Showing posts with label TREATMENT. Show all posts
Showing posts with label TREATMENT. Show all posts

June 13, 2019

ड्रग्स एडिक्शन -ईलाज क्या है ?

                                  

ड्रग्स एडिक्शन का ईलाज एडिक्टस  की  ड्रग्स को लेने के लिए बैचेनी - ड्रग्स को ढूंढ़ने और प्रयोग करने से रोकने के लिये एक साहयता है। 

ईलाज की विभिन्न सैटिंग हो सकती है ,विभिन्न तरीके हो सकते है  व विभिन्न समय अवधि हो सकती है।

एक छोटी अवधि का एक बार में लिया गया  ईलाज काफी नहीं होता है। अधिकतर ईलाज एक लंबी चलने वाली प्रकिर्या है जिसमे अनेक भाग होते है और लगातार देखभाल आवश्यक है। 

ईलाज विभिन्न प्रकार का हो सकता है जिसमे बिहैवियर थेरैपी - कॉउंसलिंग -मैडीकशन अथवा इन सब का सयुंक्त रूप से प्रयोग हो सकता है। 

विशेष प्रकार का ईलाज अथवा विभिन्न ईलाजो का सयुंक्त ईलाज एडिक्ट की आवश्यकता व उसके द्वारा प्रयोग की जाने वाली ड्रग्स पर निर्भर करता है। 

सर्वोत्तम ईलाज विभिन्न थेरैपी का सयुंक्त  प्रयोग व अन्य सर्विस का जोड़ होता है जो एडिक्ट की आवश्यकताओ को पूरा कर सके। 

एडिक्ट की आवश्यकताओ मे उसकी उम्र -कल्चर -जैंडर -दूसरी ड्रग्स का भी उपयोग -तनाव -जॉब व फिजिकल इतिहास सम्मिलित होता है। 

ईलाज संबधी दवाईया जैसे मैथाडोंन -बिनोर्फिन व नालट्रेक्सोन अफीम के एडिक्ट के  ईलाज के लिये उपलब्ध है। 

साईकोएक्टिव दवाईया जैसे एंटी डिप्रेसेन्ट - एंटी एनाक्सटी - मूड स्टेबलाईजर व एंटी साईकोटिक भी ईलाज  के सफलतापूर्वक पूरा होने मे मददगार है जब एडिक्ट मेंटल -डिसऑर्डर से गुजर रहा हो। जैसे तनाव -चिड़चिड़ापन या सिजोफ्रेनिया। 

Lesson Plan and Activity Finder बिहैवियर थेरैपी एडिक्ट को ईलाज मे भाग लेने के लिये प्रोत्साहित  करती है। ड्रग्स से दूर रहने के व रिलैप्स होने से बचने के तरीके बताती है व यदि एडिक्ट रिलैप्स हो जाता है तो उसे उस स्थिति को संभालना सिखाया जाता है।

बिहैवियर थेरैपी व  दवाईयो का  सयुंक्त प्रयोग अधिक असरकारक होता है क्योकि यह एडिक्शन के विभिन्न पहलू पर कार्य करता है। 

June 10, 2019

असरकारक ईलाज के सिद्धांत।


  1. एडिक्शन एक गंभीर बीमारी है जो दिमाग के फंक्शन और व्यवहार पर प्रभाव  डालती है लेकिन ईलाज योग्य है। 
  2. एक ही ईलाज सबके लिये उचित नही हो सकता। 
  3. ईलाज हमेशा उपलब्ध होना चाहिए। 
  4. सही ईलाज ऐडिक्ट की विभिन्न आवश्यकता पर भी केन्द्रित होना चाहिये ना की केवल ड्रग्स पर। 
  5. एक निश्चित समय तक ईलाज मे रहना आवश्यक है। 
  6. काउंसलिंग -अकेले या सामूहिक थेरैपी व अन्य बिहेवियरल थेरैपी सबसे ज्यादा उपयोग की जाने वाली विधि है। 
  7. दवाईया ईलाज का एक महत्वपूर्ण तत्व है विशेषतया जब काउंसलिंग व बिहेवियरल थेरैपी के साथ सयुंक्त किया जाये। 
  8. एक एडिक्ट के ईलाज व सर्विस योजना का लगातार मुल्यांकन करना चाहिये व परिवर्तन करना चाहिये ताकि वह उसकी बदलती आवश्यकताओ को पूरा कर सके। 
  9. बहुत से ड्रग्स एडिक्ट अन्य मानसिक डिसऑर्डर से पीड़ित होते है। 
  10. मैडिकल डीटॉक्सीफिकेशन केवल ईलाज का पहला हिस्सा है। 
  11. ईलाज के समय मरीज के ड्रग्स लेने के संबध मे ध्यान रखना चाहिये क्योकि ईलाज के दौरान रिलैप्स के अवसर बने रहते है। 
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February 20, 2019

PRINCIPLES OF DRUG DEPENDENCE TREATMENT. part 2

PRINCIPLE 2: SCREENING, ASSESSMENT, DIAGNOSIS AND TREATMENT PLANNING

Description and Justification

Patients affected by drug use disorders often have multiple treatment needs across a range of personal, social and economic areas that cannot be addressed when taking into consideration only their addictive symptoms in a standardized way. As for any other health care problems, diagnostic and comprehensive assessment processes are the basis for a personalized and effective approach to treatment planning and engaging the client into treatment.

Components


  •  Screening is a useful assessment procedure to identify individuals with hazardous or harmful drug use, or drug dependence, as well as associated risk behaviors (viral transmission via needle sharing and/or unprotected sexual activity, potentially violent behavior, suicide risk). There are standardized tools to assess drug use and its severity in an individual that help to consider the degree of help required. These tools can be applied in different environments (primary health care system, school health and counseling services, and employee assistance programmes at workplaces).


  •  Assessment and diagnosis are core requirements for treatment initiation. Diagnostic criteria commonly used in the mental health field are the references to reach a diagnosis of a drug use disorder. Diagnosis of comorbid psychiatric disorders is ideally made and followed-up by a psychiatrist, while with adequate training, other health care professionals can successfully identify and manage drug use disorders and associated psychiatric co-morbidity.


  •  A comprehensive assessment takes into account the stage and severity of the disease, somatic and mental health status, individual temperament and personality traits, vocational and employment status, family and social integration, and legal situation. It further considers environmental and developmental factors, including childhood and adolescent history, family history and relationships, social and cultural circumstances, and previous treatment attendance. An adequate assessment process creates the environment for the development of a therapeutic alliance to engage the patient into treatment.


  • The treatment plan, developed with the patient, establishes goals based on the patient’s identified needs and sets interventions to meet those goals. A care or treatment plan is a written description of the treatment to be provided and its anticipated course. Care plans set the specific needs of the individual patient and how they are going to be met by the service. The plan is then monitored and revised periodically as required to respond to the patient’s changing situation. While current research results do not support matching patient profiles to specific treatment approaches, there is evidence that matching responses and interventions to client needs following a serious diagnostic process and extensive assessment improves the treatment outcomes.
Actions to promote this principle

Ensure that:

1. primary health care staff, as well as employee assistance programmes and health/counseling staff in social services, at schools and in the criminal justice system are aware of the benefits of screening, early identification of drug use and brief interventions and are trained to administer such screening tools and associated interventions packages.
2. patient risk behaviors associated with drug use disorders are assessed at all relevant venues (primary health care, outreach services, emergency services, social services, etc) and responses planned in consequence.
3. accurate diagnosis of drug dependence and other co-morbid conditions is established before initiating drug dependence treatment, in particular, pharmacological treatment.
4. clinical protocols specify requirements for comprehensive patient assessment and the treatment plan development, patient progress monitoring and revision of written care plans, and the relevant staff is trained to fulfill these tasks.
5. documentation and standardization of all treatment steps are required from all staff involved in the treatment plan in order to ensure quality treatment for all patients

February 13, 2019

PRINCIPLES OF DRUG DEPENDENCE TREATMENT.


This paper outlines nine key principles for the development of services for the treatment of drug use disorders. It is recognized that in some circumstances resources will be rather limited and priorities in resource allocation need to be set. It is important that in such situations, a response to drug use disorders is developed as “building blocks” on which more diverse and sophisticated interventions can be developed and incorporated in the treatment system as further resources become available. Depending on human and financial resources available and the quality level of the existing health system in each country, the actions suggested by the present document may be progressively and gradually implemented, taking into account the outlined components for each principle as a general framework.

PRINCIPLE 1: AVAILABILITY AND ACCESSIBILITY OF DRUG DEPENDENCE TREATMENT.

Description and Justification

Drug dependence and it's associated social and health problems can be treated effectively in the majority of cases if people have access to a continuum of available and affordable treatment and rehabilitation services in a timely manner. To this end, all barriers limiting accessibility to treatment services need to be minimized for people to have access to the treatment that best fits their needs.

Components

Many factors contribute to treatment accessibility:
  1. Geographical accessibility, distribution, and linkages.

  • Health care system and public health networks, in cooperation with social services and the broader community, can provide essential prevention and treatment services and support for people with drug use disorders in their communities. Social services and other institutions (e.g. schools, civil society organizations, and self-help groups) can serve as points of the first contact for potential patients and help them access treatment.
  • In a comprehensive treatment system a large scale, distributed network of treatment facilities that can respond to various needs of individuals seeking treatment permits an adequate response in each community.
  • The basic prevention and treatment services for drug use disorders need to be within the reach of people with different levels of income.
  • Within a continuum of care, people with drug dependence should have access to treatment services through multiple entry points.
  • Outreach services, as part of a continuum of care, are needed to reach the ‘hidden’ populations most affected by drug use, often non-motivated to treatment or relapsing after a treatment program. Outreach services are particularly important to attract problematic drug users early and to establish contact with the population of people with severe disorders who may not seek treatment because of stigma and marginalization.
2.Timeliness and flexibility of opening hours. Same-day admission or short waiting time for structured services, as well as a provision of immediate intermediate services, including patient information. A wide range of opening hours will facilitate access to services for individuals with employment or family responsibilities.

3.Legal framework. Requirements to register drug addicts in official records, if associated with the risk of sanctions, may discourage patients from attending treatment programmes, thus reducing accessibility.

4.Availability of low threshold services. Flexibility in the organization of treatment services will improve access by a larger range of individuals in need. This includes the availability of services with a low threshold for patient admission and the removal of unnecessarily selective criteria.

5.Affordability. Payment for treatment and rehabilitation services may constitute a significant barrier for patients in many cases without sources of income. Insurance coverage or inclusion of drug dependence care in the public health care system is therefore key to promote access for those most in need.

6.Cultural relevance and user-friendliness. Current knowledge indicates that a treatment climate that is culturally sensitive, preferably multi-professional, team orientated, and that encourages patient participation and involvement in treatment facilitates patient access and retention in treatment, and ultimately improved treatment outcomes.

7.Responsiveness to multiple needs and diversification of settings. The availability of specialized services and residential settings to care for the more complex cases, e.g., patients with drug dependence and associated somatic or psychiatric disorders is essential to increase accessibility.

8. Criminal justice system responses play a significant role in improving access for individuals affected by drug dependence to treatment services: law enforcement officials, courts and prisons may closely collaborate with the health system to encourage drug-dependent individuals to enter treatment.

9.Gender-sensitiveness of services. Services tailored to gender-specific treatment needs can improve accessibility by responding to differential stigmatization, child care needs, and issues in pregnancy.


Actions to promote this principle

Ensure that:
1. the system of services permeates both urban and rural areas and builds upon the primary health care system. Key components include proactive outreach, low-threshold, early identification and brief intervention in primary health and social care services, basic drug dependence treatment services, and referral to treatment services from the criminal justice system.
2. legal frameworks guarantee protection from potential sanctions for those seeking treatment.
3. there are a functional referral and counter-referral mechanisms between different services in the system as well as to and from other agencies, facilitating a continuum of care.
4. the number of people on waiting lists and waiting times are minimized, and that intermediate responses are available.
5. staff attitudes are welcoming and non-judgmental.
6. services take into account and respect cultural norms.
7. patients’ perspectives are taken into account in service design and development.
8. eventual service costs to patients are affordable and waved if necessary.
9. services for women in primary health care and facilities for children of parents with drug dependence are built in close relationship with drug dependence treatment programs.

June 7, 2018

WHAT ARE THE PRESCRIPTION PAINKILLERS?

Prescription painkillers are strong pain relievers that include the opioid class of drugs, including hydrocodone 
(e.g., Vicodin®) and oxycodone (e.g., OxyContin®). Opioids work by mimicking the body’s natural pain-relieving chemicals, but they are more powerful and longer lasting. 
When the body senses pain following an injury or surgery, specialized nerve cells relay “pain” messages to the spinal cord and brain.
In response to these messages, natural pain-relieving chemicals—endorphins and enkephalins—are released and attach themselves to the body’s opioid receptors, where they have several functions.
In the spinal cord, they decrease pain-related signals being transmitted to the brain.
In the brain, they act in a number of areas, including those that interpret pain-related information and are involved in emotional responses. 
This reduces the sensation of pain and any associated feelings of suffering. Although our natural opioid system can relieve certain types of pain, it’s not equipped to handle severe and prolonged pain. 
That’s when opioid medications can be helpful.

Why Do Opioids Require?

Opioids require a prescription because they are powerful medications. 
Although they are used safely each year by millions of Americans who are in pain, if not taken properly, opioids can result in severe health complications or even death. 
Before writing a prescription for opioids, your doctor must evaluate several factors, including your level of pain (or expected pain after surgery), weight, other medical conditions, any other medications you are taking, and your current or past drug-use history. 

The doctor will then decide:
Whether an opioid pain reliever is necessary:
If a prescription opioid will safely and effectively treat your pain: and
The correct dosage and how long you should take it.
Your doctor will instruct you on how to safely take the medication, including which medications or 
over-the-counter drugs to avoid and the warning signs to watch for in case you have a bad reaction.
By following your doctor’s instructions carefully, you’ll be less likely to suffer serious side effects as a result of taking the drug.
risks

Why Is abusing Prescription Opioids Dangerous?

Abusing prescription opioids can put your health and life at serious risk. Opioids can make you drowsy, nauseous, constipated, and confused. 
They can also depress your breathing and lead to addiction or overdose.
Overdose: Abuse of opioids, alone or in combination with alcohol or other drugs, can slow or even stop your breathing and result in a loss of consciousness, a coma, or worse. 
In fact, the number of accidental fatal poisonings involving prescription pain relievers has more than tripled since 1999.
• Physical Dependence: Long-term use of opioids can make the body dependent, and when you stop taking them, you could experience withdrawal symptoms, like muscle and bone pain, diarrhea, vomiting, or cold flashes. 
If you are under a doctor’s care, he or she can help you avoid or manage these symptoms.
• Addiction: Opioid receptors are found in the parts of the brain involved in emotional responses, including pleasure. 
In fact, heroin is an illegal opioid drug that acts on the same receptor system as prescription opioids.
However, the dose and the way a drug is taken can affect how a person responds to it. 
People who abuse opioids often take them in doses or by methods (crushed, snorted, or injected) other than prescribed.
This can lead to high doses reaching the brain rapidly, increasing the risk of overdose and addiction.

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May 14, 2018

DRUGS DE-ADDICTION CENTER IN INDIA.

 1.National Drug Dependence Treatment Centre,Ghaziabad.

The Drug Dependence Treatment Center , AIIMS was established in the year 1988 and was functional from the premises of the Deen Dayal Upadhyay Hospital, New Delhi. In 2003 it was upgraded as the National Center (National Drug Dependence Treatment Center) and is fully operational from its new premises in Ghaziabad since April 2003.
Ghaziabad

Centre Details-

National Drug Dependence Treatment Centre, Ghaziabad
CGO Complex ,Kamla Nehru Nagar,
Ghaziabad, UP, Pin-201002
E-mail - nddtc@dtc-scheme.in


2. Department of Psychiatry and De-addiction Centre, PGIMS, Rohtak.

Department of Psychiatry and PGMIMS, Rohtak is a government run centre with both out-patient as well as in-patient facility. In their in-patient facility, they have 64 beds for psychiatry patients (32 males and 32 females) and 10 beds for de-addiction patients. Apart from these, they also have six beds allotted for emergency care.
Department of Psychiatry
Centre Details-
Department of Psychiatry and De-addiction Centre
Pt.B.D. Sharma PGIMS, Rohtak- 124001 (Haryana)
Contact No - +91-8689033888


3. Drug treatment Clinic, District Hospital, Kapurthala.

Navjeevan Kendra (Drug De-toxification and Treatment Centre) was started in September 2007, within the premises of District Hospital, Kapurthala. as a unique coordinated initiatives by District Administration, Health department and Red Cross Society, Gen. (Retd.) S.F.Rodrigues,PVSM, VSM, His Excellency, Governor of Punjab inaugurated the centre. The Psychiatrist working in District Hospital Kapurthala has been given the additional charge to look after the patients admitted in the centre.
Centre Details-
Drug Treatment Clinic
22, Friends Colony, Devi Talab Road
Kapurthala- 144601, Punjab
Contact No - +91-09814833131


4. Drug treatment Clinic, District Hospital, Bhatinda.

The Drug Treatment Clinic at Bhatinda is located within the premises of Civil Hospital opp. Woman and Children Hospital. It is three Story building having 50 bedded in patients ward, and outpatient clinic. Outpatient Clinic provides usual Psychiatry and De-addiction Services as well as substitution Treatment for Opioids, both Methadone Maintence Programme and Opioid Substitution Therapy are being run as a part of Substitution treatment Programme Under Ministry of Health & Family Welfare and NACO Respectively.
Centre Details
Model Drug De-addiction Centre
Opp. Woman and Children Hospital
Civil Hospital, Mansa Road, Bathinda
Contact No - +91-98184-35271 , +91-99889-51979

5. Drug treatment Clinic, KGMU, Lucknow.

Department of Psychiatry has an excellent history of 45 years in providing teaching, training and research in the field of Psychiatry. With a modest beginning of specialty in psychiatry in 1956, Independent Department of Psychiatry came into existence in K. G. Medical College in 1971.
The drug de-addiction unit in the department was started in the year 1976. It has outdoor & indoor facilities. All kind of substance use disorders are being treated in the unit. Apart from clinical services we are also part of various government programs like RTTC for Harm Reduction Program (Project Hifazat) under Global Fund Rd-9 IDU HIV Grant which ended the year 2016. OST Program for IDU funded and supported by NACO, UPSACS since May 2013 is still continuing. DTC has been established in the department of Psychiatry, KGMU, Lucknow in January 2016.
Centre Details-
Department of Psychiatry
King George’s Medical University, Uttar Pardesh
Lucknow-226003
Contact No - +91-9415025665

6. Department of Psychiatry, New Medical College, Kota (RAJASTHAN).

Department of Psychiatry of Government Medical College Kota is situated in New Hospital, Medical College Campus, Rangbari Road, Kota-324005. It has 30 bedded Psychiatry & 10 bedded De-Addiction ward. OPD De-Addiction services are provided through Psychiatry OPD running all days of the week. Department is already running our OST Centre funded by NACO for I.D.U’s where Buprenorphine is being administered to the patients. There are 70 patients registered. It’s Rajasthan’s 1st OST Centre running successfully.
Drug Treatment Clinic
Centre Details-
Drug Treatment Clinic
New hospital,Medical College Campus
Rangbari Road, Kota-324005 (Rajsthan)
Contact No. – 0744-2470477(New Hospital PBX)

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