Friday, August 17, 2018

Drug prevention is an empworing process...Quick fixing is Dangrous

“This is no quick fix. There is no band-aid big enough for this life.” ---Daniel Abbott, The Concrete

The story of an 18-year-old Shubam is a classic example of what is happening to our youth today and an eye-opener for us, especially parents. Shubam was a sincere student and loved by all at home and school. He was the only child of doting parents, who put him in a leading school and provided him all facilities. A car ferried him to school and back, he had private tutors at home who helped him with his homework and his parents left no stone unturned to keep him happy. But they never spoke to him about various life skills and soft skills needed by the youth today. They never taught him how to be emotionally strong and assertive. They never spoke of peer pressure, drugs and good behaviour. They loved him, but hardly communicated all this to him because they did not know this was important.

Shubam passed out of school with good grades and got admission in an Engineering college away from his hometown. He shifted to the hostel and then started his woes. He started his college life with a lot of zeal and enthusiasm. He had good and hard working friends initially but gradually he fell into bad company and his academic performance started dwindling.

He was often spotted in local pubs smoking, drinking and dancing with his girlfriends and peers. He was a bit hesitant about this life style initially but with no one to guide him, he gave in to peer pressure and started liking his new friends and their way of living. They had late night parties and missed classes. Shubam failed in his yearly exams but didn't tell his parents about this and they were blissfully unaware of the situation. By now his alcohol intake had increased considerably and he had problems concentrating and driving. He felt disoriented and once he drove his car fast and slammed it into another car leading to his arrest for negligent driving. His friends deserted him and his college suspended him. They reported this to his parents and asked them to intervene.

The parents were in a state of shock when they realised how bad and explosive the situation was, but it was too late for them to repent now. Shubam was diagnosed with alcohol addiction and sent to a rehab centre for treatment. Such cases are very common today and come to us everyday for counselling and help. The figures are staggering. About 190 million people all over the world consume one drug or the other. About100 people die daily from drug overdose. This rate has tripled in the past 20 years.

Substance abuse is the abuse of any chemical substance(both legal and illegal drugs) in which the user consumes the substance in amounts or with methods which are harmful to himself or to others.

Youth take drugs due to various reasons. Peer pressure makes them want to be accepted and fit in with his/her peers. They feel good by using the drugs, which interact with the neurochemistry of the brain. They also use substances to fight stress or depression because they feel these drugs will lessen their distress. They use them as a maladaptive coping strategy for stress management. Some think that the substances will improve their performance and they will fare better in the competitions they have to face.

Adolescents try to experiment and while the assertive youth stop after their initial trials, the emotionally weaker ones fall prey to this malady. They learn it from the social media and movies where the heroes who smoke and drink are appreciated. Some learn it from their parents whom they have seen consuming these at home.

The National Institute on Drug Abuse(NIDA) indicates the following risk factors for developing drug abuse problems (typically seen in adolescence):

•             Unstable home environment, often due to drug abuse or mental illness of the parent

•             Poor relationship with parents

•             Inadequate supervision over adolescent's activities

•             Use of drugs by friends / peers

•             Permissive attitude towards their own drug use and the drug use of the adolescent

•             Behavioural problems combined with poor parenting

•             Poor achievement in school

•             Apparent ambivalence or approval of drug use in the school, peer group or community

•             Availability of drugs in the community, peer group or home

NIDA continues to use the term “addiction” to describe compulsive drug seeking despite negative consequences. It is a brain disorder.

Drug Addiction indicates a psychological or physical dependence on the drug to function and is characterised by the person developing compulsions, tolerance and withdrawal symptoms .

Addiction is a developmental chronic disease and it usually begins in childhood or adolescence and continues thereafter. In cases of addiction changes have been found in the brain’s natural inhibition and reward centers,  and these stop a person from exerting any control on the impulse to take drugs, even when he knows that there are negative consequences like stigma and social disapproval attached to its use.

Addiction can affect us negatively in many ways. The short term effects include changes in appetite, wakefulness, heart rate, blood pressure, heart attack, stroke, psychosis, overdose, and even death. These health effects may occur after just one use. The long term effects can include heart or lung disease, cancer, mental illness, HIV/AIDS, hepatitis, and addictions.Sometimes  we face Social Stigma, unemployment, housing, relationships and criminal cases against the abusers.

•             When we see sudden changes in an adolescent's behavior, like aggression or hostility for no apparent reason—or is withdrawn,excessively tired or depressed- it should be a wake-up call for the parents. Carelessness in daily grooming habits, decline in academic performance, missing classes, loss of interest in favourite activities, changes in eating or sleeping habits, deteriorating relations with family members and friends,spending or asking for more pocket money and signs of syringes or unknown medicine strips or cigarette stubs with the person are some of the signs of substance abuse.


The initial decision to take drugs is typically voluntary by the adolescent. Children should be empowered to say no to drugs in the initial stage itself. Children should be psycho-educated and empowered with adaptive coping skills, assertive skills, resilience skills and taught to have high self-esteem so that they can say no to drugs.

Parents need to recognise that their child is not behaving as he or she normally does. If he is taking drugs, then they should find out the underlying cause for this. There could also be an associated mental health or medical disorder.

A proper medical and mental checkup with all investigations is a must. Parents who are unable to understand the problem should take professional help from a trained psychologist.

If a child is already taking drugs immediate professional help and counselling is needed. Drug addiction is also preventable and manageable with medical help and professional counselling. It is a more difficult and lengthy procedure and consumes a lot of time, effort and money. Support of the family is very important.

(The writer is a neuro-psychologist and CBSE counsellor)

Sunday, July 8, 2018

Treat Victims of Drugs Humanely.!

Treat Victims of Drugs Humanely.!
Prof.T K Thomas
Last Tuesday [26th June] was International Day Against Drug Abuse and Illicit Trafficking. One casually tuned into the lead story at 7 in the morning on Asianet News to find out that drug addiction in Kerala had gone up five times after a majority of bars were closed down in 2016 by the Congress led UDF government. During this period alcohol consumption had declined, the story mentioned. This turned out to be one’s thought for the day. Is alcohol a drug like cannabis, opiates etc? One has studied the problem of drugs and addiction for almost four decades and has learned that alcohol is indeed a drug. It comes in the category depressants [Drugs incidentally are categorized in to seven types on the basis of their effect on those who use them- for example while a depressant slows down, a stimulant speeds up or a hallucinogen disrupts communication within one’s brain and so on.]
Alcohol unlike other drugs is licit or legal and considered socially acceptable. It has since long been part of festivities and celebrations; for governments it is a major source of revenue. But it can lead to addiction which is accepted as a disease. It is considered a family disease as close relations of an addict suffers more than him; he indulges in domestic violence, starves his family, neglects his children to give a few problems.
Alcohol related diseases and alcohol related deaths are a major concern. It was estimated that in 2012 there were 3.3 million deaths in India due to alcohol consumption related diseases. No wonder successive governments have been concerned about this problem. But unfortunately the problem of addiction, first to alcohol and then to other drugs, is only showing an upward swing. Despite ban on alcohol advertisements in all the media especially television channels, surrogate alcohol ads rule the airwaves especially during popular national and international sports events. One sees it during the ongoing football World Cup in Russia or had seen plenty of them during the IPL [Indian ‘Paisa’ nay Premier League]. During the IPL Suneel Vatsyayan, a leading voice in the fight against drug addiction, prevention and alcohol advertisements blogged, ”The ongoing Indian Premier League [IPL] tournament has more liquor ads than one can count. There are ads for Seagram’s Royal Stag, Royal Challenge, Signature, Black &White and why [ASCI] Advertising Standard Council of India turning a blind eye to this charade of surrogate ads that are openly selling liquor and nothing else.
There are ads on air for Royal Challenge, Black & White, Signature and Chivas Regal. All liquor ads for sure, but masquerading as completely different products, mostly nonexistent”.
All concerned authorities seem to have closed their eyes when blatant violation of rules and regulations were adopted by the industry in circumventing the rules to unabashedly promote surrogate alcohol ads. They actually make fun of the intelligence of the average viewer. There appears to be active connivance of the industry, media and regulatory bodies. They succeed in creating an artificial or make belief world of celebrity lifestyle which cajole the young people to accept alcohol as a symbol of success and style. While on the one hand preventive agencies try to persuade and wean away young people from the reality of the danger of excess drinking of alcohol, the reel life of celebrities and the so called successful people portrayed in surrogate alcohol ads invite them to accept alcohol as a sign of success and prosperity.
The real tragedy is that it is often the poorer and the marginalized sections of our society who fall victim to deadly addiction. They tend to believe that alcohol is an antidote for all their problems; it gives them relaxation after a hard day’s work, give them a feeling of well being, good appetite and sleep, ability to forget their worries and so on. Needless to say, these are all false notions and soon they destroy their families and end up in some nondescript de-addiction or rehabilitation center which is a journey out of the frying pan into the fire. Of course there are professionally and scientifically run centers. Having visited a number of centers managed by people who had a drug/alcohol connection one can say that they were some of the worst places. People prefer private centers to government run facilities. It is reported that a Rs.5 crore 100 bed center inaugurated in Punjab in 2015 had just one patient whereas private centers are overflowing with patients. One of the main reasons is that private centers do not insist on the consent of the patients unlike government run centers.
The Indian Express, on the eve of this year’s International Day Against Drugs and Illicit Trafficking had carried a story on what happened to a number of de-addiction centers based on an inspection report on such centers submitted to the Delhi High Court. The front page story actually sums up the plight of the patients in such centers, “Asked to perform sexual favours, subjected to physical and sexual torture, treated as slave, not allowed to contact their families-and death allegedly due to torture or wrong treatment.” On the basis of writ petitions filed on unregulated de-addiction centers the Delhi High Court had asked the Delhi State Legal Services Authority [DSLSA] which submitted the report to the High Court on 1st June. “According to the report the DSLSA in fact had inspected 124 de-addiction centers, out of which 28 were found shut. In the remaining 96 centers the Authority interacted with 2135 inmates -750 said they were detained involuntarily”.
Responding to the report the Bench comprising justices S. Muralidhar and I S Mehta said that such violations of fundamental rights to life, liberty and dignity as enshrined in the constitution are “unconscionable.” The court said, “It is paradoxical too. On the one hand, there is fairly a large population of persons in need of de-addiction and on the other hand, we have several unauthorized and illegally run centers exploiting the situation, charging money and subjecting such persons to inhumane and degrading treatment.’’ The bench has also ordered the Delhi Police to act on the DSLSA report and to proceed in accordance of the law against the centers where such inmates have been subjected to inhumane treatment.
This Delhi High Court order will go a long way in regularizing the de-addiction and treatment centers for hundreds of thousands of drug and alcohol addicts in the country. There is dire need for such facilities. Government facilities are said to be grossly inadequate. Concerned civil society organizations and the voluntary sector need to come in the field with standard of care, qualified health professionals and counselors with residential facilities. Agencies like DSLSA or regulatory bodies need to ensure quality and effective de-addiction/ treatment and rehabilitation centers in all states if the scourge of addiction is to be eliminated. The problem is really serious and a new national policy on alcohol and drugs is required to combat it.
As one was concluding this piece on Monday [2nd July], breaking news from Punjab was flashed on all channels about the press statements followed by a tweet by Punjab Chief Minister Capt. Amarinder Singh, “My government has decided to recommend death penalty for drug peddling /smuggling. The recommendation is being forwarded to the union government. Since drug peddling is destroying entire generations, it deserves exemplary punishment. I stand by my commitment for a drug free Punjab.’’ His intentions are appreciated notwithstanding the fact that there are provisions for death penalty for repeat offenders even in the Narcotic Drugs and Psychotropic Substances Act [NDPS] of 1985!
The problem of drug abuse in Punjab in the light of what the CM said on 1st July has to be looked at from another angle and the urgency for such a move. Before and during the state Assembly elections in Punjab the problem of drugs was a major issue. Media reports portrayed Punjab as ravaged by rampant drug trafficking and addiction. The Congress Party that trounced the Akali Dal-BJP coalition had assured that they will rid the state of the drug menace. Ground realities today, after fifteen months of being in power, despite some initiatives are not exactly praiseworthy. In fact The Tribune had come out with a story on 29th June with the headline, “Anger, fear in Punjab as June sees 23 Deaths from Drugs”. There are heart rending stories of parents wailing and mourning the death of their children from villages like Kotakapura and Cheharta. The police and other agencies are concerned and active but the intravenous use of deadly dugs like ‘Cut’ [a new addition to the terminology of adulterated heroin] has pervaded the length and breadth of the state. The authorities are almost helpless. It is indeed tragic that these deaths have taken place during the month of June, the 26th day of which is the International Day Against Drug Abuse and Illicit trafficking.

Friday, June 15, 2018

Alcohol Marketing in India #enoughNCDs

Alcohol Marketing in India: #enoughNCDs 
The World Health Organization’s (WHO) Global Strategy identifies the importance of reducing the impact of marketing, particularly on young people and adolescents, as an important consideration in reducing harmful use of alcohol.It has been observed that alcohol use has escalated as one of the leading risk factors for global burden of disease.  
The Cable Television Network (Regulation) Amendment Bill, in force September 8, 2000, completely prohibits cigarette and alcohol advertisements.  However, it is evident that we are living in a media dark era. The industry circumvents the bans on advertising by surrogate advertising, and the images in alcohol advertising have changed from voluptuous pin-ups (targeting the traditional market of middle-aged male consumers) to depictions of a ‘good life’, aimed clearly at women and youth.
This is also an era of social media platforms like Facebook and Twitter, where the promotion of content by an alcohol brand is still a gray area and many alcohol brands aim at building a community instead of straight off plugging the alcohol.  It’s important that both the media and celebrities take into consideration the impact of the product before they’d decide to endorse or promote it. There are celebrities who do that and who receive much praise, like movie stars Ranbir Kapoor, Vivek Oberoi, Singer Shaan, cricket legend Sachin Tendulkar who turned down alcohol and tobacco brands. These sportsmen and other celebrities are true role models who put the well being of their fans and society before their own wallets and bank accounts. 

The ongoing Indian Premier League (IPL) tournament has more liquor ads than one can count. There are ads for Seagram’s Royal Stag, Royal Challenge, Signature, Black & White and why (ASCI) Advertising Standards Council of India  turning a blind eye to this charade of surrogate ads that are openly selling liquor, and nothing else?
One of the leading liquor brands was recently associated with a five-part web series on four friends trying to launch a startup. With more than 10 million viewers, the show went viral in the startup community, and is currently rated 9.7 on IMDB. By producing the show, the brand avoided surrogate advertising and revolutionized liquor advertising in India. The events sponsored by liquor brands — from music festivals to tasting sessions to sports events — have only grown bigger over the past decade. One of the Vineyards in India reveals they had 250,000 visitors at its different facilities in Nasik last year and they conducted 45,000 tastings at the vineyard. 

Consumption of alcohol in India has expanded at an average of 8.9% annually in the past six years, reaching an estimated $22 billion (1.46 trillion rupees) last year. India is the 3rd largest liquor market in the world, with an overall retail market size of $35 billion per annum. A global study by Paris-based Organization for Economic Cooperation and Development (OECD) has found that alcohol consumption in India has risen by 55% over a period of 20 years, from 1992 to 2012.With the minimum drinking age varying from 18 to 25 across states, India had approximately 485 million people of legal drinking age in 2013. This is more than the population of the United States and Mexico combined. Another 150 million are predicted to join this group by 2018. 

To address the impact of alcohol use on society, a national policy on alcohol use is needed.  The alcohol policy includes measures by the government to control supply and demand, minimize alcohol-related harm and promote public health.  At present, India does not have a national alcohol policy. However, the Ministry of Social Justice and Empowerment has a mandate for Alcohol and Drug Demand Reduction and Prevention Policies. Another central concern that the new drug demand reduction policy must address, I think, is the aggressive push by the global alcohol industry to recruit our children and youth as loyal consumers. Therefore, special measures and programs to prevent underage alcohol use and to reduce overall per-capita alcohol consumption in India is the need of the hour, as Big Alcohol marketing strategies are becoming ever more aggressive and pervasive. Also, alcohol-related harm should be urgently addressed from a child rights perspective. To achieve a healthier society, harmful substances must become much less available – socially, financially, psychologically and physically. 
*Chairperson, Nada India Foundation
  Nada India Foundation

Thursday, April 26, 2018

Knowing ADHD: A therapist can help an young people with hyperactivity

National Acupuncture Detoxification Association of South Africa » Use of Acupressure Magnetic ...Knowing ADHD
THE ASIAN AGE. | KAVI BHANDARI Published : Apr 27, 2018, 12:20 am IST Updated : Apr 27, 2018, 12:20 am IST
Here’s why it’s important to consult a mental health professional when someone starts showing the symptoms of ADHD.
While it is normal to have some inattention or unfocused motor activity, even this slight deviation is unacceptable our society....
.....Some people are hyper all the time. Their attention span is very low and they can’t focus completely. At times they appear naturally high. We talk to psychologists to find out why it happens.....

“In clinical terms, hyperactivity is one of the symptoms of ADHD (Attention Deficit Hyperactivity Disorder), which is a developmental disorder in children having low levels of attention and increased hyperactivity. Children with ADHD are unable to sit patiently or wait in queues. The origin of this disorder may be genetic or exposure to certain substances during pregnancy, which might cause structural changes in the brain and imbalance of certain neurotransmitters. Many people have little knowledge about ADHD and perceive such children to be naughty or notorious and scold them, rather than understanding that their behaviour is not intentional,” says Dr Akshay Kumar, a psychologist.
“In people living with hyper activity, these behaviours occur more often. This interferes with the quality of interaction socially or at a workplace. A professional counsellor or therapist can help an adult with hyperactivity to learn how to organise his or her life with checklists, art therapy and use of reflexologyFamily members, friends and co-workers can play a significant role by accepting his or her limitations a

Wednesday, February 14, 2018

“We young people cannot simply be spectators while somebody else is making decisions for us....

Vindhya Vatsyayan came to the 2nd Global NCD Alliance Forum as a youth delegate, eager to learn how to better represent the voices of those who suffer NCDs in silence. Today she is using the knowledge and inspiration gained there to do just that. Here she shares some of her key reflections.

My father always keeps an eye on what is happening around the world and where he can send his daughter to learn new things, and that's exactly how I ended up attending the Youth Pre-Forum Workshop at the 2nd Global NCD Alliance Forum in Sharjah, UAE. I filled in the application form very meticulously; but honestly, it was quite simple because all I had to do was share my story, experiences and the change I want to see in the world.
"People will forget what you did but will remember how you made them feel." - a person living with NCDs
It was not just focused on my qualifications, but more on why I feel so strongly for a cause and how I plan to bring change. For the first time in my life, I was sharing my grandfather's story of being isolated because of a disease the world knew little about. I grew up listening to the stories of people suffering in silence; and therefore, I wanted to bring these voices to the front. I wanted to attend the Forum to learn how to become the voice of the masses.
The morning I learnt of my selection for the Forum was one of the best days of my life. I was excited to meet people from around the world and learn from them. I wanted to come back fully equipped to bring change at all levels. The 2-day Youth Pre-Forum Workshop taught me how important it is to have a story, a story that people can relate to. It taught me facts about NCDs, and why facts are so important to understand the intensity of the problem, but that stories of people are what resonate most powerfully.
"My husband left me in the hospital when I was diagnosed with diabetes. But now I understand my disease and I am strong." PLWNCDs

The right people at the right time

One of my key learnings from the forum was how to engage the right people at the right time. That once you're clear about your mission it is extremely important to map the key stakeholders, set your priorities, and understand the importance and impact of these key priorities. I heard some excellent examples of successful stakeholder engagement and how, in collaboration, we can create an impact at all levels. The forum gave me a new motto: energise, inspire, agitate and communicate. I learned why my voice and those of other young people are so important. We young people cannot simply be spectators while somebody else is making decisions for us. NCDs do not belong to one group or section of society but can affect anyone and everyone.
"Don't try to control the input of young people - don't ask for their input, then ignore it. When you ask them to be part of something, really engage them, really listen, and really follow through and act on their insights with them." - Cajsa Lindberg
At the Forum, people living with NCDs (PLWNCDs) also participated; they gave me the strength I need to fight back. I met strong leaders who made me realise why it is so important to have complete knowledge about everything related to NCDs. From pitching our idea for change in 60 seconds to learning the cost of NCDs in the coming years, the Forum broadened my horizon in all possible ways. In two days’ time, with tons of brainstorming group activities for setting up three key priorities and the role of youth, we were able to prepare the call to action for youth(link is external).
“We young people cannot simply be spectators while somebody else is making decisions for us.”
The Youth Workshop’s success could be seen in next three days at the 2nd Global NCD Alliance Forum, where extraordinary people from civil society organisations, WHO, national NCD Alliances, PLWNCDs, NGOs, ministries, government officials and we young people deliberated and set the agenda for advocacy for the upcoming UN High-Level Meeting on NCDs.
We were given a platform to raise our voices. We were an integral part of the discussions around advocacy and key priorities for the UN High-Level Meeting. The role of youth was discussed in every session at the Forum. Time and again it was emphasised that our role should not be limited to creating awareness but should also exist at policy level. We might not have the experience, but we have the eagerness to learn and bring in the change for present and future generations.

Lasting inspiration for a lifelong mission

"Leaders don’t take action on NCDs because they lack knowledge or courage (or both!)." - Dr. Tom Frieden
Vindhya Vatsyayan adds her commitment to the  map
Towards the end of the forum I also made some commitments for my country; to mobilise youth in response to NCDs, to promote the engagement and meaningful involvement of people living with NCDs, and to mobilise and strengthen the civil society in my country. I now have a vision and a mission and am determined to have a time-bound action plan to be heard at the United Nations High-Level Meeting on NCDs later in 2018. I learned from each and every person I met at the forum, but there were a few people and their words that will stay with me forever and inspire me to courageously pursue the changes we want to see.

About the Author
Vindhya Vatsyayan (@NadaPehchaan(link is external)) holds a Master’s degree in bioinformatics, and her work at improving global health began by developing a biological database on ‘hospital acquired infections’. She is now an independent public health consultant in the field of multi drug resistant tuberculosis and a health advocate with Nada India Foundation.

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Drug prevention is an empworing process...Quick fixing is Dangrous

“This is no quick fix. There is no band-aid big enough for this life.” ---Daniel Abbott, The Concrete The story of an 18-year-old Shu...