00:00The drug problem has been growing for years and years.
00:04Our drug addiction and treatment center, DDTC, which is in PGI in Chandigarh, is in 1988.
00:16So many years, which we are seeing patients, we have seen a lot of change.
00:22Our senior colleagues, Dr. Mattu and Dr. Basu,
00:27they said that the patients who are seeing patients, they had a lot of pain and a lot of pain.
00:37But in the past 10 years, we can confidently say that the number of patients who are seeing patients and
00:51heroin are almost equal.
00:54It has been increased by such a problem.
00:57So the number of heroin cases has increased.
01:00There was also a number of heroin cases, and there was a number of heroin cases.
01:01Before that, there was a drug for it.
01:04Now it has stronger versions of it.
01:07There are also more strains of it.
01:11There is also a number of heroin cases.
01:12In the past, there is synthetic cannabis.
01:15There are chemical changes that take away from it.
01:22So heroin is actually synthetic, it's a natural form of morphine which is a pain medicine which can be given
01:30in palliative care.
01:33For patients with cancer or severe conditions, pain is very difficult to deal with it.
01:40So when we use chemical to synthetic, we call stylization, the strength increases 6 times.
01:48Morphine is already very strong, it's a pinnacle for pain.
01:52So heroin is also synthetic.
01:57We call semi-synthetic because it's a little natural form.
02:02So these are all transitions and changes.
02:06And in the beginning, when addiction happens, people take Foil.
02:12They take Foil as well as a strong injection.
02:16Because they take the Foil as well as an injection.
02:20They take the full dose and utilize the Foil.
02:23They take a little wastage because it's burning.
02:25So they take the money for the health of the child and the effect of the child.
02:32These numbers are increasing.
02:35And in these diseases, they also have infections.
02:40They call blood-borne viral infections.
02:43They are called blood-borne viral infections, which will transmit one person to another person.
02:46And in these diseases, they don't start the infection alone.
02:50They start the infection.
02:54So one person will not get infected with their infection.
02:58They don't realize the infection.
03:00They load the drug into their friends.
03:04So what happens is that one person and the other person will be transmitted.
03:08This is a very dangerous infection because the liver will damage the liver.
03:13If the liver is damaged by one time, it will be 10 years old.
03:19The good thing is that it will take care of the liver.
03:22It will take care of the liver for 3-6 months.
03:26So that the virus will reduce the numbers and the effect of the liver will not be affected.
03:33So there are also such drugs.
03:35I am talking about the HCV infection, Hepatitis C virus.
03:39This is a lot of drug injection users.
03:46If you look at patients,
03:48what kind of patients are coming to the hospital?
03:52What kind of patients are coming to the hospital?
03:55Do they leave the hospital or do they see anything?
03:57Yeah.
03:59So our center, because it is called Territory Care Center.
04:03Before coming to us, many people are living in private clinics or primary health care centers, community health care centers.
04:13They go to a lot of levels and then come to us.
04:15So it is important to know that we are living in a very severe state.
04:21But it is not just that.
04:23In the beginning of the stages, families are very concerned.
04:28Some families are very concerned.
04:29Some families are very concerned.
04:29If they are drinking in a problematic way or smoking,
04:34they also take care of them quickly.
04:35If they are living in a very positive state,
04:37we are deeply concerned.
04:38It is in the case of particular,
04:39but we look at the tertiary care centers probably more than the severe stages.
04:44We look at the time of leaving the parents.
04:48As a very patient,
04:48If they are trying to leave the families.
04:51Many people are trying to leave the parents.
04:52And so the same extent they have been relapsed.
04:54Then, again,
04:56in the addiction cycle.
04:57This is all we look at.
04:59In addiction, we all understand that it is a relapsing condition or remitting illness.
05:07This is a belief that remit means that we can leave it.
05:10And when we get a trigger, because this is a disease,
05:16we also get an internal trigger,
05:18which means that we need to take care of it,
05:22we need to take care of it,
05:23we need to take care of it internally or externally.
05:27Even though in relation to our own home,
05:29there is a lot of crisis,
05:30and that's enough of the stress.
05:33For the job-related stress,
05:34unemployment and all the stress of these things.
05:38This is a diversion and a good distraction,
05:42and it is the same for the negative emotions.
05:46And also for the emotions,
05:47it is the same for all of us.
05:52So this is a short term
05:55gratification
05:55के लिए सही use करना
05:57शुरू कर लेता है
05:58relapses अक्सर इनी कारून के वज़े से होते है
06:01और कहीं दफ़ा
06:04जैसे ही वो छोडने
06:05की कोशिश करते है उनको तोड हो जाते है
06:07body भी उनका help नहीं करता है
06:09क्योंकि वो जिस तरह से
06:11ये drug उनके system में कुछ changes
06:13ले आता है body में
06:15वो maintained रहता है
06:16जैसे ही वो system से निकल जाता है
06:19drug तोड होना शुरू हो जाते है
06:20तोड भी संभलना बहुत मुश्किल होता है
06:23तलब, तोड और stress
06:25ये तीनों चीज़े बहुत important होती है
06:28लोगों को बार-बारी
06:29relaps में चले जाने के लिए
06:32ये addiction जो होती है
06:34ये तीन कारण से होती है
06:37एक आके हम सब में
06:38एक biological risk होता है
06:40जो कि हमारे genes में
06:42carry करते हैं और रही दूसरी
06:44आके हमारा खुद का एक
06:46psychological mind जिस तरह से बना है
06:48वो भी एक कारण होता है
06:50तीसरा आके social factors
06:52जो है जिस माहोल में
06:54हम रहते हैं वो भी एक कारण होता है
06:57तीनों के लिए
06:58तीन डिफरेंट इलाज प्रिसक्राइब किया जाता है
07:00biological के लिए दवाईया है
07:02आजकल दवाईया बहुत सारे
07:04develop होते जारहें इतना research होते
07:06आरहा है आप जो भी addiction का
07:08बताएं उनके लिए helpful दवाईया
07:10कहीं सारे है और
07:12psychological उसके लिए बहुत सारे
07:14against counseling techniques है
07:17most important है कि
07:18motivational interviewing कहते है
07:21Miller, Rolnick
07:22उन्होंने develop की है
07:25यह हम regularly
07:26यूज करते हैं हमारा day in day out
07:28यह होता है हर clinical interview में
07:31हम use करते हैं इस technique में
07:33जिसमें हम important सवाल
07:34यह पूछते हैं कि क्यों छोड़ना
07:36चाहते हूं क्या कारण है
07:38छोड़ने के लिए ताकि
07:40वो reason हमें strong बनाना
07:42जुरुरत है इससे क्या होता है
07:44इंसान का motivation बढ़ता है
07:46छोड़ने के लिए
07:48हम motivation बढ़ाने का पहला step होता है
07:50क्योंकि motivation इसमें क्या है
07:52बदलाव के बारे में
07:54use कर रहे हैं नहीं
07:56यूज करना तो ये दोनों
07:58complete different end से path है
08:00इस change को ले आने के लिए
08:02हमें दवाई की
08:05counseling हम पहले use करते हैं
08:07जैसे ही वो ready हो जाते हैं
08:09दवाई definitely उनमें और भी अच्छा
08:10काम करता है और
08:12तीसरी जो की social उसमें हम
08:14family therapy भी यूज करते हैं एक तो family का
08:16education से शुरू करके
08:18family में जिस तरह से interactions
08:21होते हैं उसको healthy करने के भी होती है
08:23biological में
08:25आज की दिन में उनको
08:26दवाई के अलावा एक और भी टेक्नीक है
08:28जो की brain stimulation
08:30मेरा खास expertise उसमें है
08:32यहाँ पर तो brain stimulation
08:35में आके हम TMS करके
08:37एक device है
08:37transclanial magnetic stimulation
08:39उससे हम brain के उन regions को
08:42stimulate करते हैं
08:43जहाँ पर मैं पहले आपको बता रही थी
08:45कि brain inhibit
08:47मदलब stop करने का
08:49वो जो response नहीं देता है
08:50उन brain regions को हम activate करते है
08:52ताकि लोग उसे
08:54stop करने की उनको मदद दे
08:56तो TMS हम चला रहे हैं
08:59पिछले 20-23
09:01November से हम
09:02particularly addiction के लिए शुरू की है
09:04और अभी तक इतना result आज़ा रहे हैं
09:08मेरे पास जो data है
09:09हमने at least 82-85 patients तक हमने अभी तक दिया है
09:14और वो mixed है results
09:16कुछ लोगों में काफी अच्छा मदद किया है
09:19कुछ लोगों में शौट टम के लिए अच्छा काम किया है
09:21लॉंग तर में नहीं
09:22और कुछ लोगों में वो उतना helpful नहीं रहा है
09:25मगर मेरे belief यह है
09:28अगर patient suitable है
09:30तो try करना जरूरत है
09:31अगर नहीं helpful है वो हम figure out
09:34बात में कर सकते हैं
09:35मगर try करना जरूरत है
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