Nasha Mitra program intends to shed new light in the field of addiction treatment through range of research activities and regular auditing of electronically saved client’s recovery data. Nasha Mitra systemically records demographic and clinical data using a confidential electronic data recording system. Additionally, Nasha Mitra electronically records information gathered from customer’s satisfaction survey and often uses all these feedback for future development of services.
Nasha Mitra started it’s journey after conducting a community addiction literacy survey. Significant finding from the small survey helped a lot to develop the road map about the structure and functioning of this program.
Nasha Mitra has currently developed a research proposal to conduct a research on brief intervention on local college youths as a harm minimisation strategy.
Annual audit of our client’s recovery data helps us to identify potential barriers and provides us important ingredient for future development.
How can we scientifically diagnose problematic use of different substances?
Many people drink alcohol. However, only a small proportion of them are considered to be problematic drinker. In other words, a small proportion of them will develop symptoms suggestive of alcohol dependence that means their body is dependent on alcohol. If they don’t use it, they develop a whole range of psychological symptoms such as anxiety, irritable mood, lack of sleep etc and physical symptoms such as shakes, excessive sweating, fast heat beat. These symptoms are called withdrawal symptoms, which are very uncomfortable and often compels them to get back on drinking of alcohol.
Scientifically validated DSM V criteria for substance dependence helps us to figure out whether an individual is drinking up to a problematic level. These criteria are as following:
1. Taking the substance in larger amounts or for longer than you're meant to
2. Wanting to cut down or stop using the substance but not able to do that
3. Spending a lot of time getting, using, or recovering from use of the substance
4. Cravings and strong desire to use the substance
5. Not managing to do what you should at work, home, or school because of substance use
6. Continuing to use, even when it causes problems in different spheres of life
7. Giving up important social, occupational, or recreational activities because of substance use
8. Using substances again and again, even when it puts you in danger
9. Continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by the substance
10. Needing more of the substance to get the effect you want (tolerance)
11. Development of withdrawal symptoms, which can be relieved by taking more of the substance
Degree of severity of substance use
Mild: 2-3 symptoms
Moderate: 4-5 symptoms
Severe: 6 or more symptoms
Same criteria are applicable for any addictive substances. However, the nature of withdrawal symptoms may vary.
How scientifically validated instruments help us to determine severity of different addictions?
Identifying the substance use: CAGE Questionnaire
Excessive consumption of alcohol or any other substances for an extended period may cause dependence and affect the wellbeing of the individuals and families. Taking a drinking history require set of skills and strategies. It is essential for the service provider to take a not judgmental approach because blaming and criticism an individual is a critical error for professionals.
Several evidence-based questionnaires can detect the problematic pattern of substance use. One easy to use a questionnaire for the alcohol problem is known as an acronym of CAGE require two or more positive replies. 'C' stands for cut down (Have you ever tried to cut down your alcohol drinking?). 'A' means annoyed (Have you ever been annoyed by your friend's and family's criticism of your drinking? ). 'G' stands for guilty (Have you ever felt bad or guilty about your drinking). 'E' stands for eye opener (Have you ever felt shaky or hang over in the morning that you had to take a drink or two to get rid of that feeling?)
Apart from CAGE questionnaire, there are number of other scientifically validated scales which help to ascertain severity of withdrawal symptoms from different substance. Then we can tailor our treatment approach accordingly.
CIWA: Alcohol Withdrawal Scale
OWS: Opioid Withdrawal Sacle
BWS: Benzodiazepine Withdrawal Scale
AUDIT: Alcohol Use Disorder Identification Test
FTND: Fagerstrom Test for Nicotine Dependence
Safe limit of alcohol
For men, not more than 4 drinks on average and no more than 6 drinks on any one day.
For women, not more than 2 drinks on average day and no more than 4 drinks on any one day.
For men, 15 drinks or more per week.
For women, 8 drinks or more per week.