Shortage of psychiatrists may tone down Punjab’s drug rehab drive

CHANDIGARH: The acute shortage of psychiatrists, key drivers in a de-addiction programme, is impeding the Punjab government de-addiction efforts. Experts say that neither a complete diagnosis nor any psychosocial intervention is possible without psychiatrists.
The state that is home to around 7.2 lakh drug addicts, according to ministry of social justice report, has 2.10 lakh addicts registered for treatment at 178 government-run out-patient opioidassisted treatment (OOAT) clinics and 78 private centres.Moga has the maximum number of patients undergoing treatment at OOAT clinics. The district tops the list with 11, 236 patients, followed by Amritsar (10,907). Gurdaspur, Patiala and Ferozepur have 8,690, 8,456, and 6,313 patients.
There are only about 50 psychiatrists in the government set-up. To make up for the shortfall of specialists, MBBS doctors have been deployed in OOAT clinics after mere five-day training. However, their role is largely limited to dispensing detoxification medicines. The clinics also are short of counsellors and pharmacists.
Considering the complexity of drug abuse disorder, which not only effects the physical, but also the mental health of an addict, experts are of view that only a psychiatrist is trained to diagnose the symptoms and to come up with a treatment plan for individuals keeping in mind the psycho-social factors.
Terming the approach adopted by the state government as superficial, Dr Savita Malhotra, former head of the department of psychiatry of Post Graduate Institute of Medical Research and Education (PGIMER) said such a drug de-addiction programme will fail to yield desirable results.
She says MBBS doctor cannot effectively diagnose mental health symptoms of a substance use disorder patient. The present OOAT clinic set-up does not allow the doctor to examine each patient in detail. The system can only provide a substitute to the substance abused. It is neither a complete diagnosis nor can any psychosocial intervention be done.
Dr Malhotra said MBBS doctors are not trained for addiction treatment, which requires specialized training. “Distribution of medicines can be done by a nurse. The patient has to be taken off the medicine, which can be done properly only by psychiatrists,” she added.
Dr B S Sidhu, former principal and head of the department of psychiatry in Government Medical College, Patiala, said that addicts sufferred from different emotional and behavioural problems which could be treated effectively only by trained psychiatrists. “Psychiatric morbidity among addicts cannot be treated properly by MBBS doctors,” he added.