‘Appreciate those who’s don’t give up on you’
Addiction is any repeated behavior, substance-related or not, in which a person feels compelled to persist, regardless of its negative impact on his life and the lives of others. Addiction can also be called as substance dependence, which is a chronic, relapsing disease, affecting the brain’s reward, motivation, and related systems. People struggling with addiction are unable to control their actions or make rational decisions about their behavior, even in the face of negative consequences. Compounds and experiences with addictive potential activate the brain’s reward circuitry. These triggers are also called reinforcers because the pleasurable feeling we get from them makes us more likely to engage in them again and again. Both alcohol and illicit drugs are powerful reinforcers and cause the release of the neurotransmitter dopamine in the brain’s reward system. Repeated activation by these compounds changes the brain’s reward system structurally and chemically and produces behaviours like bingeing, increasing usage and symptoms of withdrawal when the drugs are taken away. Addiction involves:
- Compulsive engagement with the behavior
- Preoccupation with it
- Impaired control over the behavior
- Persistence or relapse, despite evidence of harm
- Dissatisfaction, irritability or intense craving, if the substance is not immediately available.
- Compulsion, impaired control, persistence, irritability, relapse and craving—these are the hallmarks of addiction.
Not all harmful compulsions are addictions, though, an obsessive-compulsive, for example, also has impaired control and persists in a ritualized and psychologically debilitating behavior such as, say, repeated hand washing. The difference is that he has no craving for it and, unlike the addict, he gets no kick out of his compulsion. Addiction is a process based in altered functioning of the reward and motivation systems of the brain. It can manifest in many ways, but historically addictions fall under two categories:
- Substance-Related Addictions
- Behavioral or Process Addictions
This kind of substance includes dependence on any of the following:
- Street drugs
- Prescription drugs
BEHAVIORAL OR PROCESS ADDICTIONS
Although less well studied, many behaviors appear to have reinforcing properties, and may involve excesses related to:
- Video Games
MULTIPLE ADDICTIONS AND CO-MORBID FACTORS
Science shows that substance and behavioral addictions can occur within the same individual and that multiple variants of substance or process addiction can be expressed at the same time. Thus, people can have multiple addictions with each addiction being active to differing degrees of severity. Additionally, depression and anxiety frequently accompany addiction as co-morbid factors.
DRUG ADDICTION IN PAKISTAN
Substance dependence is a major problem Worldwide, Pakistan being no exception. The drugs commonly used in Pakistan are Cannabis, Opium, Alcohol, Codeine, Heroin and many Tranquilizers. United Nations Office for Drug and Crime (UNODC, 2013) data revealed that about 6.7 million substance dependents with age range of 15-64 found in Pakistan. One in every 27 persons in Pakistan is using drugs while nearly 25% of the youth population is involved in some form of drug abuse in Pakistan, opiate users are about 1% which is also very high prevalence.
Drug abuse is most prevalent in Khyber-Pakhtunkhwa where 11% of the population uses drugs, followed by Sindh where 6.5% of the population is drug addict. In Baluchistan, almost 5% population uses drugs while in Punjab, 4.8% of the population is drug addict.
Cannabis (Chars) is the most commonly used drug in Pakistan; with Almost 5.8% of the adult population is addict of cannabis. Opiates namely opium and heroin are used by almost 1% of overall drug users. There are 420,000 people who inject drugs in Pakistan, which represents 0.4% population. Non-medical use of tranquilizers and sedatives is higher among women.
Young people are more susceptible to drug use. They often talk about the “highs” but may not be aware of the many “lows”. The widespread availability of drugs in Pakistan is making it easy for them to be addicts. Drug addiction among the youth is killing them morally and socially as well psychologically and even physically.
The reason why the number of drug addicted people especially youth is increasing alarmingly in Pakistan is that the drug lobbys in the country are fully backed and supported by the powerful and the wealthy who have got ample influence. Moreover, apparently, police and drug mafia are colluding. Moreover, easy availability of narcotics and psychological effects of violence are also playing part. Children who have suffered violence in their life or who have undergone a traumatic experience turn to drugs to forget about the loss.
WHAT ARE THE CAUSES OF DRUG ADDICTION
Majority of drug addicts usually start with soft drugs like ‘Chaaliya’, ‘Naswar’, ‘Gutka’ and ‘Paan’ and then move to the hard drugs like Cannabis, Heroin, Opium, Cocaine, Ice etc. The purchase of drugs or alcohol by young people is usually through dealers or ‘agents’, who are just a phone call away. Their numbers are distributed widely at hostels for students. In Pakistan, users can get up to 20 Chars cigarettes only for Rs 1400.
The drug abuse is often linked to factors such as risk taking behaviors that may involve experimenting with narcotics, smoking and alcohol, social isolation, stress, anxiety, depression, peer pressure (bad company), modern life style, hippy culture, family conflicts, unemployment, excessive pocket money by parents and lack of supervision and attention, the desire for social acceptance, boredom, curiosity, just to feel good, weak religious belief and lot of free time, easy access to drugs at low prices, and easy availability, existence and presence of drug dens, to heighten sexual pleasure, and extension of timing, to overcome frustration and/or tragedies, usage as a pain medication and fashion.
Physical health and sexual health of addicts weaken so rapidly that a young man of thirties looks an old man of over-sixties. “Drug use in general leads to a number of health problems, such as malnutrition, apathy, menstrual irregularities in women and irregular heart rhythm and premature death.” Some of the physical effects of drugs might sound nice but they do not last long. Many people get depressed and start feeling sick. There is economic breakdown of family, loss of self-confidence and a will to work, loss of job, indulgence in crimes such as theft, and suicidal thoughts.
Drug addicts are also more prone to accidents and are at higher risk of HIV/AIDS, hepatitis B & C, tuberculosis, suicide, overdose deaths and cardiovascular diseases. Married drug addicts have high probability of having mentally retarded and physically handicapped children. Young people who use cannabis are doubling their risk of psychotic symptoms like schizophrenia, hallucinations, hearing voices etc.
TREATMENT AND REHABILITATION PROGRAM
An addict is a sick person who needs humanistic treatment. Our 90-days Treatment Program for drugs and alcohol addiction is the minimum required treatment program at Safe Care Trust International and serves as the cornerstone for maintaining sobriety. Our 90-Day Program is segmented into three 30-days “Stages”, each covering a unique range of appropriate topics and protocols. Over the course of the next 90-days, Clients are presented with an intensive daily regimen which takes place at the Skill House. The schedule includes:
- Group Therapy Sessions that Focus on Early Recovery Skills
- Relapse Prevention Skills
- Social Support in Recovery
Group therapy sessions run 1.5 hours, include up to 12 Client participants, and follow a curriculum-based process and problem solving approach. Individual counseling sessions run 50 minutes, though shorter sessions may be scheduled as a function of the Client’s needs or his counselor’s request to provide additional support or crisis management.
Treatment of drug addicts usually done in three stages:
- Stage 1
- Stage 2
- Stage 3
The first 30-days of this core treatment program is referred to as “Stage 1”. It begins with an initial overall assessment and stabilization period. During this time our clinical team establishes a formal Individualized Treatment Plan for each Client while seeking to identify the core issues contributing to the addiction and any stumbling blocks to a lasting recovery.
Components of Stage 1:
- Comprehensive Client Assessment (family, social, work, health, emotional, spiritual, legal, recovery patterns)
- Assessing Client’s true motivation for change
- Identification of core clinical issues
- Stabilization (physical and emotional)
- Identification of potential relapse risks
- Completion of “Family Assessment” PACKET by Client’s family
The next 30 days of treatment, or “Stage 2”, offers group therapy sessions, as well as generous individual therapy sessions with a licensed therapist who will provide comprehensive treatment and discharge planning. Using a variety of treatment modalities, Clients closely examine the specific behaviors or situations that could trigger relapse. Coping strategies, that are designed to be both positive and life-affirming, are put into practice. Real-time interventions are utilized.
Components of Stage 2:
- Exploration and clarification of the Client’s understanding of the disease of addiction (mental, emotional, physical, and spiritual)
- Development of a detailed plan to address underlying core issues
- Demonstration of the continued ability to adhere with increasing consistency to program structure and recovery-based attitudes and behaviors
- Attending of all assigned groups
- Completion of all specified writing assignments
- Individualized family works
- Begin exit plan and update treatment plan to reflect
During the remaining 30 days of the 90-day Treatment Program, activities are focused around the Client’s smooth reentry into his new life of sobriety and personal responsibility. Safe Care Trust International Clients will therefore be familiarized with local 12-Step programs and other community support groups. Personal responsibility is another critical component of continued success after treatment. In Stage 3 Clients will be taught time management and scheduling skills in order to assure that the Client is able to keep his promises, appointments and commitments.
Components of Stage 3:
- Developing a range of strategies and behaviors that maximize the Client’s chance of success
- Providing cognitive behavioral treatment driven by a developmental approach to staying sober
- Periodic testing for alcohol, drugs and other substances
The most difficult part of the treatment is rehabilitation in which there is need to motivate a patient to take up a healthy activity preferably away from old places and old company. Drug Rehab is a life-saving process whereby a patient is helped to regain their life and dignity as a human being. Rehabilitation from any addiction can be painful, but when compared to the troubles that drug use brings about it is clear that addiction treatment is by far the better option.
To eliminate drug addiction from society, awareness campaigns through mass media, essay contests, lectures and declamation contest in schools, colleges and universities should be run in order to create awareness about the ill-effects of drug addiction. “Provincial education departments should develop a curriculum against drugs for inclusion in textbooks at school, college and university levels.”
The researches proved that people who start tobacco smoking and/or drink alcohol at young age are much more likely to experiment with illegal drugs than people who do not smoke or drink. “Efforts should be made to control the tobacco smoking in the country because it is the gateway to drug abuse.”
Awareness and prevention must start at home, with parents. Parents should be vigilant and keep an eye on the company and activities of their children and should spend more time with their children. They should keep their children busy and motivate them to offer their prayers regularly. Religious scholars should be encouraged to take up this issue in their Friday Sermons. “A drug-free life-style and a healthy society is very much a part of the Islamic way of life.”
The government should dedicate help lines for youth and parents with informtion and diversion to rehabilitation centers or hospitals. “Government should solve unemployment problem in the country because economic worries provide a fertile ground for drug addiction,” the smuggling routes and its entry into cities have to be blocked. The police have to be taken to task on this corruption. Some new accountability laws have to be made and implemented. The supply line has to be broken. People who are playing with lives of our youth do not deserve any concession. Unless serious measures are taken now, the very future of a large chunk of today’s youth will be compromised.