BERNAMA NEWS - Drug Addiction, A Chronic Brain Disease

Drug Addiction, A Chronic Brain Disease

By Ravichandran D.J. Paul

KUALA LUMPUR, (Bernama) -- The number of drug addicts is anticipated to double by 2015 from the current 270,000 and the figure indicates addiction to drugs is more than a social or behavioural problem.

A recent workshop held in conjunction with World Anti Drug Month emphasized that addiction is a chronic brain disorder. This view backed by scientific studies is increasingly gaining acceptance.

Dr Sivakumar Thurairajasingam, Consultant Psychiatrist with Monash University's Clinical School in Johor Baharu, explained that drug addiction is a chronic, often relapsing, disease caused by the changes in the structure of the brain due to prolonged drug abuse.

DIFFICULT TO CURE

It will be difficult to kick the habit, especially when the person has reached the dependence level. A person who has reached such stage is actually suffering from an addiction disease.

At this stage, addicts take drugs not to attain the 'reinforced' feeling anymore but to enable them to continue functioning psychologically and physiologically.

Thus in treating them, they are given safe drugs as substitute (drug substitute therapy).

Dr Sivakumar said the treatment goals for the addicts focus on rebuilding their life, work towards harm reduction and lessens the dependence on substances.

TREATMENT AN EFFORT IN FUTILITY?

The Association for the Prevention of Dadah Abuse (Pemadam) revealed that it costs RM50 million annually to rehabilitate drug addicts but the question still remains as to whether they can be fully rehabilitated?

Dr Salina Abdul Aziz, Consultant Psychiatrist and Clinical Epidemiologist at the Kuala Lumpur Hospitals Department of Psychiatry said there is probably no cure for those who have reached the dependency stage but the problem can still be controlled and managed.

"Just like diabetes and asthma, drug addiction can be managed successfully if not cured completely.

"No one could claim to be an ex-addict even after staying away from drugs for up to 20 years because the habit could relapse anytime.

"So thats why we often hear from those in the recovering process stating that `I'm a recovering addict or `a clean addict'.

"Also, those who come to seek treatment must be informed that a relapse does not necessarily means failure, it merely indicates that either treatment should be reinstated, adjusted or alternate treatment methods are needed to regain control and recover," she said.

WHAT ARE THE OPTIONS AVAILABLE

As addiction is now seen as a disease, drug substitute therapy tailored to individual needs is recommended. The process starts with detoxification before undergoing substitute therapy using methadone or buprenorphine/naloxone.

Addicts also undergo counseling and treatment for ailments including HIV infection and others as part of the rehabilitation programme.

Dr Salina emphasised that therapy had to be easily accessible, considering the easy availability of drugs.

"Drugs can be delivered to your door step upon request. Synthetic drugs can be made anywhere," she said adding that if treatment is not easily accessible then they will return to taking drugs.

To ensure easy access to treatment, a number of private medical practitioners provide the Community Based Treatment (CBT) under the guidance of the Ministry of Health. CBT offers addicts confidential drug substitute therapy in settings such as private clinics, specialist centers or at homes all over the nation.

So far 528 private medical practitioners have enlisted to provide the services with 18,000 patients on the register roll, with Selangor recording the highest number of patients at 4,000.

The CBT program utilises a centralised surveillance Internet platform called the National Drug Substitution Therapy (NDST) Register to monitor the supply of the substitute drugs for patients undergoing addiction treatment.

Dr Salina noted that surveillance would help avoid the abuse of substitute drugs.

ADDICTS FREE FROM BLAME?

If drug addition is a disease, can the addicts be exonerated from any blame for their own destruction?

Here both Dr Sivakumar and Dr Salina are unanimous in their opinion by saying that we should not tempt fate in the first place by trying drugs.

"If you are addicted, then you only have yourself to blame," said Dr Sivakumar.

The road to recovery is a long one with no guarantees on the outcome. Nevertheless, drug addicts must be given assurance that change is possible though rehabilitation.

-- BERNAMA