During an interaction at The Indian Express office,founder of de-addiction centre Muktangan,Anil Awachat,and his daughter,Mukta Puntambekar,talk about addiction to alcohol and drugs and rising obsession with Internet and Facebook.
You have been working in the field of de-addiction for a long time. How is the situation different today vis-a-vis when you started? What are the new trends?
MP: Muktangan was started by my parents (Anil and Sunanda Awachat) 25 years ago. When we started,about 80 per cent of people who came to us were drug addicts and about 20 per cent alcoholics. Now,it is the other way round. Around 80 per cent are addicted to alcohol and about 20 per cent to drugs. Out of this 20 per cent,10 is brown sugar addicts and rest is addicted to other drugs like charas,ganja and even prescription drugs. Today,the average age is going down. We get even 13 and 14-year-olds addicted to whitener or volatile solvents. We are also getting patients aged between 15 and 25 years who are addicted to Internet.
aa: But 80 per cent drug addicts as patients did not mean that there were no alcoholics. It did not represent the number in the society. Back then,very few thought that alcohol was a problem that needed treatment. The awareness has increased.
Your book Muktanganchi Gosht is story of Muktangan. How has your approach changed over the years in treating people?
MP: When my mother,who was a psychiatrist,started treating patients,she had no experience of dealing with them. We never call them patients,we call them friends,and she decided to learn from them. She asked about their expectations and needs. The Muktangan model was developed on this learning base and it continues even today. Baba (Anil Awachat) always tells us to remain a student.
AA: When a person comes to us,our effort is to develop a rapport with him or her. We first talk to them about their problems. After that,we discuss if he or she wants to get back to the good days and what can be done for that. They have to indirectly infer that the only alternative is leaving behind the addiction. Seventy per cent of our staff are recovered addicts.
Is 100 per cent recovery
AA: No. This is a disease prone to relapse. Some need just one session of treatment. For some,it has to be repeated. Five to 10 per cent keep coming back. When they fall prey to craving,we tell them to start afresh. We focus on what went wrong the last time. One to two per cent are beyond cure,they are structured that way. We can hardly do anything about underlying mental disorders and addictions.
MP: Recovery rate is better in India than in many other countries,basically due to family support. There is a lot of family involvement which is very crucial after discharge. In cases where people are not ready to leave the addiction,we continue helping the family through guidance and counselling.
AA: After the discharge,we call them with the family and celebrate various occasions. There are sessions of husband-wife together,called Sahajeevan. We imbibe the thought that December 31 can be celebrated without alcohol. It is never a problem of just one person,it is essentially of the family.
Has there been any change in peoples willingness to admit that they need professional help?
MP: People are now quite open about it. Earlier their reaction used to be,”Am I mad,why do I need help?” But now people are accepting it as a disease and the need for professional help.
What about trends in age groups,sex and social strata from which patients come?
MP: It is mixed. We get 13 and 14-year-olds and even 70-75-year-olds,both men and women. In terms of socio-economic status,we get very highly educated doctors,engineers to even those who are illiterate.
What is the proportion of men and women?
MP: Our centre for women had 15 beds with two-three extra admissions,where as we treat about 150 men at a time.
Has the number of women
MP: Yes. When I started,a group of foreign students visited us and one of them asked why there were no women. Back then,I was surprised at the question. We do not have women addicts,was my view then. But since the last six-seven years,we are getting a lot of women. Initially,we treated women only in OPDs or just did counselling. But then they started telling us that they also want to get admitted. We started a new ward called Nishigandh. We get women commercial sex workers,housewives,highly educated women,even doctors.
You mentioned about Internet addiction. How does one distinguish between use and addiction?
MP: They are compulsive users. If we use it during our office hours it is OK. But if even after that one is obsessed to use it,there is something wrong. One of our friends used to play interactive games on Internet from 9 pm to early morning. Like in the case of alcohol,they develop tolerance,usage increases and if they do not use it,they get withdrawal symptoms.
What are the withdrawal symptoms?
MP: Irritation,aggression,restlessness,sleeplessness,lack of concentration.
How do you tackle these
MP: Through counselling. We have to convince and motivate them. Mostly,these are youngsters. They argue that they are addicted to drugs. We counsel them about lifestyle management.
Are there any accompanying addictions with that of the
MP: Yes,drugs,smoking,chewing tobacco. Sometimes there are underlying psychiatric disorders too.
Is growing stress level a reason for rise in addictions?
MP: Yes,stress level is one of the factors. It is more about how stress is dealt with. If we look back,we see that people used to discuss their problems,women used to cry. But now they want to suppress it.
Do you get celebrity patients?
AA: Yes. We do get children of celebrities. Once,Sunil Dutt had come to us. He said he and his wife used to be busy in shooting and never had time to look at what their son was doing. They never went to his school gathering,everything was left to servants. An industrialist’s son was brought to us. His mother used to drink and take sleeping pills. This boy took a sleeping pill when he was eight and started drinking when he was 11 or 12.
You talked about economically higher class and those from slums. But what about the middle class,which is known to hold on to its values? Is addiction less there?
AA: On the contrary,it is the highest in the middle class. The middle class has now climbed a step up. They are in highly paid jobs in IT and other industries. A completely different culture is being acquired. A lady,originally from rural areas,had come to us with alcohol addiction. She had never seen the culture of social drinking,but her husband forced her to drink at parties. It went out of control.
MP: Parents do not spend quality time with children. They never eat together. The only communication is in the form of instructions.
What about addiction in senior citizens?
MP: We have some of those cases also. Some who have taken early or voluntary retirement and did not know what to do after that.
Is there a specific span for a patient to be cured?
MP: There is no specific span. For example,the first case of Muktangan,a peon had got admitted on the first day as there was an advertisement in the newspaper. His name is Mahadev Ghare and he has been sober for the past 25 years. My mother used to call him our person of shagun. The recovery is better in less educated people as they believe in us. Those who are educated,argue with us.
There are a lot of outstation students in Pune. Do they also come to you?
MP: Yes. They are alone,have no family here and have no one to control them. They think small amounts of drugs and alcohol will help in dealing with stress and fall prey to it.
Have you ever tried talking to politicians who encourage alcohol consumption. On one had you fight against alcohol and on the other hand some of them promote drinking?
AA: The availability has gone up. If there are more social drinkers,there would be more addictions. Of every 100 social drinkers,there are at least 20 to 30 addicts. Narendra Dabholkar and Abhay Bang from our side have raised their voices against this. But it has hardly helped. They have vested interests.
Cigarettes packets containing a warning. But it is not so
MP: Yes,that is true. We think there should be warnings on everything,even Facebook. There are so many things which when used excessively can be harmful.
Do you think Facebook poses problems because you always see good things of other
people which in turn brings in frustration?
MP: One of the other problems with Internet addicts is low self esteem. One lady who came to us had opened her eight-year-old daughter’s Facebook account with a false age. Her husband said that whenever they would go out ,mother and daughter wanted to go back home quickly as they wanted to water their strawberries and feed cows in an Internet game.
Are there case where parents offer alcohol to their children ?
MP: Yes there are. But most have observed their parents drinking. Even parents are their role models. A father who used to drink daily used to tell his son that it was his medicine as he had stress. As the son grew up,he started demanding the medicine and got addicted to it.
AA: The probability of alcoholics’ children getting addicted is always more. Many kids had hated their fathers for they drank,but as the son grows up,he also starts drinking because the patterns have been unknowingly transferred.
Your book Srushit Goshtit won a prize. The book tells stories of beautiful things in nature. Your writings,drawings,wood carving,origami have always portrayed nature. Tell us something about your love for nature.
AA: Fifteen years ago,I met a respected figure,my guru in Botany,S D Mahajan. He introduced me to trees. Then I met another guru in Zoology. For the first time I started admiring the beauties of nature. I had been a village boy. I had seen mountains,trees,but not this way; I started talking to trees,animals. The day I start believing that it is true,I may need a psychiatrist.