Substance dependence can simply be defined as a pattern of harmful use of any substance for mood-altering purposes. Illegal drugs are not the only substances that can be abused. Alcohol, prescription and over-the-counter medications, inhalants and solvents, and even coffee and cigarettes, can all be used to harmful excess. Theoretically, almost any substance can be abused.

Addiction is a complex but treatable disease that affects brain function and behavior. No signal treatment is appropriate for everyone

The best way to treat people who are addicted to substance is:-

• Medications
• Behavioral therapy
• Combined medication and behavioral therapy
• Support groups like AA and NA

People trying to recover from substance abuse and addiction are often doing so with altered brains, strong substance-related memories and diminished impulse control.

Accompanied by intense substance craving these brain changes can leave people vulnerable to relapse even after years of being abstinent.

As a chronic recurring illness, addiction may require repeated treatments until abstinence is achieved. Like other diseases, substance addiction can be effectively treated and managed, leading to a healthy and productive life.

To achieve long-term recovery, treatment must address specific, individual patient needs and must take the whole person into account.

MEDICAL TREATMENT

Treatment during detoxification period is generally symptomatic so to relieve the withdrawls and craving. Replacements like benzodiazepines and morphine group of medicines are used. It is recommended that detox should be medically supervised ,at times patients can also develop serious complications.

Treatment medications, such as methadone, buprenorphine and naltrexone, are available for individuals addicted to opioids. Disulfiram, acamprosate, naltrexone, and topiramateare medication used for treating alcohol dependence, which commonly co-occurs with other substance addictions. In fact, most people with severe addiction are polysubstance users and require treatment for all substance abused. Even combined alcohol and tobacco use has proven amenable to concurrent treatment for both substances.

PSYCHOTHERAPY

Behavioral therapies can also help people improve communication, relationship, and parenting skills, as well as family dynamics. Some of the more established behavioral treatment, such as contingency management and cognitive behavioral therapy, are also being adapted for group setting to improve efficiency and cost-effectiveness. However, individual treatment outcomes depend on the extent and nature of the patient’s problems, the appropriateness of treatment and related services used to address those problems, and the quality of interaction between the patient and his or her treatment providers.

For the addicted patient, lapses to substance abuse do not indicate failure – rather, they signify that treatment needs to be reinstated or adjusted, or that alternate treatment is needed. Trying to locate appropriate treatment for a loved one, especially finding a program tailored to an individual’s particular needs, can be difficult process.

Cognitive behavior therapy is based on the idea that feelings and behaviors are caused by a person's thoughts, not on outside stimuli like people, situations and events. People may not be able to change their circumstances, but they can change how they think about them and therefore change how they feel and behave, according to cognitive-behavior therapists. In the treatment for alcohol and drug dependence, the goal of cognitive behavioral therapy is to teach the person to recognize situations in which they are most likely to drink or use drugs, avoid these circumstances if possible, and cope with other problems and behaviors which may lead to their substance abuse. To treat alcohol and drug-dependence individuals, cognitive behavior therapy has two main components: functional analysis and skills training.

Functional Analysis: Working together, the therapist and the patient try to identify the thoughts, feelings and circumstances of the patient before and after they drank or used drugs. This helps the patient determine the risks that are likely to lead to a relapse. Functional analysis can also give the person insight into why they drink or use drugs in the first place and identify situations in which the person has coping difficulties.

Skills Training: If someone is at the point where they need professional treatment for their alcohol or drug dependence, chances are they are using alcohol or drugs as their main means of coping with their problems. The goal of cognitive behavior therapy is to get the person to learn or relearn better coping skills. The therapist tries to help the individual unlearn old habits and learn to develop healthier skills and habits. The main goal of cognitive behavior therapy is to educate the alcohol or drug-dependent person to change the way they think about their substance abuse and to learn new ways to cope with the situations and circumstances that led to their drinking or drugging episodes in the past.

ALCOHOLICS ANONYMOUS

Alcoholics Anonymous (AA), the first twelve-step fellowship, was founded in 1935 by Bill Wilson and Dr. Bob Smith.

"Each group has but one primary purpose -- to carry its message to the alcoholic who still suffers." Consequently, drug addicts who do not suffer from the specifics of alcoholism involved in AA hoping for recovery unless they have a desire to stop drinking or drugging. The reason for such emphasis on alcoholism as the problem is to overcome denial and distraction. A Twelve-Step Program is a set of guiding principles outlining a course of action for recovery from addiction, compulsion, or other behavioral problems.

The process involves the following process:-

• admitting that one cannot control one's addiction or compulsion;
• recognizing a higher power that can give strength;
• examining past errors with the help of a sponsor (experienced member);
• making amends for these errors;
• learning to live a new life with a new code of behavior;
• Helping others who suffer from the same addictions or compulsions.

Intervention at TULASI is a multi pronged approach; Treatment module is divided into 3 broad categories Medical Intervention, Psychotherapy, Behavior Modification and Support groups like A.A., N.A., and ALANON.

We believe in making a difference and that can only come about, if we enable these individual and their families to get empowered. Similarly in process to do that we just don’t involve patient but try our best to involve the family members as well.

Efforts are to make the treatment as smooth as possible, however the nature of illness can only be dealt with some amount discipline.

We enforce rules, regulation and discipline on the client so to achieve his goals at earliest.

In Tulasi, we intensively focus on the how we can educate every individual, to develop and build an insight about their illness.

We have treated patient from different background and different countries, hence the program we have here is appreciated worldwide.

This approach has lead to the recovery success rate of 50% to 60%.

POINTS TO REMEMBER

• Treatment needs to be readily available.
• Effective treatment attends to multiple needs of the individual, not just his or her substance abuse.
• Remaining in treatment for an adequate period of time is critical. Counseling—individual and/or group—and other behavioral therapies are the most commonly used forms of substance abuse treatment.
• Behavioral therapies vary in their focus and may involve addressing a patient’s motivation to change, providing incentives for abstinence, building skills to resist substance use, replacing substance-using activities with constructive and rewarding activities, improving problem solving skills, and facilitating better interpersonal relationships.
• Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies.
• An individual’s treatment and services plan must be assessed continually and modified as necessary to ensure that it meets his or her changing needs.
• Many substance-addicted individuals also have other mental disorder.
• Medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change long-term substance abuse.
• Treatment does not need to be voluntary to be effective. Substance use during treatment must be monitored continuously, as lapses during treatment do occur.
• Research has shown that long-term substances abuse results in changes in their brain that persist long after a person stops using substances.
• These substance-induced changes in brain function can have many behavioral consequences, including an inability to exert control over the impulse to use substances despite adverse consequences – the defining characteristic of addiction.
• Substance treatment is intended to help addicted individual stop compulsive substance seeking and use.
• For many, treatment is a long-term process that involves multiple intervention and regular monitoring.
• Specific needs may relate to age, race, culture, sexual orientation, gender, pregnancy, other substance use, co morbid conditions (e.g., depression, HIV), parenting, housing, and employment, as well as physical and sexual abuse history.

We at Tualsi are there to help the addicts and we aim to make society addiction free.