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Year : 2017  |  Volume : 33  |  Issue : 1  |  Page : 57-62

Overcoming barriers to community participation in drug dependence treatment: An ethnography approach

1 Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
2 Department of Psychiatry, All Institute of Medical Sciences, Bhubaneswar, Odisha, India
3 Department of Psychiatry, S. H. K. M. Government Medical College, Nalhar, Haryana, India

Correspondence Address:
Bir Singh Chavan
Department of Psychiatry, Government Medical College and Hospital, Sector-32, Chandigarh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0971-9962.200087

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Introduction: Substance use and dependence has been a part of Indian society for centuries. However, abuse of more hazardous drugs including intravenous use, younger age of initiation, and high prevalence has made it a major public health issue. Community-based interventions for drug/alcohol use are often hindered by a lack of community participation, which is the result of stigma associated with drug/alcohol use and its treatment. We describe our attempt to address this issue of lack of community participation in a particular community of Dhanas, Chandigarh, using an ethnography approach. Methodology: Despite drug/alcohol use being rampant in their community, the leaders of the community (Sarpanch and Medical Officer of Primary Health Centre) not only denied the problem, but also refused to support community outreach team. In the absence of facilitation by community leaders and prevalent stigma, drug/alcohol users from the Dhanas village did not seek treatment even when the treatment was offered close to their homes. Using an ethnography approach, a 6 point questionnaire was developed to investigate the severity of the problem as well as to engage the community leaders in the delivery of community-based treatment. Results: The questionnaire highlighted that key leaders chose to deny existing drug/alcohol problem whereas those who were aware of the problem did not have a say in the decision-making process. The questionnaire facilitated a thorough understanding of the sociocultural and political ethos of the community which in turn helped in chalking out an action plan in this village. Conclusion: With the help of various individuals such as former and current healthcare workers, community leaders, drug users, and their family members, the community outreach team successfully mobilized the community from denial to activism. This was evident in the number of individuals seeking treatment for drug/alcohol use that showed an increasing trend over the months.

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