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Alcoholism and Drug Addiction

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Welcome to Muktangan

Am I really an addict?

Have you ever pondered over this question? Do you think of yourself as a social drinker? Take the simple quiz below to find out. Even though the quiz talks about alcohol, the questions are relevant for drugs too.

Answer these questions Yes or No as honestly and truthfully as possible.

  1. Do you lose time from work due to drinking?
  2. Is drinking making your home life unhappy?
  3. Do you drink because you are shy with other people?
  4. Is drinking affecting your reputation?
  5. Have you ever felt remorse after drinking?
  6. Have you ever got into financial difficulties as a result of drinking?
  7. Do you turn to lower companions and an inferior environment when drinking?
  8. Does drink make you careless of your family welfare?
  9. Has your ambition decreased since drinking?
  10. Do you crave for a drink at a definite time daily?
  11. Do you want a drink the next morning?
  12. Does drinking cause you to have difficulty in sleeping?
  13. Has your efficiency decreased since drinking?
  14. Is drinking jeopardising your job or business?
  15. Do you drink to escape from worries or trouble?
  16. Do you drink alone?
  17. Have you ever had a complete loss of memory as a result of drinking?
  18. Has a physician ever treated you for drinking?
  19. Do you drink to build up your self-confidence?
  20. Have you ever been in a hospital or institution on account of drinking?

If you answered YES to any ONE of these questions, there is a definite warning that YOU MAY BE AN ALCOHOLIC.

If you answered YES to any TWO questions, the chances are YOU ARE AN ALCOHOLIC.

If you answered YES to any THREE OR MORE, YOU ARE DEFINITELY AN ALCOHOLIC.

(The test questions are taken from an AA publication and are used by John Hopkins University Hospital, Baltimore, Maryland, in deciding whether or not a patient is an alcoholic)

Addiction: Questions and Answers

.. Addiction is a disease
.. Abstinence is the only method to control addiction
.. Treatment will help in controlling addiction
.. Treatment can be given at any stage but is easier in the early phase

You ask questions and we'll try to provide answers. Here are some questions people have been asking us. If you don't see a question listed below, or need more explanation or clarification, send us an email. We'll be glad to provide an answer.

What are the common misunderstandings about addiction?

  1. Addicts are bad, misbehaved, lazy or useless people
  2. Addicts should not be treated unless they are violent or fall in gutters and create problems in social setting
  3. People who do not abuse/drink continuously, that is throughout the day, don't have a problem
  4. People who are into substance abuse can be left alone if they earn well and work well
  5. Alcohol, ganja are used in festivals, while cough syrups etc. are medicines, therefore they can be consumed without any harm
  6. Alcohol improves appetite and sexual libido
  7. Smoking filtered cigarette and drinking foreign liquor is fashionable and an occupational etiquette

Is hospitalization always necessary?

Only if the person has a previous history of seizure, delirium or any such complications. Addicts require compulsory hospital admission for physical sickness such as blood pressure, liver or heart related complications.

What is recovery?

A person is on the recovery path when he abstains from or stops the use of addictive substance completely, examines and improves self-thinking, feeling and behaviour patterns; that is he tries to make reasonable changes in his lifestyle. The recovered addict also starts rehabilitating himself in family, job, education and career. He also takes efforts in learning ways to cope with free time, money and relationships, that is channelling energies into positive ways.

What is detoxification?

It is a process in which the patient is administered drugs, diet and a change of atmosphere to break the routine of addiction. Required medical and counselling support is also provided as withdrawal symptoms (commonly called "turkey") like disorientation, sleeplessness, restlessness often occur during detoxification.

What does a rehabilitation center do?

A rehabilitation center helps addicts in the recovery process. The centers usually have an outlined residential program. Use of discipline, creative & constructive routines and psychological treatment methods are the salient features of the centers. The addicts are helped to analyze themselves, confront defensive behaviour and learn coping patterns. The duration of the patient's stay may vary from 35 days to 6 months.

What happens after treatment?

Person comes back educated about his illness, believes that he can remain without addictive substance, and continues with his work. He sees other addicts in worse conditions and remains watchful of his own deterioration if he goes in to relapse. He is also aware of the disadvantages of substance abuse, and that if he does not take proper precautions there are chances of relapse.

What is AA, NA?

AA is Alcoholics Anonymous, a self-help group started by and for the alcoholics. (The story of birth of AA).
NA is Narcotics Anonymous, a self-help group for users of narcotic drugs like brown sugar, charas, ganja, cocaine etc.
These groups have free membership, they provide anonymity and a sense of belonging to their members.

What is the role of family members?

Role of family members/caregivers in helping the addict is very crucial.

  • They need to accept that the addict is ill, and should accompany him for treatment like any other patient
  • They need to play a remedial role as prescribed by the counsellor
  • Changing their thinking, feeling and behaviour patterns is necessary
  • It is important to play a vigilant role in case the patient slips back to addiction
  • The family should try and lead a normal life within the circumstances

What is sobriety?

Sobriety is not merely abstinence from the substance but a qualitative change in attitude regarding self, others and the world. It also includes a sense of self-development and effort towards active reinstatement of self in the social mainstream.

Can an addict lead a normal life?

Yes, and he can even progress and help other addicts during their treatment and recovery. He can restart his education, career plans, family reunification etc. He should however always completely abstain from all addictive, dependency-producing substances as there is a danger of relapse of some abuse or shift to a new abuse.

Addiction: MORE Questions and Answers

Alcoholism...

  • ranks with cancer, heart disease and stroke as a major disease
  • reduces the life expectancy of its victim by 10 to 12 years
  • is related to 1/3rd of all deaths reported as suicides
  • is related to 1/3rd of all fatal automobile accidents
  • destroys marriages and careers of 3/4th of its victims

What others say of addiction?

  1. Addiction is a conditional response
    - Behavioural psychologist
  2. Addiction results from learned behaviour
    - Cognitive psychologist
  3. Addiction results from dysfunctional family
    - Social psychologist
  4. Addiction is a permanent, progressive, cunning, baffling and powerful disease, marked by mental obsession and physical craving
    - AA / NA member
  5. Addiction is either substance abuse or substance dependency
    - As classified in Diagnostic and Statistical Manual IV
  6. Addiction is a biological disease
    - A Research Psychiatrist
  7. Addiction is a neurotic self-destructive behaviour resulting due to Low Frustration Tolerance (LFT) or themes such as - addiction equals worthlessness, addiction as a coping mechanism, addiction as a result of demand for excitement etc.
    - REBT Therapist
  8. Addiction is generally applied co-habits that are not needed for life and also are hazardous to health
    - Mental Health Terms Glossary by Mark Dombeck, PhD
  9. Addiction is best understood as an individual's adjustment, albeit a self-defeating one, to his or her environment. It represents a habitual style of coping, albeit one that the individual is capable of modifying with changing emotional and life circumstances
    - Stanton Peel
  10. Addiction is a feeling of "I shall continue it as long as I can" despite having devastating effects on oneself or others
    - Arnot Oregon Medical center
  11. Although there are many kinds of addictions, no matter what the addiction is, every addict engages in a relationship with an object or event in order to produce a desired mood change
    - Mr. Craig Nakken, author of "Addictive Personality"
  12. Maladaptive genes that produce and maintain the craving for the addictive substance(s) and as a result, alter the metabolism in "reward" centers within the central nervous system
    - The Biogenic Model
  13. Drug dependence is a state, psychic and sometimes also physical, resulting from taking a drug, characterised by behavioural and other responses that always include a compulsion to take a drug on a continuous or periodic basis in order to experience its psychic effects, and sometimes to avoid the discomfort of its absence. Tolerance may or may not be present. A person may be dependent on more than one drug
    - WHO ICD 1990 (p. 1131)
  14. Addiction is maladaptive pattern of spirituality
    - Religious Leaders
  15. Addiction is anaesthesia
    - Daniel Laguitton

During the sharing at AA, it is often heard that there are 16000 reasons for drinking. Similarly, there are different and divergent definitions of addiction. At least fifteen of such views are given above. We at Muktangan are not interested in defining the term Addiction. However, for the purposes of treating addiction we follow a simple elaborate statement so that the goal of treatment can be achieved.

How Muktangan looks at addiction?

Muktangan, since its inception, has preferred to be a "treatment" center. All our activities are focussed upon helping addicts and their family members to live a happy, healthy and productive life. It is a known fact that Muktangan staff mainly consists of recovered addicts along with professional psychologists, psychiatrists and social workers. The professionals working with us are essentially involved in medical & psychiatric management of the patients and updating the knowledge base of our staff. Muktangan neither claims nor is in a position to present a clinical definition of addiction.

Muktangan has treated almost a thousand of patients every year since inception. Our patients have enlightened us about the experience of addiction. Based on what we have gathered from our friends we look at addiction as:
"Substance addiction is a self-destructive behaviour marked by physiological dependence & tolerance, followed by medical complications with emotional consequences, interpersonal problems, and adversely affecting individual's capacity to work and live a social life."

We would also like to add that addiction might be caused by any reason whatsoever. Addiction may be the result of a particular event or a series of activating events, or an individual might be genetically, socially, culturally or for any other reasons be trapped in the addiction for which he may or may not be exclusively responsible. However, he owns the responsibility of choosing the narcotic substance as a coping mechanism, he is responsible for the acts committed during his addiction and more importantly he has to take the sole responsibility of sober living.

What is denial?

When a person takes alcohol or drugs excessively, several problems arise which are clearly visible to others. Yet the person continues to say that he has no problems at all. This is called 'denial'. Addicts deny their problem in order to protect themselves from feeling hurt, sad or guilty and also to continue with their drinking or drug-taking.

Denial can be observed in various forms:

  1. Simple denial: The addict says he has no problem with drinking or drug-taking
  2. Blaming: Claiming that others are the cause of his addiction
  3. Minimising: Accepting the problem of addiction but claiming it's only a small problem
  4. Rationalising: Producing 'intelligent' excuses for addiction
  5. Diverting: Avoiding any talk about his addiction
  6. Aggression: Initiating fights and quarrels, which provides an excuse to drink or take drugs

What are the physiological facets of addiction?

Physical dependence as characterised by tolerance is defined by either of the following:

  • Need for increased amounts of the substance to achieve intoxication or desired effect
  • Markedly diminished effect with continued use of the same amount of substance

Withdrawal is manifested as either of the following:

  1. Development of a substance-specific syndrome due to the cessation of or reduction in the intake of a substance that the person previously used regularly. In case of alcohol: increased hand tremors, insomnia, nausea or vomiting, anxiety, rum-fits, irritability. In case of drugs: dysphoric mood (excessive restlessness and impatience), muscle aches, pupilary dilation, piloerection (goose bumps) or sweating, diarrhoea, yawning, fever, delirium tremens, hallucinations etc.
  2. Clinically significant distress or impairment in social, occupational and other important areas of functioning.

Medical complications caused by substance abuse are as follows:

  • Liver Diseases: Fatty liver, Alcoholic hepatitis, Liver Cirrhosis
  • Gastrointestinal Disorders: Ulcers, Pancreatitis
  • Nutritional Disorders: Malnutrition, Anaemia, Peripheral neuropathy
  • Heart Disease: Cardiomyopathy, Hypertension, Ischaemic Heart Disease (IHD)

Addiction: MORE Questions and Answers (Continued)

What are the emotional aspects of addiction?

It is argued that addiction is essentially an emotional problem. We at Muktangan are not interested in analysing whether the emotional problems are the root causes of addiction or not. But here we would like to present some of our observations.

  • Depression -- in some cases leads to addiction. Some depressed persons use the substance to cope with depressive thoughts.
  • Generalised Anxiety Disorder (GAD) -- It is very difficult to identify whether GAD is the cause or the effect of addiction. However, a negligible percent of patients were earlier found to be treated for GAD.
  • Personality Disorders (PD) -- Diagnosing PD is quite a difficult task. However, in a few cases if history is properly provided & clinical tests are carried out, personality factors can be identified.

What are the emotional problems caused by addiction?

As stated earlier, addiction has definite emotional consequences. We have observed the following emotional consequences:

  • Emotions of an addict are usually "inappropriate". Consequently his behavior is irrational. He ignores his material & emotional goals, he cannot think of alternatives, invites unnecessary conflicts with others and at the extreme state harms himself.
  • 'Hate' is at the top of the list of most commonly experienced negative feelings at the onset.

After cessation of addiction following feelings are most often experienced - disgusted, resentful, bitter, detested, fed-up, frustrated, sad, depressed, sick, dissatisfied, fatigued, worn-out, useless, weak, hopeless, rejected, guilty, embarrassed, inhibited, bewildered, frightened, anxious, dismayed, apprehensive, disturbed, antagonistic, vengeful, indignant, mad, torn.

Now here is the list of extreme emotions experienced by the addicts. All the following feelings are intense and "inappropriate": Hate, unloved, abhorrence, despised, angry, hurt, miserable, pain, lonely, cynical, worthless, impotent, futile, accursed, abandoned, degraded, humiliated, shocked, panicky, trapped, horrified, afraid, scared, terrified, threatened, infuriated, furious, exhausted.

What is addictive thinking?

We at Muktangan believe that it is largely the patients' self-defeating thoughts and resulting feelings and actions that sabotage their lives. Many of our recovering patients share that it is their "thinking" rather than "using" that leads towards or away from the "first drink". Therefore AA slogans like "One day at a time", "Easy does it but do it" are the guiding thoughts that keep patients away from the first drink. Thousands of fellow members of AA & NA admit that these slogans have been helping them to stay sober.

We have listed below some characteristic features of addictive thoughts and general beliefs leading to self-sabotaging behavior.

Qualitative descriptions of addictive thinking:

  • Autonomous and non-conscious
  • Rigid and inflexible
  • Dichotomous, all or nothing quality
  • Over-generalised and illogical
  • Jumping to conclusions
  • Negative opinion about oneself
  • Self-criticism and self-blame
  • Negative interpretations of the event
  • Ignoring the positive

Common content or theme of addictive thinking:

  • Denial: Alcohol and/or drugs are not the problem
  • Low frustration tolerance and/or self defined needs for high levels of stimulation, gratification and or excitement
  • Substance is the only way to solve emotional problems
  • Discomfort anxiety: all negative emotions are to be avoided at all costs
  • Change is too difficult, therefore one is hopeless, helpless and worthless
  • Self-blame, guilt and shame for being an addict

What are the interpersonal problems caused by addiction?

Addiction directly affects the interpersonal relationships of the person. The wife and/or mother of the person are the first victims of addiction followed by other family members. We have observed that in almost all cases, the interpersonal relationships are shattered in one way or other.

The most common problems faced by an addict are related to love:

  • Rarely receives loving and confiding behaviour from the parents & siblings
  • Diminishing love, respect and trust of the spouse
  • Hatred, fear, anxiety and distress expressed by the children

How is the behavior during active addiction?

Behavior is marked by the following:

  • Arrogant or conceited: for example, boastful, self-important, self-centered, jealous or envious
  • Attention-seeking or theatrical: for example, always tries to be the center of attention, dramatises, displays theatrical and exaggerated expressions of emotion
  • Intolerant or cruel: for example, unkind, mean, merciless, brutal etc.
  • Lying or cheating: for example, malicious gossip, secret extramarital affairs
  • Domineering or dictatorial: for example, bossy, over aggressive, disrespectful, over-controlling, authoritarian behaviour
  • Criminal and/or violent: for example, destroys property, physically assaults others etc.

Can an addict have a productive life?

Addiction results in diminishing capacity to work and/or have a productive life. Based on our experience following responses are observed towards productive work during addiction:

  • Poor concentration or attention
  • Fidgeting, pacing or hyperactivity
  • Loss of initiative, interest and motivation
  • Lack of spontaneity and slowed reactions
  • Procrastination and avoiding responsibilities
  • Rationalisations, justifications and blaming others at the work place
  • Poor memory and learning ability
  • Frequent errors in decisions and work
  • Overly dependent behavior
  • Disorientation

What about disorganised social life and financial problems?

During active substance abuse, the person faces several social and financial problems. The indicative symptoms are given below.

Social problems:

  • Unstable and intense social relationships: for example, goes from crisis to crisis, loves someone one day and hates them the next
  • Lack of loving and confiding with friends
  • Avoidance of social gatherings, functions etc.
  • Detached from organised social group(s)
  • Phobia: for example, fear of public speaking, staying in a group, travelling etc.
  • Prefers to be with other addict friends
  • Avoids religious activities
  • Mistrust or suspicion: for example, belief that others are always exploiting, harming or deceiving
  • Prolonged anxiety

Financial problems:

  • Loss of work or job typically leads to scarcity of money
  • Spends whatever money is available on substance
  • Spends money extravagantly, on material goods, gambling etc.
  • Owes money to people
  • Lives without income which causes further depression

What is REBT?

Created in 1955 by Dr. Albert Ellis, Rational Emotive Behavior Therapy (REBT) is an action-oriented therapeutic approach that stimulates emotional growth by teaching people to replace their self-defeating thoughts, feelings and actions with new and more effective ones. REBT teaches individuals to be responsible for their own emotions and gives them the power to change and overcome their unhealthy behaviors that interfere with their ability to function and enjoy life.

Contact Us

Address Muktangan Deaddiction Center
Mohanwadi, off Pune-Alandi Road,
Yerawada, Pune 411006
Email muktangan@vsnl.net
Phone +91 (20) 2669-7605/3271 Telefax +91 (20) 2565-9407


How to get there?

By bus

From Pune station: PMT bus number 154
From Corporation: PMT bus number 119

The ride takes approximately 20 minutes. Get down at Pratiknagar bus stop. Muktangan is behind hotel Landmark and near Shethia hospital.

By shared rikshaw

These are available from Pune station and Corporation. Ask for hotel Landmark.

By private vehicle

The driving directions are:

  • Take Bund Garden road going towards the airport
  • Turn left towards the bridge at the end of Bund Garden road
  • Turn left after crossing the bridge
  • Continue for about a kilometer
  • Turn right when you see Bombay Sappers compound on the right
  • Continue for about 3 kms, going past Pune RTO
  • After Vishrantwadi police station,
    turn right in the lane going to Shetia hospital
  • Take the first left
  • Continue past 5/6 buildings
  • Muktangan building is on your left

Admission Procedure

Miracle is an everyday affair at Muktangan
- Dr. Anil Awachat

Admissions are made on Thursdays between 10am and 1pm. Due to a possible waiting list, prior appointment must be taken before admission. If you are a resident of Pune, you can personally come to the center and pay Rs. 500/- in cash to confirm the admission.
For out station patients, you can send a money order of Rs. 500/- and confirm the admission on phone.
You should confirm your date of admission before visiting the center for admission.

Expenditure for boarding and extra facilities charged for 35 days is Rs. 4000/-. This amount is to be paid in cash or cheque at the time of admission. Besides Rs. 4000/- client has to pay a deposit of Rs. 1000/- towards extra medicines, pathological tests etc. The deposit or the remaining amount is returned to the client at the time of discharge.
The fees once paid will not be refunded under any circumstances.

At the center, psychological treatment is given to the patient. Besides his detoxification and de-addiction treatment, if he falls sick due to any other illness, then parents and guardians are responsible for his extra treatment. During the 35 days indoor treatment, the patients have to follow all the rules and regulations very strictly. On completion of 35 days, the patient is discharged on Wednesday after 10am. That is on the Wednesday of the fifth week after admission date. During 35 days, the patient is NOT allowed to make or receive phone calls. Relatives are allowed to meet their patients only on Thursday between 9am and 3pm. No one is allowed to meet the patient on any other day.

Things to bring

At the time of admission, please bring the following personal items: 2 white pyjamas, 2 white shirts, blanket or shawl, sleepers, shaving kit, 2 sets of undergarments, tooth brush and paste, bathing soap, washing soap, brush for washing clothes, nail-cutter, a lock and key set, half pant, T-shirts, chutney, pickle, farsan, biscuits and non-perishable eatables. You are NOT allowed to bring beedies, gutkha, tobacco, medicines, non-vegetarian foods or any kind of drugs.

History - You are supposed to bring your patient's history at the time of admission. It should include childhood, since when he started taking drugs or drinks, his behaviour during addiction days and his relationship at home. What are the instances that led him to drink or take/use drugs, and what made him an addict. Any prior treatment taken before admitting to Muktangan. What are the patient's good qualities, habits and characteristics.

Parents' meetings

These are held every month on the first and third Thursday at 11:30am. The meeting MUST BE attended by the parents and/or wife of the patient. On second Thursday of the month, there is a meeting for wives of the patients and on fourth Thursday a meeting for marital counselling is arranged.

Out-patient treatment is available on Monday, Wednesday and Saturday between 9 A.M. and 11 A.M.

See Contact Us page for directions to the center.

Treatment - The Muktangan Way

Our Mission

Surge Towards The Skyline...

Our dream is creation of an addiction free society. To translate it into reality, we employ awareness programs, de-addiction treatment facilities and comprehensive rehabilitation programs.

Our primary objective is the evolution of a spontaneous treatment module in tune with our culture and human values, based on actual life experiences.

We are convinced that this collective and collaborative experiment based on scientific methods will awaken the spirit inherent in human beings and enhance hopes of a meaningful life, in every individual who shares this dream.

Every moment stands for commitment for our mission and has dedicated us to enhance versatility in our efforts. Interdependence, self-discipline, creativity and mutual respect are our guiding principles.

We extend total support and assistance to achieve rehabilitation of every individual and his family to the path of addiction free life.

We maintain the professional ethics - extending the best of every possible support towards the achievement of this goal.

Having established a mission let us see how Muktangan went about developing a treatment model.

Evolution

Muktangan De-addiction Center was established on 29th August, 1986. The late Dr. Anita Awachat, founder of the center decided to follow an evolving approach in developing a treatment model. From what she perceived of the addiction problem, she was convinced that:

  • Addiction is a disease
  • Friends admitted need security and love
  • They should be given opportunity to express their creative instincts
  • They should restore faith in values
  • They need to be accepted by family members and support also should be given to their family members
  • Most importantly, the friends admitted should be emotionally comfortable

Dr. Anita (fondly called Madam) kept her options of treatment open for suggestions from the friends. As for the therapeutic milieu, since she respected and attempted to follow Mahatma Gandhi's teachings, a system akin to Gandhiji's ashram system was her goal. Consequently, simplicity, self-reliance, maintaining the center by the inmates was part of the center since inception. There are no special rooms for anyone and self-discipline is the key factor.
Madam used to discuss with the friends what would help them recover. Some said that music might help, so music therapy was introduced. One of the friends admitted was a physical trainer. He set up an exercise regime for the inmates. Madam used to learn Yoga and she thought it would be useful during recovery, so Yoga was introduced. Madam started attending AA meetings and understood their vital importance in the recovery process so AA meeting was introduced. Gradually, a systematic therapy structure evolved.

Counselling

Rehabilitation of the recovered addicts was a big problem. Madam thought that the recovered addicts, irrespective of their educational qualifications, have the experience of addiction and know the difficult process of recovery. They can talk with new entrants and share their experiences and empathise with them. At the same time they can be role models. She always encouraged recovering addicts to become social workers and counsellors. At present Muktangan is manned by 80% recovering addicts. We believe that the success of the program lies here.

Groups

Madam used to discuss with the family members. She realised that they also need emotional support, education about the disease and support during recovery of the addict. She then started regular family meetings. She also encouraged family members to attend group therapy, so they can understand what has been taught to the patient and how far he is progressing.
There were some married friends. After treatment madam realised that even if our friend is sober he has many marital problems. To deal with such problems she started the meeting for couples. And then she realised that wives of addicts had inhibitions about talking freely in the presence of their addict husband. Therefore a special group called Sahachari - exclusively for the wives of addicts was formed. Gradually madam came to realise that the children of addicts were also affected. They were not doing well in studies and facing many emotional and behaviour problems. They also needed counselling, hence special services to kids were rendered in the Ankur group.

Our therapeutic model is a learning model. We go on changing the inputs based upon current requirements. When ILO (International Labour Organisation) requested us to execute workplace prevention program, we learnt about WPR (Whole Person Recovery) and modified our program. Similarly at the instance of ILO we adopted a slum area and learnt to effectively implement community based programs.
Our trustee and well-known psychiatrist and a pioneer of de-addiction work in India, Dr. Anand Nadkarni, has been providing new therapeutic insights to us. At his instance Rational Emotive Behaviour Therapy (REBT) was made a part of the treatment. Our staff is given ongoing training by visiting experts. A nutrition specialist fixes the food menu at Muktangan.

Treatment - The Muktangan Way (continued)

12 principles of treatment

We at Muktangan now believe that addiction as a disease affects every aspect of the afflicted person's life; at the physical and mental level, in relationships, and even causes the person to lose all sense of morality. The disease has a way of recurring and only a total change in attitude can bring any meaningful recovery.
Through our experience of treating more than 14,000 friends, we have developed the following 12 principals of treatment:

  1. Unconditional acceptance: Unconditional acceptance of our friend as a human being differentiates his behavior and person-hood. We avoid labeling, so instead of calling a client an "addict", we always refer to him as a friend or "bandhu” (brother).
  2. Every human being is rational & trustworthy: We believe that every individual is rational, constructive, positive, trustworthy and full of potential. He may for some time act, think, feel and behave irrationally, but he has an innate capacity of correcting his thoughts, feelings and actions if he realizes that they are causing hindrances in life. We try to help our client to detect his distorted cognitions and help him replace those by appropriate ones.
  3. Security, love and gratitude: Security and love are very important needs of the person suffering from the disease of addiction. We feel that dormitory living and community approach provides emotional bonding among the friends. They sense and feel love in the setting. We don't have a separate ward for detoxification. Observing severe withdrawals of new friends helps others understand the gravity of the problem. Further, senior inmates help in nursing the newcomers during withdrawals.
  4. Role models: 'Living role models' motivate our friends and they identify their emotions with their counsellors. Therefore a majority of Muktangan staff consists of ex-addicts. Our staff acts as sponsor, big brother, role model and counsellor. Due to this, family members develop faith in the program.
  5. Values: Restoring faith in human values is the essence of recovery. Honesty, open-mindedness and willingness are considered to be values of recovery. Our daily routine reinforces value of time while yoga reinforces value of discipline, cleanliness and commitment.
  6. Work is recovery: We believe that work conditioning is an essential part of recovery. All maintenance jobs, cooking, cleaning is done by inmates by rotation. It helps them to condition themselves for physical work. Further they are supposed to wash and iron their own clothes, clean their own plates and glasses irrespective of their financial statuses. This gives them realization about the value of family members' work and many are motivated to share household work after discharge. We also help many friends get jobs through placement agencies. If possible the friends are accepted at the center as volunteers or staff. Some of them attend only therapy sessions while staying at home ('Day Care') and some who are working in the city make Muktangan their 'half-way home' before getting absorbed in the social mainstream.
  7. Reintegration in the family setup is the key of rehabilitation: In India family system is still strong. Generally family assumes the responsibility of rehabilitation of the recovered addict. Therefore we primarily focus on reintegration in the family. During the course of the treatment we arrange two family educative group sessions and motivate the family members to accept the friend as a person while condemning his behaviour. We stress the need to provide watchful support for his sober living. For co-dependents we extend exhaustive counselling sessions and group therapy. We also try to include influential members from the society to help in recovery and reconciliation process.
  8. Recovery - a journey of happiness: Human beings are happiest when they establish their life goals and actively strive to achieve them. The process satisfaction is more relevant than the point satisfaction. We help our friend to establish his life goals and also short term, mid term and long term goals. He is encouraged to stay on the path.
  9. Gandhiji's five principles of simple life to be adopted: Our founder late Dr. Anita Awachat was a staunch follower of Mahatma Gandhi. She believed that if a person follows the tatvas (principles) of satya (truth/honesty), ahimsa (non-violence), asteya (non-borrowing/stealing), aparigraha (destitution, living with minimum needs) and bramhacharya (celibacy, ever preferring to be a student) he can be reckoned as god's child. The community living at Muktangan is based on these principles. We believe that these principles and rational thinking together are the building blocks of a sober life.
  10. Self-help groups: Self-help groups - Alcoholics Anonymous & Narcotics Anonymous are the inevitable part of the recovery process. Therefore we organize institutional meetings of NA/AA thrice a week. We also arrange day-long meetings where senior members share their experiences. The local addresses of AA meetings are provided to every friend at the time of discharge. Children of addicts meet regularly under the banner of Ankur group. Wives of addicts try to learn from each others' experiences in Sahachari group.
  11. Nurturing relationships: Restoring and/or nurturing and enriching relationships is a very important part of the recovery process. Healthy relations assist the recovery process. We realized that friends after discharge suffer from many marital problems. Therefore, we started the group called Sahajeevan, for marital counselling. It has helped many couples to restore their relationship.
  12. Positive substitutes for addiction: Healthy and creative activities like art, music, hobbies, and physical exercise can substitute addiction. We believe that no artificial drug should be used for treating addiction. We encourage friends to develop hobbies and express themselves in the art of their choice. Inmates publish a handwritten magazine (Manogat) monthly, beautify the premises and learn music. We have our own library of books, audio and video-cassettes. Yoga and meditation is taught to all patients. All these activities give a healthy high!

Apart from these, some of the other aspects of our treatment are:

  • Minimum medication administered - enough to relieve the patient of the intense withdrawals
  • Emphasis on clinical and ward observation. The patient's validated history is collected
  • Psychological tests administered as required to get an idea about the patient's personality and coping up patterns

 

Daily routine

The de-addiction treatment program is for five weeks - 35 days starting every Thursday. The daily routine for the friends is as below:

Time Activity
6.00 Wake up time
6.30-7.00 Warming up and physical training
7.00-7.10 Instructions and prayer
7.15-8.30 Tea, maintenance duties & personal hygiene
8.30-9.00 Breakfast
9.00-10.00 Meditation - Input sessions by experts
10.00-12.00 Time slot for visiting counsellor/Diary writing/Library
12.00-13.00 Group therapy
13.00-14.00 Lunch
14.00-15.00 Rest for new patients
14.30-15.30 Group therapy for 4th and 5th week inmates
15.00-16.00 Relaxation therapy for newly admitted and time for counselling
16.00-17.00 Yoga postures
17.00-17.15 Tea
17.15-18.30 Recreation/Gymnasium, Games
18.30-19.30 AA/NA meetings (Thrice a week)
19.30-20.00 Prayer and distribution of medicines
20.30-21.00 Dinner
21.00-22.00 Entertainment- TV/Audio/Video/Indoor games/Books
22.00 Lights off

Group therapy

This is a very important part of the Muktangan Therapeutic Model. The groups are formed on the basis of date of admission. All friends admitted on Thursday are considered as first week friends. On completion of a week on subsequent Thursday they graduate to the second week. Likewise at any given moment we have five groups.
We have experienced that this pattern of group formation is the crux of recovery process. During first week our friends are just recovering from withdrawals. Many of them feel homesick. Some of them are in denial. Some of them find it difficult to cope up with the fact of being admitted to a center. So the first week group is more or less experiencing discomfort. Even if the group may include friends from varying financial, educational or intellectual background, they are emotionally at one level, and hence relate to each other. We feel that this emotional cohesiveness works well in the process of recovery.
Our friends graduate to the subsequent weeks and evolve in a wonderful group. Just like defence staff or college students, Muktangan graduates proudly call each other "batch-mates". The five-week program is designed keeping in view the emotional, cognitive and awareness levels of our friends.

  • Initially topics for group therapy are more focussed on information and motivation.
  • In the second week they are introduced to first four steps of AA and basic concepts of REBT.
  • Third week primarily focuses on emotional problems and stress management.
  • Fourth week deals with skills training.
  • Fifth week deals with behavioural and cognitive skills to stay sober.

Here is a sample of the weekly timetable for group therapy:

Week Friday Saturday Monday Tuesday Wednesday
1 Introduction to Muktangan program Self-awareness Here and now Disease concept Introspection and diary writing
2 First 4 steps Rock bottom Perception Slogans Handling emotions
3 Lifestyle Importance of physical activity RET Stress management Abstinence and sobriety
4 Living sober Commincation Relapse prevention Goal setting and future plan Character defects
5 REBT Decision making Assertiveness skills Importance of family relationship Follow-up

RET is Rational Emotive Therapy and REBT is Rational Emotive Behaviour Therapy

Special therapies, feature activities

Every Saturday: 9.00-10.30: Music therapy
Every Sunday: 11.30-1.00: Life enrichment therapies viz.- Values, time and money management, social issues, laughter therapy, creativity therapy, physical theatre by visiting faculties
Every Thursday: 9.00-10.15: Special groups for model therapy, quiz contests, role plays etc.
Every Friday: 9.00-10.00 Gardening and/or viewing films about nature
Every Wednesday: 10.30-11.30: Antardeep send-off function to the inmates in a very traditional way.
Last Saturday of every Month 10.00-1.00: Celebrating sobriety birthdays

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stanley mammen