User talk:A.S.M.Kamrul Huda

A.S.M. Kamrul Huda MBBS, PhD. (Japan) Medical Science. Special training on Neuromedicine. Kidney, Medicine, and liver specialist. APOSH; Center for Rehabilitation of Drug Addiction. Luxmipur. Jhautola More, Rajshahi-6000, Bangladesh. Email: kamrulasm@yahoo.com. Phone: + 88-0721- 760357.

Detoxification is not requiring for the typical Bangladeshi drug users.

Typical Bangladeshi drug users were commonly started their addicted life with phensedyl syrup, a codeine phosphate containing cough suppressant which manufacture in India. Bangladesh Government banded this syrup at 1982, even it is smuggling in Bangladesh because of huge abuse especially among of young generation in Bangladesh. Phensedyl drug users also abused sedative/hypnotics, nicotine and caffeine (tea, coffee) drug often seeming that these increase their duration of feelings. After certain time when created tolerance, then, they abused alcohol for excitement. Next, they started to abuse pethidine, buprenorphine etc like pain killer via injection and finally started to abuse the opium king, heroin. Most of these drugs are depressants do depression of central nervous system. Typical drug users also abused relatively cheaper stimulants drugs marijuana often. Once they habituate on heroin or either on pethidine or buprenorphine generally they gave up abusing the earlier less effective drugs.

I worked 8 months with total 480 (60×8) drug users as a single doctor in a rehabilitee center at Rajshahi city in Bangladesh. Among of 60 drug users of each month, 40 came from different part of Bangladesh with cost free facilities and 20 from local community. Among local drug users, few were recommending of professors of psychiatric department of Rajshahi medical College. Routine Hospitalization period was of 1 month but some among of self admitted patients willingly stayed additional two or three months at the center. I would like to state my analysis in detoxification in typical Bangladeshi drug users.

Among of all adult male patients 4.34% and 30.43% patients were aged between 45-50 and 25-30 years respectively. 95% cost free patients were poor, illiterate. 90% local patients were student. 30.43% and 4.34% patients used phensedyl and heroin as “gateway” drugs respectively. 39.13% and 13.04% used heroin and buprenorphine respectively as the last drug before admitting at the center. 90% students were typical Bangladeshi drug users. 24% patients were used their main drug in combination with other drugs. I did not find any cocaine or amphetamine like stimulant drug users during these 8 months at my center.

I physically examined each patient and advised to 16.25% patient to check the kidney, liver, lung etc function to excluding other mimicking disease. Test reports were with in normal limit. Their system detoxified showing minor withdrawal syndromes such as sleeping problem, anorexia and low-grade fever. Depressant drug like withdrawal syndrome i.e. seizures found among 17 patients from cost free population. Stimulant drug like withdrawal syndrome i.e. syncope found among 4 patients. 3.96% and 18.12% patients showed psychoses and neurosis like withdrawal syndrome respectively.

I managed seizures with non-pharmacological management using showering and oral saline. I prescribed antipsychotic, antidepressant etc drugs in the psychoses patients to helping them in the chemical balancing function in their brain. Closely monitoring the patients I recommended to exercising one hour every day to adjusting them in drug free state (1). I don’t have to gradual administration of decreasing doses of the drug of dependence or of a cross-tolerant drug.

Bangladesh is golden triangle of drug smuggling. Illiteracy, poverty and hopelessness are the 3 of major relapse triggers in Bangladesh. Beside, the illicit drugs in Bangladesh are cheap and contaminated. I found no physical dependence among Bangladeshi drug users. This study could be useful in worldwide drug dependence treatment.

References: 1.Meeusen R. Exercise and the brain: insight in new therapeutic modalities. Ann Transplant. 2005; 10 (4): 49-51.