Tuesday, August 12, 2008

Humane way to tackle addiction

Ever heard of addiction psychiatry? It’s new in the medical field. Addiction psychiatrist Dr. Sanju George loves his job and the satisfaction that he derives from it is his greatest payoff. The reason that I am sitting with Dr. George is that he recently won the ‘Hospital Doctor’ Award in the United Kingdom in his field of work.

Dr. George (and “my team”, he insists) was chosen for the award for the innovation that he brought into the treatment of alcoholics and drug addicts. Traditionally treatment for substance misuse would be provided by a specialist and what Dr. George (and his team) has done is introduced the concept of ‘shared care’. Dr. George heads ‘The Bridge’. The Bridge is the specialist drug service in Solihull, part of the Birmingham and Solihull Mental Health Trust.

Innovation is what led him and his team to evolve this system of ‘shared care’ where the General Practitioner can treat an addict rather than referring him to a specialist. “Obviously there is stigma attached to addiction treatment. GPs do not want drug addicts walking in for treatment. What we are doing is encouraging them to treat addicts. We provide training, supervision and support.” Apparently unlike here where we head straight to a specialist the moment we suspect something, there everybody has to visit a GP who then decides where the sick person should be headed. The treatment would therefore be comprehensive because the patient gets holistic care. Drug addiction is accompanied by several other problems,” says Dr. George. Besides, according to him, there are fewer stigmas attached when an addict is treated at the level of GP. Of course if things get difficult at the GP’s then the specialist team steps in and takes over.

Family involved

Humaneness is what marks the system, the understanding that there are other people – the family – involved. In a gesture seldom done in foreign countries, Dr. George has handed his mobile number to his patients and their families. “It is fairly traumatic for family members when they have to bail a family member out of jail or any other problem. It is therefore good to establish a therapeutic relationship with the family too because they too need empathy and understanding,” he says. All said and done, he admits that this is no magic formula, but this is one formula that has worked or is working although there are occasional failures.

Would a system like that work in India? “I am not qualified to make a comment on that because I am not familiar with what the system is here.”

He has been at the Bridge, based in Birmingham for the last three years. Dr George did his schooling at Rajagiri School and pre-degree from Maharaja’s College before heading to St Johns, Bangalore for his MBBS and then to the United Kingdom for higher studies where he specialised in Addiction Psychiatry.

Addiction psychiatry is in its nascence. “There is a lot of scope to do things, whether it is innovative or research.”

Coming back to his payoff? “It is as I said. The satisfaction, of course I am at a privileged position of having the time as well to spend time with my patients, of being allowed to do this.” When he is not at The Bridge, Dr. George does research and he also teaches at the Birmingham Medical School.

Working in a place where 99 per cent of the population is white, has the colour of his skin been a problem? “I have never experienced discrimination because of my race, when a patient walks in my door for treatment I don’t think my race becomes the issue,” says Dr. George. How about coming back home? Dr. George stops, pauses, thinks and says, “Maybe. Sometimes I do think about doing something for my people but there are several things that have to be considered,” he signs off.
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