Wanted: De-addiction centres

K V Navya

CHENNAI: On June 1, a suspended police constable died at a de-addiction centre in Tiruchy. It was found that incorrect treatment was administered to patients.

Following this, CE dug up reports to check on the number and state of the de-addiction facilities in the state, considering Tamil Nadu is one of the states that records the highest number of alcohol-related problems. But it was found that the state capital itself lacks proper de-addiction facilities.

No government centre

Most of the de-addiction centres in the city are run by NGOs and there is not even one exclusive government rehabilitation centre as they are either merged with public health centres (PHC) or major government hospitals like Kilpauk Medical College, Rajiv Gandhi Government General Hospital and Stanley Medical College. 

“The private rehabilitation centres charge at least Rs 10,000 - Rs 15,000 a month and only government hospitals are affordable for many people. But, the issue is that there is no privacy in government hospitals because it is attached to the psychiatric block. As alcoholism is a no-pride disease, a lot of addicts refrain from taking treatment,” said an expert in the field of de-addiction, on condition of anonymity.     

He said that most of the de-addiction centres in the city lack a close monitoring system, trained psychiatrists or proper food for the patients.

Rules violated 

The Tamil Nadu State Mental Health Rules, 2013 states that the 24X7 presence of a psychiatrist and staff nurses is a must. Also, there should not be any extra floor beds. However, most of the de-addiction centres in the city flout these norms blatantly, say patients who have been admitted here, at least once. 
“For seven days, I slept on the cot and when there were new joinees I was asked to occupy the floor. When I questioned, the authorities said I could use the bed if I pay more money. Already, they charged Rs 10,000 per month,” said R Pranav, who was admitted at a centre in Porur.

Even the rehabilitation centre at Royapettah — the only centre maintained by the Greater Chennai Corporation — is violating the norms. “Though the staff members at the centre do not compel anyone, at times when the number of patients increases, they ask the new ones to either take the floor or come back after a few days. Most of them choose the former,” said SP Prakash, who was admitted six months. 

Also, while the minimum period recommended for rehabilitation is two months, the centre at Royapettah provides only a 15-day treatment, free of cost. Moreover, it is only famous for the PHC it is connected with than the rehabilitation service.

Most of the people who have been admitted in rehabilitation centres say that a lot of rehabs lack trained psychiatrists. “I was in three de-addiction centres — Guindy, Porur and Tambaram — and not even one centre had a psychiatrist round the clock. They come once in two weeks and psychologists come once in a week. Also, most of them are social workers who completed their Bachelors or Masters in Social Work,” said 28-year-old Ananth Rajan.  

Due to lack of expert care, many de-addiction centres rely on Antabuse drug to reform the addicts. Antabuse tablets such as Disulfiram produce many unpleasant symptoms and must be used with great caution and monitoring, said the expert.

Illegal operations

A lot of rehabilitation centres in the state operate illegally. To begin a centre, the primary requirement is an in-house psychiatrist. Any family member seeking this service must first check whether the rehabilitation centre has a proper licence or not. “A prolonged medical complication is associated with substance abuse. The patient might experience both physical and psychological withdrawal symptoms. 
To manage this, the rehab needs a qualified medic for appropriate medication. If it is not done at the right time, it can even prove fatal. We must understand the fact that there is neuroscience behind addiction. The circuit of the brain gets hijacked and the substance takes control over you. Psychiatric care is most important in an alcohol or drug rehab,” said Dr Vivian Kapil, a psychiatrist at Sri Ramachandra Medical Centre.

Need for drug rehab

While alcohol rehabilitation is at least taken care of, drug rehabilitation still takes a backseat in the city.

This is at a time when cannabis addiction is becoming common due to its cheap price and easy availability. 

“I get at least five patients in a week for drug-related problems. It is a little tricky and requires specialised knowledge to treat them. So, with social workers or untrained professionals, it is impossible to treat drug addiction,” said Dr R Vishwaas, a psychiatrist.

Staff members at rehabilitation centres, on condition of anonymity, said they do not admit patients of drug abuse unless they have specialised manpower and infrastructure, which in most cases, they don’t.