Over years of clinical practice as a psychiatrist, the domain that appealed most to me was addiction psychiatry. Or rather, from the patient and caregiver’s point of view, deaddiction. As I keep saying, addiction is so much more than bad behaviour or a bad choice. It is a disorder in its own right. Even when the patient is trying very hard to give up, there are slips. Lapses in abstinence, as they are called in medical jargon. And once there is a slip, frustration and guilt take over, leading the patient down a very slippery slope. Old patterns re-establish themselves. Before long, it is a relapse. The patient starts drinking as hard as before and is back to square one. Actually, we are worse off than we were at the beginning. The patient had tried and failed. It leaves him utterly demotivated.

This is where the rules come in. They are simple, doable and work every time. There are several things that the patient should avoid like a plague while attempting deaddiction –

1. Hunger – Hunger pangs increase cravings for alcohol. So the meals should be properly spaced and wholesome.
2. Thirst – Dehydration is another devil to be avoided. Hydrating well is a necessity.
3. Anger – Arguments and resentments create an emotional turmoil, preparing the ground for a relapse. It is worth mentioning here that the lack of emotional stability is often what underlies the addiction problem in the first place. People with personality disorders, depression, anxiety disorders, bipolarity or psychosis often self- medicate with alcohol, quickly establishing unhealthy patterns.
4. Boredom –An empty brain is the devil’s workshop. Studies show us that anxiety and depression peakwhen we let our mind wander on autopilot for too long. Productive work focuses the mind, taking it off unhealthy thoughts, including cravings.
5. Familiar settings – The moment one sees one’s drinking buddies or steps into a familiar bar, the cravings resurface. Therefore it is mandatory to avoid all settings that trigger such cravings completely till the therapy is complete.
6. Availability – This is a no- brainer. But trust me when I say sometimes people need to be reminded of the obvious. If the drinks are within reach, the craving will hit every time one lays eyes on them. Better to keep the alcohol at arms length.

To summarise, addiction is a disorder that needs to be approached systematically. It takes time, patience, expert guidance and a concrete plan. Lapses are frequent and are to be expected. But a lapse is not the end of the world. It is a pause. To step back, determine what went wrong, regroup and start over. The process of deaddiction is painfully slow and tedious. It is also physically and emotionally demanding. But at the end of the day, it is worth the effort.

drdebasmitapsychiatrist