“Getting fucked up on drugs was never the plan, bro.” - Arjun Nath, White Magic
In his book, White Magic, a story of “heartbreak, hard drugs and hope,” Nath tells a fellow addict this during his fourth and most successful attempt at overcoming his addiction. Today a Delhi-based successful corporate lawyer and author of one of the most raw and riveting pieces of writing in contemporary Indian fiction, he’s been six years clean after a decade of heroin abuse. This quote (simplistic) as it seems, became my pre-emptive for understanding alcohol and drug addiction and it should for you too.
Contrary to popular belief in Indian society, addiction of any kind is neither a “luxurious indulgence” nor a “bad habit”. It is a medical disorder. And much like the rhetoric around mental health in India and the world, most people’s understanding of addiction seems to come tinged with the idea that addicts have a choice. Nobody chooses to be depressed, nobody chooses to get cancer, and nobody chooses to be an addict. In fact, drug addiction is defined as “a chronic, relapsing brain disease that is characterised by compulsive drug seeking and use, despite harmful consequences.” This means that for addicts, their life is spiralling out of control and, like any medical patient, need professional help to recover. It’s where rehabilitation centres come into the picture, and it’s where India falls heartbreakingly short on every account.
With an estimated 3.4 million drug abusers in the country and ten suicides everyday due to drug abuse, the government has only 401 rehabilitation centres functioning at present. That is an overwhelming average of 8,478 victims per centre.
As with suicide helplines and other deep-seeded social epidemics in the country, these numbers paint a clear picture of national apathy and stigma.
To break this long-standing taboo we spoke to people who were willing to share their stories of attending rehab in the country along with a few facilitators behind these rehabs which look at addiction through the lens of solutions as opposed to sin.
The Road To Rehab
Imagine having admitted to yourself that you have a problem so grave, you must give up your freedom to be happy to fix it? Moreover, success is not guaranteed. This is what life looks like for most addicts when rehab comes into the picture. But even when choice presents itself, reasons vary.
For 27-year-old Gaurav from Haryana who went to Cadabams Rehabilitation Centre on the outskirts of Bangalore to treat his marijuana addiction, matters were far worse because he wasn’t even given a choice. “I was twenty around the time when my father decided to put me into a rehab. He never asked or consulted me. Being financially dependent on him, there was little I could do to resist,” he says matter-of-factly in a conversation over the phone.
37-year-old Siddharth Basrur’s experience wasn’t any easier because of personal agency–rehab still meant uprooting his entire life. “I was under multi-substance abuse. It begun with alcohol, and escalated to weed, pharmaceutical tablets, cough syrup till I was consuming around 30 pills a day,” he confesses about an addiction that began as the seemingly harmless result of peer pressure.
In 2002, when he hit rock bottom - homeless and starving due to his addiction - he decided to go to Drug Abuse Information Rehabilitation And Research Centre (DAIRCC), also popularly known as “Land”.
“I chose Land, because unlike other rehab centres this one did not focus on religion and spirituality,” he explains, highlighting a common core principle of de-addiction programmes around the world. “I was able to speak to its ex-programmers who reassured me that there was no physical abuse and they themselves seemed really level -headed,” he continues. “Though the best part was they allow you to smoke 20 cigarettes a day! A stupid reason now, but back then, it was a relief that motivated me to go there.”
On the other hand, for 56-year old Mumbai-based Vijay Swami, who has visited several rehabs across the country to treat his chemical drug addiction, the choice of organisation made little difference to him. “I never believed I was an addict. Just like you take a car to a servicing centre when it gets damaged so you can use it again, I took my body to these places so it would get better in order for me to use drugs again,” he confesses. For Swami the cycle of abuse that began as an expression of teenage rebellion that continued due to unwavering support from his late wife. “She loved me crazily. I manipulated her into financing my addictions. She didn’t realise what she was doing was wrong. I would use drugs even when at the nursing homes detoxifying my body,” laments Swami who, now, eighteen years clean, runs a rehab centre of his own in Mumbai’s western suburbs.
How Do You Treat An Addict, Anyway?
To prevent cases fuelled by enabling like Swami’s, Reboot Wellness, a one-year-old day care centre in Gurgaon that treats mental illness including addiction educates their clients’ families on four key reasons which will propel the addict towards sobriety. “Running out of money, a major health problem, being involved in a legal issue or the leaving of a spouse is what usually proves a ‘rock-bottom’ stage for addicts. We often encourage family members to create these situations for them - temporarily or artificially. This motivates them to get help,” says 36-year-old Saloni Malhotra, entrepreneur and co-founder at Reboot. This day-centre that sees an average footfall of 100 people a week provides various mediums of counselling addicts - group and individual therapy given by psychologists, psychiatrists and ex-addicts through paid and unpaid sessions.
Though one of the really innovative and successful ways in which Reboot has been opening up the dialogue around addiction has been through their Hangout Cafe - a space that hosts book readings, poetry recitals, movie screenings and other such expressions. These recreational events then transform into a convention for those who have brought their friend or family to address their addiction problem. “Almost 60% of callers seek our advice around how to bring up addiction in conversation with people in their life who are going through it,” says Saloni, explaining the cafe’s initiative.
Another organisation dedicated to breaking the silence around abuse through a multi-disciplinary and more new-age approach is TATVA, in North Goa. Started by Kripi Malviya, a trained addiction counsellor and British national David Stanton, who has been working in rehab centres across Asia, Africa and Europe for three decades, Tatva is a space for tertiary treatment in mental health after primary care or detox.
“In 99% of the cases, addicts abuse to shield themselves from issues like abandonment, anxiety, sexual abuse. If these aren’t addressed through conversation a relapse is bound to take place. That’s why at TATVA we want to treat the traumatic culture of addiction abuse and not just the physical prevention of it,” says Stanton, expressing TATVA’s philosophy.
TATVA not only uses psychotherapy to achieve this but also focusses on engaging their clients through services like yoga, nature therapy, music and didactic lectures.
Malviya tells us why they have moved away from the traditional medical model to this kind of unconventional approach.
“You have to understand that addiction makes one completely powerless. One has broken all that one wanted to be and distanced themself from family friends. How do you find your way back?” retorts Malviya. “At TATVA, we believe making these connections again is the antidote of addiction. If we can inject that back into an individual’s life through whatever they loved before addiction - writing, gardening, caring for animals, then their treatment goals will become sustainable,” she asserts confidently.
Finding Lines That Join The Dots
Making connections is at the core of recovery. At DAIRCC, situated on the foothills of Haji Malang mountain, on the outskirts of Mumbai, connection is the antithesis of addiction. Founded in 1983, the rehab has detoxified over 20,000 chemical dependants through a simple mantra- “All you need is love.”
Dr. Yusuf Merchant, founder of DAIRCC, who has been treating addiction and mental illness for the past three decades gave me insights into why he thinks the Beatles are the best way to cure addiction.
“Addicts are always on the run from their past of hate, resentment and anger. This forms a wall between their ability to make connections.We have to reappraise their past in a way so they can make peace with it,” says Merchant in between incessant drags of his cigarette as we sit in his quaint Fort office.
Exercises like ‘catharsis’ is an important way in which Merchant allows his programmers to confront the past. In this exercise, programmers are paired together. Each one must take turns to release the pain, grief and frustrations they harbour towards a particular person in their life towards their partner. As one does not share a past with their partner, expressing internalised frustrations without inhibitions is natural. “Deleting the past means deleting the deficiencies that led to addiction,” says Merchant.
Still, he does not believe in limiting his practices to the sprawling 85,000 sqft grounds of his rehab. When programmers begin to show progress, he often takes them on a group holiday - anywhere between Pattaya and Paris. “Rehab is not only about staying away from drugs. I have to show them how to enjoy life, how to be ‘high’ on it, without being chemically ‘high’,” says Merchant. It cannot be ignored that his rehab’s highly personalised treatment has a success rate of over 82%.
The Other Side (Or Punitive Realities)
Unfortunately, not all rehabs share the holistic vision that DAIRCC does. Gautam found the doctors, counsellors and staff at his rehab in Bangalore “conservative and judgemental” and he made no progress through the narcotics anonymous model of counselling they provided. When he decided to run away from this ‘hostile’ environment, the consequences were punitive.
“I was locked down, injected with sleeping pills and subjected to solitary confinement. This process was repeated every time they felt I didn’t act in accordance to the behaviour they expected out of me,” says Gautam, hesitantly recalling these traumas. “Once they even bound me in ropes and paraded me through the centre in order to humiliate me,” he adds. Gautam relapsed soon after he left rehab.
For 23-year-old Pune-based Rohan who has been to three rehabs in the past six years for drug-induced bipolar disorder, this kind of treatment is standard. “The atmosphere at rehabs is like a prison hostel. You can’t leave, you are locked down. So one can either sit quietly and enjoy the silence, or get agitated and then be tranquilized back to their beds,” he says nonchalantly.
34-year-old Armaan’s experience at rehab in NIMHANS, Bangalore, weren’t violent but nonetheless unfruitful. “During my three weeks there, there wasn’t an effort to understand my history and story which might have led to counselling towards self-realization. There was also a concerted effort to convey that marijuana is a terrible substance,” he says. However, as he was admitted to the programme along with his parents, he feels that with their support, he was able to address his “impulsive and indulgent nature.”
At TATVA, family and couple therapy is the norm. “The addict in rehab needs to be reassured that when he goes through periods of uncertainty and conflict, he will have a support system to rely on. Also, the family must be involved in therapy to understand and then change, if need be, the atmosphere at home where addiction first fostered,” Stanton explains.
Basrur, now a successful musician, couldn’t agree more. “I wouldn’t be here if my family had not looked out for me. I will always be grateful for the sacrifices they made for me,” he says, reminiscing that he spent almost a year in rehab and is now over seventeen years clean.
Though for some, blood relations can no longer find faith in the promises of an addict and at those times support must and often does come from complete strangers. When 24-year-old Pritesh Ambavale, who used to be a multi-drug abuser, arrived at Vijay Swami’s New Life Rehabilitation centre in Kandivali, he was at the brink of death.
“I was a hopeless case,” says Ambavale over a cold drink of kokum sharbat that he made for me. “My family had disowned me, I was broke, homeless and starved. When the doctor claimed I had a few days to live, I brought myself to rehab,” he says, now a healthy and happy-looking young man. Today after two years of treatment Ambavale is the manager of the rehab that helped him recover. “Sir (Vijay Swami) gave me his full support and I walked on the path of spirituality that he showed me,” he says when asked the story behind his success.
The Permanent Impermanence Of Sobriety
Like Ambavale, even Basrur chose to stay connected with his rehab after he had completed his term. That’s because while the the struggles in Land were overcoming his ego to really engage with the programme and baring his soul out to strangers in therapy, he felt his biggest challenge was when his farewell was announced. “I was just not ready to leave Land. The outside world scared me. Dr.Merchant was kind enough to give me a job there for a while that helped me gain confidence in myself.”
So have finally all his struggles with addiction ended today?
“Yes and no,” he says keeping me in limbo. “I sniff a drink every time I consume it. Once, unintentionally, I took a sip from a glass of rum and coke, I spat it out right then and there. There will always be this borderline paranoia,” he confesses.
For 62-year-old Shobhana Mannadiar director of National Addiction Research Centre (NARC) an NGO in Bhardawadi Hospital, Andheri, her struggles are completely different. Despite having a success rate of 90% she is unable to treat addicts seeking the rehab’s services for the past year. “The BMC has taken our one-floor space on the pretext of making repairs. It’s been over a year and they refuse to give it back. They are also now asking us to pay rent, which we definitely cannot afford,” says a frustrated Mannadiar whose patients are usually those from the marginalised and lower-income group.
In the years since 1985 that NAARC has been operational, Mannadiar has had to continuously raise funds and pitch in through her own savings to run it. “From our patients, we take whatever money they can offer. The government funds us for medicines and food and part time salaries for the staff. No nurse is willing to work for Rs 4000-5000 a month, the measly sum provided to us, she laments. As for private funding, matters are even more bleak. “Nobody wants to spend their money on treating addicts. They see it as paying for somebody else’s sins,” she says honestly. Mannadiar gets 4-5 calls everyday from addicts and their loved ones who want to seek NARCC’S aid. “I feel so helpless. I don’t know how to reassure them anymore,” she admits.
Is this then the desolate state of affairs for government-run rehabs throughout the country?
The Good, The Bad And The Ugly
“There is a tremendous gap between the services provided for addiction between the upper and lower classes. Except for Chennai’s, all the others have no real trained staff, just ex-addicts counselling the present ones,” says Malviya from TATVA who has worked at close to 60-70 government-run rehab centres across India which are managed by the Ministry Of Social Justice and Empowerment. “Most of these places have no autonomy and a they are complete lock-down for individuals whose family cannot deal with them anymore. They are far from spaces of healing,” she says candidly.
When Vijay Swami gives me a tour of his rehab centre in Kandivali that caters to both the lower and middle class, I thought to myself that perhaps private rehabs in the country were in better shape. Swami’s establishment was clean and modest with programmers who looked both happy and healthy. But Swami was quick to burst my bubble.
“For private rehab centres in India, it’s nothing but a money-making racket. The biggest profits are made at the expense of the patient’s physical and mental health-especially when they deprive them of food and make them do free labour,” he says vehemently, after working and volunteering at addiction centres across the country. Narrating one such instance he says, “A private rehab owner whom I cannot name once reprimanded me because I sent one of his patients home in a positive state of mind. His justification was that my counselling had cost him business, for that person was unlikely to return to the rehab.”
Dr. Yusuf Merchant feels that the state of rehabs is such because the government focuses on ‘demand-reduction’ when it comes to the drug problem in India as opposed to concentrating on ‘harm reduction.’ “Legally cutting short the drug supply will only increase the demand of drugs in the market. We need to be spreading awareness about addiction through education, counselling and training staff at rehabs. This is only way to rewire the drug sensibilities of the nation for a brighter future,” says Merchant whose own Drug Resistance Education program reaches out to over 6000 school children in the country annually.
Just Another Chink In Our Armour Of Taboos?
Truth be told, after intensive research and conversations with people representative of just about every side of this ecosystem, the story of addiction is not a new one for India. We’ve seen it with mental health (even as thousands of suicide calls a day go unanswered), we’ve seen it with stigmas around sexuality that refuses to conform and we see it with a million under deep-rooted issues in Indian society that refuse to tackle taboo issues with the urgency it requires, even when it could well be considered an epidemic. As with all of these, the real path to any kind of real change is rooted in mindsets. A rewiring of our understanding and our ability to empathise with people who simply get pushed to the fringes of our society is the need of the hour. Why? Because sobriety, as Rohan says swiftly, “lets him breathe.” The saving of lives seems a worthy goal to battle all the stigmas of addiction.
Representational feature image source: Calcutta Yellow Pages
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