Revolving doors of rehabilitation

Namira Hossain reveals the controversial methods being used on drug addicts in most unauthorised rehabilitation centres of the country and why most addicts are likely to cling on to their habits despite several visits to such centres

ex08Rajib’s (25) daily routine has been the same for the last five years or so. He wakes up around 2:00 PM, has his lunch, calls up his dealer who delivers Yaba pills straight to his house and smokes, first alone and then with friends.
Despite being a bright young man and having spent several months out of every year in different rehabs since he was 19 years old, he seems to be rather stubborn in resisting a change of habits, ‘I will quit when I want to. They keep locking me up but they do not understand that their negativity and lack of trust would often drive me to use,’ he says.
Ludmila, a 29-year-old ex-user shares her experience in rehabilitation centres. ‘I had been using for about six years and my parents never had a clue because I still kept up appearances of a “normal life”. It is only after I went through a bad break-up that coincidentally Oishee’s story came out in the press, and my parents, who still did not understand how addiction works decided to put me in rehab,’ she says. Ludmila goes on, ‘It was a shock for me, as I never thought I would end up there. If anything, being confined affected me rather negatively as the experience really knocked my confidence, made me feel isolated and cut off from the rest of society. I felt as though people looked at me differently and even my old friends treated me differently. I felt as though the only people who understood me were the whole new circle of users whom I got to know while in rehab.’
ex09According to the Department of Narcotics, there are 69 privately-owned drug rehabilitation centers in Bangladesh, from which five are government-run. However, in Dhaka alone there are at least 200 rehabs, many of which resort to questionable methods of treatment that they do not care to disclose to the public.
The questionable techniques used in these rehabs are mostly not enough to steer most addicts away from their habits. As most former addicts and experts tell New Age Xtra, the feeling of isolation from society plunges them into despair, letting them to cling on to their addictions as a last resort.

Water-boarding and physical punishment
ex10Ishnad, 40, says during his stint in a rehab in Mirpur called Golden Life, he was subjected to instances of waterboarding and being handcuffed to a chair while being beaten with bamboo sticks. While speaking to New Age Xtra, the spokesperson from Golden Life said that they do not use any physical violence on their patients, but have various kinds of ‘punishments’ for breaking rules, one of which is making them wear a board around their neck, which informs everyone of what rule they have broken.
Majid, 28, now lives in America and is sober after multiple attempts, claims that during his time in CREA, he witnessed a patient being beaten badly while trying to escape. He says, however, his two stays in Prottoy, a well-known rehabilitation centre in Dhaka really helped him due to the rigorous programme they follow and because he got to make friends who were a positive influence.
This works differently for everyone as Turag, 33,  who had also been to Prottoy and had been sober for two years relapsed again last year. He tells New Age Xtra, ‘I had gotten sick of leading a user’s life so I thought sobriety would be different. But the rehab and indeed the support structure seems to be built in such a way that it benefits the patients who are financially well off. They want you to keep coming back as patients or to join the support structure so they can make money’.
ex11Dr. Sat Prakash, director at Prottoy, says they keep in touch with their patients and only about 30 per cent of patients relapse.
According to statistics from the Department of Narcotics on the types of drug addictions, available until 2013, 30 per cent patients were treated for heroin addiction, followed closely by 27 per cent for marijuana addiction and only 10 per cent for Yaba addiction. There seems to be some discrepancies in the statistics, as the rehab centers that New Age Xtra spoke with all said that an overwhelming majority of patients nowadays are treated for Yaba addiction.
This is a field, that still has no standardised guidelines and all the different facilities follow different methods and different philosophies. Also due to lack of research, it is hard to track the graduates of the programmes followed at different facilities and their success rates.
Dhaka University Educational and Counseling Psychology department chairman professor Shaheen Islam says torture is a malpractice in the treatment of drug addicts. She, however, adds that sometimes rehabilitation centres use some techniques that can seem to be like torture. ‘But if any rehabilitation centres do torture patients, then it is entirely a criminal offence,’ she says.
When asked about the issue, DNC director (operations) Pranab Kumar Neogi tells New Age Xtra that he is aware of such maltreatment in many drug rehabilitation centres in the city. ‘Sometimes we have found such awful treatment strategies followed by the rehabilitation centers and have directed them not to carry out such treatment procedures,’ he says.
Meanwhile, a senior official of DNC informs, ‘Most of the treatment centres are owned either partially or fully by influential people; therefore we cannot take necessary steps against these centres’.

A vicious cycle
According to the statistics published on the website of the Department of Narcotics, 2013 saw a total of 8,108 patients treated for addiction, out of which 4,160 were new patients and 3,948 were relapse cases.
For 2014, the statistics are only available till June, during which time a total of 5,019 patients were treated – out of which, 2,716 are relapse cases.
The ugly twin sisters of addiction and rehabilitation are amongst the embarrassing realities of life for many families in Bangladesh, which they simply prefer to sweep under the carpet rather than trying to understand how and why this vicious cycle is perpetuated.
Rajib’s mother, a 68 year old schoolteacher says, ‘what choice do we have as parents? He does not behave normally at home when he is using and everyone would be scared of him. As long as he keeps using, I will keep putting him in rehab’.
The above statement would be a good example of what is known in psychology as ‘Revolving Door Syndrome’, which is used to describe a certain pattern of behaviour such as attending rehab and then relapsing.
According to alcoholrehab.com, it is common for people to get caught in this pattern. ‘Until they are able to break out of the cycle there can be no real progress. Attendance at rehab can be highly beneficial, but only if it means that people can achieve sustained sobriety in the real world. Otherwise they are just taking a holiday from their addiction,’ says the website.
Hence the sort of mindset that families of users display really are detrimental to the recovery of the users. Often they hide where their children have disappeared to for months, claiming they went abroad. As drugs users suffer from low self-esteem anyway, this sort of attitude makes them feel shame at their attempts at sobriety rather than pride at overcoming their addiction.Continued relapses and increasing amount of time spent institutionalized, makes those who attend the rehabs lose faith in their own abilities to stay sober.
Most of them have already alienated friends and family members who simultaneously grow cynical and weary not only due to the financial drain, but also the lack of understanding of the root of addiction itself makes them view their own family members as monsters who lie and steal, who are capable of doing anything just to get their fix. This lack of understanding leads to miscommunications and makes the transition into ‘real life’ that much harder after confinement.
Khurshid, a 26-year-old male who has spent over eight months out of every year in different rehabs, says that drugs is the easier option because of the lack of belief that he can get better. ‘It becomes a self-fulfilling prophecy, and I understand how self destructive it is but my parents treat me like a thief in my own home,’ he says.
‘They do not trust me to get or keep a job, nor do they give me money. I even have to share a room with my younger brother because they do not trust me to be alone. According to the programmes I have completed in different rehabs, these are all justifications for my habit. But I have already been over-institutionalised,’ adds Khurshid.

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