The applicable legislation is the ‘Narcotic Drugs and Psychotropic Substances Act, 1985. Act No 61 of 1985’. Published in 1997, Government of India Press. Amended in 2002 & 2008. (141 pages, 6 Chapters, 6 Annexures).Some important definitions:
- Drug addiction is a complex illness characterized by compulsive, and at times, uncontrollable drug craving, seeking, and use that persist even in the face of extremely negative consequences.
- Refers to an inappropriate or excessive and extra prescription or illicit use of mood altering substances
- Patterns of use of the substance and resultant phenomena fit the criteria of Dependence, Abuse and other associated diagnoses given in the American Psychiatric Association’s Diagnostic and Statistical Manual IV (DSM-IV revised) and WHO-International Classification of Diseases (ICD-10).
- A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:
- Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance, related to substance use, substance- related absences, suspensions, or expulsions from school; neglect of children or household)
- Recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use)
- Recurrent substance related legal problems (e.g., arrests for substance-related disorderly conduct)
- Continued substance use despite having persistent or recurrent social or interpersonal problems caused by or exacerbated by the effects of substances (e.g., arguments with spouse about consequences of intoxication, physical fights)
- A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12 month period.
- The substance is often taken in larger amounts or over a longer period than intended
- There is persistent desire or unsuccessful efforts to cut down or control substance use
- A great deal of time is spent in activities necessary to obtain the substance
- Important social, occupational, or recreational activities are given up or reduced because of substance use
- The substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance (e.g., current cocaine use despite recognition of cocaine induced depression, or continued drinking despite recognition that an ulcer was made worse by alcohol consumption)
- (Note: the above are abbreviated and detailed definitive criteria are available in DSM-IV).
- housing instability, difficulty budgeting funds, symptom relapses apparently unrelated to life stressors, treatment non-compliance
- prostitution, sexual deviance, social isolation, violent behaviour or threats of violence
- pervasive, repeated social difficulties, sudden unexplained mood shift , suicidal ideation or attempts
- employment difficulties, legal problems
- hygiene and health problems, cognitive impairments
- avoidance of disclosure (of likely concurrent disorders) for fear of being admitted to an inpatient psychiatry unit
- repeated self-harm in the absence of clear situational relevant stressors
- cyclical history of substitute or replacement addictions.
In addition to alcohol or illicit drugs, these problems often arise from inappropriate use of prescription medications in a therapeutic or quasi therapeutic setting.