National Drug Dependence Treatment Centre Research Articles

Use of alcohol among treatment seeking illicit drug users in India

Introduction: Concomitant multiple substance use by clients in drug abuse treatment settings has been recognized as an important treatment issue for many years, and remains under-researched in Indian context. Aim: To examine the patterns and prevalence of concomitant alcohol and illicit drug use among the patients seeking treatment for illicit drug use. Materials and Methods: A total of 110 patients attending the National drug dependence treatment centre having multiple drug use were included for the present study. Data was collected by face-to-face structured interview on a semi-structured proforma. Results: It was observed that overall 38.2% of the illicit drug users had concomitant alcohol use. Concomitant use of alcohol was found to be 37.1%, 45.5% and 44.4% among heroin, cannabis users and Doda (opium) users respectively. The maximum quantity of alcohol consumption was reported by patients who used opium (Doda) (mean = 703.13 ml/day). A multinomial logistic regression analysis showed that middle aged males and those with lower educational levels, were at greater risk for concomitant exposure to alcohol and illicit drugs. Conclusion: Many people use alcohol in combination with illicit drugs. Clinicians should warn every patient about alcohol-drug interactions, especially those at high risk for concomitant exposure. These findings have implications for prevention, as well as clinical risk for adverse consequences of concomitant alcohol and illicit drug consumption.

Asian paradox of psychological support: Findings from the second Diabetes Attitudes Wishes and Needs study (DAWN-2)

Asia-Pacific PsychiatryVolume 5, Issue 4 p. 354-355 LETTER TO THE EDITOR Asian paradox of psychological support: Findings from the second Diabetes Attitudes Wishes and Needs study (DAWN-2) Sanjay Kalra MBBS MD DM, Sanjay Kalra MBBS MD DM Consultant Endocrinologist B.R.I.D.E. Hospital, Karnal, IndiaSearch for more papers by this authorYatan Pal Singh Balhara MBBS MD DNB MNAMS, Yatan Pal Singh Balhara MBBS MD DNB MNAMS Assistant Professor of Psychiatry Department of Psychiatry, National Drug Dependence Treatment Centre (NDDTC), All India Institute of Medical Sciences (AIIMS), New Delhi, IndiaSearch for more papers by this authorKomal Verma MA, Komal Verma MA Consultant Psychologist Noida, Uttar Pradesh, IndiaSearch for more papers by this authorAmbika Gopalakrishnan Unnikrishnan DM, Ambika Gopalakrishnan Unnikrishnan DM Consultant Endocrinologist Amrita Institute of Medical Sciences, Kochi, IndiaSearch for more papers by this author Sanjay Kalra MBBS MD DM, Sanjay Kalra MBBS MD DM Consultant Endocrinologist B.R.I.D.E. Hospital, Karnal, IndiaSearch for more papers by this authorYatan Pal Singh Balhara MBBS MD DNB MNAMS, Yatan Pal Singh Balhara MBBS MD DNB MNAMS Assistant Professor of Psychiatry Department of Psychiatry, National Drug Dependence Treatment Centre (NDDTC), All India Institute of Medical Sciences (AIIMS), New Delhi, IndiaSearch for more papers by this authorKomal Verma MA, Komal Verma MA Consultant Psychologist Noida, Uttar Pradesh, IndiaSearch for more papers by this authorAmbika Gopalakrishnan Unnikrishnan DM, Ambika Gopalakrishnan Unnikrishnan DM Consultant Endocrinologist Amrita Institute of Medical Sciences, Kochi, IndiaSearch for more papers by this author First published: 30 October 2013 https://doi.org/10.1111/appy.12107Citations: 1 Conflicts of interest: None. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article.Citing Literature Volume5, Issue4December 2013Pages 354-355 RelatedInformation

The rise of super (?sub)-specialties courses in psychiatry: Is India ready for it!

Byline: N. Manjunatha, Murali. Thyloth, T. Sathyanarayana Rao The field of psychiatry is still growing; [sup][1] however, the phenomenal growth occurred in many areas in the field of Indian psychiatry in last decade. One of them is the increase in postgraduate seats (Diploma in Psychological Medicine (DPM)/Doctor of Medicine (MD)/Diplomate of National Board (DNB) of psychiatry to address the shortage of psychiatrists in our country. In curious latest development two medical institutes in our country started two super-specialties psychiatry courses (after branching out from department of psychiatry) in the academic year of 2011-2012 such as Doctor of Medicine (DM) (Geriatric Mental Health) at 'King George Medical University', Lucknow (http://www.kgmu.org/dept_geriatric.php) and DM (Child and Adolescent Psychiatry) at 'National Institute of Mental Health and Neurosciences' (NIMHANS), Bangalore (http://www.nimhans.kar.nic.in/cap/default.htm) for candidates of MD/DNB psychiatry. Other awaiting super-specialty psychiatry course is DM (Addiction Medicine) at 'National Drug Dependence Treatment Centre' of 'All India Institute of Medical Sciences', New Delhi and 'Centre for Addiction Medicine', NIMHANS, Bangalore. Debate *In an outlook it is a welcome step, however, authors consider this rise of super-specialties in still growing field of Indian psychiatry is a debatable issue. When our country is already facing 77% average national deficit of psychiatrists, [sup][2] will not this step lead further shortage of general psychiatrists in India? India is currently producing 357 MD (Psychiatry) and 129 Diploma in Psychological Medicine (DPM) per year in various medical college/institutes of our country. [sup][3] Along with these reasons and the migration of qualified psychiatrists to developed countries, will this step be a pragmatic one for MD psychiatry candidates to enter DM in these super-specialties? *Then, what is the need of having super-specialty psychiatric courses? Is there a demand for clinical service, if so, having separate clinic/unit in the psychiatry department (one of the requirement of Medical Council of India (MCI) to start MD psychiatry course) shall be sufficient. Is there a demand in research point of view, if so, developing a separate 3 years course is not justified? If the development for teaching purpose due to lack of expertise, having separate clinic/unit within department of psychiatry would suffice. Considering all above points, Indian academic psychiatry is not ready for premature branching out as 3 years DM course. It may be pragmatic to wait till required number of psychiatrists of India is available for clinical service. *Another important aspect of this development is the employability after their training. Authors tend to believe as not so lucrative for these super-specialties as there are already inadequate practicing general psychiatrists and inadequate teaching psychiatric faculties in medical colleges. *In view of public mental health, when India is struggling to provide primary care psychiatry and facing difficulty in the implementation of 'National Mental Health Program', can we afford to have these super-specialties in psychiatry which further reduces the human resources? Progress in Indian Medical Education with Respect to Super-Specialties Authors feel that the developing new courses with new name are becoming fashionable in the field of Indian education. Medical education of our country is not the exception for this and is already developed new courses in last few decades such as DNB, DM, Magister Chirurgiae (MCh), etc., Irony in this development is having same name (i. …

Addiction Research Centres and the Nurturing of Creativity: National Drug Dependence Treatment Centre, India—a profile

The National Drug Dependence Treatment Centre (NDDTC) is a part of the All India Institute of Medical Sciences, a premier autonomous medical university in India. This article provides an account of its origin and its contribution to the field of substance use disorder at the national and international levels. Since its establishment, the NDDTC has played a major role in the development of various replicable models of care, the training of post-graduate students of psychiatry, research, policy development and planning. An assessment of the magnitude of drug abuse in India began in the early 1990s and this was followed by a National Survey on Extent, Patterns and Trends of Drug Abuse in 2004. Several models of clinical care have been developed for population subgroups in diverse settings. The centre played an important role in producing data and resource material which helped to scale up opioid substitution treatment in India. A nationwide database on the profile of patients seeking treatment (Drug Abuse Monitoring System) at government drug treatment centres has also been created. The centre has provided valuable inputs for the Government of India's programme planning. Besides clinical studies, research has also focused on pre-clinical studies. Capacity-building is an important priority, with training curricula and resource material being developed for doctors and paramedical staff. Many of these training programmes are conducted in collaboration with other institutions in the country. The NDDTC has received funding from several national and international organizations for research and scientific meetings, and, most recently (2012), it has been designated as a World Health Organization Collaborating Centre on Substance Abuse.

Concordance Between Urinary Cotinine Levels and Self-Reported Tobacco Use Among Drug-Dependent Persons: A Pilot Study

ABSTRACT Self-reported drug use is a principle measure in the evaluation of treatment outcome. As there have been concerns about the accuracy of self-reporting, it is necessary to establish its validity by an objective method. The aim of the study was to examine the concordance between urinary cotinine concentrations and self-reported tobacco use among drug dependents seeking treatment at National Drug Dependence Treatment Centre, AIIMS, New Delhi, India. Eighty consecutive male drug addicts attending the OPD at National Drug Dependence Treatment Centre were interviewed by the clinician. Their tobacco as well as drug use history was recorded, and thereafter their urine sample was analyzed for drug testing. Mean age of the subjects was found to be 33 years (SD: 10). Urinalysis showed high concentration of cotinine (mean ± SD: 586.40 ± 222.15 ng/ml) in 95% of the subjects. High concordance was observed between self-report of tobacco use and urinary cotinine. The quantity of tobacco consumption and FTND scores were also correlated with the urinary cotinine levels. Urinalysis also showed misuse of opioids, benzodiazepines and antihistaminics. The treatment for tobacco use has been given low priority in the de-addiction centers. Tobacco is highly prevalent among the drug abusers. The effectiveness of the treatment program may be increased by using the combination of urine analysis along with self-report.

Ethnographic Mapping of Alcohol Use and Risk Behaviors in Delhi

This paper examines mapping and related data-gathering at geographical locations of vulnerable urban groups with regard to risky sexual behaviors and alcohol/drug use in the capital city of Delhi. The aim is to describe the situations of special geographic locations and sub-groups in relation to alcohol/drug use and risks of HIV/STI infections. The study was part of a community program for alcohol and drug users in slum communities in West and East Delhi carried out by the National Drug Dependence Treatment Centre (NDDTC) of the All India Institute of Medical Science (AIIMS), New Delhi, India. As part of a WHO multi-centered qualitative study among selected groups, mapping was done at different sites concerning alcohol use, social contexts, involvement in sexual risk behavior, availability of sex partners and related factors. Easy access to alcohol and drugs, accompanied by availability of sex workers appeared as compound risk factors in the study sites. Reported risky sexual behaviors included nonuse or irregular use of condoms, multiple sex partners, group sex, and anal sex with hijras (eunuchs).

Can you trust self‐reports among injectable drug users in clinical setting?

Aim: The aim of the study is to examine the agreement between self‐reports of drug use pattern and urinalysis data of 112 male intravenous drug users seeking treatment at National Drug Dependence Treatment Centre of All India Institute of Medical Sciences, New Delhi, India.Design: All the male intravenous drug users (n = 112) seeking treatment during the study period were included in the study. Addiction Severity Index Questionnaire was administered, and the agreement between self‐reports of drug use and urine analysis of drugs using gas liquid chromatography was compared.Findings: The data showed that although the primary drug of use was heroin in all the subjects a significant number of them were currently using a combination of buprenorphine, diazepam and pheniramine. The agreement of self‐report and urine analysis varied across the type of drug used. Acceptable agreement was seen with buprenorphine, diazepam, pheniramine and promethazine. The reports of patients on heroin and morphine showed poor agreement. Over reporting and under reporting was also observed in these subjects and the physician should be aware of this possibility.Conclusions: Combination of urine analysis and self‐report is a useful tool for better patient care and treatment.