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Rehab for women addicts

High on a prescription

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For Madhavi, 45, taking an Alzolam tablet every night is a must. The homemaker, who claims that it gives her sound sleep and an escape from the anxieties that she fears confronting, started taking the medication after she lost her husband a few years ago. Never realising when she became completely dependent on it, today she cannot cope without the drug: "It makes me go crazy. I start feeling sick and extremely tired. " 

Madhavi's case illustrates the growing substance dependency among women today, with a very large number into sleeping pills, anti-depressants, injectibles, inhalants, cannabis, prescription drugs, alcohol and cigarettes. Pyschiatrists are baffled by the phenomenon. However, with addiction being considered a male problem till recently, rehabilitation or treatment facilities exclusively for women have been almost non-existent.

Fortunately, this is set to end with the initiative of the National Institute of Mental Health and Neurosciences (NIMHANS) in Bangalore. NIMHANS will be the first government institution in the country to start a special women's deaddiction ward - a decision arrived at after its general de-addiction ward was not able to meet the needs of the rising number of women addicts who came seeking help. Psychiatrists at NIMHANS realised that these women would need a separate residential facility and a treatment focused on women.

A couple of decades ago, it was almost unimaginable to see a woman walk into a rehab centre, given the taboo factor. Even though many women did engage in alcohol and drugs, they were barely treated. "In the late '80s and early '90s the number of women seeking help was around 100 patients in ten to 12 years. Now, over a hundred women seek residential rehabilitation every year, " says Dr Pratima Murthy, a professor at NIMHANS. Unable to accommodate so many women in the general de-addiction ward, NIMHANS started constructing a 20-bed women's ward in 2011. The facility is almost ready now. "We hope to open it to patients by the end of this financial year, " Murthy says.

Strangely, no government surveys on alcohol or drug use have covered the female population till now - it, evidently, being assumed that their numbers are negligible. However, the United Nations Office on Drugs and Crime (UNODC) in 2008 carried out a detailed survey on 'Women and Drug Use in India' and found that addiction was gaining serious proportions even among women.

Who are these women? Dr Murthy says that unlike the general perception, a lot of them are young and educated. "They are successful entrepreneurs, mid-level employees, students, homemakers, " she says. "Women pretty much from every section of society. We cannot pinpoint a single reason behind this trend. The changing economic and social status of women has in many ways influenced their behaviour. We have to also remember that possibly a lot more women now are coming ahead to seek help from institutions like ours. Earlier, they were fearful of doing so openly. "

The UNODC report attributes the rise in addiction to two reasons. One, stress and depression in women who live with addicted partners. They end up taking anti-depressants and often get addicted to them. The other explanation given by psychiatrists is the radical change in the roles played by women. "A paradoxical development is that gender empowerment, which seeks to improve financial and social status, social equity and the stress of multiple roles sometimes results in newer problems. One such problem associated with gender gender 'emancipation' is psychoactive substance use (alcohol and other drugs), " observed the authors of the study.

Interestingly, the causes of addiction are very different in women and men. Stress is often the biggest driver toward addiction for women. "Several studies on addiction trends in women show that they have many co-morbidities like depression and anxiety associated with their drug abuse. This is not the case with men. Women undergoing a lot of stress may give in to addiction as a measure to find relief, " says Dr Anju Dhawan, associate professor at the National Drug Dependence Treatment Centre at the All India Institute of Medical Sciences (AIIMS).

No wonder then that a large section of women drug users (almost 20%) today are hooked on to sleeping pills (benzodiazepines ) and anti-depressants. "Taking low doses of sleeping pills is a form of self-medication that many women practise. They have an underlying anxiety, a depressive or a somatoform disorder (mental disorder characterised by physical symptoms). These women usually continue to take such medication without any consultation with doctors, " points out Dr Dhawan.

An American survey conducted last year by Medco Health Solutions found that women are more likely to take prescription medication than men. The study, done on 2. 5 million Americans, also found that 25 per cent of women are given medication for a mental health condition as compared to just 15 percent of men.

According to data with the National Drug Dependence Treatment Centre, the mean age of women addicts is in the midthirties. The majority of women addicts still happen to be from a lower socio-economic background but the number of women from stable, well-to-do families or working women resorting to drug abuse is also very high. They usually go to private clinics for rehabilitation.

At Tulasi Healthcare Centre, a private deaddiction facility in Delhi, doctors started a ward for women after they saw the demand for exclusive residential care for women. "The emotional needs of women are very different, " says Dr Gorav Gupta, senior psychiatrist and head of Tulasi healthcare centre. "We see a high number of cases of alcoholism and pill-popping. I think the rise in numbers has much to do with a higher disposable income. We have found that many women start as social drinkers and gradually become alcoholics. "

Dr Gupta adds that private clinics see fewer cases of substance abuse. "Women who come for treatment are usually hooked on to cough syrups, sleeping pills and anti-depressants, " he says. "Women prefer abusing prescription drugs because they don't leave an odor like alcohol and can be easily bought. "

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