and friends,” says Dr V Sunil Kumar.

In some cases, counselling alone may help the person, but confirmed, hardened addicts, more than ten years into the habit, should be put in a rehabilitation centre. “Sometimes, a word of caution or love could bring about a change. But in many cases, the addiction is so dominant and deep-rooted that they develop a convenient way of thinking — they don’t even admit they are addicts,” says Manimeghalai, a psychologist who treats addicts.

Choosing a treatment facility

If intervention by family, friends and support groups fail to yield results, a rehabilitation centre is the only way out. Ideally, if the patient is willing to seek help to get rid of the habit, the success rate is higher. The patient can be counselled by support groups or someone he/she has put on a pedestal.  But if the patient is uncompromising, forced rehabilitation with family consent is the only resort.

In such cases, it is important for the family members to do some thorough, probing research on a number factors.

• Legality: Enquire if the centre has a license issued by the Institute of Mental Health, Family and Health department, Government of Tamil Nadu — any functioning centre without one is illegal. It is mandatory that the centres hang the license in the reception or any space that is accessible to the general public.  A centre should be open to the general public for enquiries and to clear their doubts.
• Space:  There should be at least 2.5 to 3 feet distance between two beds in the centre. Do not opt for a separate room for the patient, as a common space often enables them to mingle and share problems with fellow addicts. Most of the common facilities are not air conditioned, which makes it all the more important to check for proper ventilation.  It is an added benefit if the centre has an outdoor facility so that the patients don’t feel they are in confinement.
• Access: Since a disconnect with family helps in self reflection, many centres do not allow any form of contact between family members and patients for the initial three weeks. Ensure that wards are CCTV-equipped so that the activities of patients can be monitored. It also reassures the family members about the patient’s well being.
• Security: A suicide-safe facility should be a priority, since a majority of the addicts have suicidal tendencies. “Even threads in the pajamas are not allowed. Things like razors, chains, lengthy clothes that could be used as possible suicidal weapons are restricted. 24*7 monitoring is a must,” said K N S Varadan, founder of Freedom Care, a de-addiction centre in Kovalam.
• Staff:  Each centre should have an administrator, a general physician, in-house nurses, psychologists and psychiatrists. Addiction is a disease that should be treated through 60 per cent medication and 40 per cent counselling. Take time to be in regular contact with the treating psychologist, who is the only bridge of communication between the patient and his family.
• Engagement: A series of activities like yoga, music, dance and art therapy should be conducted regularly at the facility, to engage the patient.  Motivational speeches by former drug/alcohol addicts can sow seeds of change among patients.
• Medication: A master check up is a definite requisite. Medication to address withdrawal symptoms and other maintenance doses, if required, should be prescribed based on any other physical ailments that the patient may have.
• Treatment modes: Even though adoption of violent or cruel methods in rehabilitation is a human rights violation, a few centres do believe in and indulge in extreme treatment. Do read up thoroughly on a centre, check for reviews and if possible, talk to a former patient admitted therein.  DO NOT choose such centres. After all, addiction is a disease that has to be treated in medically-approved ways.