Community Orientated Non-Specialist Treatment for Alcohol Dependence

Alcohol dependence is a major and growing social problem with high morbidity and mortality in India. However, the number of existing de-addiction centres providing treatment for alcohol dependence is not adequate to meet the requirements; and is plagued by problems like poor funding, lack of adequately trained staff and limited accessibility. This effectively means that a large proportion of people with alcohol dependence in India do not have access to help with their alcohol-related problems.

In CONTAD we will address this problem by developing a package of care for alcohol dependence to be delivered by lay health workers (LHW) at home or in primary health care centres (PHC).

CONTAD aims to develop an approach to deliver two packages of care for alcohol dependence which will cater to the needs related to alcohol detoxification and the longer term goals of relapse prevention. Both these packages will be delivered by lay health workers (LHW) at home or in primary health care centres (PHC) thus leading to increase in remission rate and reduction of relapse rates in men with alcohol dependence.

CONTAD specifically aims to:
1) Develop a community detoxification package and a psychosocial intervention to address relapse prevention.
2) Develop a training, supervision and competence assessment system for the Lay Health Workers(LHW).
3) Recruit and train PHC doctors to provide shared collaborative care (diagnosis and prescription of medicines, monitoring of the patient’s clinical condition in the Detoxification Package) with LHWs in providing community detoxification and relapse prevention.
4) Demonstrate that these packages are acceptable to alcohol-dependent patients and their families.
5) And provide preliminary evidence that these packages increase remission and reduce relapse.

Expected Outcome
At the end of this process we have developed a community approach to treatment of alcohol dependence that will not only be potentially more effective than the institutional model of care, but much cheaper and achieve much greater coverage due to its community orientation and use of low cost human resources through primary care reaching out to a sizable portion of people with alcohol dependence. This community-based approach to the treatment of alcohol dependence will be potentially more accessible, effective and affordable than the standard institutional model of care, and achieve much greater coverage due to its community orientation.

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