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 or illegal. 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:
- 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
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.