Drug abuse cases on the rise in post-prohibition Bihar

Over the past year, Dr M E Haq, a general medical officer, logged at least 700 cases of alcohol addiction at the out-patient department of the de-addiction centre in Bihar's Gaya district after Bihar imposed total prohibition.

But now, Dr Haq is facing a new problem, reports The Indian Express. The de-addiction centre where he is posted has started recording cases of substance abuse, ranging from cannabis, inhalants, and sedatives to opiates.

Dr Haq is among the 38 general medical officers from Bihar being trained at the National Institute of Mental Health and Nuerosciences (NIMHANS), Bengaluru. These doctors are undergoing training on the Virtual Knowledge Network at NIMHANS to deal with disorders arising from substance abuse.

All they need to do now is log into this network using their mobiles, raise their queries, post case files and photos, and get advice from specialists at NIMHANS.

''About 25 per cent of cases in these de-addiction centres now are related to abuse of other substances, mostly opioids, cannabis, inhalants and sedatives. Since alcohol is not available in Bihar any more, these people might have moved to other substances. The state government felt that these doctors need to be trained in handling such cases. NIMHANS agreed to train us,'' says Dr A K Shahi, state programme officer, de-addiction centres, Bihar.

''We have screened, treated and counselled over 3,000 persons with alcohol addiction. These people are now able to recognise those involved in substance abuse and have started bringing them here, too,'' says Dr Shahi.

The first such training stint at the Virtual Knowledge Network in NIMHANS took place last March and involved doctors and counsellors from 11 districts.

''The Bihar government requested NIMHANS to train doctors to treat alcohol addiction. We created a virtual learning network by connecting health professionals with addiction specialists at NIMHANS. They were trained for 10 days in Bengaluru. Now, the de-addiction programme takes place through the use of mobile technology,'' says Dr Prabhat Kumar Chand, additional professor and co-ordinator, Virtual Knowledge Network, NIMHANS.

In the months that followed, doctors across Bihar were connected to the network - every fortnight, cases were discussed through the virtual network. ''Our objective was very clear. The medical officers and the counsellors have to identify the problem. Every 15 days, we are connected to them. The learning process is case-based. Using mobile technology, doctors present their case and specialists at NIMHANS engage with them in capacity building,'' says Dr Chand.

 ''If someone encounters a problem, they put it on the WhatsApp group we have created. If a doctor doesn't understand the case, he sends us the details - photos and videos – and obtains instant advice from the virtual knowledge network,'' says Dr Shahi.

Between March and September 2016, 2,695 cases of alcohol addiction were screened. And in 49.1 per cent of these cases, patients returned for follow-ups; only 14.9 per cent cases were referred to other centres.

''The virtual knowledge network has clearly worked for the doctors. Higher follow-up rates, lesser referrals and no deaths mean that capacity building through the use of technology has been a success,'' says Dr Chand.

The 38 doctors being trained at NIMHANS will now train over 300 family counsellors. ''Once every 15 days, these 338 members will be connected to specialists at NIMHANS. Cases will be discussed and the grievances addressed,'' says Dr Shahi.

This time, even the offices of the district collectors will be connected to the virtual knowledge network. ''The counsellors can just visit their respective collector's office. They can connect with specialists from there directly and seek advice fortnightly,'' says Dr Chand.