Addiction Psychiatry Hub

Addiction Psychiatry Hub Addiction awareness, psychiatric illness, education, mental health promotion & suicide prevention. Let’s break stigma together.

After years of ineffective treatments and persistent distress due to chronic bipolar disorder, our family has finally wi...
07/12/2025

After years of ineffective treatments and persistent distress due to chronic bipolar disorder, our family has finally witnessed genuine recovery for the first time. We are profoundly appreciative to the entire team for rekindling hope in our lives.

Thank you Doc.

07/12/2025

Myths **in Addiction

07/12/2025

De-addiction medicine services are related to but different from general mental health care. They overlap in many areas, but their focus, methods, and goals differ. Here’s a clear breakdown:

1. Core Difference in Focus

De-addiction Medicine

Main focus: Substance use disorders (alcohol, drugs, to***co, etc.)

Primary goal: Stop substance use + prevent relapse

Target problem: Addiction and dependence
_________________________________________
Mental health services :

Main focus: Mental illnesses (depression, anxiety, schizophrenia, OCD, bipolar disorder, etc

Primary goal: Stabilize mood, thoughts, emotions & behavior

Target Problem: Psychiatric disorders

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2. Type of Conditions Treated

✅ De-addiction Services Treat:

Alcohol dependence

He**in, brown sugar, opioid addiction

Cannabis, co***ne, inhalants

Prescription drug misuse

Ni****ne & to***co addiction

Behavioral addictions (gaming, gambling – in some centers)
_______________________________________

✅ Mental Health Services Treat:

Depression

Anxiety disorders

Schizophrenia & psychosis

Bipolar disorder

OCD

PTSD

Personality disorders

Child & adolescent disorders

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3. Treatment Approach Differences

🔹 De-addiction Treatment Includes:

Detoxification (medical withdrawal)

Anti-craving medicines

Relapse prevention therapy

Motivational counseling

Family counseling

Urine drug screening

Rehabilitation (3–6 months or more)

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🔹 Mental Health Treatment Includes:

Psychiatric medications (antidepressants, antipsychotics, mood stabilizers)

Psychotherapy (CBT, psychotherapy)

Behavior therapy

Electroconvulsive therapy (ECT) – in severe cases

Long-term follow-up
_________________________________________
4. Doctors Involved

De-addiction Medicine → Psychiatrist with addiction training, Addiction Medicine Specialist

Mental Health Care → Psychiatrist, Clinical Psychologist, Psychiatric Social Worker

👉 In India, psychiatrists are trained to handle both, but specialized de-addiction centers focus only on addiction.

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5. Where They Overlap (Very Important)

Many patients have both conditions together, called dual diagnosis, for example:

Depression + Alcohol dependence

Schizophrenia + Cannabis use

Anxiety + Prescription drug misuse

✅ Such cases must be treated together, otherwise relapse becomes very likely.

_______________________________________

6. Legal & Program Difference in India

De-addiction Services are supported under:

Ministry of Social Justice & Empowerment

Ministry of Health (NDDTCs, Drug Treatment Clinics)

NDPS Act (for treatment instead of punishment)
---------------------++----------------------------+++-
Mental Health Care is governed by:

Mental Healthcare Act, 2017

✅ In Simple Words:

De-addiction medicine treats addiction.

Mental health care treats mental illness.
Many times, both are needed together for full recovery.

07/12/2025

Respected Dr. Satish Rasaily Sir,

I don’t have enough words to express my gratitude and respect for you. At a time when my life was completely lost in darkness, you believed in me when I couldn’t believe in myself. When everyone had almost given up, you gave me hope, strength, and a new direction in life.

Today, as I complete almost 7 years of my recovery journey, I stand with pride, stability, and self-respect—and this is all because of your guidance, patience, and compassion. You didn’t just treat me as a patient; you treated me like a human being who deserved another opportunity. Because of you, I am living a clean, meaningful, and responsible life today.

These 7 years of sobriety are not just years of survival, but years of growth, healing, and rebuilding my life with dignity. I will remain forever grateful to you for pulling me out of the worst phase of my life and helping me stand on my feet again.

You are not just a doctor to me, Sir—you are a true life-saver and a blessing in my life.

Thank you sir

05/12/2025

. Myth: Only “bad” or criminal people use he**in

Truth:
He**in addiction can affect anyone—students, professionals, parents, rich or poor. Addiction is a medical condition, not a moral failure.

05/12/2025

Myth: All he**in users overdose and die

Truth:
While he**in does increase overdose risk, not everyone dies. Early treatment saves lives and prevents fatal complications.

05/12/2025

Myth: Talking about he**in increases drug use

Truth:
✅ Open discussion reduces addiction.
Awareness, education, and early warning signs prevent drug abuse.

05/12/2025

common myths about he**in addiction—along with the truth behind each one. These myths create stigma and prevent people from seeking timely help.

1. Myth: Only “bad” or criminal people use he**in

Truth:
He**in addiction can affect anyone—students, professionals, parents, rich or poor. Addiction is a medical condition, not a moral failure.

2. Myth: Once addicted to he**in, recovery is impossible

Truth:
✅ Recovery is absolutely possible.
With proper detox, medical treatment, counseling, family support, and rehabilitation, many people live healthy, drug-free lives.

3. Myth: Strong willpower alone can stop he**in use

Truth:
He**in causes physical and psychological dependence. Withdrawal can be severe. Medical support is essential—willpower alone is often not enough.

4. Myth: All he**in users overdose and die

Truth:
While he**in does increase overdose risk, not everyone dies. Early treatment saves lives and prevents fatal complications.

5. Myth: He**in addicts don’t care about their family

Truth:
Most people with addiction deeply regret hurting their loved ones. Their behavior is driven by brain changes from addiction, not lack of love.

6. Myth: He**in addicts can never be trusted again

Truth:
Trust can be rebuilt gradually through:

Consistent treatment

Clean drug tests

Stable behavior

Honest communication

Many former users become responsible family members and professionals.

7. Myth: If someone relapses, treatment has failed

Truth:
Relapse is often part of the recovery process, like in diabetes or hypertension. It means treatment needs adjustment, not abandonment.

8. Myth: Rehab alone cures he**in addiction forever

Truth:
Rehab is only the starting point. Long-term recovery requires:

Follow-up counseling

Family support

Medication sometimes for lifelong

Lifestyle change

9. Myth: Only homeless people use he**in

Truth:
Many he**in users:

Have jobs

Live with families

Appear normal socially
Addiction is often hidden.

10. Myth: Talking about he**in increases drug use

Truth:
✅ Open discussion reduces addiction.
Awareness, education, and early warning signs prevent drug abuse.

✅ Key Message

He**in addiction is a treatable medical illness—not a character defect.
Support, not stigma, saves lives.

Dr Satish Rasaily
Addiction Medicine Specialist
Center For Addiction Medicine
Chuwatar , Sawney, West Pandam
Dept. Of Health and Family Welfare
Sikkim


05/12/2025

✅ Treatment of Brown Sugar (He**in) Addiction

Brown sugar (he**in) is a highly addictive opioid. Treatment is possible and effective, but it must be structured, long-term, and medically supervised.

Treatment happens in 4 main stages:

🧠 1. MOTIVATION & ASSESSMENT (Before Admission)

Before starting treatment, doctors assess:

Type of drug used

Duration of use

Route (smoking, injecting)

Quantity and frequency

Medical complications (HIV, hepatitis, abscesses)

Psychiatric illness (depression, anxiety, psychosis)

Family and social support

✅ Motivation counseling is started here
✅ Family is involved from the beginning

💊 2. DETOXIFICATION (Withdrawal Management) – 7 to 14 Days

This is the most physically difficult phase, where the body clears he**in.

Common Withdrawal Symptoms:

Body pain, cramps

Vomiting, diarrhea

Insomnia

Intense craving

Anxiety, irritability

Sweating, runny nose, goose flesh

Medications Used:

Buprenorphine / Methadone – to control withdrawal & cravings

Clonidine / Lofexidine – for autonomic symptoms

Painkillers (non-addictive)

Anti-vomiting & anti-diarrheal medicines

Sleep medicines (short term only)

✅ Detox must be done under medical supervision
❌ Home detox is dangerous and often fails

🏥 3. LONG-TERM TREATMENT & REHABILITATION (3–6 Months or More)

Detox alone is NOT treatment. Without rehab, 90% relapse.

A. Medications for Relapse Prevention:

Buprenorphine maintenance

Methadone maintenance

Naltrexone (blocks he**in effect)

Nalmefene (in some cases)

✅ These reduce craving and prevent overdose
✅ Can be used for months to years if needed

B. Psychological & Behavioral Therapy:

Individual counseling

Cognitive Behavioral Therapy (CBT)

Motivational Enhancement Therapy (MET)

Group therapy

Family therapy

Relapse prevention therapy

C. Lifestyle & Behavioral Recovery:

Sleep routine

Nutrition and weight recovery

Exercise and yoga

Skill training & vocational rehab

Spiritual & community support (if patient agrees)

🛡️ 4. AFTERCARE & RELAPSE PREVENTION (Minimum 1–2 Years)

Addiction is a chronic relapsing brain disease, not a one-time illness.

Aftercare Includes:

Regular OPD follow-up

Continued medication if advised

Urine drug screening

Ongoing counseling

Family supervision

Avoiding high-risk friends & areas

Structured daily routine

✅ Relapse risk is highest in first 6–12 months

⚠️ IMPORTANT MEDICAL COMPLICATIONS TO SCREEN

HIV

Hepatitis B & C

Tuberculosis

Heart infections

Vein damage

Liver & kidney failure

Depression, su***de risk

✅ TREATMENT SUCCESS FACTS

With proper treatment:

60–80% achieve stable recovery

Without rehab:

Relapse rate > 85–90%

Medication + counseling works far better than either alone

🧍‍♂️ ROLE OF FAMILY IN RECOVERY

Family must:

Stop giving money directly

Avoid blaming/shaming

Ensure treatment follow-up

Watch for relapse warning signs

Support but not enable

🏛️ LEGAL LINK UNDER NDPS ACT

Under Section 39 of NDPS Act:

Courts may refer users to de-addiction & rehabilitation instead of jail

Applicable only for small quantity & consumption cases

Treatment duration decided by medical & judicial authorities

✅ ONE-LINE HOPE MESSAGE (For Patients & Families)

> “Brown sugar addiction is severe—but with medical care, family support, and long-term follow-up, complete recovery is absolutely possible.”

BS Adulterated He**in – A Public Health Explanation🔹 What is “Brown Sugar (BS)” He**in?In India and South Asia, “brown s...
03/12/2025

BS Adulterated He**in – A Public Health Explanation

🔹 What is “Brown Sugar (BS)” He**in?

In India and South Asia, “brown sugar” (BS) is the street name for impure he**in. Unlike purified white he**in, brown sugar is:

Brown or dark in color

Sticky or powdery

Chemically impure

Usually smoked, inhaled, or injected after dissolving

It is not a safe or medicinal substance in any form.
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🔹 What Does “Adulterated” Mean?

Adulterated he**in is he**in that has been mixed (cut) with other harmful substances to:

Increase profit

Increase quantity

Modify or intensify the effect

Therefore, BS adulterated he**in means brown sugar he**in that is mixed with toxic chemicals and other drugs, making it even more dangerous.
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🔹 Common Adulterants Mixed With BS He**in

Adulterated brown sugar often contains:

Caffeine

Paracetamol

Quinine

Lidocaine

Sugar, chalk powder, talcum powder

Detergents, rat poison, industrial chemicals

Synthetic opioids (e.g., fentanyl) – extremely deadly

⚠️ These substances cause severe internal organ damage and sudden overdose deaths.

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🔹 Why Is BS Adulterated He**in So Dangerous?

Because it causes:

✅ Unpredictable potency

✅ Very high overdose risk

✅ Severe physical dependence

✅ Vein damage, abscesses, infections

✅ Liver & kidney failure

✅ Brain damage

✅ Risk of HIV, Hepatitis B & C (injecting use)

✅ Sudden death even in young users

Even experienced users cannot judge the purity or strength of adulterated he**in.

--------------------++++++-+++++++++++++++

🔹 Clinical Features of Overdose

Slow or stopped breathing

Pinpoint pupils

Bluish lips and nails

Unconsciousness or coma

Low blood pressure

Cardiac arrest and death

---+++++++++++++++++++++++++++++(

✅ Public Health Message

There is NO safe form of he**in. Adulterated brown sugar he**in is one of the most lethal street drugs in India. However, recovery is completely possible with timely medical treatment, Opioid Substitution Therapy (OST), counseling, and family support.

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Issued in the interest of public health by:

Dr Satish Rasaily
Hony. President : Sikkim State Branch of Indian Psychiatric Society ( IPS)

CME on Lemborexant & Annual General Body Meeting of Sikkim State Branch of IPS Held at Gangtok. The Sikkim State Branch ...
01/12/2025

CME on Lemborexant & Annual General Body Meeting of Sikkim State Branch of IPS Held at Gangtok.

The Sikkim State Branch of the Indian Psychiatric Society (IPS) successfully organized a Continuing Medical Education (CME) programme on “Lemborexant” on 1st December 2025 at Hotel Sinclairs, Gangtok. The academic programme witnessed enthusiastic participation from psychiatrists and mental health professionals from across the state.

Scientific Session on Lemborexant

The scientific session was delivered by Dr. Bishnu Sharma, Honorary Treasurer and Consultant Psychiatrist, who served as the Resource Person. Dr. Sharma presented a comprehensive overview of insomnia, including its neurobiological mechanisms, clinical impact, and evolving treatment strategies. He placed special emphasis on Lemborexant, a new-generation Dual Orexin Receptor Antagonist (DORA).

He explained that unlike conventional hypnotics such as benzodiazepines and Z-drugs that work through GABA-mediated sedation, Lemborexant selectively blocks orexin receptors, which regulate wakefulness. By targeting the wake-promoting system of the brain, the drug restores a more physiological sleep–wake rhythm, thereby reducing sleep onset latency, improving sleep maintenance, and enhancing overall sleep quality.

Dr. Sharma further elaborated that Lemborexant has shown promising results in managing insomnia associated with various psychiatric comorbidities, including:

Depressive disorders

Anxiety disorders

Bipolar affective disorder

Substance use and addictive disorders

Its low potential for dependence, minimal cognitive side effects, and better safety profile make it especially suitable for patients vulnerable to addiction. The session concluded with an interactive discussion, where participants shared clinical experiences and deliberated on issues related to dosage, safety, drug interactions, and long-term use.

Annual General Body Meeting (AGM)

The CME was followed by the Annual General Body Meeting (AGM) of the Sikkim State Branch of IPS. The meeting began with a welcome address by the Hon’ble Secretary, Dr. Satish Rasaily, who greeted the esteemed members and reflected upon the journey, growth, and academic progress of the Sikkim State Branch.

The Outgoing President, Dr. C. L. Pradhan, addressed the gathering and outlined the primary objectives and future direction of the State Branch. He emphasized the critical role of the Society in strengthening mental health services and su***de prevention initiatives in Sikkim. He reiterated that the key objectives of the Society are:

Promotion of academic growth and professional excellence

Facilitating sharing of clinical experiences and research

Strengthening community psychiatry and public awareness

Conducting educational campaigns to reduce stigma related to mental illness

Dr. Pradhan expressed his sincere gratitude to all members for their cooperation and support during his tenure and urged them to continue active participation in Society activities for continuous learning and improved patient care.

Tribute to Founders & Academic Milestones

During his address, Dr. Satish Rasaily expressed deep gratitude and respectful remembrance of Late Dr. Indralall Sharma, along with Dr. Sanjiba Dutta, Dr. C. S. Sharma, and Dr. Netra Thapa, for their visionary leadership and pioneering efforts in establishing the Sikkim State Branch of the Indian Psychiatric Society.

Following its formal recognition by the East Zone and National IPS, the Sikkim State Branch has achieved significant academic milestones. It has successfully organized two East Zone Conferences of the Indian Psychiatric Society (CEZIPS) in 2017 and 2023. Additionally, the State Branch has conducted several CMEs between 2017 and 2025, thereby significantly strengthening psychiatric education, addiction services, and community mental health initiatives in the state.

East Zone Indian Psychiatric Society (EZIPS)

The East Zone Indian Psychiatric Society (EZIPS) is a zonal body under the Indian Psychiatric Society, comprising eastern states including Sikkim, West Bengal, Bihar, Orissa, Jharkhand, Assam, Arunachal Pradesh, Manipur, Meghalaya, Mizoram, Nagaland, and Tripura. EZIPS plays a vital role in coordinating academic conferences, CMEs, research collaborations, leadership training, and mental health advocacy across the eastern region. The Sikkim State Branch remains an active and contributing member of EZIPS.

Election of New Office Bearers (2025–2027)

The AGM was followed by the nomination and unanimous election of the new Office Bearers and Executive Council for the financial year 2025–2027 under the chairmanship of Dr Netra Thapa ( HOD, Dept. Of Psychiatry, STNM Hospital).

Dr. Satish Rasaily – President

Dr. Geeta Gurung – Vice President-cum President-Elect

Dr. Bibhusan Dahal – General Secretary

Dr. Upashna Gurung – Joint Secretary

Dr. Bishnu Sharma – Treasurer

Mr Anand K Khatiwora-Assistant Treasurer

Dr. Shetal Chettri – Editor

Dr. C. L. Pradhan – Chief Patron

Dr. Netra Thapa – Chief Advisor

Dr Anmol Pradhan - State Representative to East Zone IPS

The house congratulated the newly elected team and expressed confidence in their leadership to further strengthen mental health services and academic activities across the state.

During the programme, Dr. Samrat Singh Bhandari was felicitated with a traditional khada in recognition of his recent nomination as Editor of the East Zone Indian Psychiatric Society (EZIPS) at the Conference of East Zone IPS (CEZIPS), Kolkata. The gathering congratulated him for this prestigious academic responsibility.

The meeting was attended by all psychiatrists of the state, reflecting strong professional unity and commitment toward advancing psychiatric care, academic excellence, and su***de prevention in Sikkim.

The programme concluded with a formal Vote of Thanks delivered by Dr. Kunzang Ongmu, who expressed heartfelt appreciation to all the resource persons, office bearers, participants, and organizers for their active involvement and support in making the CME and AGM a grand success.

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