Final Project Report on Starting Dead Diction Center

Project report on starting

De-addiction centre

at

shree Krishna hospital

By: VIRAL ROY(8086)

NRIBM-GLS

GUJARAT UNIVERSITY

Executive Summary

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Shree Krishna Hospital is a full facility, multispeciality hospital situated near

Karamsad. The main aim of the hospital is to provide a service to the patient at very low

rate. It has a full facility from surgery to pharmacy.

Now-a-days addiction of tobacco and other abuse drugs have drastically

increased. SKH and Charutar Arogya Mandal need to fight against that. So there is a

need of one de-addiction cum rehabilitation center for prevention of addiction and fight

against such abused substances.

Ministry of justice and empowerment, Government of India also encourages such

type of activity and gives a grant to open a new de-addiction center, to give initial help

to them. So for that this project includes the different activities and programs done in

such kind of centers and the daily routine in such center.

The legal aspects, financial aspects and different facilities and equipments need

in such center that also includes in this project, which will be helpful to Charutar

Arogya Mandal Trust to open a new de-addiction cum rehabilitation center.

N.R.INSTITUTE OF BUSINESS MANAGEMENT-GLS by VIRALROY (8086)

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TABLE OF CONTENTS:

INDEX

NO. TITLE PAGE NO.

1 INTRODUCTION

1.1 DEFINITION

1.2 SPECIFIC: Sign And Symptoms

1.3 International And Domestic Scenario With Facts And Figures

1.4 Government Initiatives

1.5 Case Study

2 Need For The Project

Objectives

3 Shree Krishna Hospital

3.1 Introduction About Services And Schemes

3.2 Short Literature Survey

3.3 Research Methodology

3.4 Data Sources

4 De-Addiction Centre

4.1 Addiction Centre

4.2 Main Functions Of The Centre

4.3 Treatment Strategy


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4.4 Comprehensive De-Addiction Services

5 De-Addiction Therapy For Treatment

5.1 Psychotherapy

5.1.1 Perception Therapy

5.1.2 Metaphor Therapy

5.1.3 Life Transformation / Relapse Prevention Tools

5.1.4 Cognitive Behavior Therapy

5.1.5 Addiction Councelling

5.2 Pharmacotherapy

5.3 Sports Program

5.4 Yoga And Meditation Program

5.5 Recreation And Naturopathy

5.6 Extended Care Program

5.7 Recovery Monitoring Program

6 Human Resource Department

7 The Program For Addicts

7.1 The 12 Step Program


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7.2 Daily Schedule

7.3 Rules And Regulation

8 Budget

8.1 Recurring Expenditure For Staff

8.2 Recurring Expenditure Other Then Staff

8.3 Non Recurring Expenditure

8.4 Expenditure For Awareness Cum De-Addiction Camps

9 Legal Formality

9.1 Norms For Assistance

9.2 Application And Sanction

9.3 Condition For Assistance

10 Conclusion

11 Annexure

11.1 Scheme For Prevention Of Alcoholism And Substance (Drugs) Abuse

Application Form

11.2 Application Cum Montoring Form For Grant-In-Aid For Scheme For

Prevention Of Alcoholism And Substance (Drugs) Abuse

11.3 Verification

12 Bibliography

13 List of tables


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LIST OF TABLES

NO. TITLE PAGE NO.

1 Global Burden Of Disease Attributable To Alcohol

6 Human Resource Department

7 Daily Time Table For Addicted Person In De-Addiction Centre

8 8.1 Recurring Expenditure For Staff

8.2 Recurring Expenditure Other Then Staff

8.3 Non Recurring Expenditure

8.4 Expenditure For Awareness Cum De-Addiction Camps

9 9.1 Extent Of Assistance

9.2 Periodic Return

9.3 Utilization Certificates

CHAPTER ~1

INTRODUCTION

1.1 ADDICTION


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A mal-adaptive pattern of substance use, leading to clinically significant impairment or distress, as

manifested by three (or more) of the following, occurring at any time in the same 12-month period:

(1) Tolerance, as defined by either of the following: a. A need for markedly increased amounts of the

substance to achieve intoxication or desired effect. b. Markedly diminished effect with continued use

of the same amount of the substance.

(2) Withdrawal, as manifested by either of the following: (a) The characteristic withdrawal syndrome

for the substance. (b) The same (or a closely related) substance is taken to relieve or avoid withdrawal

symptoms.

(3) The substance is often taken in larger amounts or over a longer period than was intended (loss of

control).

(4) There is a persistent desire or unsuccessful efforts to cut down or control substance use (loss of

control).

(5) A great deal of time is spent in activities necessary to obtain the substance, use the substance, or

recover from its effects (preoccupation).

(6) Important social, occupational, or recreational activities are given up or reduced because of

substance use (continuation despite adverse consequences).

(7) The substance use is continued despite knowledge of having a persistent or recurrent physical or

psychological problem that is likely to have been caused or exacerbated by the substance (adverse

consequences).

1.2 SPECIFIC: SIGNS AND SYMPTOMS

ALCOHOL:


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Odor on the breath, Intoxication, Difficulty focusing: glazed appearance of the eyes.

Uncharacteristically passive behavior; or combative and argumentative behavior, Gradual (or sudden

in adolescents) deterioration in personal appearance and hygiene, Gradual development of dysfunction,

especially in job performance or school work, Absenteeism (particularly on Monday), Unexplained

bruises and accidents, Irritability, Flushed skin, Loss of memory (blackouts). Availability and

consumption of alcohol becomes the focus of social or professional activities. Changes in peer-group

associations and friendships. Impaired interpersonal relationships (troubled marriage, unexplainable

termination of deep relationships, and alienation from close family members).

Marijuana/pot:

Rapid, loud talking and bursts of laughter in early stages of intoxication. Sleepy or stuporous in the

later stages, forgetfulness in conversation. Inflammation in whites of eyes, pupils unlikely to be

dilated, odor similar to burnt rope on clothing or breath. Tendency to drive slowly-below speed limit,

distorted sense of time passage - tendency to overestimate time intervals. Use or possession of

paraphernalia including roach clip, packs of rolling papers, pipes or bongs. Marijuana users are

difficult to recognize unless they are under the influence of the drug at the time of observation. Casual

users may show none of the general symptoms. Marijuana does have a distinct odor and may be the

same color or a bit greener than tobacco.

COCAINE/CRACK/METHAMPHETAMINES/STIMULANTS:

Extremely dilated pupils, Dry mouth and nose, bad breath, frequent lip licking. Excessive activity,

difficulty sitting still, lack of interest in food or sleep. Irritable, argumentative, nervous. Talkative, but

conversation often lacks continuity; changes subjects rapidly. Runny nose, cold or chronic sinus/nasal

problems, nose bleeds. Use or possession of paraphernalia including small spoons, razor blades,

mirror, little bottles of white powder and plastic, glass or metal straws.

DEPRESSANTS:


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Symptoms of alcohol intoxication with no alcohol odor on breath (remember that depressants are

frequently used with alcohol). Lack of facial expression or animation, Flat affect, flaccid appearance,

Slurred speech.

Note: There are few readily apparent symptoms. Abuse may be indicated by activities such as frequent

visits to different physicians for prescriptions to treat "nervousness", "anxiety"," stress", etc.

NARCOTICS/PRESCRIPTION DRUGS/OPIUM/HEROIN/CODEINE/OXYCONTIN:

Lethargy, drowsiness, Constricted pupils fail to respond to light. Redness and raw nostrils from

inhaling heroin in power form. Scars (tracks) on inner arms or other parts of body, from needle

injections. Use or possession of paraphernalia, including syringes, bent spoons, bottle caps, eye

droppers, rubber tubing, cotton and needles, Slurred speech. While there may be no readily apparent

symptoms of analgesic abuse, it may be indicated by frequent visits to different physicians or dentists

for prescriptions to treat pain of non-specific origin. In cases where patient has chronic pain and abuse

of medication is suspected, it may be indicated by amounts and frequency taken.

INHALANTS:

Substance odor on breath and clothes, runny nose, watering eyes, drowsiness or unconsciousness, poor

muscle control, prefers group activity to being alone. Presence of bags or rags containing dry plastic

cement or other solvent at home, in locker at school or at work. Discarded whipped cream, spray paint

or similar chargers (users of nitrous oxide). Small bottles labeled "incense" (users of butyl nitrite).

SOLVENTS, AEROSOLS, GLUE:

Nitrous Oxide - laughing gas, whippits, nitrous. Amyl Nitrate - snappers, poppers, pearlers, rushamies.

Butyl Nitrate - locker room, bolt, bullet, rush, climax, red gold. Slurred speech, impaired coordination,


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nausea, vomiting, slowed breathing, brain damage, pains in the chest, muscles, joints, heart trouble,

severe depression, fatigue, loss of appetite, bronchial spasm, sores on nose or mouth, nosebleeds,

diarrhea, bizarre or reckless behavior, sudden death, suffocation.

LSD/HALLUCINOGENS:

Extremely dilated pupils, Warm skin, excessive perspiration and body odor, distorted sense of sight,

hearing, touch; distorted image of self and time perception. Mood and behavior changes, the extent

depending on emotional state of the user and environmental conditions Unpredictable flashback

episodes even long after withdrawal (although these are rare). Hallucinogenic drugs, which occur both

naturally and in synthetic form, distort or disturb sensory input, sometimes to a great degree.

Hallucinogens occur naturally in primarily two forms, (peyote) cactus and psilocybin mushrooms.

Several chemical varieties have been synthesized, most notably LSD, MDA, STP, and PCP.

Hallucinogen usage reached a peak in the United States in the late 1960's, but declined shortly

thereafter due to a broader awareness of the detrimental effects of usage. However, a disturbing trend

indicating resurgence in hallucinogen usage by high-school and college age persons nationwide has

been acknowledged by law enforcement. With the exception of PCP, all hallucinogens seem to share

common effects of use. Any portion of sensory perceptions may be altered to varying degrees.

Synesthesia, or the "seeing" of sounds, and the "hearing" of colors, is a common side effect of

hallucinogen use. Depersonalization, acute anxiety, and acute depression resulting in suicide have also

been noted as a result of hallucinogen use. Note: there are some forms of hallucinogens that are

considered downers and constrict pupil diameters.

ECSTASY:

Confusion, depression, headaches, dizziness (from hangover/after effects), muscle tension, panic

attacks, paranoia, possession of pacifiers (used to stop jaw clenching), lollipops, candy necklaces,

mentholated vapor rub, severe anxiety, sore jaw (from clenching teeth after effects), vomiting or

nausea (from hangover/after effects) .


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Signs that your teen could be high on Ecstasy: Blurred vision, rapid eye movement, pupil dilation,

chills or sweating, high body temperature, sweating profusely, dehydrated, confusion, faintness,

paranoia or severe anxiety, trance-like state, transfixed on sites and sounds, unconscious clenching of

the jaw, grinding teeth, very affectionate.

1.3 INTERNATIONAL AND DOMESTIC SCENARIO WITH FACTS AND

FIGURES:

Substance abuse disorders (alcohol and drugs) form one of the most significant behavior related

problems the world over. Behavior related problems account for 34% of all disability (World Bank

1993) and include problems such as violence, malnutrition, tuberculosis, diarrheal disease, sexual

transmitted diseases, motor vehicle accidents and other unintentional injuries. Substance abuse can

directly lead to a range of physical, psychological and social problems as well as indirectly contribute

to disability.

Substance related problems are increasing the world over. However, the study of substance abuse and

its treatment is still in a state of evolution in most countries. In most low-income countries, although

the problem of substance abuse is increasingly recognized to be a major social cost and often publicly

acknowledged, treatment facilities are woefully inadequate and there are high rates of recidivism.

There is thus a need for a comprehensive programme and careful planning in the organization of

services for alcohol and drug problems.

Public health approaches have traditionally looked at primary, secondary and tertiary levels of

prevention. With regard to substance abuse treatment, the focus in India has largely been on tertiary

prevention: the individual receives attention only when addiction or serious physical or psychosocial

problems have already occurred – with the emphasis on detoxification and rehabilitation.


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The costs of intervention at this stage are high, the result is disappointing, and the poor outcome

intensifies the therapeutic nihilism associated with treatment of substance abuse. There is thus a need

for a logical shift of emphasis to secondary and primary levels of prevention.

This project is an effort in that direction and has attempted to examine the utility of various approaches

in the community in an attempt to evolve a model for early detection and early intervention of alcohol

and drug problems in the community.

INTERNATIONAL SCENARIO

ALCOHOL

According to the 1993 World Development Report, alcohol related diseases affect 5 to 10% of the

world’s population each year and accounted for approximately 3% of the global burden of disease in

1990. Data from the food and Agricultural Organisation of the United Nations indicates that

production of beverage alcohol worldwide has steadily increased from 1970, mainly accounted for by

distilled spirits and beer.

Alcohol use is related to a wide range of physical, mental and social harm. It is now clear that

practically no organ in the body is immune from alcohol related harm. Several conditions are by

definition caused by alcohol use such as abuse, dependence, polyneuropathy, cardiomyopathy,

gastritis, cirrhosis, alcoholic psychosis, ethanol toxicity and methanol toxicity. Other conditions have

been identified where the fraction attributable to alcohol has been in excess of 30%, including

oesophageal varicies, chronic pancreatitis, unspecified cirrhosis, road injuries, fall injuries, fire

injuries, drowning, suicide and homicide.

There are also enormous social costs of alcohol which include the direct costs of treating injuries and

diseases as well as that of treatment and rehabilitiation, property losses, law enforcement costs and

losses of productivity due to absenteeism or loss of productive life years (Global Status Report on

Alcohol 1999). The global burden of disease and injury attributable to alcohol use in 199 are

summarized in the accompanying table:


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Table 1: Global Burden of Disease attributable to alcohol

Other Drugs

The annual global prevalence rate of illicit drug consumption is likely to be in the range of 3.3% to

4.1% of the total population (World Drug Report 1997).The most widely abused drug is cannabis,

which is consumed by 2.5% (140 million people worldwide). In comparison to the main licit

psychoactive substances, tobacco and alcohol, which are consumed by at least 20% and 50% of the

world’s population respectively (figures from the WHO and US Household Survey 1994), regular


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abuse of illicit drugs at the worldwide level is relatively less common (World Drug Report 1997).

Although the numbers are smaller, it is recognized that people have started drug use at an earlier age,

and change in the patterns and type of drug use (eg. Intravenous use, sniffing of inhalants, high risk

behavior) bring with it newer and serious problems. Higher mortality is often related to overdose,

impurities in the drug and dangerous practices (cocktailing). In addition, serious public health

problems related to drug use include accidents, tuberculosis, hepatitis, sexually transmitted diseases,

HIV and AIDS. There is a definite relationship between crime and illicit drug use but the relationship

defies any simple analysis.

INDIA

Alcohol Consumption and Prevalence:

Alcohol related problems in any country are related to trends in alcohol consumption. Although

reliable data are not available for the country, there is enough evidence from production and sales data,

growth of the alcohol industry, increased accessibility to alcohol through increasing licenses to

breweries, distilleries and liquor shops and increased excise earnings from alcohol. Despite the

limitation in accurate and uniform data on the different aspects of alcohol use and related problems,

two comprehensive reviews provide valuable insights into data available on various aspects of alcohol

consumption, consequences and responses to the problem (Global Status Report on Alcohol 1999).

IMPACT OF ALCOHOLISM

5.5% of 46 alcohol dependent patients had died in an 18 month. The figure increased to 11.3% in a 5

year follow-up study of 71 patients. Several studies have reported hepatic dysfunction, cognitive

impairment, head injuries, serious psychosocial problems including family disruption, marital discord,

problems in children, financial difficulties, domestic violence, employment problems consequent to

alcoholism.

Other Drugs


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The proximity to the golden triangle and golden crescent, disappearing social controls, political and

social instability have resulted in a perceptible increase in illicit drug use in India. A vibrant

pharmaceutical industry, increased prescription of psychotropics and a lack of a prescription

monitoring system has led to greater possibility of psychotropic drug misuse.

The South Asia Drug Demand Reduction Report estimates that there are 2.25 million substance users

in the country. Apart from alcohol, cannabis, opiates and benzodiazepines have been recognized as

common drugs of misuse.

Solvent use among street children has been reported from street children’s groups throughout the

country. Injecting drug use brings it with the additional dangers, and a host of physical problems,

ranging from cellulitis and septicemia to endocarditis, hepatitis, HIV and tuberculosis have been

reported among IV drug users.

RESPONSES TO THE ALCOHOL AND DRUG PROBLEM

ALCOHOL POLICY

Prohibition has been one of the “Directives of State Policy” incorporated in the Indian Constitution

(Section 47). Alcohol policies in different states in the country have swung between total prohibition to

unrestricted sales with no controls. Mass movements have also contributed to policy development in

some states of the country. In Andhra Pradesh, what began as a lesson in an adult literacy book led to a

local agitation by poor rural women grew into a state wide arrack movement. Similar movements have

been intitiated elsewhere. However many of the mass movements have not succeeded in the long run,

largely due to socio-political reasons and a continuing demand.

DRUG POLICY - NARCOTICS AND PSYCHOTROPICS SUBSTANCES ACT 1985


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This Act consolidates and amends the laws relating to narcotic and psychotropic drugs. It makes

stringent provisions for the control and regulation of operations relating to these drugs. It provides for

punishment with varying fines/imprisonments for unlawful possession of different substances in these

categories. While the Act essentially deals with supply reduction activities, it also authorizes the

Central Government to take necessary measures for preventing addiction and comprehensive treatment

of addicts, as well as the power to establish treatment centers. It also provides individuals arrested with

‘small quantitites’ the option of diversion from the criminal justice system to the treatment system for

first offences.

1.4 GOVERNMENT INITIATIVES

Nodal points for the drug demand reduction activities have been the Ministry of Health and Family

Welfare and the Ministry of Social Justice and Empowerment, Government of India. The Ministry of

Health lays emphasis on treatment, including community based treatment, health educational activities,

human resource development through training of health personnel in substance abuse management

throughout the country. It established 5 treatment centres in 1988. Seventy two treatment centres were

initiated at medical colleges and district hospitals. Training curricula for resource staff have been

developed by the Ministry of Health and Family Welfare. In the early 1990’s, it was estimated that

1000 medical officers had been trained over 32 courses across 18 institutions. The feedback from such

evaluation however, has been the inadequate clinical exposure, inadequacy of adequate resource

material, inadequate exposure to community based services.

The Ministry of Social Justice and Empowerment funds more than 341 NGOs throughout the country

for counseling, rehabilitation and aftercare. It also supports public awareness campaigns, media

publicity and community based action in the area.

Alcohol and drug abuse has emerged as a serious concern in India. The geographical location of the

country further makes it highly vulnerable to the problem of drug abuse.


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In a national survey conducted in 2001-2002, it was estimated that about 73.2 million persons were

users of alcohol and drugs. Of these 8.7, 2.0 and 62.5 million were users of Cannabis, Opium and

Alcohol respectively. About 26%, 22% and 17% of the users of the three types respectively were found

to be dependent on/addicted to them.

Article 47 of the Constitution provides that “The State shall regard the raising of the level of nutrition

and the standard of living of its people and the improvement of public health as among its primary

duties and, in particular, the State shall endeavour to bring about prohibition of the consumption except

for medicinal purposes of intoxicating drinks and of drugs which are injurious to health.”

The Narcotic Drugs and Psychotropic Substances Act, 1985, was enacted, inter alia, to curb drug

abuse. Within the purview of the Act, “Narcotic Drug” means “coca leaf, cannabis (hemp), opium,

poppy straw and includes all manufactured goods”.

Whereas “Psychotropic substance” means “any substance, natural or synthetic, or any natural

material or any salt or preparation of such substance or material included in the list of

psychotropic substances specified in the Schedule”.

Section 71 of the Act (Power of Government to establish centres for identification, treatment, etc of

addicts and for supply of narcotic drugs and psychotropic substances) contains provisions for setting

up of rehabilitation and treatment centres for addicts.

India is a signatory to three United Nations Conventions, namely:

(i) Convention on Narcotic Drugs, 1961;

(ii) Convention on Psychotropic Substances, 1971; and

(iii) Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, 1988.

Thus, India also has an international obligation to, inter alia, curb drug abuse. The demand reduction

strategy consists of education, treatment, rehabilitation and social integration of drug addicts for

prevention of drug abuse.


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For the purpose of drug demand reduction, the Ministry of Social Justice & Empowerment has been

implementing the Scheme of Prevention of Alcoholism and Substance (Drug) Abuse since 1985-86.

The Scheme was revised twice in 1994 and 1999, and at present provides financial support to NGOs

and employers mainly for the following items:

i) Awareness and Preventive Education

ii) Drug Awareness and Counselling Centres (CC)

iii) Treatment- Cum- Rehabilitation Centres (TC)

iv) Workplace Prevention Programme (WPP)

v) De-addiction Camps (ACDC)

vi) NGO forum for Drug Abuse Prevention

vii) Innovative Interventions to strengthen community based rehabilitation

viii) Technical Exchange and Manpower development programme

ix) Surveys, Studies, Evaluation and Research on the subjects covered under the scheme.

The National Institute of Social Defence (NISD) maintains an electronic database hosted on the World

Wide Web called Drug Abuse Management System (DAMS) for collection of data on the addicts

receiving treatment in the TCs supported by the Ministry.


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1.5 CASE STUDY:

Routinely Asking

Case 1: A dentist in Pandavapura regularly asks each patient about smoking and drinking habits

irrespective of presenting problems and routinely advises them about modifying these practices. He

reported that 30% of his patients stopped substance use with brief advice. He is presently associated

with several primary prevention activities.

Early Intervention:

Case 2: A 27 year old man came in following a fall sustained during intoxication. The doctor explored

with the patient his reasons for drinking after attending to the physical problems. The patient attributed

his drinking to an expectation of improvement of sexual performance, as he felt his wife may not be

sexually satisfied with him. The physician called the patient’s wife for follow up, educated both on the

long term consequences of alcohol and counseled them about misconceptions. The patient has been

abstinent for the last six months and reports no problems in the marital area.

Case 3: A young female, married six months ago, came with a lacerated wound on the scalp sustained

when her intoxicated husband beat her with a log of wood. The physician called the husband,

explained to him the legal consequences of his action, and simultaneously offered him detoxification.

Case 4: One physician very effectively used this technique to explain the role of alcohol in producing

gastritis- he would pour some spirit onto a piece of cotton and set it alight. He reported successful

change in patients following such a simple, but dramatic explanation.

Detecting underlying alcohol problems indirectly

Case 5 : In a female patient presenting with non-specific aches and pains, the medical officer took the

trouble of asking if there were any problems, including about alcohol use in the spouse. Having


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established this, he insisted on seeing the couple together at follow-up and was able to counsel the

husband after evaluating him.

Case 6: A female patient came with ulcerated and infected wounds around the nipple region, caused by

the spouse during intoxication. The medical officer called the spouse, evaluated him for drink related

problems, counseled him. The husband has been abstinent for the last year.

Case 7: John, 28, was a drug addict, with a habit that was costing him more than just the thousands

he'd spent. His liver was dying, his heart weakening, yet regardless of how hard he tried he just

couldn't get out of his rut. And it wasn't just a physical thing - he was emotionally dependent on

substances to make it through the day. With will power he had tried and failed. John recognized he had

a problem. John knew he had to get out there and do something about it before it killed him. Where

John succeeded, many others have failed, and it is unfortunate that John should be considered an

unusual case in this modern age.

John was one of the lucky ones to receive help. There are millions of addicts worldwide that don't get

the adequate support and help they need to overcome their hbo addiction. We tend to associate

addiction with smoking tobacco, and those who do smoke on a regular basis may even claim to be

addicted themselves. Unfortunately, this gives a very poor and frankly incorrect impression of

addiction. Addiction involves an actual physical dependency on a substance, as well as a mental

reliance. Smoking bears more of the characteristics of a habit, which, although firmly engrained, can

be broken with little comparative effort. Of course many who try to give up do feel physical side

effects, and that's all part of your body getting used to the breaking of what may be a lifetime habit.

The problem with addiction is a physical dependency, which is significantly stronger than a mere

craving. In order to function accordingly, the body requires the subject of the addiction, as it requires

oxygen. Without this substance, the body will fight back, which ultimately easily overturns any

personal desire to succeed.

Effective addiction treatment curbs the nature of addiction, whilst nurturing the patient's mentality to


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maintain will power. The combination of physical and mental stimulants helps keep the body away

from its overwhelming requirement. Addiction is a difficult process at the best of times, and can be

particularly horrible and demoralizing when it comes to the fight. Support is not only helpful but a

necessity as part of a treatment program. Addictions can be a lonely place, so being with the right

people can mean the difference between complete success and utter failure.

Furthermore, medication and replacement substances can be used to help dampen the side effects and

bodily urges. Thankfully, there is a wealth of empirical research on the subject of addiction from a

variety of viewpoints, and the developments of more comprehensive drug abuse recovery programs are

astonishing. Addiction is finally becoming recognized as a curable disease, and is being afforded the

necessary resources to make a real difference to lives around the world. Addiction doesn't just affect

the addicted, but also everyone involved in his or her life. By making support and medication available

to those who have the will, there can be a realistic way out of addiction towards a new, reformed life.

With increasing resources and treatment plans available, addiction need no longer plague its victims

forever.


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CHAPTER ~2

NEED FOR THE CURRENT PROJECT

Alcohol and drug related problems represent a significant and growing proportion of the total health

burden of the country. While people with drug and especially alcohol related disorders constitute a

serious health problem in both rural as well as urban centres (Gujarat has an estimated around 0.5

million people with alcohol dependence and many more with early stage problem drinking) most

treatment centers and intervention efforts are concentrated in the major urban centers. Those affected

in the rural areas need to travel long distances to access residential care at overcrowded urban facilities.

Anticipation of the consequent disruption (which affects job and family) contributes considerably to

delayed help seeking as well as to poor follow up and long term outcome. This adds to a considerable

cost to the individual and the community.

One of the biggest shortcomings of the existing services for alcohol and drug problems is that most of

these services cater to an urban population. Rural places have less access to these services hence the

current model was implemented in the kheda, karamshad, anand and nearby surroundings area of the

Gujarat state.

Substance abuse services in order to reach the unreached, need to have a presence in the communities

they serve. Most community outreach programmes for substance abuse (focusing on rural populations)

have generally relied on the De-addiction center approach. While this approach has significant

benefits, it needs the concerted efforts and commitment of a host community. Sustainability of the

programme in the long run is thus a vital aspect any treatment programme needs to consider. A project

that is designed to provide direct care to the community through a specialized team is unlikely to have

a sustained impact on demand reduction following the withdrawal of services of the team. However, a

programme that envisages training and empowerment of various local resource personnel in tackling

the alcohol and drug problem in their community, is likely to be self reliant and have a more lasting

impact. There is thus a need to develop outreach programmes, which will be resident in the

communities it serves and which draws its resources locally.


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PROJECT DETAILS:

The primary objective of the project was to evolve a Model Programme for the Prevention of Alcohol

and Drug Problems in the Community. During the project, it was proposed to test out the ease and

efficacy of various approaches and potential agents of change in the community.

The project undertook and evaluated the following approaches in an attempt to evolve an integrated

district model for prevention of alcohol and drug use in the community.

OBJECTIVES:

The objectives of the center for Prevention of Alcoholism and Substance (Drug) Abuse as DE-

ADDICTION CENTRE are:

a) To create awareness and educate people about the ill-effects of alcoholism and substance

abuse on the individual, the family, the workplace and society at large;

b) To provide for the whole range of community based services for the identification,

motivation, counselling, de-addiction, after care and rehabilitation for Whole Person

Recovery (WPR) of addicts;

c) To alleviate the consequences of drug and alcohol dependence amongst the individual, the

family and society at large;

d) To facilitate research, training, documentation and collection of relevant information to

strengthen the above mentioned objectives; and

e) To support other activities which are in consonance with the mandate of the Ministry of

Social Justice & Empowerment in this field.


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CHAPTER~3

SHREE KRISHNA HOSPITAL

3.1 Services and Schemes

Shree Krishna Hospital was set up in 1981 as a precursor to the setting up of the medical college, the

dream that drove the late Dr. H.M. Patel to establish Charutar Arogya Mandal. A 136-bed hospital

initially, the hospital has today not only grown to accommodate 550 patients, but has armed itself with

facilities and equipment that are not available within a radius of 50 kilometers.

The twenty five years of the hospital's existence have been both tumultuous and exhilarating. From a

130-odd bed hospital with minimal facilities in 1981, the hospital today is one of the largest and most

well-equipped general hospital in Gujarat. Its treatment facilities, such as the ICUs, Operation

Theatres, Trauma Centre, Laboratories, CT-Scan, Colour Dopplers and a host of other state-of-the-art

facilities that would be the envy many urban hospitals, are well-supported by skilled staff.

Facilities

Operation Theatres

Trauma and Emergency Centre

Radiology and Imaging Centre

Laboratories

ICUs

Dialysis Centre

Blood Bank


http://www.charutarhealth.org/?page_id=48








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Pharmacy

SPECIALITY CLINICS

The Hospital boasts not only of its exclusive and modern diagnostic facilities and its treatment but

shree Krishna hospital is also proud to have a staff consisting of more than 200 efficient and eminent

specialist doctors in various branches and more than 25 super specialist consultants too.

In this direction to facilitate the patient to consult a super specialist doctor as and when required, and to

provide convience to the patient to offer the consultation in the same campus itself , a super speciality

clinic has been developed as a separate wing in the hospital.

DIALYSIS CENTRE

In an effort to provide solace to those chronic renal patients who require regular dialysis, the hospital

has started a Dialysis Centre, which currently has three machines. The Centre, with its affordable

packages, has been of considerable help to patients from the areas surrounding the hospital, who earlier

had to travel some distance to obtain the dialysis services. The Dialysis Centre has a provision to add

at least four more machines in the future.

HEALTH CHECK -UP PROGRAMMES :

An Ounce of Prevention Is Worth A Pound Of Cure

Hectic work schedules, pressures of modern life-styles, add to it, the increased pollution levels; all

contribute to a set of diseases which the educated and upwardly mobile are prone to. Research all over

the world has proven that it is more economical to invest in preventive healthcare rather than to think

of a hospital only in times of distress.

While the emphasis in the villages is to create awareness, for those who have a certain level of



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awareness and are conscious about their health the Shree Krishna hospital offers an array of health

check up programmes.

"Hello Good Health and Good Life", is about celebrating the spirit of wellness - the joy of feeling

hale and hearty and realizing the value of prevention. World-class services are offered at surprisingly

affordable prices. These programmes have been classified under two Categories -regular programmes

and premier programmes.

While the former is more of a screening and quick health check, the latter has more detailed

components.

There are five types of check up programs:

@ General health check up

-Whole body check up,

-premium,

-regular

@ Cardiac,

@ Cancer.

PRIVILEGE DAY CARE PROGRAM:

A premium service that would enable you to meet hospital’s consultants quickly, get your

investigations done promptly, have your reports hand-delivered and receive medicines without waiting

in the queue all while you are seated comfortably in hospital’s specially designed lounge and being

attended to by our trained staff.

In this program hospital providing service like

-Prompt consultation,

-Quicker investigations,

-Hand-delivered reports,


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-Medicines in your hands,

-Comfortable waiting.

Here new suggestions we can provide are

-free gift kit at admission of the patient and

-transportation facility should be provide to patient for pick up and delivery to home.

KRUPA AAROGYA SURAKSHA- FACILITIES

• Indoor Facilities

• Out Door Facilities

• Additional Banefits

Krupa Arogya Suraksha (KAS) is a social security scheme promoted by Shree Krishna Arogya Trust

(SKAT), a charitable organization supported by Charutar Arogya Mandal. The scheme is aimed at

extending the safety net of modern health facilities and services to communities living in the villages

and towns.

Here in this hospital we have seen many services and facilities but there is something is missing

regarding the drug abuse treatment. They have tobacco cessation project which is not that much

effective. To remove this loophole we are suggesting one research proposal for opening of new de-

addiction centre to the Shree Krishna Hospital.

3.2 SHORT LITERATURE SURVEY:

Visit of different hospitals to understand their services and different programme for their customer.

1) SAL hospital and medical institute


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300 bedded super speciality hospital with following located in the heart of Ahmadabad with following

facilities. The 300 beds include 75 ICU beds. We have 4 Theatres for cardiac surgery and 8 theatres for

other specialities. In cardiology 2 flat panel digital Cathlabs.

-Health check up programme

-Cardial evaluation plan

-Heart check plus

-Executive health check

-Family health check

-Sal diabetics Club

-Special privilege offered to members

2) Apollo hospitals

the 400 bed Apollo Hospital, Ahmedabad has an overall success rate of 97%. The hotel was the first to

set up the Oncology Department in private hospital.

Areas of expertise

Cardiology

Orthopaedics

Cardiothoracic Surgery

Paediatric Cardiothoracic Surgery

Nephrology

Urology

Gastroenterology Surgical

Gastroenterology Medical

Oncology

Health check up programme

-Advanced Heart check


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-Well woman check

-Cancer check

3) Sterling Hospital

Core specialities include: Cardiac Science, Gastroenterology, Neuro Science,

Orthopaedics, Critical Care, Nephrology & Oncology

Other specialities include Anaesthesiology, Dentristry, Dermatology, Endocrinology,

ENT, General Surgery, Gynaecology & Obstretrics, Haematology & Bone Marrow

Transplant, Internal Medicine, Neonatology, Onco Surgery, Opthalmology, Paediatrics,

Psychiatry.

Health check up plan

Primary

Executive

Comprehensive

Jeevan Saathi

Diabetic

Cardiac

Child Care

Well women

Senior citizen

4) Civil Hospital

Civil Hospital, Ahmedabad (CHA) is basically a tertiary hospital with facilities for

specialised diagnostic, therapeutic & rehabilitative patient care. Spread over 110 acres of

land, it houses a number of prestigious institutes and allied hospitals, the Gujarat Medical

Council and Gujarat Nursing Council. The new building and infrastructure of CHA came

into existing in 1953 with the help of benevolent donations given by Shri Hutheesing,

Shri Premabhai and Surgeon General D Wyllie.


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This hospital is one of the oldest, biggest and modern hospitals of India, treating about 6

to 6.5 lac Outdoor patients, admitting 70,000 patients annually. It performs about 26,000

surgeries and 6500 deliveries per year.

Services Available :

1. Emergency & Casualty- An ultra modern Trauma centre has been constructed at

CHA, which will perform an role in the EMS(Emergency Medical Services) of

Ahmadabad city.

2. Medical- all specialists & super specialists are available with special OPDs for

Diabetes, geriatrics, HIV- AIDS, Tuberculosis etc.

3. Surgical- General surgery, pediatrics surgery, urology, cardiothoracic surgery,

plastic surgery, neurosurgery, gastroenterology surgery, ENT, ophthalmology &

orthopedic services are available round the clock. All types of endoscopies ,

laparoscopies, arthroscopies, orthopedic implants are being performed in the

respective departments.

4. Pediatrics

5. Gynecology and Obstetrics

6. Laboratory Services

7. Imaging Services

8. Intensive care units

3.3 RESEARCH METHODOLOGY

1) Information collection:

Visiting different hospitals, de-addiction centers and rehabilitation centers


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-Unstructured interviewing of management

-Collecting written material of different hospitals

2) Analysing Information:

Analyse and comparing different services and programmes with other hospitals

And identify relative service or programme that may be helpful to shree Krishna hospital

to improving their services and programmes.

And providing suggestions for opening of the de-addiction center

Like…

De addiction Centre in civil hospital which is presently available in Civil hospital of

Ahmadabad but not available in shree Krishna hospital.

And different services for privilege customer which is more valuable in SAL hospital

and not provided in Shree Krishna hospital.

3.4 DATA SOURCES:

1. Primary Data Source

-Direct Interview.

2. Secondary Sources

-Internet,

-Pamphlets of Hospitals.

DATA COLLECTION


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For this data collection we visited many de addiction centres.

Some main centres from where we collected our data are mentioned below:

1) Centre Name: Gujarat Kelavani Trust

Address: Mangal Prabhat Building, Opp.- St. Xavier’s High School,

Mirzapur,

District: Ahmedabad

State: Gujarat

Phone: (079) 25500309

Contact person: Mr. Natubhai Patel

2) Centre Name: Sardar Vallabhbhai Patel De-addiction cum Rehabilitation

Center

Address: Sardar Vallabhbhai Patel De-addiction cum Rehabilitation

Center 301-302-D, Sweni Complex, Akhabarnagar Circle, Nava Wadaj,

Ahmedabad-380013

District: Ahmedabad

State: Gujarat

Phone: (079)27643585, 69905537

Contact person: Shri G.D Shukla , Mr. Prafful Nayak.

3) Centre Name: Dr.B.R.Ambedkar De-addiction Centre

Address: B.R.General Hospital, Kalpi Nagar, Last Bus stop, Asarwa

District: Ahmedabad

State: Gujarat

Phone: (0792) 2684351

Contact person: Dr. Parmar.


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We get the following information from these centers. That includes the following

services and information.

Pre-admission Counselling:

Management of withdrawal symptoms:

Psychosocial counseling:

Yoga and meditation:

Behavior Change Communication:

Community Therapy:

Family Counselling:

Follow up by Telephone Calls/ House/workplace visits:

We also get information regarding the time table and working schedule for the addicted

person who are admitted in their centers with the charges for each patient.


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CHAPTER~4

THE DE-ADDICTION CENTRE

4.1 DE-ADDICTION CENTRE

Addiction is a progressive and chronic condition which addicts have to struggle against

for a lifetime. The best proven manner to assist these addicts in reclaiming a balanced

life has been found to be the Addiction Center. The Addiction Centre is well equipped to

cope with the challenges of assisting an addict return to normality within their social,

occupational and domestic lifestyle.

The de-addiction Centre administers therapeutic techniques which have been proven

successful in countering overwhelming effects of the deceptive and alluring qualities of

the particular addictive substances; the criminal or corporate economic interests which

have a vested interest in promoting these substances; the confusing variety of mixed

signals which are present in our societal structures when it comes to addictive

substances; and the stigmas and discrimination which are associated with addiction.


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The de-addiction Centre is able to implement a coherent and clinically proven sequence

of clinical, biological, pharmacological, psychological and emotional therapeutic

processes which can help the addict maintain abstinence for a lifetime and minimize the

serious risk of any future relapse back into the addictive substance abuse.

There are many factors which predetermine whether a person will fall into the trap of

addiction or not. Some of these include:

- Family History

- Trauma

- Genetic Predisposition

- Stress

- Occupational Pressures

- Social Disorders

- Medical Disorders

- Psychological Disorders

- Environment

- Abuse

The de-addiction Centre makes clear to the addict that they cannot be faulted for their

addiction. However, it is their immediate and clear responsibility to participate in the

sequence of programs which are directed towards ridding the addict of the malaise of

addiction. An addict cannot be assisted if they resist any form of help.

De-Addiction Centres have been able to assist millions of people around the rural area

and the world in overcoming and breaking through the obstacles which keep them

imprisoned within the bars of addiction.

Many of these addicts are now living coherent, sane, healthy and balanced lives thanks to


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the effective therapies administered and managed by the various treatment centers

around the world.

Superb treatment options are now available in the psychological, counseling and psycho

pharmaceutical fields for Addiction Centers to be able to custom tailor a bespoke

program of comprehensive assistance which meets the needs, desires and aspirations of

each individual addict.

Clinical research continues to enlighten medical and social professionals in the area of

addiction to the underlying sources and the various therapeutic options which are a part

of any Addiction Centres goal.

To successfully minimize or eliminate the desire of the addict for their particular

addictive substance and reintegrate that individual as a constructive and positive member

of their greater society as a whole.

Treatment Centres understand that a chronic and complex condition such as chemical

dependency is very difficult to prevent, however they also understand that it is one that

can be effectively treated and managed on an ongoing long term manner by the

application of a synchronized and harmonized sequence of strategies which take all

aspects of the addict's particular characteristics and personality into prior and careful

consideration.

Most treatment centres are based on the belief that long term recovery is possible for

each and every addict, regardless of their current condition, level of addiction, history of

substance abuse, or psychological characteristics. Addicts require the assistance of

Addiction Centers in order to receive the clinical and psychological interventions that

they desperately require in order to live harmonious and balanced lives.


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De-Addiction Centres plan their approach to recovery based on the individual needs of

each and every addict. There is no one size that fits all course of therapy, as each is

dictated by the particular situation and unique characteristics that each and every addict

brings. The treatment center can assist the addict in mapping out a personal path to

recovery, carefully planned out to avoid the pitfalls of dangerous and possibly

irretrievable relapse in the future. These centers act as a guide along this path, directing,

nudging and facilitating the addict towards their goal at every single step along the way.

It is conventional knowledge that it is important for an addict to "hit the bottom" prior to

being able to begin along a therapeutic path. That is not necessarily true, as treatment

centers around the world have found that recovery can be initiated long before the

addict's desire and indulgence in their own particular addictive substance has devastated

their lives and those of his loved ones, friends, co-workers and his community in general.

There have been remarkable developments in the field of chemical dependency and

substance abuse therapeutics in the past couple of decades. Certain prerequisites have

been found to apply universally to Addiction Centre’s approach to applying effective

therapies to their patients, regardless of their age, race, gender, culture, sexual

orientation, social class or history of deficient parenting or sexual and physical abuse.

One of the primary steps has been found to be to address the situation of the

addict's problem with their particular addictive substance as early as possible in order to

be able to implement a long term program of effective therapeutic courses before the

addictive behaviour patterns become too firmly engraved in the addict's psyche. Highly

skilled medical, clinical, psychological and social professionals work in harmony with

the Addiction Centers programs to ensure that such care is given in an accessible,

immediate and reassuring manner to the troubled addict.


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Society has a responsibility to assist the invaluable work being conducted by the

Addiction Centers around the world. The stigmas, myths, misconceptions and

discrimination all too often applied to addicts must be brushed away, and the mixed

signals in the media and peer environment which seem to surreptitiously wink at

substance abuse must be eliminated. In this manner, the Addiction Centers will be able to

apply their treatment programs effectively and in accordance with the best interests of

the community.

4.2 THE MAIN FUNCTIONS OF THE CENTRE ARE AS

UNDER : -

1. PREVENTION: Activities such as Seminars, Lectures, Exhibitions, Rallies, Jhankis,

etc, are undertaken towards awareness of this modem menace.

2. TREATMENT: The patient is required to stay at the Centre accompanied by

someone who can attend him in a better way for about 30 to 35 days, during which, he,

along with getting medical attention for his physical withdrawal symptoms, also

undergoes drastic counselling and Yoga exercises. The treatment and stay at the Centre

is totally free of cost.

3. REHABILITATION: Different type of activities are undertaken to rehabilitate the

addicts to their normal life, such as teaching them ways and means to earn their

livelihood through candle making, Bee keeping and any activity they prefer and for

which they want to get loan from the Banks to start their own business. So far 791

addicts have been rehabilitated and they are leading a normal drug-free life.


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4. FOLLOW-UP: Great importance is given to this since the relapse of the patients is

common. The Centre is now taking a new shape to become one of the leading Centres in

India. The wards are fixed with Air Conditioners. Outdoor games like cricket,

volleyball, badminton, etc, and Indoor games are introduced as a part of their treatment.

High power Generator is also fixed in the Centre to check unpredicted power-cuts and

provide the clients a comfortable stay in the Hospital. The Clients at the time of their

stay at the Centre are under supervision of highly trained and experienced staff, and

looked after by one of the best Medical Specialist of the town. The facilities now

provided at the Centre had almost doubled the flow of Indoor and Outdoor patients.

Measures adopted by the Centre to promote/facilitate better services to the

clients…

* By and by the Centre is briskly advancing forward to the success and become one of

the leading Centres of the Nation. The Infrastructure of this 30-bedded Centre has been

fully modernized.

* The Centre is fully air-conditioned for the comfortable stay of the clients during the

course of their treatment.

* Outdoor games like Cricket, Volley Ball, Badminton, etc, are made an important and

compulsory part of the treatment, and Indoor games like Ludo, Chess, Cards etc, as,

reading News Papers/ Magazines, watching Television, etc, is encouraged, in order to

keep the patients busy.

* To ensure provision of 24 hours electricity supply and dealing with the unpredictable

power cuts, a high power Generator has been installed at the Centre.


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* Facility of an Indoor Kitchen has also been provided a carefree stay of Indoor clients in

the Centre during their course of Detoxification.

* All the records of the Centre have been computerized.

* Hot Coffee / Tea /Soup Vending Machine is also installed at the Centre to provide safe

and fresh material to the patients protecting them from any untoward physical illness and

to help them gain health along with total detoxification.

* The patients are being attended by one of the experienced and leading Medical

Specialist of the day.

* All these facilities presently provided at the Centre have almost doubled the figures in

registration at the Out Patient Department and Indoor admissions, as well.

4.3 TREATMENT STRATEGY

An integrated approach is followed by the centre to address these problems and

rehabilitate the individuals by bringing wellness and well being in his life. This been

done by building the capacity to perform different roles and responsibilities in the society

as well as to lead a full fledged and meaningful life.

1) Physical Aspect

Naturopathy, Yoga & Meditation is effectively used in the management of physical and

psycho-social withdrawal symptoms. The main objective is to avoid the side effect of

sedatives and tranquillizers as well as to effectively combat the challenge of substitution

to prescribed medicines (pharmaceutical solvents). Therapeutic value of Earth, Water,

Massage has been well established in the managing withdrawal symptoms

2) Psychosocial Aspect


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The psychosocial counseling aims at the Behavior Change of the addicts by providing

them with knowledge pertaining to addiction and developing a positive and constructive

attitude towards society. This enables them to have a new attitude towards life. The

individual will be empowered to manage his desires, thoughts, emotions, feelings etc.

without the help of any addictive substances.

3) Involvement of Family

Drug/Alcohol Addiction is not only a disease that lands the individual in distress but

also it badly affect the family. So the family members are intrinsic part of a successful

treatment. Family interactive sessions and meetings are conducted in regular intervals at

the Centre.

4.4 COMPREHENSIVE DE-ADDICTION SERVICES

Pre-admission Counselling:

This will help the addict to identify his problems, accept it and the need to undergo the

treatment. This also prepares the addict mentally for the transition period.

Management of withdrawal symptoms:

During first few days of detoxification, the patient may undergo the withdrawal period.

The severity of withdrawal symptoms depends on person to person, types of drugs used

and period of abused.


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Psychosocial counseling:

It’s an ongoing process during which it helps to identify ones strengths and weakness

and address it with the guidance of a counselor.

Yoga and meditation:

To address the spiritual bankruptcy/spiritual vividness and better coordination of body

parts and organs. It also helps to identify the potentiality of ‘self ‘within and use the

spiritual energy to manage the challenges of daily life.

Behavior Change Communication:

This involves providing information/knowledge, building awareness and changing

attitude and behavior for healthy & safer choices in life.

Community Therapy:

It essentially teaches empathize and expressing ones feelings and emotions appropriately.

This shall equip the person with better interpersonal relationship and communication

skills and thereby will have better adjustments with community and society.

Family Counselling:

In most of the cases the immediate family members will also be in distress due to the

tremendous social, economical and psychological pressure. The family counseling

sessions enables the family members to better understand the situation, cope up with that

and act appropriately.


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Follow up by Telephone Calls/ House/workplace visits:

As a part of the after care services, the discharged patients are encouraged to keep in

touch in person or with help of communication tools. In case of need, the counselors visit

the homes/workplaces.

Treatment Period:

As we are concerned about the results and well being of the beneficiaries, we DO NOT

have any Out Patient Treatment facility.

In Patient Service: Since we believe that Drug de-addiction is a subjective matter

(varies from person to person), we have customized treatment plan for each patient.

However, a patient has to stay back at the centre for a minimum of 30-45 days.

CHAPTER ~5

DE-ADDICTION THERAPY

DE-ADDICTION CENTRE include lot many useful therapy for removing the addiction of the patient (addicted).

THERAPY USED ARE LIKE

Psychotherapy, Pharmacotherapy, Yoga therapy,


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Isolation therapy, Sports program, Naturopathy, Hobby development therapy Recovery monitoring program etc.

5.1 PSYCHOTHERAPY

It includes many therapy which is going to have one main therapy called as

psychotherapy.

5.1.1 PERCEPTION THERAPY


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Innovative and successful therapeutic treatment model utilizes its own MIND-BODY-

SPIRIT-ENVIRONMENT approach that "treats the whole person and the cause of the

problem, not just the symptom".

Group and Individual Psychotherapy Treatments

Alternative Treatment International, Inc. is dedicated to providing its clients with the

highest level of psychotherapeutic and clinical care. All clinical staff members possess a

minimum of a Masters Degree and have years of experience in working with addictions

and psycho-emotional disorders. Our clinical staff is also experienced in providing a

wide variety of therapeutic techniques, and tailor the clinical therapy to each client's

specific disorder and needs. Psychiatric evaluations and medications are provided by our

Psychiatrist when indicated, to better understand and meet the needs of each client.

This work uses wisdom derived from ancient practices of energetic movement, breath,

and sound to integrate body, mind, and spirit. Dynamic experience that invites a

collective bond and the formation of community among participants.

Clients receive individual psychotherapy sessions that are designed to uncover and

resolve the causes of the problems that have resulted in their addictions or behavioral

disorders. Clients also receive individual and specialized groups to uncover and resolve

early childhood and adult traumas, as well as building a spiritual understanding and

enlightenment that will assist them in their recovery, throughout the rest of their lives.

Psychotherapy sessions are conducted by Professional Therapists. Our Therapists have a

minimum of a Masters Degree, extensive education and training in conducting both

individual and group psychotherapy for all addictions and psycho-emotional disorders.

Group therapy sessions are designed to assist clients in learning how to overcome their

addiction and behavioral problems and strengthen their foundation for a balanced and

healthy life. Intensive individual psychotherapy sessions specifically address, uncover


http://atiwellness.com/staff.php

http://atiwellness.com/staff.php

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and resolve the underlying causes of the problem. Unlike many programs, our focus is on

assisting our clients to transform their thinking. It is the thinking that has been producing

the dysfunctional behaviors. When thinking changes, behaviors change by themselves.

This is the basic premise of Perception Therapy.

Mind-Body-Spirit-Environment

Many holistic program philosophies include Mind, Body and Spirit; however we take it

a step further to include an awareness of the environment as part of the healing process.

Mind - this includes small group therapy, individual therapy, lectures, reading and

assignments. Perception Therapy addresses perceptions that patients have been taught

about how they perceive themselves and the world around them. Perceptions may

include intelligence, family, learning, reading, thinking, personality, wit, humor,

addictions, emotional problems, fears, traumas, etc.

Body - this includes physical fitness, education on physical fitness, nutrition and sports.

Perception Therapy uncovers taught perceptions about body type, weight, eating

disorders, diet and dieting, appearance, physical limitations, etc.

Spirit - this includes daily meditation, Yoga, spiritual readings, deep relaxation/guided

imagery, and spiritual philosophies. Perception Therapy examines learned perceptions

about spiritual philosophies and practices, spiritual understanding, self-realization, self-

empowerment, and a sense of oneness.

Environment - this includes learning to develop a mindful awareness of the

environment, healing your own environment through "Aware" living and intentional

action. Taking this therapeutic technique a step further, Perception Therapy looks at

perceptions of living environments, the planet, caring for the environment, one's own


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surroundings, and changing perceptions about the environment which helps to heal the

individuals from a broader perspective.

This comprehensive approach is designed to address all aspects of the healing process

utilizing Perception Therapy® techniques that address a change in perception about the

Mind-Body-Spirit-Environment®.

Perception Therapy: The program is designed to assist clients to understand

conscious and unconscious learned perceptions and how they shape thinking and

behavior. Changing perceptions and thinking about yourself, the world around

you as well as your relationship to addictions and psycho-emotional feelings will

enable you to formulate your own conclusions and ultimately make better and

more productive choices leading to a more fulfilling and productive life. Learned

perceptions in many cases begin in early childhood and produce thinking that

remains in the sub-conscious mind throughout life. Many unproductive behaviors

of adulthood begin at this source. These learned perceptions could have been the

result of trauma, but may also have been simply concepts taught by parents,

friends, teachers, relatives, etc. who have been taught by others, who were taught

by others, and on and on.

It must be remembered that traumas are different for everyone and something that

may have been traumatic for one may have had no effect on another. Traumas do

not always have to be devastating events to produce a stamp on the unconscious

mind.

These learned perceptions may not be truth or even your truth, but someone else's

perception of truth. As these false perceptions remain in the sub-conscious mind,

they produce thinking and behaviors of which you have no conscious

understanding. Without a conscious understanding of their origins, it is extremely

difficult for most people to analyze and devise appropriate ways to modify your


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thinking and change behaviors. This is one of the reasons we see such high rates

of addiction and emotional relapse.

HOW TO CHANGE PERCEPTION, THINKING AND BEHAVIOR :

1. Begin to open your mind to new concepts.

2. Question, rather than just accept what is being told.

3. Admit to new possibilities.

4. Acknowledge that not everything is either black or white.

5. Understand that what one may believe to be true may just be someone else’s

truth.

6. Adopt new ways of viewing one’s own specific situation.

7. Recognize that people behave in the way that they think.

8. Explore philosophies and theories that may help to change the way one perceives.

9. Realize that what works for one may not work for all.

10. Show willingness to recognize a change in perception when it occurs.

11. Seek spiritual awakening and understanding.

12. Gain acceptance that the Mind, Body, Spirit, and Environment are all connected.

13. Gain acceptance that we all have an impact on one another and the environment

and that in seeking healing for yourself, you are helping another.

14. Become aware of your impact/input on your immediate environment and the

global environment.


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15. Continually practice building awareness by reviewing your perceptions, thinking

and behaviors.

5.1.2 METAPHOR THERAPY AND INDIRECT SUGGESTION

Patients are exposed to the use of metaphor (stories) which relate to their problem.

Through the use of metaphor, patients are able to form their own conclusion about its

meaning, which assists them in making positive changes. The best therapeutic result

always occurs when the client is brought to his/her own conclusions. The use of indirect

suggestion and Metaphor Therapy enables this process to take place.

Confrontation techniques are NOT utilized by our staff. All therapies are conducted in a

loving, caring and clinical manner that enables clients to focus on their individual

therapeutic process and specific issues without the added stresses produced by

confrontation techniques.

Special group therapy sessions are provided, when indicated for men's and women's

issues, dual diagnosis, trauma/abuse, depression, eating disorders, impaired professionals

and other specialized groups. Relapse prevention techniques are taught to all clients with

the goal of eliminating relapse potentials which hamper success.

5.1.3 LIFE TRANSFORMATION/RELAPSE PREVENTION TOOLS:

Relapse Prevention, Recovery and Life Transformation Tools

Promotes a philosophy that allows one to obtain healing of the Mind-Body-Spirit-

Environment and the whole person. Our corporate mission is to bring Self awareness to

the highest level by formulating philosophies, treatments, techniques and protocols that

address the whole individual. Here goal is to examine the perceptions one has about

Mind-Body-Spirit-Environment and how those perceptions produce thinking. Perception


69

Therapy reviews those perceptions throughout the learning process and as those

perceptions transform, we witness changes in thinking, which in turn brings hope and

healing. When a change in thinking produces a new view, all things are possible

including good health, lifestyle change, successful resolution to addictions and emotional

problems, and happiness, peace and self-esteem. Healing of the Mind-Body-Spirit-

Environment promotes total health and well-being.

5.1.4 COGNITIVE BEHAVIOR THERAPY (CBT)

Cognitive Behavior Therapy (CBT) is a form of psychotherapy that emphasizes the

important role of thinking in how we feel and what we do. Cognitive behavior therapists

teach that when our brains are healthy, it is our thinking that causes us to feel and act the

way we do. Therefore, if we are experiencing unwanted feelings and behaviors, it is

important to identify the thinking that is causing the feelings / behaviors and to learn how

to replace this thinking with thoughts that lead to more desirable reactions.

Cognitive Behavior Therapy is used for the treatment of such conditions as alcoholism

and drug addiction, depression, mood swings, social anxiety, panic attacks, phobias,

obsessions and compulsions, eating disorders, Post-Traumatic Stress Disorders, insomnia

and other sleep problems, insufficient self-esteem, and relationship issues.

Cognitive Behavior Therapy is effective because it combines two very effective kinds of

psychotherapy — cognitive therapy and behavior therapy. Behavior therapy helps you

weaken the connections between troublesome situations and your habitual reactions to

them, such as fear, depression, and rage. It also teaches you how to relax your mind and

body, so you can feel better, think more clearly, and make better decisions.


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Cognitive therapy teaches you how certain thinking patterns are causing your symptoms

— by giving you a distorted picture of what's going on in your life, and making you feel

anxious, depressed or angry for no good reason, or provoking you into ill-chosen actions.

When combined into Cognitive Behavior Therapy, behavior therapy and cognitive

therapy provide you with very powerful tools for stopping your symptoms and getting

your life on a more satisfying track.

5.1.5 ADDICTION COUNSELING

DUAL DISORDERS RECOVERY COUNSELING (DDRC)

Dual disorders recovery counseling (DDRC) is an integrated approach to treatment of

patients with co-morbid psychiatric disorders and chemical, marijuana, alcohol,

methamphetamine, cocaine and other drug use disorders. The DDRC model, which

integrates individual and group drug addiction counseling approaches with psychiatric

interventions, attempts to balance the focus of dual treatment so both the patient's

addiction and psychiatric issues are addressed.

The DDRC model is based on the assumption there are several treatment phases patients

go through. These phases are rough guidelines delineating some typical issues patients

deal with and include:

Phase 1 —Engagement and Stabilization.

In this phase, patients are persuaded, motivated, or involuntarily committed to addiction

treatment. The main goal of this phase is to help stabilize the acute symptoms of the

psychiatric illness and/or the drug or substance abuse disorder. Another important goal is

to motivate patients to continue in treatment once the acute addiction crisis is stabilized


69

or the involuntary commitment expires. Dealing with ambivalence regarding recovery,

working through denial of either or both illnesses, and becoming motivated for continued

care are other important goals during this phase.

This phase usually takes several weeks, but for some patients it takes longer to become

engaged in recovery and to stabilize from the acute effects of dual disorders.

Phase 2 —Early Drug Addiction Recovery.

This phase involves learning to cope with desires to use chemicals, alcohol, cocaine,

meth or other drugs; avoiding or coping with people, places, and things that represent

high-risk addiction relapse factors; learning to cope with psychiatric symptoms; getting

involved in support groups, such as Alcoholics Anonymous (AA), Narcotics Anonymous

(NA), Cocaine Anonymous (CA), Rational Recovery (RR), Dual Recovery Anonymous,

or mental health support groups; getting the family involved (if indicated); beginning to

build structure into life; and identifying problems to work on in recovery.

This phase roughly involves the first 3 months following stabilization. However, some

patients take much longer in this phase because they do not comply with addiction rehab

treatment, continue to abuse drugs, experience exacerbations of psychiatric

symptomology, or experience serious psychosocial problems or crises.

Phase 3 —Middle Addiction Recovery.

In this phase, patients continue working on issues from the previous phase as needed. In

addition, patients learn to develop or improve coping skills to deal with intrapersonal and

interpersonal issues. Examples of intrapersonal skills include coping with negative affect

(anger, depression, emptiness, anxiety) and coping with maladaptive beliefs or thinking.

Interpersonal issues that may be addressed during this phase include making amends,

improving communication or relationship skills, and further developing social and

recovery support systems. This phase also focuses on helping patients cope with


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persistent symptoms of psychiatric illness; drug use lapses, relapses, or setbacks; and

crises related to the psychiatric disorder. It also focuses on helping identify and manage

relapse warning signs and high-risk relapse factors related to either illness.

The middle recovery phase involves months 4 through 12, although some patients never

get much beyond early recovery even after a long time in treatment. Patients who are

treated for an initial acute episode of psychiatric illness with pharmacotherapy in

addition to DDRC and who do not have a recurrent or persistent mental illness may be

tapered off medications during this phase. Patients are usually not tapered off

medications until they have several months or longer of significant improvement in

psychiatric symptomology.

Phase 4 —Late Recovery .

This phase, also referred to as the "maintenance phase" of recovery, involves continued

work on issues addressed in the middle phase of recovery and work on other clinical

issues that emerge. Important intrapersonal or interpersonal issues may be explored in

greater depth during this phase for patients who have continued abstinence and remained

relatively free of major psychiatric symptoms.

This phase continues beyond year 1. Many patients with chronic or persistent forms of

psychiatric illness (e.g., schizophrenia, bipolar disease, recurrent major depression), or

severe personality disorders such as borderline personality disorder, often continue active

involvement in treatment. Treatment during this phase may involve maintenance

pharmacotherapy, supportive DDRC counseling, or some specific form of psychotherapy

(e.g., interpersonal psychotherapy). Involvement in support groups continues during this

phase of recovery as well.


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5.2 PHARMACOTHERAPY (ANTI-ADDICTION

MEDICATION)

Addiction to drugs and alcohol is a chronic disease that begins in the brain. Powerful

chemical changes occur in the brain, causing cravings and driving each person to use,

often overwhelming even the strongest desire to quit. In addition, because the body also

becomes physically dependent upon the drugs and/or alcohol, abruptly stopping can be

physically dangerous and cause harmful physical trauma.

Fortunately, amazing breakthroughs in addiction and medical science have greatly

minimized and, in many cases, even eliminated risks associated with trying to quit your

drug and/or alcohol addiction.

Much like other chronic medical illnesses such as diabetes, hypertension, and asthma,

certain medications in combination with behavioral approaches can prove powerfully

effective. This medical and scientific breakthrough for addiction therapies uses highly

advanced, proven anti-addiction medicines.

These anti addiction medication therapies:

Block the Effects of Alcohol and/or Drugs caused within the Brain

Significantly Decrease Cravings of the Addictive Substance

Significantly Decrease the Physical Effects of Addiction Withdrawal

Block the” high" or euphoria from the Substance

Center offers the safest, most effective anti-addiction medications available, including:

SUBOXONE


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Suboxone is the first opioid medication approved under DATA 2000 for the treatment of

opioid dependence in an office-based setting. Suboxone also can be dispensed for take-

home use, just as any other medicine for other medical conditions.

The primary active ingredient in Suboxone is buprenorphine.

Because buprenorphine is a partial opioid agonist, its opioid effects are limited compared

with those produced by full opioid agonists, such as oxycodone or heroin. Suboxone also

contains naloxone, an opioid antagonist.

The naloxone in Suboxone is there to discourage people from dissolving the tablet and

injecting it. When Suboxone is placed under the tongue, as directed, very little naloxone

reaches the bloodstream, so what the patient feels are the effects of the buprenorphine.

However, if naloxone is injected, it can cause a person dependent on a full opioid agonist

to quickly go into withdrawal.

Suboxone at the appropriate does may be used to:

Reduce illicit opioid use

Help patients stay in treatment by suppressing symptoms of opioid withdrawal

and decreasing cravings for opioids

VIVITROL

The FDA approved Vivitrol in June 2005 for the treatment of alcohol dependence.

Vivitrol is an injection that you receive in the gluttial (buttock) muscle once a month.

During that month period, it slowly releases medication called naltrexone into your

bloodstream. The Vivitrol (long-acting naltrexone) basically helps to prevent relapse to

alcohol use by causing three things to occur:

It decreases your cravings for alcohol by 90%.


69

If you do drink alcohol, Vivitrol block the euphoria or the "high" that you get

from alcohol; therefore, when you are on Vivitrol, you can't get drunk. If you do drink

alcohol, you still have symptoms of intoxication, like driving or walking poorly;

however, you do not benefit from any of the positive (pleasant) effects of alcohol.

Consequently, because it is a very frustrating effect for you to continue drinking when

you are on Vivitrol, you are more likely to stop. Of course, you, along with most

alcoholics, are going to test whether you can get high (drunk) on alcohol or not. When

you find out that you can't, you'll say "Okay, the doctor was right. I'll go listen to my

counselor. I'm not going to test it anymore, so now I'm just going to go learn how I can

stay sober."

The Vivitrol prevents the first drink from "priming the pump" for more alcohol,

and unlike alcohol use without Vivitrol in which you will have one beer which then

seems to set off a "cascading compulsion" to have five more beers or 12 more beers in

that sitting, the Vivitrol blocks that "priming" effect and you may only have half of a

beer in total. By only having half of a beer, which does not even give you a buzz, you are

able to keep your judgment appropriately and stop drinking, leave situation where you

used and call your sponsor to ask for help. This "new" healthy behavior greatly limits the

severity of use after the attempted sobriety and frequently allows you to keep the relapse

to a "slip" rather than it causing a full-blown relapse.

PROMETA

Prometa is used for addiction to cocaine, amphetamine/methamphetamine and

alcohol.

The treatment is designed to "jump-start" the recovery process by addressing one of the

key reasons why people relapse - cravings. If identified as an anti-addiction medication

to supplement a client's recovery process, an Enterhealth medical professional

administers three to five IV therapy sessions, lasting approximately two hours over the

course of a month. Additionally, nightly oral medications are provided over the same

approximate timeframe.


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CAMPRAL

Campral (generic name: Acamprosate), a drug that is widely used in Europe since the

late 1980s to reduce alcohol cravings in problem drinkers who have quit, was approved

by the U.S. Food and Drug Administration in 2004 to treat alcohol dependence in the

United States.

Although the precise mechanism of action or "cellular target" of Campral is unknown, it

appears to decrease cravings primarily by restoring the balance in certain

neurotransmitter pathways (most likely GABA + Glutamate) that have become altered

by chronic alcohol consumption.

The GABA neurotransmitter system in the brain is a very important control system that

is responsible for "calming you down" and helping you to relax. Because it calms you

down, it is referred to as an "inhibitory" system. The Glutamate neurotransmitter system

in the brain is just as important as the GABA system but it has the opposite effect on the

body: it causes you to get energized (referred to as your "excitatory" system).

Another way to look at these two important systems is to take an analogy of a car. The

GABA system is like your brakes, allowing you to slow down, while the Glutamate

system acts like the accelerator. If you have a car with only one system or the other, it is

not a very functional car - you need both systems to balance each other out in order to be

able to use the car effectively.

So, when anyone drinks alcohol (not just an alcoholic, but anyone), it stimulates the

GABA system in your brain and you become sedated and relax. (The brakes slow you

down.) At the same time the Glutamate system is suppressed (so the accelerator is not be

pressed). When the alcohol wears off, your excitatory system "rebounds" and you feel

more irritable, agitated and may find it difficult to sleep (remember: the brakes are now

off and the accelerator is being pushed).


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ANTABUSE

Disulfiram (Antabuse), a sensitizing or deterrent agent, was approved by the FDA for

the treatment of alcoholism in 1951. It has been used as an aid in managing chronic

alcoholic patients who want to remain in a state of enforced sobriety so that they can

participate in outpatient treatment and 12-step programs effectively.

Disulfiram produces sensitivity to alcohol that results in a highly unpleasant reaction

when the patient taking it drinks even small amounts. It does this by interfering in the

alcohol enzymatic metabolism (breakdown) pathway resulting in an accumulation of

acetaldehyde in the blood. This toxic by-product of normal alcohol metabolism produces

a complex of highly unpleasant symptoms, including intense nausea and vomiting,

sweating, flushed skin, throbbing headache, respiratory difficulties, blurred vision and

confusion.

Antabuse has a valid place as an integral part of certain recovery programs. However,

because of its toxic reactions, it does have some safety issues, although they are much

less than the safety issues related to continued alcohol use. Therefore, it is not usually

used as a first line treatment for alcoholism any more. Rather, it is a medication to be

used only if all other standard treatments fail, or it can be added to other pharmacological

strategies, such as adding it to Vivitrol/Campral or Campral by itself.

When Antabuse is used, it is very important that it is given to you under a monitored

situation. You need to be watched while you are taking it each morning, and your mouth

should be orally inspected after swallowing in order to ensure compliance. If the

compliance is ensured via visual monitoring (observation), Antabuse can be very

effective.

Unlike Campral, however, Antabuse acts only as a deterrent; it does not heal any of the

damage caused by the alcoholism. The dose of Antabuse is 250 mg/day and live function

blood tests should be obtained by your primary care physician on a quarterly basis (four

times/year).


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5.3 SPORTS PROGRAMMES

Engaging the youth intensively in any sports programme, every day and throughout the

year, will be one of the most important strategies for preventing youth from getting into

the drug habit. Intensive engagement in sports has the following benefits:

It will usefully fill up their free time and divert their attention from drugs, T.V and other

self-destructive habits. With daily sports activity, there is something to do every day,

something to look forward to and some clear direction to channelize their energies.

Involvement in sports will keep their body and mind healthy.

Involvement in any team game like volleyball, football, basketball etc will deeply

inculcate life skills like discipline, confidence and compassion, which will help them

handle their lives better.

Team games like volleyball, football, hockey and basketball deeply inculcate team spirit

and camaraderie. Villages and localities where youth are active in sports will have little

tension or fighting and will be more harmonious than other localities.

For many of the youth who become proficient in the sports, there is a better employment

opportunity and career options.

The essential features of the sports programmes will be as follows:

A. Such of those deviant youth who are troublemakers, prone to anti-social activities will

be compulsorily involved the games. Their

already high energy levels will be channelised into sports and when properly guided they

are most likely to be easily transformed into successful sportspersons and human beings.

B. All youth in the age group of 16 and above will be motivated, mobilized and

organised to play games in their villages/localities. Persons from all age groups above 16

will also be encouraged to get involved in sports. Girls and ladies will also be specially

encouraged to get involved in sports activities.

C. Sports will be organised for both boys/men and girls/women, separately, in their

villages/localities.


69

D. To start with, volleyball game will be organised in the villages/localities separately

for boys and girls. Volleyball has been chosen because of the reasons that it is an intense

team game in which a large number of youth can be engaged, it is easy to organise as it

requires less space, less cost and proficient players in volleyball can get good job

opportunities. If youth in specific localities show keeness in other sports like football,

hockey, basketball and kho-kho this will be separately organized.

5.4 YOGA AND MEDITATION PROGRAMMES

Yoga and Meditation programmes will be a key ingredient, both as preventive and

curative strategies. Yoga and meditation are ancient, Indian, invaluable and most

effective, rather transformative technologies, which are now available in rediscovered

forms for joyful living.

Yoga and meditation are powerful techniques which bring back a sharp inward focus on

one's body mind, energy and emotions and if pursued intensely they can be a spiritual

path towards self- realisation.

These techniques work on the body, mind and the spirit and bring about a balance, a state

of harmony and pleasantness within oneself, irrespective of the outside circumstances.

Though this is exactly what everyone needs, this is all the more required for those who

have lost control of their body and mind to the drugs.

It has been observed that within few months of practice of Yoga and meditation, there is

a complete transformation in the persons due to its effect on their body and mind.


69

As both curative and preventive strategies, Yoga and meditation are to be used as

techniques to enable the youth, who have lost control of their body and mind to drugs, to

take control of their body and mind and regain life in most effective way.

The essential features of the Yoga and Meditation programmes will be:

a. Intensive Yoga and meditation practices will be given for the patients admitted in the

center by a trained instructor.

b. Free Yoga and meditation programmes will be offered by trained instructors to all

those interested persons above the age of 14. Two such programmes in each of the 5

blocks will be organised every month at the village/locality level for the next two years.

C. Yoga and meditation classes will be extensively imparted in schools and colleges for

the youth above 14 years of age.

D. Ten Yogashalas in each of the 5 blocks, as dedicated centers in the villages/localities,

where yoga and meditation can be practiced, will be established with the help of

volunteers.

5.5 RECREATION SERVICES AND NATUROPATHY :

We provide a wide variety of fitness, recreational, and alternative healing activities, as

scheduled, which include:

Fitness Activities

Yoga and Meditation

Swimming

Tennis


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Beach Activities

Walking

Extensive recreation and fitness amenities at an off-site 50,000 sq. ft. fully

equipped spa-resort

Recreation at the off-site spa and fitness center includes:

Fully Equipped Workout Facility

Yoga

Spinning Classes

State-of-the-art cardio-vascular

and weight training rooms

Fitness and aquatic recreation

Swimming

Tennis

Beach Activities

Walking

A full range of Spa services are available at an extra cost and are scheduled at the Spa.

Scheduling at the Spa has to be approved.

Spa and fitness activities may change according to Spa schedules.

5.6 EXTENDED CARE PROGRAM:


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Strengthening the Foundation of Complete Health and Wellness

For Those That Require Further Residential Care Due To:

A negative home environment

Behavioral problems of adolescents

Continued psycho-emotional problems

Chronic relapse

A lack of a positive support system

Impaired professionals

Self-harming behaviors

A demonstration of anti-social or childhood abuse & traumas

Adult trauma and grief

Unresponsive attempts to out-patient treatment

Continued anger and rage

Dual diagnosis and eating disorders

A need for extended care

Now that you have received primary care for your addiction and/or emotional disorders,

you may require further continued residential care due to the above symptoms. Your care

and concern for your health and welfare may indicate a need for extended care.

5.7 RECOVERY MONITORING PROGRAM


69

The goal of Recovery Monitoring Program is to make transitioning back into the

mainstream of society easy and safe. The Recovery Monitoring Program is designed to

help each client maintain their sobriety while slowly adding more activities to their lives.

This Program works well because of the safety net we provide.

If we notice that a client is moving away from their recovery or needs extra attention, it

is easy for us to add more groups to his/her schedule to ensure continued sobriety. We

are here to help everyone in every stage of recovery and we will always do our best to

help each individual person on the road to long-term recovery.

WHY IS RECOVERY MONITORING IMPORTANT?

Treatment works. However, nearly 50% of those who successfully complete treatment

still relapse within the first year. The leading cause of relapse is failure to follow the

prescribed continuing care plan. Structured after care programs have been shown to

provide better recovery outcomes than treatment alone.

Recovery Monitoring Program was designed to significantly increase rates of recovery

for those struggling with addiction by providing a bridge during the critical first year out

of treatment.

As a result those individuals enrolled in Recovery Monitoring are achieving recovery

rates in excess of 80% across all addictions.

HOW DOES RECOVERY MONITORING WORK?

The Recovery Monitoring Program is a year-long program divided into four concrete and

distinct phases.

Phase One - Transition

Phase Two - Re-entry, Months 1-3


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Phase Three - Stabilization, Months 4-6

Phase Four - Maintenance and Growth, Months 7-12

Recovery Monitoring Program is a comprehensive set of services provided by a

professional and experienced staff, designed to complement and reinforce the recovery

life-style begun in treatment.

Each participant receives an individualized plan based on their personal history, progress

in treatment, and the prescribed continuing care plan. The plan is flexible, adaptive to the

participant's progress as well as his/her relapse potential.

AFTERCARE PROGRAM FEATURES:

Regularly scheduled meetings with participants

Resource planning and referral

12 step

Psychiatrist/ psychologist/therapist/ medication management

Intensive outpatient/outpatient/aftercare group

Medical/legal/financial

Transition support

First 72-hrs out of treatment

Family integration

Employment/school re-entry

Social /spiritual support network

Leisure/recreation

Ongoing relapse prevention education


69

Participant progress and accountability review

Personal growth and development

WHO BENEFITS?

Families of individuals who have completed treatment

Employers managing recovering employees

Individuals seeking support and advocacy for long term recovery

WHY?

Recovery Monitoring facilitates the transition from treatment to recovery

Expedites the return to home, school or work

Intervenes on the relapse before it happens

Provides third party verification and compliance documentation

Removes the family and employer from the role of monitor

Time and cost effective

THE HOMA THERAPY

In-residence Drug/Alcohol Deaddiction Program has been developed to provide a

simple, holistic approach and solution for people suffering from addiction to drugs and

alcohol.

The aim of the program is to offer anyone at any level of addiction a way out. The basis

of the program is to train the mind how to react positively to all circumstances in life.


69

We take help from nature's cycles, their effect on mind and the potential of Agnihotra

copper pyramid fire to mould the atoms of the mind and help make it full of love.

Homa Therapy Mind Training Program is taught, giving the addict the ability to

practice and use the Homa Therapy In-residence Drug/Alcohol Deaddiction

Program to live a sober/straight lifestyle.

As part of the Mind Training Program a few simple and easy to do Hatha Yoga

exercises are shown along with breathing exercises, depending on the individual

and age group.

-Guidelines of the Homa Therapy In-residence Drug/Alcohol Deaddiction

Program are given as a roadmap to achieve and maintain happiness and freedom

from addiction. The Mind Training Program is a prerequisite for following the

Guidelines in that it is the foundation upon which the Guidelines were

established.

The Alcoholics Anonymous Program is studied, discussed and put into practice

in a group setting.

A Cleansing Diet Plan is provided which helps to facilitate the cleansing process

necessary to the addict's recovery.

CHAPTER ~6

HUMAN RESOURCE DEPARTMENT (staff for 50 bedded centre)


69


S.No. Name of the post No. of the post

50 bedded

Administrative

1 Project coordinator cum counselor 1

2 Account cum clerk 1

3 Sweeper, gate keeper 2

Medical

4 Medical officer(part time) 1

5 Counsellor/ social worker/

psychologist/community worker

7

6 yoga therapist(part time) 1

7 Nurse /ward boy 5

8 Peer educator 1

Total 19

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CHAPTER ~7

THE PROGRAM


69

ADDICTION RECOVERY –

7.1 A 12 STEP PROGRAM

Most people have heard of the 12-Step program for dealing with addiction recovery, but

unless you have actually experienced it personally, or when working with a friend or

loved one who is in addiction recovery, you may not know too much about what it is and

how it works. The first 12-step program was a group called Alcoholics Anonymous

founded in 1935. Literally millions of people have been helped through addiction

recovery by Alcoholics Anonymous, Narcotics Anonymous, Overeaters Anonymous and

Gamblers Anonymous, just to name a few of the similar programs which all use the 12-

steps concept.

Although many of the original graduates of the program used only the 12 steps in their

fight to regain sobriety, today it is considered part of a comprehensive multi-part

approach that helps in all the aspects of addiction recovery. It translates well into a

residential drug and alcohol treatment center as a part of the program, although many

other facets are included as well.

Since its founding in 1935, Alcoholics Anonymous (AA) has given assistance to

innumerable people both men and women, to admit that they were alcoholics and that

they are not able to control the drinking. The acknowledgment of powerlessness has

expanded into the areas of drugs, overeating and gambling particularly. Through the

encouragement of Alcoholics Anonymous Fellowship, the individuals are privy to a

healthy, happy way of living that rules out drugs and drinking.

The basic part of the 12 Step program meetings consists of asking those who have

recovered from substance abuse to relate the tales about their own over use of alcohol or


69

drugs. They talk about the addiction recovery which the 12 Step program has provided

and then ask any newcomers to join with them in the supportive fellowship of peers.

The heart of the program which is suggested for addiction recovery is to make use of the

12 Steps concepts. These have been successfully used by millions in the treatment

program.

Step One

This is considered by outsiders as the most difficult step of all. The individual must

admit that there is an addiction, that they are not able to control their use of the addictive

substance or activity. They must recognize that they are can no longer manage their own

lives.

Step Two

The addict must believe that there is a power outside of themselves which can and will

restore the person's sanity as well as control over the power of the addictive substance.

Step Three

The next step is to make a conscious choice to hand the life and will over to the care and

safekeeping of God however He is understood by the individual.

Step Four

This is usually where the momentum begins to slow down and where a conscious effort

to continue the program must emerge. Step four is to prepare an exhaustive moral

review of one's character.

Step Five

The step which follows also stops many people on their way to addiction recovery. Step

five is to make admission not only to God, but to oneself and to one other person the

information prepared under step four.


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Step Six

The next step consists of being prepared for God to remove all the character defects

previously named and confessed.

Step Seven

Next, the individual should plead with God to get rid of any character defects that are

standing in the way of recovery.

Step Eight

Step eight consists of preparing a list of all those who have been wronged by our actions

and be prepared to make restitution to them.

Step Nine

The next step is to use the list prepared in step eight and make restitution to them if

possible unless that action would further hard the victim or others around them.

Step Ten

Taking personal inventory and making admission of errors committed promptly is an

ongoing process.

Step Eleven

The next to the last step urges individuals to continue to attempt improvement of our

relationship with God through meditation and prayer. Requesting knowledge and

understanding of God's plan for the life and the strength to carry out that plan is key.

Step Twelve

Because the previous steps have helped the person receive an awakening in the spiritual

steps, the 12 steps should be shared with others. In addition, the stated principles can be

carried out throughout one's entire range of business affairs.


69

Newcomers are always invited to join with the peer group in pursuing addiction recover,

but are never pressured to accept or live according to the 12 steps is they are not yet

ready to do so. They are urged to stay in open regarding the information which they are

hearing. They are provided with literature prepared by Alcoholics Anonymous regarding

the 12 steps of the program and invited to continue to participate in meetings during

which they will hear recovered alcoholics relate their individual stories in their effort to

gain sobriety.

The 12 Step program doesn't believe that addiction recovery can be accomplished by any

ordinary means currently available to mankind. AA's principles state that alcoholism can

be halted through a program of total abstinence from any form of alcohol.

Addiction recovery through the 12-step programs is targeted on the goal of helping

members find and implement complete abstinence and sobriety throughout life. Often

residential treatment for addiction recovery is supplemented or succeeded by use of the

12 step program on an outpatient basis.

There are of course similarities between 12 step programs and other addiction recovery

modalities, but they are actually relatively common. The concept of seeking help from

one's peers as well as help from a higher Power can be helpful if the person's spiritual

make up is such that they can utilize the principles. Treatment centers which are

affiliated with religious organizations can use the 12 step program effectively in their

programs without limiting the other program components in any way. This knowledge

helps to provide continuity of treatment bridging the time within the residential center

and the stresses which are part of the immediate return to society.

The main functions of the Centre are as under:-

1. PREVENTION: - Activities such as Seminars, Lectures, Exhibitions, Rallies, Jhankis,

etc, are undertaken towards awareness of this modem menace.


69

2. TREATMENT: - The patient is required to stay at the Centre accompanied by

someone who can attend him in a better way for about 30 to 35 days, during which, he,

along with getting medical attention for his physical withdrawl symptoms, also

undergoes drastic counselling and Yoga exercises. The treatment and stay at the Centre

is totally free of cost.

3. REHABILITATION: - Different type of activities are undertaken to rehabilitate the

addicts to their normal life, such as teaching them ways and means to earn their

livelihood through candle making, Bee keeping and any activity they prefer and for

which they want to get loan from the Banks to start their own business. So far 791

addicts have been rehabilitated and they are leading a normal drug-free life.

4. FOLLOW-UP: - Great importance is given to this since the relapse of the patients is

common. The Centre is now taking a new shape to become one of the leading Centres in

India. The wards are fixed with Air Conditioners. Outdoor games like cricket,

Volleyball, Badminton, etc, and Indoor games are introduced as a part of their treatment.

High power Generator is also fixed in the Centre to check unpredicted power-cuts and

provide the clients a comfortable stay in the Hospital.

7.2 Daily Time Table For The Addicted Person In The De-

Addiction Center

6:00am-7:00am All the patients will get up

7:00am-8:00am Clean your bed, Light exercise/Yoga, take bath,

offer prayers

8:00am-9:00am Breakfast will be served

9:00am-11:00am Medicines & Individual Psychotherapy


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11:00am-1:00pm Games, Reading, TV

1:00pm-2:00pm Lunch

2:00pm-3:00pm Medicines & Group Psychotherapy

3:00pm-4:00pm Take a nap

4:00pm-5:00pm Tea & biscuits, Reading, Games

5:00pm-8:00pm motivational talk by spiritual leaders/

8:00pm-10:00pm Dinner & Medicines

TV, Light Music, Offer prayers

10:00pm Lights will be switched off

7.3 Rules & Regulations

o Give admission to only who is self willing or sent from a family or an organization

or a company.

o Treatment period will be minimum for 30 days, in this period, a patient is allowed

to visit his home only in case of emergency, like if he gets ill for other than

alcoholic related problems or if someone from his family has expired.

o If any patient wants to discontinue the treatment and want to leave the camp, the

fees paid by him will not be refunded.

o Once a person gets admitted, for next 20 days he/she is not allowed to make any

kind of contacts for any reason to their home. But the family members of the

patient can contact or visit the hospital.

o Family members or friends are strictly not allowed to give food or alcoholic things.


69

But they can give fruits.

o First 10 days of the total treatment period is called de-toxication and after that no

medicine will be given to patient until it is necessary.

o The remaining 20 days will be rehabitation treatment, individual &group

counseling, group therapy, yoga, dhyana, pranayama & the works told by hospital

chief will be held.

o Close relatives of patient are only allowed to visit the patient.

o Visitors are allowed to meet the patient according to the date & time given in their

visiting pass which has been given to the family, it should be produced at the time

of visit & only one person is allowed to visit at a time.

o Patient should be kind with other patients & he has to work in a group in the

hospital.

o The neatness in the hospital is to be maintained by the patients.

Note: The patient has to agree and sign the same for admission & treatment procedures with

acceptance for Disulfiram medicine.

CHAPTER ~8


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BUDGET

(SETTING UP OF A 50-BEDDED DE-ADDICTION CENTRE FOR ADDICTS )

S.

No.

Name of the Post No.

Of

Posts

Monthly

Expen-

diture

(Rs.)

Yearly

Expen-

diture

(Rs.)

Minimum Qualifications

8.1 ) RECURRING EXPENDITURE FOR STAFF

a. Administrative:

1. Project Coordinator

cum-

Vocational

Counsellor

1 8,000 96,000 Graduate with experience of

managing such centers for a

minimum period of 3 years

or demonstrable capability

for running such centers and

having working knowledge

of computers.

2. Accountant cum

Clerk (Part time)

1 5,000 60,000 Graduate with knowledge of

accounts and working

knowledge of computers.

3. Sweeper/ GATE

KEEPER

2 4,400

52,800

b. Medical:


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1. Medical Officer (Part

time)

1 6,000 72,000 MBBS or equivalent degree

recognized by the Department

of Indian Systems of Medicine,

Ministry of Health and Family

Welfare, Government of India.

2. Counsellor/ Social

Worker/ Psychologist/

Community Worker

7* 45,500 5,46,000 Graduate with a minimum

experience of three years in the

relevant field or an experiential

Counsellor (recovered addict)

with sobriety of two years.

Preference will be given to

candidates with

degree/diploma in addiction

counselling.

4. Yoga therapist (Part

time)

1 3,300 39,600 Adequate experience in the

discipline as recognised by the

Deptt. Of ISM&H, Ministry of

Health and Family Welfare,

Government of India

5. Nurse/Ward Boys 5* 25,000 3,00,000 Nurse: High School or

equivalent with certificate in

nursing from a recognized

institution.

Ward boy: VIIIth Class pass

preferably experienced in such

centres.

6. Peer Educator 1 2,000 24,000 Should be literate; Ex-drug user with 1-2

years of sobriety,

Willing to work among drug using population

as well as is possessing qualities like


69

empathy, communication skills.

Willing to get trained; Agrees to refrain from

using, buying, or selling drugs; Ready to

work for the prevention of harmful drug use

and relapse

TOTAL 19 99,200 11,90,400

8.3 NON RECURRING EXPENDITURE (Admissible once only during the setting-up

of the Centre)

50 beds, tables, 3 sets of linen, blankets, office furniture,

equipments, computer, refrigerator etc.

: Rs.2, 50,000


8.2) RECURRING EXPENDITURE [OTHER THAN STAFF]

S.No. Item Monthly Expenditure

(Rs.)

Annual Expenditure

(Rs.)

1. Rent 20,000 – 25,000 3,00,000

2. Medicines 10,000 1,20,000

3. Contingencies (Stationery,

water, electricity, postage,

telephone, maintenance and

replacement of bed, linen etc.)

9,000 1,08,000

4. Transport/Petrol and

Maintenance of Vehicle

7,000 84,000

5. In house Kitchen expenditure 13,500 1,62,000

TOTAL 64,500 7,74,000

TOTAL A +B 1,63,700 19,64,400

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The payment of ‘rent’ for the centre would be to the location of the Centre in Type C,

and D cities. The maximum rent would be as under Rs.20000/-p.m.

8.4 EXPENDITURE ON AWARENESS CUM DE-ADDICTION CAMPS

1. Number of Patients Not less than 25 and not more than 40

2. Duration of each Camp Not less than 15 days

S.NO. Item In Rural areas

(INR)

In Urban

areas(INR)

1. Allowances for the Staff 12,000 7,500

2. Medicines 6,000 6,000

3 Transport 4,500 4,500

4. Contingencies (including rent, water,

electricity charges, hiring of beds and other

essential equipments and expenses on

follow-up)

7,500 12,000

5. Publicity 1,500 1,500

Total 31,500 31,500

S.No Organizations/

Institutions

Name of

States/UTs

Extent of Assistance

1 Universities/schools of

social work/institutions

of higher learning

All 100% of the approved

expenditure

2 All other eligible

organizations under the

scheme

For the Seven

North-East States,

Sikkim & Jammu

& Kashmir

Upto 95% of the approved

expenditure


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3 All other eligible

organizations under the

scheme

Other States/UTs Upto 90% of the approved

expenditure

9.2 APPLICATION AND SANCTION

1) For Ongoing Programmes

(Programmes already funded under the Scheme)

- For the release of grant-in-aid under the Scheme, an Organization/Institution, shall

apply in the prescribed proforma along with the relevant documents immediately on the

commencement of the financial year to the Ministry of Social Justice & Empowerment

(Social Defence Division), Government of India, New Delhi.

- Grants for a particular year will be released in one or more instalment as per

instructions issued in this regard by the Ministry.

- For release of full amount of grants in a financial year, the recommendations and

inspection report of the State Government or any other authority/institution designated

by the Government of India shall be mandatory.

2) For a New Activity/Programme

(Programme not yet funded under the Scheme)


69

- Any request for a new programme/activity should be sent to the Ministry of Social

Justice & Empowerment, Government of India in the prescribed proforma, accompanied

with the relevant documents, along with the recommendation and inspection report of

the State Government. The receipt of such an application would not suo moto entitle an

organisation to the sanction of grants and the Ministry of Social Justice &

Empowerment, Government of India, shall consider the release of financial support, in

each case, on the basis of the procedure prescribed by it from time to time.

- An aided organization/institution/establishment shall, before it receives assistance from

the Ministry of Social Justice & Empowerment, execute a bond in a prescribed proforma.

The transfer of funds would be done only after acceptance of the Bond by the competent

authority in the Ministry. The requirements regarding indemnity bond and pre stamped

receipt and transfer of funds shall be fulfilled by the

organization/institution/establishment as per the extant instructions of the Ministry in this

regard.

9.3 CONDITIONS FOR ASSISTANCE

1) An aided organization/institution/establishment shall be open to inspection by an

officer of the Central Government and the State Government or a nominee of their

authorities or any other agency so designated by the Ministry.

2) An aided organization organizing a seminar, conference, refresher course or a

workshop at Government’s expense could invite foreign delegates only with the prior

approval of the Govt. of India.

3) If an organization has already received or is expected to receive a grant from some

other official sources for the purpose for which the application is being made under this


69

Scheme, assessment for central grant will normally be made after taking into account

grant from such other official sources.

4) An aided organization shall maintain separate accounts of the Grants received under

this Scheme. They shall always be open to check by an officer deputed by the

Government of India. This shall be open to a system of internal audit or concurrent audit.

They shall also be open to test check by the Comptroller and Auditor General of India.

5) An aided organization shall maintain a record of all assets acquired wholly or

substantially out of Government grant in the Stock Register and present these to the

Auditor when required to do so. In this regard the provisions of the General Financial

Rules, 1963 (Govt. of India) would be applicable.

PERIODIC RETURNS

Every organization/institution receiving grants under this Scheme shall submit half

yearly progress report to the Ministry of Social Justice & Empowerment as per the

following details

S. No Title of Return Due date for receipt in the

Ministry

Form

1 Half Yearly Progress Report

(HYPR)

Within 15 days of the end of

the half year (April-

September and October-

March)

Form V

It may be noted that the proforma for the HYPR includes, inter alia, information

regarding progress of utilization of grants during the half-year. Failure to furnish the

information about the utilization of grants during the half year will affect further release

of grants.


69

UTILIZATION CERTIFICATES(UCs)

Every organization/institution receiving grants under this Scheme shall submit

Utilization Certificates (UCs) at the end of each financial year as per the following

details:

S. No Type of UC Due date for

receipt in the

Ministry

Form

1 Utilization

Certificate in

respect of grant-

in-aid

30th June of the

following

financial year

GFR-19 A


69

10

CONCLUSION

As per the budget required and grant given by the government, it is feasible

for the Shree Krishna Hospital and Charutar Arogya Mandal Trust to open

one de-addiction cum rehabilitation centre for the needy people to fulfill the

objective. As the hospital is situated at rural area where maximum cases

addicted patients of various abuse substances are present so it is good social

services to treat patients from the abuse substances.


69

11

ANNEXURE

11.1 SCHEME FOR PREVENTION OF ALCOHOLISM AND SUBSTANCE

(DRUGS) ABUSE

APPLICATION FORM

1. Name and complete address of the organisation/

institution/establishment and date of establishment

2. Whether registered under Societies Registration Act, 1860 or any relevant Act of the

State Government/Union Territory Administration or under any State Law relating to

registration of literacy, scientific and Charitable Societies or as public trust and as a

charitable company, if so :-

(a) Give name of the Act under which registered

(b) Registration No and date of registration

(Please attach an attested photocopy)

3. Whether or not receiving foreign contribution, if so:-

(a) No. and date of the Registration certificate issued by the Government of India

in the Ministry of Home Affairs under the Foreign Contribution

(Regulation) Act, 1976.

(Please attach an attested photocopy thereof)

4. List of papers/statements attached

(a) Constitution of Board of Management/Governing body, etc. and the particulars of

each member (i.e. name, complete residential address, percentage, occupation with

designation)


69

The life of the Board of Management (i.e. the last date on which it was constituted and

upto which date) may also be indicated.

(b)Constitution/Memorandum of Association and bye-laws of the

organisation/institution/establishment.

(c) A copy of the annual report for the previous year

(d) A copy each of the Receipt and Payment, Income and Expenditure Statement and

Balance Sheets for the previous one year certified by Chartered Accountant or a

Government Auditor.

(e) List of staff with full particulars detailing name, address, educational qualifications,

designation and experience in the field and period of employment.

(f) Detailed budget estimates with break-up of expenditure for which grant is required.

(g) Brief note indicating the sources of income, including foreign contribution, if any,

and also details of assets acquired during the previous three years.

(This note should also give details of activities undertaken by the

organisation/institution/establishment in various fields, including alcoholism and drug

abuse prevention, with details about areas/places covered and the expenditure incurred)

5. Additional information, if any, not covered by the above but relevant to the project

may also be submitted.

SIGNATU

RE

(

)

Name of the Secretary/President

Name of the organisation/Institution/Establishment

(with office stamp)

Place:

Date:

Note: - The applicant organisation/institution/establishment is to ensure:-


69

(a) That each document is serially numbered by them as Annexure-A, Annexure-B,

Annexure-C, etc. and that appropriate entree is also made against the corresponding Sl.

No. in the Application Form.

(b) That each document is duly certified/signed by the President/Secretary of the

Organisation/institution/establishment after affixing their office stamp, and

(c) That the Registration Certificate is in the name of the applicant

organisation/institution/establishment only


69

11.2

APPLICATION CUM MONTORING FORM FOR GRANT-IN-AID FOR

SCHEME FOR PREVENTION OF ALCOHOLISM AND SUBSTANCE (DRUGS)

ABUSE

1. Financial year for which grant-

In-aid is applied : ……………………………..

2. Name of the Organisation : …………………………………….

3. (a) Nature of the Project : ………………………………

(b) Date of commencement of

the Project : ………………………………

(c) Year of Commencement of

grant-in-aid from G.O.I. for

the Project : …………………………….

(d) Whether the Project is

recognized by the State Govt. : ……………………………..

(e) Enclose justification for setting up of the programme

based on the following (for New projects):

• nature and incidence of alcohol /drug abuse in the area as provided in any established

study/survey;

• details (with address)of available services in the district;

• need for new programme in addition to available services

• approximate distance of the proposed programme from the available services; and

• professional experience of the organisation for implementation of the programme)


69

4. Date of Registration of the

Organization : …………………………….

5. Address of registered office : ……………………………………

6. (a) Complete Address of location/ : (STD Code) Tele No.

location where programme/ (STD Code) Fax No.

project/scheme is being E.Mail

implemented.

(b) Nearest Railway Station/Bus :

Stand

7. Whether building is :

(please indicate against appropriate box)

1. OWNED

2. DONATED

3. ON LEASE

4. RENTED

8. (a) Is the building being utilized

exclusively for this programme : Yes No

(b) If no, provide details of usage : ……………………………..

9. (a) Area of building : …………..(in sq. meters)

(b) Number of rooms : ………………………….

10. Whether separate project wise : Yes No

accounts have been maintained

for grants sanctioned earlier?


69

11. whether principle of joint : Yes No

operation of banks is being

followed?

12. Details of bank accounts in which grant-in-aid released during previous financial

year:

S.

No

Grant-

in-aid

for

financial

year

Sanction

letter

Number

Date Recurring

Amount

Non-

recurring

Amount

Bank

A/c

No.

Name

and

address

of Bank

Person

Operating

the joint

Account

1.

2.

13. Whether the Statements of accounts :

submitted alongwith the application (Please indicate against appropriate box)

14. (a) Distance from the nearest : …………………. Kms.

Organisation running

operating similar/

same program/scheme/project

(b) Name and locational address of : ……………………………………

such nearest organization/Institution.

15. The amount of support sought from : …………………………….

the Ministry for recurring grant-in-aid


69

Cost Head Group Rs. In Lakhs

(a) Recurring

(b) Non-recurring

(c) Total

16. Whether List of Benenficiaries Enclosed as per Form-I

Yes No

17. Whether List of Managing

as per Form – II Yes No

18. Whether the List of Employees

as per form – III Yes No

19. Whether the Half Yearly

Progress Report, required for Monitoring by Ministry Enclosed as per form-V Yes

No

20. Whether Fund Flow statement

as per Form- IV Yes No

(mark tick above against the appropriate box)


69

11.3 VERIFICATION

Certified that above information is in accordance with the records and accounts audited/to be audited and

is correct to the best of knowledge and belief of the office-bearers of the organisation and after its perusal

and satisfaction, they have authorized the undersigned by a resolution dated ________________ to verify

and submit the statement of information for purposes of monitoring the scheme for which grants-in-aid

was received from the Ministry of Social Justice & Empowerment.

2. I also hereby certify that I have read the rules and regulations of the scheme and I undertake to abide by

them. On behalf of the Management, I further agree to following condition:

a. All assets acquired wholly or substantially out of the central grant shall be encumbered or disposed of or

utilized for purposes other than those for which the grant is given. Should the organisation cease

to exist at any time, such properties shall revert to the Government of India

b. The accounts of the project shall be properly and separately maintained. They shall always to be open to

check by an officer deputed by the Government of India or the State Government. They shall also

be open to a test check by the Comptroller and Auditor General of India at his discretion.

c. If the State or the Central Government have reasons to believe that the grant is not being utilized for

approved purposes; the Governemnt of India may stop payment of further instalments and recover

earlier grant in such manner as they may decide.

d. The institution shall exercise reasonable economy in its working especially in respect of expenditure on

building.

e. In the case of grant of buildings, the construction will be completed within a period of two years from

the date of receipt of the first instalment of grant unless further extension is granted by the

Government of India

f. No change in the plan of buildings, the construction will be made without the prior approval of the

Government of India


69

g. Progress reports on the project will be furnished at regular intervals as may be specified by the

Government

h. The orgnisation will bear 10% of the estimated expenditure or the balance of the estimated expenditure

on the project as per the guidelines.

i. The organisation agrees to make reservation for the Scheduled Castes/Scheduled Tribe

Candidate/Disable person for appointment against the posts required for the working of the

organisation in accordance with instructions issued by the Government of India from time to time.

j. It is hereby certified that no grant is being received for the same project form any (Govt. Private or

foreign) source.

Yours faithfully,

( )

Signature of the Authorised Signatory

Name:

Designation:

Address:

Date:

Office Stamp:


Documents

Final Project Report on Starting Dead Diction Center