Journey Of Establishing The Pioneer De-Addiction Centre In Armed Forces

BACKGROUND: Substance use disorder (SUD) is a global public health concern. National Mental Health Survey 2015-2016 brought out that 22.4% of adult Indian population was addicted to psychoactive substances A study by Raju et al estimated 15.53 % prevalence of Alcohol Use Disorder (AUD) cases amongst all psychiatric admissions in a year. Keeping in view, the relapsing nature of substance use disorder cases conflicting with the organisational requirements of having “combat-fit” armed forces, there was a necessity of having specialised centres for providing a well-structured de-addiction therapy to difficult cases. AIM: To highlight the journey of establishment of the first De-Addiction Centre (DAC) of Indian Army and its achievements. Development of a De-addiction Centre: In Nov 2017, under aegis of Director General of Medical Services (Army), the inception of 50 bedded DAC at Base Hospital, Barrackpore occurred. A dedicated de-addiction team was ear-marked, headed by a specialist in Addiction Psychiatry. A batch wise, six- week duration, structured de-addiction course was charted out for difficult to treat serving SUD cases posted in the Eastern sector of Indian Army. It was divided into 3 phases – Evaluation (1 week), De-addiction phase (04 weeks) and Post treatment protocol (1 week). The first structured de-addiction course commenced in Sep 2018. RESULTS: 10 batches with total of 345 patients have received benefit of de-addiction therapy. 94% of these were AUD cases, 4% cannabis and 2% were addicted to opioids. On the basis of feedback received from units, 58.4% were reported to be completely abstinent, 16.7% occasionally drinking with satisfactory vocational performance, 13.9 % had relapsed into substance use and 11 % were lost to follow up. CONCLUSION: The humble beginning of this DAC is in the process of growth wherein a lot still needs to be achieved in terms of building “state of art” SUD Laboratory harbouring specialised equipment for diagnostic and therapeutic purpose and initiate teaching and training curriculum in addiction psychiatry for Post Graduate residents, medical officers and paramedics.