1 YOU CAN BE OF SUPPORT TO THE ADDICTED PERSON IN RECOVERY Addiction is a disease which leads to physical and emotional problems. It also causes problems in almost all areas of life. The drug dependents have to stop taking drugs totally and also take efforts to improve their life style, making it productive and meaningful. Treatment for addiction helps them work on both these aspects. Yet, this process of recovery can often seem difficult for the alcohol / drug dependents. Support persons can make recovery less threatening and meaningful for them. Who can become a support person? Anybody who is genuinely concerned about the addicted person and his family can be a support person. He can be the brother, sister, aunt, uncle, a neighbour, friend, colleague, boss, employer, or even the priest or a doctor. Patient Occupation Friends Health Family Religion Support people are Managers At work Family Parents Clergymen Supervisors neighbours physician -in-law Medical officer Siblings - ideally those who do not use alcohol or drugs - persons for whom the patient has respect and regard - those who meet the patient on a regular basis, so that the support is ongoing and continuing What kind of an additional support can you give? - Apart from his immediate family, you can provide encouragement and assistance to the patient. - By being available and helping him discuss his anxieties and concerns as well as improvements with you, you can assist him in dealing with issues that can hinder or enable his recovery.
2 2 - You can help prevent relapses from occurring by ensuring his regular attendance to follow-up programmes - In the event of a relapse, if the family members are unable to convince him to get back to the treatment center, you can motivate him to do so. - If a problem regarding his job or marriage arises, we may seek your assistance to sort out the issue. - If he changes his residence, we would like you to intimate us so that we don t lose touch. To help you to be an effective support person, we are giving information about - Addiction as a disease - Treatment provided at the center - Disulfiram reaction - Follow-up regimen - Understanding relapse symptoms and handling them Understanding addiction as a disease After extensive research, it has been established that addiction is a disease a disease which can be treated by giving medical and psychological help. In the process of treatment, the patient gets help to keep away from alcohol / drugs totally for life. Total abstinence is the only solution to the problem of addiction. Treatment provided at the center a) Medical treatment (Detoxification ) for 3 7 days) - Helping the patient overcome withdrawal symptoms like fits, sleeplessness and severe pain which may set in when he gives up alcohol / drugs - Dealing with associated physical problems like gastritis, neuritis, depression, malnutrition etc. - Providing appropriate medications to help the patient get back to normal eating and sleeping pattern b) Psychological therapy for 21 days This helps him to - understand that addiction is a disease, recognise the need and ways by which he can stay off alcohol / drugs. - Recognize the damage caused by addiction and make positive changes in his life style.
3 3 Psychological therapy programme includes lectures, group therapy, individual counseling sessions and self-help group meetings. c) Follow-up (2 years) The patient and family members need to be in touch with the treatment center for two years after completion of treatment. This ensures that recovery takes place smoothly and any problems that arise are handled in a timely manner. During follow-up, the patient meets the - Doctor to discuss medical problems if any and review medications - Counselor to discuss progress or problems related to any area of his life. Is the patient given any medications after discharge? Yes. All alcoholic patients are prescribed disulfiram which they need to take daily for 2 years. Narcotic drug abusers may be prescribed naltrexone. Once he crosses this two year mark, maintaining sobriety becomes easier for him. Depending on each patient s health problems, a few more medicines may be prescribed. The dosage, frequency and duration for which they should be used is decided by the doctor and evaluated regularly during the follow-up visits. How does disulfiram help the patient stay off alcohol? Disulfiram is a deterrent drug. The patient should not consume even a small amount of alcohol after taking disulfiram. If he drinks, it produces several unpleasant effects like flushing, sweating, palpitation, shortness of breath, discomfort in the chest, fall of blood pressure, blood vomiting, unconsciousness etc. It can become life threatening. The patient is being repeatedly warned about disulfiram reaction during treatment. Disulfiram tablets are available only at the hospital, not in any pharmacy. Patients outside Chennai can send a money order / DD to Dhanvantari Society (the pharmacy, attached to TTK) with the name and registration number of the patient and the name of the counselor to get disulfiram tablets. During recovery, even cough syrups or tonics containing alcohol should not be taken by the patient, as these can precipitate a reaction.
4 4 The necessary precautions to be taken and the warning signals What should be done if the patient drinks after taking disulfiram? If the patient has consumed alcohol over disulfiram, it is an `Emergency. Take the patient to a nearby hospital. The patient has an emergency card which has to be shown to the doctor. The patient and the family members have to ensure that the emergency card is kept in a safe place and easily accessible. Even if there is a suspicion that the patient might have taken alcohol, do not give him disulfiram. The effect of disulfiram will lost for 72 hrs. To restart disulfiram after a relapse, it is important to meet the doctor. Emergency Card to be shown to the doctor in case the patient has consumed alcohol over disulfiram. Mr. is on disulfiram tablet. If you find him unconscious, vomiting, and with low BP, it is probable that the person has taken alcohol when on disulfiram tablet against medical advice. Hence, he has to be treated as an emergency case and the following treatment should be given. Injection Decadron 2 vials IV Injection vitamin C - 2 amp. IV Injection Avil 1 amp. IV Injection Glucose 5% drip Injection vitamin C and Decadron can be repeated till the BP is restored to normalcy. How frequently should the patient come for follow-up? Period following treatment Frequency of visits (Chennai based patients) Outstation patients 1 3 months Once in days Once a month 4 6 month Once a month Once every two months 7-12 month Once every two months Once every three months After 1 year Every quarter Once in six months Patient can also write letters, make telephone calls or communicate through .
5 5 Is it possible that patients drink or take drugs even after treatment? Yes. Unfortunately some patients may drink / take drugs again. However, relapses can be prevented if the patient and others are alert and look out for warning signs that precede a return to alcohol / drug use. Some of the warning signs are The patient - Becomes over confident- ignores follow-up measures - Appears depressed does not communicate, prefers to be lonely - Becomes irritable, angry, argumentative, resentful over minor issues - Indulges in gambling. - Makes major decisions without adequate thinking - Is unable to eat / sleep properly - Stops taking disulfiram tablets and other medicines - Spending time in the company of drinking / drug taking friends - Stops meeting counselor / attending self help group meetings - Talks about social drinking If these symptoms are seen repeatedly, the patient has to be persuaded to meet his counselor. What should be done if he takes alcohol / drugs again? Encourage him to meet the counselor and doctor as soon as possible. The earlier he does it, the easier it is to stop alcohol / drug use and recover. Depending on the need, he may be given medicines and counseling on an out patient or in patient basis. Relapse Prevention Programmes are conducted once a month at the center for seven days. Encourage him to attend the programme. About us - A treatment center for addiction T T Ranganathan Clinical Research Foundation - TTK Hospital is a pioneer, voluntary organization dedicated to the treatment and rehabilitation of people addicted to alcohol and other drugs. The center offers a comprehensive in-patient treatment programme for a period of four weeks and a special programme for families for two weeks.
6 6 TTK Hospital also runs an After Care Centre which offers an intensive, long-term treatment programme of three months duration. We also run a Vocational Training Centre TEJAS to teach tailoring and computer education for patients and their family members. Awareness and prevention programmes for various groups and training programmes for personnel who work in the field of addiction treatment, are conducted. Publications are also regularly brought out. For further information T T Ranganathan Clinical Research Foundation TTK HOSPITAL IV main Road Indira Nagar Chennai Phone: / / / Fax:
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