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Tuesday August 16, 2022

No psychiatrist in Rs361.8m project for drug addicts

October 08, 2021

PESHAWAR: Huge funds meant for an important project worth Rs361.812 million being launched by the Khyber Pakhtunkhwa Social Welfare, Special Education and Women Empowerment Department for establishing detoxification and rehabilitation centres are likely to go waste as not a single psychiatrist has been taken into the workforce supposed to deal with drug addicts and serious issues of psycho patients.

The project is being launched in 11 districts of the province, including Peshawar, Mardan, Swabi, Charsadda, Karak, Malakand, Kohat, Dera Ismail Khan, Swat, Nowshera and Dir Lower.

The same project will be extended to the rest of the districts on a need basis.

According to documents available with The News, the director of the Social Welfare Department would supervise the project and would be the drawing and disbursing officer (DDO).

“This is the biggest joke with mental health in the history as you are going to establish a drug rehabilitation centre in a district and addiction, which is the most difficult field of psychiatry, would be handled by a medical officer, social welfare officer or psychologist and a mullah. What would be the scientific protocols and guidelines of this project under these non-technical people,” said a senior psychiatrist.

He accused the Social Welfare Department and particularly its officials of their failure to understand the importance of psychiatrists and seek their input in the multi-million rupees’ project.

He said it was neither the capacity of the medical officer nor psychologist or cleric to cope with serious challenges associated with drug addiction and suicidal behaviour.

“I don’t need any job or favour from this project as I am well settled but it hurts me when I see almost Rs4 billion of the poor people of Khyber Pakhtunkhwa being wasted and going to the pockets of a few individuals,” said the senior psychiatrist.

The project is aimed at enhancing the capacity of the existing centres from 25 to 100 bedded centers/hospitals to motivate drug addicts and provide treatment and rehabilitate them free of cost.

According to two other senior psychiatrists in Peshawar, it would be beyond the capacity of a medical officer, social welfare officer and a cleric to motivate drug patients from harm effects of drugs and prescribe them treatment or offer guidance to the affected families for proper treatment of drug patients.

The target of the project is drug addict population so the selected motivated recovering drug addicts to take part in different rehabilitation activities.

Besides, the social welfare department wanted to address the limitation of unemployment, enhanced productivity and reduction in crimes in this project.

The department has mentioned in the PC-1 that students of psychology, sociology, anthropology and social work/paramedics, MBBS and psychiatry department (three numbers each) of the universities and NGOs would be encouraged for apprenticeship.

An Islamabad-based noted psychiatrist, Dr Abdul Wahab Yousufzai, told The News that drug abuse is a very complex issue and the treatment and rehabilitation is also very complex in nature.

“It’s highly specialised field of psychiatry. The treatment team comprises psychiatrist, psychologist and social worker. The management of patients is usually tailored-made, depending on the type of addiction. There are serious complications of addiction including suicide, psychosis and aggressive behaviour,” he opined.

He said a highly specialised team is required to do risk assessment in addiction. “For example risk to self, risk to others,” Dr Abdul Wahab Yousufzai argued.

“Addictionology is a highly specialised branch of psychiatry requiring a well-trained clinical team. Substance use disorder (addiction) is a complex problem which is usually associated with risky, suicidal behaviour and other major psychiatric disorders like psychosis. The solution to this problem is also very complex,” he explained.

The management strategy for substance use disorder (addiction) should always be tailored-made keeping in view various biological, psychological and social factors. Dr Abdul Wahab said that treatment should be evidence-based following the scientific guidelines.

“And risk assessment, which encompasses risk to self and risk to others, should be an integral part of the management strategy,” he added.

Besides Dr Wahab Yousafzai, almost all other senior psychiatrists expressed concern over wastage of public resources in the name of detoxification and rehabilitation and demanded Chief Minister Mahmood Khan and Chief Secretary Dr Kazim Niaz to take note of the issue.

“This is a huge amount and can be used to build a state-of-the-art centre for patients of drug addiction and their rehabilitation,” a Peshawar-based psychiatrist explained on condition of anonymity, demanding of the high ups to protect public resources from misuse.

A senior psychiatrist of Khyber Teaching Hospital, Prof Bashir Ahmad said that “the so-called detox centres run by non-professionals are simply torture centres with no concept of treatment or rehabilitation. Dozens of similar centres have been recently seized by the health care commission in Islamabad for having no qualified professionals (psychiatrists).”

The detoxification centre will accommodate 25-50 drug addict patients.

It would depend on the patient’s condition but each one would need 10 to 15-day detoxification services and would be referred to the rehabilitation department.

The rehabilitation center will have the capacity of accommodating 50 drug addicts from 30 to 45 days, where the staff would control epidemics of HIV AIDS, HCV, T.B. and other blood borne diseases.

The project aims at providing rehab and vocational training to the detoxified patients enabling them to be self-reliant and become functional again in society.

“To pick all drug patients from the streets, parks, roads and public places in district and adjacent districts of the province for treatment and aftercare.

According to a UNODC report, drug use in Pakistan 2013 Khyber Pakhtunkhwa has the highest prevalence of drug use in Pakistan, with 10.9 per cent of the adult population using centres.

This correspondent called secretary social welfare Zulfiqar Ali Shah and sent a text message to his cell phone, seeking his comments but he neither answered the phone nor replied to a text message.

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