Professional Documents
Culture Documents
DE ADDICTION CENTER
INTRODUCTION:
Substance use disorder is best conceptualized as a chronic, noncommunicable disease. The disorder requires a comprehensive
treatment, delivered by trained professionals, belonging to various
disciplines, in a variety of settings.
In India, The drug dependence treatment sector is still developing and
undergoing refinement. The treatment services for substance use disorder in
India are delivered by three major players1. The first major player is the NonGovernmental Organization (NGO) sector. There are around 430 drug
dependence treatment centers throughout the country, which are being run by
NGOs, supported by the Ministry of Social Justice and Empowerment,
Government of India (MSJE, 2008). Another major group is the private sector;
many doctors including a large number of psychiatrists are providing services to
people for substance use related problems. The third major group is the
government de-addiction centres2 (DACs). The Ministry of Health and Family
Welfare (MOH&FW), Government of India, has established about 122 drug
dependence treatment centers (or DACs as they are called) throughout the
length and breadth of the country (Panda, 2007). Most of these government
centers are associated with either general hospitals at the district levels or with
departments of Psychiatry at certain medical colleges.
5000 BC : The Sumerian people used the Joy plant , which is believed to be
Opium.
The code of Hammurabi (1792-1750 BC) is the oldest known form of legal code ,
that had regulatory provisions and guidelines for preventing Alcohol Abuse.
King Hammurabi
Cocaine Kit
Harrison Act (1914): made the possession of Narcotics without a prescription a
criminal offence.
DEFENITIONS:
Drug use: is simply the ingestion of substance/substances without
experiencing any negative consequences. It may be social use, like in parties;
recreational or experimental use, dietary practice or maybe religious ritual.
Drug Abuse: the use of any substance for purposes other than medical and
scientific, including use without prescription, in excessive dose levels, over an
unjustified period of time.
Addiction: is defined as the repeated use of the substance/drugs to the extent
that the user is periodically or toxically intoxicated, shows a compulsion to take
the preferred substance or substances, has great difficulties in volunteering,
ceasing or modifying substance use, and exhibits determination to obtain
psychoactive substances by almost any means.
Dependence: is defined as, the cluster of cognitive, behavioral and
psychological symptoms indicating that the individual continues use of the
substance despite the significant substance related problems.
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OVERARCHING ISSUES AND PRINCIPLES
There are certain overarching issues and principles which must be adhered to
for providing the services. All the Government De-addiction centers should
strive to achieve the following:
Licensing / Accreditation: Ideally a system should be in place which provides
certification or accreditation to a Government De-Addiction centre as an
authorized substance use treatment centre. This issue has been discussed
elsewhere in the monograph. For this purpose, the senior management of the
centre / hospital should take the necessary steps.
OBJECTIVES
Providing accurate information
Clarifying myths and misconceptions
Offering methods for early identification, providing motivation,
etc
Equipping trainees with the necessary skills to become
effective trainers
SCOPE
*A
SELF RELIANCE
1. POWER(Electricity)
effectively using Solar Energy)
2. COOKING GAS
3. WASTE MANAGEMENT
4. CULTIVATION (veg/pulse)
Plant (Bio-Fertilizers)
5. FUND GENERATION
fertilizers , Agri.Produce and
Bio-gas Plant
Bio-gas Plant
Bi-Product of Bio Gas
Marketing of biosurplus Solar Energy
Cultivation (Organic)
METHODOLOGY
1) PLAN:
A. Research:
*Drug use and addiction
Drug and Drug use A pharmaceutical preparation or a naturally occurring
substance used primarily to bring about a change in the existing process or
state (physiological, psychological or biochemical) can be called a drug When
drugs are used to treat an illness, prevent a disease and improve health
condition, it is termed drug use. Drug abuse and Addiction Intake of drugs for
reasons other than medical in a manner that affects physical or mental
functioning is termed drug abuse. Any abuse can lead to addiction. Tolerance
refers to a condition where the user needs more and more of the drug to
experience the same effect. Smaller quantities, which were sufficient earlier,
are no longer effective and the user is forced to increase the amount of drug
intake.
Dependence This can be physical and psychological . The person becomes
dependent and starts feeling uncomfortable in the absence of the drug.
Withdrawal symptoms When the drug intake is stopped, withdrawal symptoms
are experienced. Physical dependence gives rise to withdrawals such as tremors
and vomiting. Psychological dependence causes withdrawal symptoms like
restlessness or depression. The intensity of withdrawal symptoms depends on
the physical condition of the user, type of drug abused, the amount of drug
intake and the duration of abuse.
Classification of Addictive Drugs:
a.
b.
c.
d.
e.
f.
g.
Narcotic Analgesics
Stimulants
Depressants
Hallucinogens
Cannabis
Volatile Solvents
Other drugs of abuse.
B. Observations:
The use of drugs has a History of more than thousands of years like use of
Opium in 5000BC by Sumerians , Cannabis from 2000BC in India , Tobacco and
Cocaine from 16th century in USA etc . Even introduction of the idea of deaddiction was introduced by king Hammurabi in 2nd millennium Before Christ.
The Harrissons Narcotics Act 1914 engendered it as a criminal offence to keep
drugs in hand without any prescription.
According to World Drug Report 2012 about 230 million people, or 5 per cent of
the worlds adult population, are estimated to have used an illicit drug at least
once in 2010.10-13 per cent of drug users continue to be problem users. The
prevalence of HIV (20 per cent), hepatitis C (46.7 per cent) and hepatitis B (14.6
per cent) among injecting drug users continues to add to the global burden of
disease.
Annual prevalence of the use of alcohol is 42 per cent (the use of alcohol being
legal in most countries), which is eight times higher than annual prevalence of
illicit drug use (5.0 per cent).Approximately 1 in every 100 deaths among adults
is attributed to illicit drug use
India is located close to the major illicit opium growing areas of the world, withGolden Crescent on the Northwest and Golden Triangle on the NorthEast.
Licit substances (alcohol and tobacco) are the most commonly used
substances. Among the illicit substances , cannabis and opiates are the most
frequently used ones.
G OLDEN C RESCENT
AND
G OLDEN T RIANGLE
C. U NDERSTANDING :
To create awareness about the ill-effects of alcoholism and substance abuse to
the individual, the family and the society at large.
To develop culture-specific models for the prevention of addiction and treatment
and rehabilitation of addicts.
To evolve and provide a whole range of community based services for the
identification, motivation, detoxification, counseling, after care and
rehabilitation of addicts
To promote community participation and public cooperation in the reduction of
demand for dependence-producing substances.
To promote collective initiatives and self-help endeavors among individuals and
groups vulnerable to addiction.
To establish appropriate linkages between voluntary agencies, working in the
field of addiction and government organizations.
To support activities of non-governmental organizations, working in the areas
of prevention of addiction and rehabilitation of addicts.
The activities to reduce the drug use related problems in the country could be
broadly divided into two arms :
Supply reduction and Demand reduction.
These activities are run by agencies under the Ministry of Health and Family
Welfare, and the Ministry of Social Justice and Empowerment.
D. Analyze :
Analyzing the basic services, the environment surroundings, the legacy of
existing de addiction centers, etc..
Registration At a minimum level all patients attending de-addiction
treatment services should be registered in a dedicated register and should
receive a unique registration number. This service is linked to record
maintenance and thus patients unique registration number should be reflected
in all the records of the patient. While most hospitals (of which the de-addiction
centers are a part) are expected to have a central registration system, the deaddiction registration number should be separate from the hospital
registration as this would be important for monitoring and evaluation purpose.
Outpatient services
Given the dearth of the specialist medical human resources in the country, the
de-addiction services would have to be provided by doctors who may be either
General Duty Medical Officers (GDMOs) or medical specialists / physicians.
While these doctors may encounter many patients with substance use disorders
in their routine general clinics, such patients should be referred to /
encouraged to attend, the exclusive and dedicated outpatient clinic for
substance use disorders. Thus all hospitals with Government De-Addiction
centres should offer an exclusive outpatient De-addiction clinic. The expected
patient load would determine the frequency of this De-addiction outpatient
clinic; it may vary from daily (i.e. on all working days) to once/twice/thrice a
week. Following services should be available in a De-addiction centre at
outpatient level:
cost from the dispensary. In addition, the centre should strive to also make
available medications listed as Other medications, though they have not
been put on the essential list.
2) DESIGN :
E) Case Studies
TTk Hospital of Drug De Addiction , Chennai
Hope Trust Alcohol and drug de-addiction center , Hyderabad
F) Business Process
A business process is a collection of linked tasks which find their end in the
delivery of a service or product to a client. A business process has also been defined as a
set of activities and tasks that, once completed, will accomplish an organizational goal.
i.
In-patient care Services
Detox
Comprehensive medical Assessment
Psychiatric assessment
Orientation
Daily Yoga and Meditation
Mindfulness training
Individual counseling
Daily AA/NA meetings
Input sessions
Emotional Management Group sessions
Audio and video input
Family Interventions and meetings
Psychological Interventions
Psychiatric help
Relapse Prevention
Psycho Education
External Support
Making Goals
Communication Exercises
ii.
Out- patient care services
Marital counseling
Parental guidance (teenage, adolescence, behavior issues)
Pre- and post-surgery counseling
Grief counseling
Conflict management
CBT for anxiety and depression
G) WIREFRAME:
Wire frame represent the built form in which only lines and vertices
are represented .Here a basic sketched site plan is shown.
H) DESIGN CONCEPTS:
Designing an environment for rehabilitating drug addicts needs sensitivity and a
better understanding of their situation. Here the issues of primary concern are:
Can our architecture contribute to this healing process? - with the quality
of our outer space helping to modify our inner psychological space and
with the help of nature
Can our design enhance human interaction and reduce the isolation?
While discussing the brief with the clients, the clients explained the importance
of being connected for the patients there. Being isolated increases their
depression and their craving. Therefore the design attempts to create as much
transparency, openness and fluidity of space to help in the healing, correcting
process.
A small, enclosed landscaped amphitheatre in the Centre, breathes light and joy
into the building while helping the inmates to connect with each other and the
staff there.
The building is functionally easy to monitor with only one controlled entrance.
The increased visibility because of the transparency makes this supervision
easier. A balance has been struck between a sense of freedom and disciplinary
control.
This architecture attempts at raising a sense of belonging and sharing between
the users and therefore indirectly causing recoveries.
3) DEVELOP
1.
DESIGN HANDOVER :
The Design Handover is the stage where client and the designer
(architect) sign the Design Transfer Agreement and the designer transfers
the finished design files to the client.
J) COMMUNICATE:
An essential communication shall be made between the architect and the
client on the basic facilitations , building design , landscape features etc..
which are important for an effective produce.
K) MONITOR:
Clear observation and checking the progress or quality of the structure over the
constructional period of time and thus ; keep under a systematic review of it..
L) VISUAL DESIGN:
Graphic/Visual design is the process of visual communication, and problem-solving
through the use of type, space, image and color. The field is considered a subset
of visual communication and communication design, but sometimes the term
"graphic design" is used interchangeably with these due to overlapping skills involved.
4) DEPLOY:
M) USABILITY TEST:
The verification of the Usability test is done in this process . A positive result
in the conclusion of the verification can prove the the mental feeling of an
admitted patient , his collaboration with the surroundings and the
qualitative provisional requirements.
O)
Package services
Judgekunnu , Thiruvallam ,
3.19 Acre
400 feet apprx from sea level
SITE PHOTOS
Ghat Road
Ghat Road 2
Reaching Hilltop
Hilltop reached
Proposed site I
Proposed site II
Terrain Texture
Proximity to Airport
The Sunset