Drug De-Addiction Programme (DDAP)

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A drug, broadly speaking is any chemical substance that, when absorbed into the body of a living organism, alters bodily function. In the area of a substance use disorder, a drug or a substance is any chemical that, upon consumption, leads to changes in the functioning of the human mind and more specifically leads to a state of intoxication. The World Health Organization (WHO) lists substance use disorders for the following classes of substances: 
1.Alcohol 
2.Opioids 
3.Cannabis 
4.Sedative-hypnotics 
5.Cocaine 
6.Other stimulants including caffeine Hallucinogens 
7.Tobacco 
8.Volatile solvents

Abuse is a maladaptive pattern of use resulting in physical, social, legal harm on continued use in spite of negative consequences. Drug abuse is quite common in the country. A nationwide survey (2000-01) among males 12-60 years has brought out that tobacco is the most frequently used substance (55.8%), followed by alcohol (21.4%) cannabis (3.0%), opiates (0.7% ) and sedatives (0.1%). Drug abuse was slightly more common in the areas and drugs Drug addiction in India has of late emerged as a matter of great concern both due to the Social and economic burden caused by substance use and due to its linkage with HIV/AIDS associated with drug lies the Central and were mostly introduced by 20 years of age.?
Drug addiction in India has of late emerged as a matter of great concern both due to the SOcial and economic burden caused by substance use and due to its linkage with HIV/AIDS The onus of responding to the problem associated with drug use lies on the Central and State Governments. The Constitution of India under Article 47 enjoins that the state shall endeavor to bring about prohibition of the consumption, except for medical purposes, of intoxication drinks and of drugs, which are injurious to health.3 The activities to reduce the drug use related problems in the country could broadly be divided into two areas: supply reduction and demand reduction. The supply reduction activities which aim at reducing the availability of illicit drugs within the country came under the purview of the Ministry of Home Affairs with the Department of Revenue as the nodal agency and are executed by various enforcement agencies.1

The demand reduction activities focus upon awareness building, treatment, and rehabilitation of drug-using patients. These activities are seen by agencies under the Ministry of Health and Family Welfare, and the Ministry of Social Justice and Empowerment. The objectives of the entire strategy are to empower the society and the community to deal with the problem of drug abuse. Rehabilitation of addicts, as well as their counseling, comes under the domain of the Ministry of Social Justice and Empowerment (MSJE) in Government of India, while demand reduction by way of treatment and aftercare is the concern of Ministry of Health and Family Welfare. However, the activities of both government agencies overlap considerably in several ways. The Ministry of Health and Family Welfare (MOHFW), Government of India, in 1976, appointed a high power committee to examine the problem of Drug de-addiction and suggest future guidelines. The report of this high powered committee was submitted in 1977 and was accepted by the Planning Commission in 1979. In 1987-88 Drug-De-Addiction Programme was launched by the Ministry of Health and Family Welfare which was later modified in 1992- 93. The Programme was initiated as a scheme with funding from the central government and implementation through the state.

Objectives of the Programme are
1. Demand reduction by providing treatment services including preventive health care and aftercare 
2. To develop human resources for providing treatment to addicts 
3. To improve the quality of services and delivery 
4. To secure the participation of the local govt. body/institution

Under this scheme, a one time grant in aid of Rs. 8.00 lacs was given to states for construction of each drug de-addiction center and a recurring grant of Rs 2.00 lacs was given to the drug de-addiction centers established in North Eastern region to meet the expenses on medications and other requirements.
Under this program, National Drug Dependence Treatment Centre (NDDTC) has been established under the AllIndia Institute of Medical Sciences (AllIMS, New Delhi), which is located in Ghaziabad while drug de-addiction centers of NIMHANS and PGI Chandigarh have been upgraded to 30 beds. Furthermore, de-addiction centers have been established in other three central government institutions viz., Dr. RML Hospital, New Delhi, Smt. SK Hospital, New Delhi and JIPMER, Puducherry.
NDDTC has now become one of the 20 global resource centers for training and capacity building for doctors to treat substance use disorder. It is associated with a project on Buprenorphine Maintenance Programme. The purpose of all these centers is not only to provide de-addiction and rehabilitation services to the patients but also to conduct research and provide training to medical doctors in the area of drug de-addiction.
Under this Programme 122 drug de-addiction centers have been established across the country of which 43 centers have been established in the North Eastern Region.
The annual expenditure made by the Government for this Programme during 2011-12 was Rs. 16.75 crore while the approved budget for 2012-13 for the Programme is Rs. 20.70 addiction.3 crores.
National Drug Demand Reduction Policy has been proposed in March 2013 under the Ministry of Social Justice and Empowerment with the objectives of
1.Create awareness about the ill effects of the substances of abuse 
2.Provide multiple ranges of community-based interventions
3.Strengthen human resource development 
4.Facilitate research, capacity building, and documentation
5.Active effort to avoid stigmatization and discrimination of individuals 6.consuming drugs

Here areas like the involvement of NGOs in demand reduction and regulation of the Private Deaddiction Centers have been addressed.

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