Drug abuse treatment in India – a mixed bag

Drug abuse treatment in India is often a mixed bag. Firstly, rehabilitation centres operate on the ‘pleasure principle’- they do whatever they please! There are no guidelines to adhere to and no rules and regulations. There is not even a regulatory authority or body which can keep them in check.

Three types of rehabilitation facilities

In India, there are three categories of rehabilitation centres. The third tier drug or alcohol abuse rehab comprises of a building in which several ‘patients’ are crammed in, under almost inhumane circumstances, follow a schedule and set of arbitrary rules. Any deviation from which would result in a set of punitive measures which usually cross the broad ethical guidelines to be followed by any mental health institution. Patients are usually unwilling participants and yield from the lowest economic class in society. Physical and verbal aggression is common. As for therapy it would usually find its way through some form of psycho-education and indoctrination.

There is usually no effective therapeutic structure and the patients involved usually regress into a primal state of ‘fear, fight or flight’. All three are known to happen. As for the staff in this type of drug and alcohol abuse rehab, are usually recovering alcoholics or addicts, hold no mental health degree or training and come from all walks of life. Finally, there is no means of supervision. The second tier drug or alcohol abuse rehab comprises of comparatively better infrastructure, living conditions are far better than outlined above and the same schedule, arbitrary rules and punitive measures apply. Again, there may be little or no ethical guidelines. The patients are from a better class, educated, and may be partly willing.

A therapeutic structure comprising of psycho-education, group and individual therapy is put in place. The staff would be a mix of recovering addicts/alcoholics, medical and paramedical staff. The first tier drug and alcohol treatment centres are the rare sort in India. With less than a handful currently operating, these rehabilitation centres operate on a strict protocol, with usually state-of-the-art and luxurious facilities and cater to the upper class of society. These centres usually provide an option to going for foreign rehabilitation centres. Any punitive measures usually fall under the category of behaviour modification with strict ethical guidelines operating within these treatment centres.

Therapy is a holistic combination of 12 Step facilitation, CBT (cognitive behaviourial therapy) and others like DBT (dialectical behaviour therapy), Motivational Interviewing and is complemented by other alternate therapies such as Yoga and mindfulness based practice. Staff comprise of qualified and trained counsellors, 12 step facilitators, clinical psychologists, psychiatrists, medical and paramedical staff. Hope Trust is one of the only rehabilitation centres in India that offers such a comprehensive milieu of therapeutic services and operates within a very strict ethical protocol. It is a licensed rehabilitation centre with several layers of supervision and accountability.

The therapeutic modalities are unparalleled in India, with both inpatient and outpatient services offering a comprehensive care package, reflecting expertise along with a humane touch. Treatment involves the family too, which is greatly impacted by one family member having a substance abuse problem. The rehab usually cater to clients from India and abroad, having reached an international standing in 13 years of excellent service. It is a compliment to it that it finds its unique model attempted to be replicated across India by people starting their drug abuse treatment centres.