An extensive campaign is on in Kerala against substance abuse, with the State government and various sections of society, including law enforcement agencies, making efforts to curb the menace. Psychiatrists in the State have also sought to treat it as a medical disorder, which needs proper treatment and rehabilitation.
Functionaries of the State branch of the Indian Psychiatric Society say that patients who wilfully seek treatment for substance addiction should be treated empathetically, as it takes a lot of courage to seek help. Mohan Sundaram, State president, and Anees Ali, State general secretary, say that the recent letters sent by the police to mental health institutions asking for personal details and period of abstinence of patients who are seeking treatment for substance addiction, or who have completed de-addiction treatment, are not legally tenable.
These institutions include hospitals caring for patients with mental illness, including substance addiction, and de-addiction centres, as per the Mental Health Care Act, 2017. Psychiatrists point out that under Section 27 (1) of the Act, persons with mental illness shall have the right to confidentiality in respect of their mental health, mental healthcare, treatment, and physical healthcare. The only authorities who can order the release of information as per Section 23(2) are the Mental Health Review Board, Central Mental Health Authority, High Court, Supreme Court, or any other statutory authority competent to do so.
Even if a patient can be charged under Section 27 of the Narcotic Drugs and Psychotropic Substances (NDPS) Act, 1985, or with offences involving small quantities of narcotic drugs or psychotropic substances, 64A of the NDPS Act provides immunity from prosecution to those with an addiction who are volunteering for treatment. It should be conducted in a hospital or an institution maintained or recognised by the government or a local authority. The immunity from prosecution may be withdrawn if the person with addiction does not undergo complete treatment for de-addiction.
Dr. Sundaram and Dr. Ali say that timely and appropriate provision of medical care is essential to ensure the health and well-being of any person with substance addiction. This will also prevent them from harming themselves and others. Therefore, only a system where the patient feels safe, secure, and free from legal retributions will allow effective treatment seeking. Any fear of legal retribution will drive them away from treatment seeking, to the detriment of themselves and others and may increase substance-related crimes, they say.
According to T.C. Vishnu, State treasurer of the society, a majority of those who seek treatment for substance abuse are in the 15 to 25 age group. While those belonging to the middle class formed a large chunk of the patients earlier, now even those from the lower socio-economic backgrounds are also found to be accessing drugs. Peer group pressure, impulsive behaviour, and an urge to experiment are driving most of them to this habit. They are taken to psychiatrists when behavioural problems are noticed, says Dr. Vishnu.
The different evidence-based approaches to substance use, like intervention, detoxification, relapse prevention/ rehabilitation, harm reduction, and follow-up care, with an integrated team of mental health professionals, support groups, and other governmental and non-governmental organisations, are imperative in solving the problem, the psychiatrists say.
Published – March 30, 2025 09:24 pm IST
