A Journey from Despair to Hope
In a recent judgment, the Kerala High Court has come up with a slew of strategies and action plans to prevent and control the alarming spread of illegal substance use among school and college-going students. The court has seriously taken steps to address this issue through a multi-pronged and inter-disciplinary approach involving students, parents, teachers, health care professionals, civil and law enforcement agencies.
In another development, a newly released film, Vellam (Water) depicts the real-life story of a young man whose protracted and destructive dependence on alcohol and his amazing success story after kicking the alcohol habit, made a great impact on the general public. Numerous media reports about youth gang violence, drug peddling, etc have caught the attention of the general public and law enforcement agencies.
A recent publication of a book by the superintendent of prisons in Kerala, Mr. Rishiraj Singh, titled, Before It’s Too Late, traces the root causes of children’s narcotic abuses.
The following is the painful story of a family whose one member slipped into the habit of narcotics use, and how the entire family was forced to put up with untold misery and pain in the process of regaining health and sanity.
Shocked and Shattered
The parents of a young man came in for psychological consultation about their son (30 years, married and separated) Deepak who was acting strange, lately. Deepak was estranged from his wife, and lately, he couldn’t keep up with his job also. Besides, he showed signs of aggression, irritability, and depression. All the good efforts of the parents to take him to some health care professionals failed. The family was quite anxious about Deepak’s increasing aggression and abusive stance. He has a younger sister and he even attacks her physically.
The entire family was undergoing fear, shock, shame and helplessness. Deepak was seen as more aggressive and verbally abusive towards his estranged wife, especially when he was on ‘high’. As the parents came to know for sure that their son was using the illegal substance ganja (marijuana). The family members were shocked and shaken by the discovery of their member’s use of an illegal substance, and they went through a time of emotional pain, loss, and helplessness. One wayward member can destroy the family’s traditional good name and prestige (Cfr.‘the family ego’, M. Bowen, 1978).
My first job was to strengthen the parents’ resolve to be resourceful to their son who needed help. They had to pay special attention not to get enmeshed in their son’s destructive habits, blaming games, avoidant tactics, etc. The parents were specially prepared not to get into arguments or confrontations with their son. The parents had to prepare themselves to be resolute and resourceful to deal with their son’s dysfunctional habit and destructive behavior which was endangering the peace of the entire family.
Deepak was getting more and more agitated and aggressive day by day, and peaceful life was impossible for the entire family, and for their neighbors. After exhausting every available avenue for motivating Deepak, the family was advised to seek help from a law enforcement agency. With the help of the local police who did an excellent job of persuading Deepak, gently but firmly, the family succeeded in taking him to a detox center, with some force, of course. At the detox center, Deepak was quite reluctant and did express maximum resistance to every form of intervention. He kept on blaming and cursing his parents and wife for locking him up in a ‘mental asylum’. As the resource team at the center was used to such resistance and non-cooperation, they succeeded in overcoming Deepak’s antagonism and resistance in a few day's time, of course, with appropriate medication.
Treatment modality was based on the diagnostic assessment and the etiology (causes of the ailment). Generally the therapeutic (behaviour) and medical models of intervention are applied. Deepak’s substance use had escalated to dependency which is the last and dangerous stage. At this stage, the user cannot live without the substance even for a day. (The other stages of substance use are 1. Recreational use ( less frequent use) 2. Regular use 3. Addictive stage 4. Dependence stage). When drug/substance abuse escalates to dependence, treatment becomes complicated. There is the potential danger of withdrawal symptoms such as anxiety, depression, muscle weakness, nightmares, body aches, sweating, nausea, vomiting, etc.
Hence detoxing needs a professional setting and medical supervision. Although there are different perspectives on what causes drug abuse, they have not generated a single accepted account for why a person develops an addiction, but a number of empirically-grounded theoretical approaches that broadly fall into three domains—biological determinants, psychological determinants, and social determinants. These are collectively referred to as the biopsychosocial model of addiction. Deepak’s treatment plan included all these three aspects of life’s vexing problems. A three-pronged approach of medical, behavioral, and social (relational) intervention model was applied.
The treatment program was planned in a phased-out manner. The first phase was focused on detoxing, namely, weaning Deepak from the dependency of the substance and overcoming the consequent side-effects. This initial stage is dominantly, medically assisted therapy. Gradually, behavior intervention and later on, social-relational interventions took place.
After a month’s detox and rehab treatment program, Deepak was brought home. He had made remarkable progress in every aspect of his life. However, he along with his family realized that great challenges lay ahead. The advantage was that the family was going to face new challenges together. Deepak had to be supervised and assisted in his further journey, he needed the support of the family, the acceptance in a support group, a resolution to his marital discord etc. Ongoing treatment along with marital counseling was required.
According to research, only 11% of the persons with substance use disorder approach for treatment, and among them, 40 to 60% falls into relapse within a year. The etiology and treatment of addictive disorders involve a lot of complexities and involves multiple disciplines and divergent perspectives. Despite the importance of numerous psychosocial factors, at its core, drug addiction involves a biological process: the ability of repeated exposure to a drug of abuse to induce changes in a vulnerable brain that drives compulsive seeking and taking pleasure. When a family member is caught in the addictive web of an illegal substance, the entire family goes through the emotional rollercoaster from agony and anguish, to confusion, helplessness, and outright despair.