Substance abuse releases up to 10 times more dopamine

Health Care, Heart Care Foundation of India, Medicine Comments Off

The number of addiction cases have increased drastically in India

New Delhi, 20th February 2019: As per a recent survey conducted by the National Drug Dependence Treatment Centre (NDDTC) of the All India Institute of Medical Sciences (AIIMS), states including Uttar Pradesh, Andhra Pradesh, Punjab, Chhattisgarh, and Arunachal Pradesh have emerged as front runners in alcohol abuse and health complications due to the same. About 5.7 crore people in India suffer from alcohol-related problems and need treatment. Of the 16 crore who consume alcohol, the prevalence is 17 times higher among men.

Over 4 lakh children and 1.8 million adults need help for inhalant abuse and dependence, said the survey. The current use of Heroin is 1.14%, followed by pharmaceutical opioids (current use 0.96%), and opium (current use 0.52%). This was more prevalent in Uttar Pradesh, Punjab and Haryana.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “Unlike activities like food, drinking, reading, music, which produce the optimum levels of dopamine, addictive substances or behaviors can release up to 10 times more dopamine. This leads to the “high” that is associated with use of drugs. Recurring activation of the “reward system” due to repeated use of addictive drugs leads to addiction. Drugs that modify dopamine affect motivation, motor functioning, sense of pleasure and important events experienced by a person. On the other hand, drugs that affect serotonin affect the ways how a person learns, remembers, sleeps and feels emotions.”

Addiction may worsen an underlying mental disorder or trigger a mental disorder such as attention-deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), anxiety, depression etc. Such persons are more at risk of addictions.

Adding further, Dr Rajiv Garg, Sr Consultant Physician, said, “Reducing or stopping the consumption of alcohol is harm reduction. It can be the gateway to preventing other health complications later in life. Similarly, those who indulge in substance abuse should be counselled and provided with adequate help to be able to quit the habit.”

Some recommendations

  • Put it in writing why you want to reduce or stop: Write what you want to achieve for example will feel healthier; will sleep better, will improve my relationships.
  • Write confessions: learn and practice various confession exercises. This will help you take care of inner guilt which may be the precipitating factors.
  • Set a drinking limit: Those who are cutting back should set a limit as per your health. Most healthy people should limit to less than 40 ml in one hour, 80 ml in one day and less than 240 ml in a week. Women should take less than half of this amount.
  • Keep a diary of your drinking. For initial 3-4 weeks, keep track of every drink. Note the situations you are most likely to drink. Give each situation rating out of ten. Try avoiding those situations for the next few weeks.
  • Don’t keep alcohol within your reach. Remove alcohol from your living place. This can help limit drinking.
  • Eat your drink. Drinking slowly can help. Sip and do not gulp. Sip soda, water, or juice after each drink. This is called Mindfulness drinking. Be aware of your drinking will cut it down. Never drink on an empty stomach.
  • Keep a weekly spiritual fast. This will allow alcohol-free days. Decide not to drink a day or two each week.
  • Observe spiritual retreats: Observing spiritual retreats (Navratri by Hindus, Ramazan by Muslims, and Easter by Christians) with no drinking can help. Or try abstaining for a week or a month to see your commitment to not drinking.
  • Last but not the least, be persistent in your efforts to quit.

Nida, a success story: Addressing social determinants of health to improve health equity

Health Care Comments Off

Nida came to us, at Samir Malik Heart Care Foundation Fund, in 2014, with complaints of breathlessness on exertion. She was born with an atrial septal defect (ASD), which had been diagnosed four years back during a routine health checkup in school. Her parents took her to a hospital, where she was advised open heart surgery to correct the condition at an estimated cost of around Rs 1.5 lakh. Her father, a welder, was the sole earning member of his family, which had six dependent family members. He had no insurance cover, ESI or CGHS. So, clearly, he could not afford the surgery.

He was then referred to us by the doctor who had first diagnosed the child.

When Nida came to us in 2014, she was 9 years old; after reviewing her condition, the Samir Malik Heart Care Foundation Fund decided to adopt her. In September 2014, she underwent ASD device closure by Dr Smita Mishra through the fund. An open heart surgery was avoided.

Since then, Nida has been regularly coming to us for follow up care.

She is now 14 years old and a student of class 9. She has friends and participates enthusiastically in all school extracurricular activities – drawing, poem recitations etc.; she enjoys sports like Kho Kho, Kabaddi and above all, she is doing very well academically.

Nida is another success story of the Samir Malik Heart Care Foundation Fund.

Using the device closure method avoided the trauma of open heart surgery, a more invasive procedure, to correct the congenital heart defect. It also meant a shorter hospital stay, quicker recovery. Undergoing the device closure also helped to remove the social stigma of living with a scar on the chest.

Social gradient has been identified as one of the 10 social determinants of health. The others are: Stress, early life, social exclusion, work, unemployment, social support, addiction, food and transport. Social gradient means “people who are less advantaged in terms of socioeconomic position have worse health (and shorter lives) than those who are more advantaged”.

Social gradient needs to be addressed to eliminate the inequalities in health in the society.

To see Nida as a healthy and active child today only helps us to stay committed to our cause, which is to provide assistance to needy heart patients, young and old, so that they can live a healthy and productive life – “no person should die of a heart disease just because he/she cannot afford treatment”.

Since it was first established in 2014, the Fund has successfully sponsored 279 heart surgeries such as valvular heart surgery, pacemaker implantation, surgeries for congenital heart diseases, bypass surgery and stents. It has also helped more than 1788 patients, both children and adults.

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA