Drug Demand Reduction - Term Paper Example

 Drug Demand Reduction Introduction: The concepts of drug abuse, drug dependence, drug addiction and abstinence syndrome need some clarity. “Drug” is a chemical substance associated with distinct physical and/or psychological effects. It alters a person’s normal bodily processes of function. But this definition is too broad. In medical sense, a drug is a substance prescribed by a physician or manufactured expressly for the purpose of treating and preventing disease and ailment by its chemical nature and its effect on the structure and functions of a living organism. In the psychological and sociological context, drug is termed for habit forming substance which directly affects the brain or nervous system. More precisely, it refers to “any chemical substance which effects bodily function, mood, perception, or consciousness which has potential for misuse, and which may be harmful to the individual or the society.” In terms of this definition, the frequent use of drug is considered so dangerous and sometimes even immoral and anti social that it arouses a variety of drug abusers. Therapeutic drugs are, however, relatively innocuous and are not addictive or accompanied by harmful physiological effects. The use of such drugs -stands in market in contrast to the use of illegal drugs like heroin, cocaine and LSD or the co consumption of legal drugs like alcohol, tobacco, barbiturates, and amphetamines, all of which are associated with distinctly harmful physical effect on the person habituated to them. Drug abuse may be perceived both as aberrant behavior and as a social problem. In the former sense, it is regarded as an evidence of individual’s social maladjustment. In the latter sense, it is viewed as widespread conditions that have harmful consequences for society. In several western countries, drug abuse is regarded as an important social problem. The drug abuse is increasing alarmingly all over the world. Psychological dependence occurs when an individual comes to rely on a drug for the feeling of well-being it produces. The word habituation is sometimes used to refer to psychic or psychological dependence. Addiction to drug means that the body becomes so dependent to the toxic effects of the drug that one just cannot do without it. Experimental, interactive treatment methods are the basis for treating drug addicts. It is counseling-related treatment. Apart from medication, lots of interpersonal work is involved. What the counselor needs to know-the characteristics of drug addiction: Counseling Has The Dominant Role To Play In The Cure Of The Drug-Addict. All other therapies have more or less failed to provide total cure to the addict. By taking such treatments, the patient has suffered relapse within a very short time. The characteristics of drug addition are so strong. They are: 1. An overpowering desire or need (compulsion) to continue taking the drug and to obtain it by ay means; these include the largest number of drug-using students devoted to pleasure-seeking new excitement and thrill. 2. Mostly people take drugs as an escape mechanism or to alleviate distress and this tendency tends to increase the dose (amount of intake) 3. A psychological and generally a physical dependence on the effects of the drugs, a very small number of people receiving drugs in course of medical treatment for the relief of pain continued to take them long after the treatment was over. 4. Psychological causes, like relieving tension, easing depression, removing inhibitions, satisfying curiosity, removing boredom, getting kicks, feeling high and confident, and intensifying perception. 5. Social causes, like facilitating social experiences, being accepted by friends, and challenging social values. 6. Physiological causes, like staying awake, heightening sexual experiences, removing pain, and getting sleep and 7. Improving study, deepening self-understanding, and solving personal problems, etc. 8. Drugs are generally obtained from non-medical sources such as friend, acquaintances, family members and home-cupboards. Solutions and intervention: To treat drug-addicts is not like the treatment of patients with cold or headache. Each addict is a special person and his problems are his own and they are quite intriguing. The broad rules of the treatment game, are as under but as you go on to treat more and more cases, the horizon of your experience will also expand. You have to deal with a cluster of problems relating to an individual before he is cured finally. This is a job of great perseverance, apart from your medical knowledge about the treatment. Drug demand reduction is a co-operative effort. Several persons are involved in the treatment of a drug addict. The co-operation of the addict is all the more important. Control over drug abuse can be made possible by adopting the following measures: 1. Imparting education about the misusage of drugs. 2. Sensitizing the family and relative about the ill-effects of misusing drugs and that they constitute a major influence upon the victims. 3. Undertaking follow-up study of the addicts under detoxification program and also to ensure that the enforcement institution execute their duties and to check on erring officers in collusion with the peddler. 4. Establishment of Centers where proper treatment to addicts is provided and such measures are worked out that could prevent the relapsing of the recovered addicts. British Association for Counseling and Psychotherapy: What you do is not important. How you do, what you do is indeed important! Profession of treatment (the medical profession), has of late has lost the pristine purity, and has become an area of motivated economic gains and exploitation. Wise people say, the greatest act of merit is to help others and the greatest act of sin is to cause intentional pain to others. “The BACP is a large organization that many counselors around the UK are registered with. They're not only a charity but also an accrediting body that set certain standards and codes of ethics for counselors and psychotherapists to adhere to. If counselors are accredited by the BACP it means they have completed a certain amount of training and practice under supervision of the BACP.”(Counselling Directory, 2007) Ethics for counseling and psychotherapy: This statement, Ethics for Counseling and Psychotherapy, unifies and replaces all the earlier codes for counselors, trainers and supervisors and is also applicable to counseling research, the use of counseling skills and the management of these services within organizations. It is intended to inform the practice of each member of the British Association for Counseling and Psychotherapy. The term ‘client’ is used as a generic term to refer to the recipient of any of these services. The client may be an individual, couple, family, group, organization or other specifiable social unit. Values of counseling and psychotherapy The fundamental values of counseling and psychotherapy include a commitment to: Respecting human rights and dignity Ensuring the integrity of practitioner-client relationships Enhancing the quality of professional knowledge and its application Alleviating personal distress and suffering Fostering a sense of self that is meaningful to the person(s) concerned Increasing personal effectiveness Enhancing the quality of relationships between people Appreciating the variety of human experience and culture Striving for the fair and adequate provision of counseling and psychotherapy services Values inform principles. They represent an important way of expressing a general ethical commitment that becomes more precisely defined and action-orientated when expressed as a principle. Personal qualities to which counselors and psychotherapists are strongly encouraged to aspire include empathy, sincerity, integrity, resilience, respect, humility, competence, fairness, wisdom, and courage. (BACP, 2007) Skills in Person-Centered Counseling and Psychotherapy: This is where one learns about the counseling process, giving appropriate advice, structure and manage he therapeutic work. From the initial meeting, right through the treatment period, and the ending of the relationship, hopefully on a merry note. The counselor-client interactions are very important here. The counselor is not only the treatment giver-he is the friend, philosopher and guide of the patient. Each paten is a new subject for him and you need to redraft the course of the treatment according to the need and level of the patient. How to make the patient to rely upon him more and more, to chisel a perfect individual out of his heap of imperfections—all these are challenging tasks for the counselor. If you make the patient ‘look after yourself,’ that is the greatest achievement of the counselor. To understand and practice the ‘easy job’ of dealing with the difficult patients! Yes, the “easy job!” The mere counseling, the endless counseling is indeed easy. It is mere repetition of what one has learnt in theory books! But what is important is your courageous implementation and brave interaction with your difficult patients. You should have the grit to suffer with them. Handle difficult situations, without losing heart. You will remember the story in Aesop’s Fables a fine stag, is looking at his form reflection in a lake, and is saying to his young one, “How powerful I am, look at my limbs, how strong and muscular they are; and how swiftly I can run.” In the meantime, he hears the barking of dogs in the distance, and immediately takes to his heels, and after he has run several miles, he comes back panting. The young one says,”You just told me how strong you were, and how was I that when the dogs barked, you ran away?” “Yes, my son, but when the dogs bark all my confidence vanishes.” “Such is the case with us. We think highly of humanity, we feel ourselves strong and valiant, we make grand resolves, but when the dogs of trial and temptation bark, we are like the stag in the fable.” That which is not practical, can not be ethical or spiritual either. Every good idea must successfully withstand the test of practicability. I recall how a hardcore drug addict, who came to us with his one foot in grave, was completely cured within a period of six months. Six months time for the complete cure of a drug addict is not an ordinary achievement. Those working in this are aware of this fact. He was an illiterate, but an expert mechanic. Let me call him X for the purpose of this illustration. X became a drug addict under strange circumstances. His expertise in repairing motor vehicles, trucks in particular, was his undoing. When other mechanics had not enough work, X worked in two shifts, sometimes even more! He had such a good feel of the vehicles that arrived at his workshop for repairs, that every one wished to have the vehicle repaired by him. For doing it quickly and efficiently, sometimes for doing the repairs job on priority basis, gifts of whiskey bottles arrived. Soon, he was addicted to whiskey, work or no work! He neglected his family, quarreled with his wife, beat her, children did not study, for there was no money for paying fees, his health deteriorated…..he could hardly balance his body, talked incoherently, when he came to the rehabilitation centre, to try his last hope. In fact, his wife brought him to then rehabilitation centre. X didn’t wish to go anywhere for treatment. He just wished to die-by drinking a few more pegs of whiskey, if possible! A perfect case arrived for the counselors to handle! A hard-core drug addict, A devastated and economically ruined family, Education of children in shambles, A socially humiliated wife, Under such grim conditions, anybody will become cynical. Even though the rehabilitation centre has an outpatient department, for individual counseling, family counseling, group counseling, treatment evaluation, medication management and intensive out patient therapy for psychiatric and addiction problems, the case of X was considered as the extremely serious one. X was admitted to the Inpatient department with residential facilities. This treatment module generally lasts for six months. The first thing we did was to get the children of X admitted to a school, by extending to them the facility of scholarship established by certain philanthropic organizations, through our centre. Some beds at the centre are reserved for the economically poor patients, with free boarding and lodging facilities. The treatment programs for patients like X were: 1. Identification of the addict. 2. Spiritual psychological counseling and motivation 3. Detoxification through authentic methods of Meditation, Naturopathy and Yoga. 4. Psychoanalytical recovery treatment 5. Nutrition and proper diet to the addict. 6. Specific yogic and naturopathy treatment for Abstinence Syndrome 7. Spiritual Healing in all aspects 8. Spiritual discourses and practices 9. Building of inner strength through spiritual exercises and exclusive Psychoanalytical Treatment Module that would prevent relapsing after recovery. It is also necessary to mention about the succeeding care program. This program is, actually, post treatment support to the recovered addicts. This support will be in the form of intensive counseling, troubleshooting, providing emotional support, and assistance for rehabilitation, after their discharge from the treatment centre. In the case of X, economic support from the centre would not be necessary. We had information that he was such a skilled mechanic; he will earn his bread very comfortably from day one of his discharge from the centre. As days and weeks rolled by, X responded very well to the treatment. After about two months he had developed intense will and determination to reform and turn over a new leaf. The main problem with addicts, as for drug demand reduction, is that the de-addiction treatment can treat and secure recovery of an addict, but it is difficult to prevent relapsing. The treatment provided at our centre takes this aspect into account as well. This is a treatment that treats, cures, detoxifies, recovers and rehabilitates an addict. Also transforms him in such a manner that there is a total denial to and abstinence from drugs, alcohol and any type substance abuse. The most encouraging part was that after two months, X made a request that was immediately conceded, to service the vehicles at the centre. He did a perfect job. His experience and skill was showing in his work. The vehicles were either owned by the centre, or belonged to the regular visitors to the centre. Soon the news spread that a highly skilled mechanic is available at the centre. X was allowed to keep his earnings and that gave him lots of confidence that he will recoup his original health and he will be able to find a respectable place in the society. In another case of a hardcore dug addict, his main problem was that he would not get sleep at night. After the supper, he was advised to take several rounds of the centre ground by walk, and he was asked to clap vigorously. Throughout this process, counselors accompanied him turn by turn. At the end of an hour’s work, he was tired, by this double exercise for both hands and legs. Soon thereafter, he dropped down to a sound sleep. On a careful analysis and study of the framework of British Association for Counselling and Psychotherapy, it can be stated without any doubt, utmost consideration and concern is given to human values. The entire text reads like a spiritual document. And that’s how it should be. It is pertinent to mention here about the oath that a medical practitioner is duty-bound to take when he steps out as a qualified medical practitioner to serve humanity (as well as to make a living out of it!) Hippocratic Oath 1. i. I swear ii. by Apollo the Physician and by Asclepius and by Health and Panacea and by all the gods as well as goddesses, making them judges [witnesses], iii. to bring the following oath and written covenant to fulfillment, in accordance with my power and my judgment; 2. i. to regard him who has taught me this techne as equal to my parents, and ii. to share, in partnership, my livelihood with him and to give him a share when he is in need of necessities, and iii. to judge the offspring [coming] from him equal to [my] male siblings, and iv. to teach them this techne, should they desire to learn [it], without fee and written covenant, and to give a share both of rules and of lectures, and of all the rest of learning, to my sons and to the [sons]of him who has taught me and to the pupils who have both make a written contract and sworn by a medical convention but by no other. 3. i. And I will use regimens for the benefit of the ill in accordance with my ability and my judgment, but from [what is] to their harm or injustice I will keep [them]. 4. i. And I will not give a drug that is deadly to anyone if asked [for it], ii. nor will I suggest the way to such a counsel. And likewise I will not give a woman a destructive pessary. 5. i. And in a pure and holy way ii. I will guard my life and my techne. 6. i. I will not cut, and certainly not those suffering from stone, but I will cede [this] to men [who are] practitioners of this activity. 7. i. Into as many houses as I may enter, I will go for the benefit of the ill, ii. while being far from all voluntary and destructive injustice, especially from sexual acts both upon women's bodies and upon men's, both of the free and of the slaves. 8. i. And about whatever I may see or hear in treatment, or even without treatment, in the life of human beings -- things that should not ever be blurted out outside --I will remain silent, holding such things to be unutterable [sacred, not to be divulged], i. a. If I render this oath fulfilled, and if I do not blur and confound it [making it to no effect] b. may it be [granted] to me to enjoy the benefits both of life and of techne, c. being held in good repute among all human beings for time eternal. ii. a. If, however, I transgress and perjure myself, b. the opposite of these (Von Staden, 1996) Working on ethical lines, when the profit-motive is the immediate next door neighbor, is no ordinary sacrifice. Again we need to talk about the ethical approach to treatment, which may involve sacrifice on the part of the medical practitioner, both with regard to time and money. You need to pay ‘sacri-price’ for sacrifice! Firstly, there needs to be a cause for the sacrifice; secondly you need to have the heart for the sacrifice; thirdly, you need to have the stamina, the will and the grit to achieve the objective of the sacrifice; and finally to receive the rewards or punishments of the sacrifice with a balanced mental attitude! That is what a perfect counselor is supposed to be! This is the sum and substance of the approach to treatment as elucidated and explained by the British Association for Counselling and Psychotherapy. Conclusion: “The challenge of working ethically means that practitioners will inevitably encounter situations where there are competing obligations. In such situations it is tempting to retreat from all ethical analysis in order to escape a sense of what may appear to be un resolvable ethical tension. These ethics are intended to be of assistance in such circumstances by directing attention to the variety of ethical factors that may need to be taken into consideration and to alternative ways of approaching ethics that may prove more useful. No statement of ethics can totally alleviate the difficulty of making professional judgments in circumstances that may be constantly changing and full of uncertainties. By accepting this statement of ethics, members of the British Association for Counselling and Psychotherapy are committing themselves to engaging with the challenge of striving to be ethical, even when doing so involves making difficult decisions or acting courageously.”(BACP, 2007) More or less, the ethical concepts of BACP, were applied in the treatment of X. When a drug addict is constantly nagged and abused, condemned and ostracized by society, he turns into a viler and bitter individual. That was the position of X when he was admitted to the centre as in patient. In such cases showering of pity alone will not help much. Heartfelt care and concern, an understanding approach, and tender regard for feelings are necessary prerequisites to heal the inner wounds, the self-inflicted damage. Coupled with this, everybody involved in the treatment, directly and indirectly, need to learn to forgive and forget the past of the patient in order to help him build a new identity. Thus the downward march to destruction was replaced by an upward march to ethical and spiritual elevation making X a worthy individual and citizen. After 6 months, X was discharged from the centre and all concerned are fully confident that his condition will never relapse. X has that confidence. Once in a week, he arrives at the centre to offer his free services to counsel other addicts-the reformed turned reformer! ---------------------- Word Count:3515 (Most of the contents of the article, derived from experience, as I am attached to an NGO.) References British Association for Counselling and Psychotherapy (2007). Ethical Framework for Good Practice in Counselling and Psychotherapy. BACP. 21 March 2007. . Counselling Directory (2007). British Association for Counselling and Psychotherapy. Memiah Limited. 21 March 2007. Von Staden, Heinrich. 1996. In a pure and a holy way. Personal and professional conduct in the Hippocratic Oath. Journal of the History of Medicine and Allied Sciences. Volume 51. March 21, 2007, 406-408. Available from www.indiana.edu. See Reference BACP: see British Association for Counselling and Psychotherapy Read More