A substance use disorder (SUD), also known as a drug use disorder, is a condition in which the use of one or more substances leads to a clinically significant impairment or distress.

Substance use typically refers to the misuse of drugs such as alcohol, amphetamines, caffeine, marijuana, cocaine, hallucinogens, inhalants, nicotine, pain relievers, and sedatives.

People who are addicted to a particular drug need to use increasing amounts of the drug, experience withdrawal, and have difficulty cutting down on use of the drug. Over time, daily occupations can be negatively affected by substance use, impacting relationships, work performance, and daily routines that support health and effective coping.

Drug and drug addiction both are rejected from our culture. Drug is a dangerous addiction which can destroy anyone’s life and family. According to sources at different healthcare facilities, nowadays nearly 10 percent of outpatients are visiting the country's hospitals with cases of addiction-related complications.

The trend of drug consumption is higher in youth and teenagers, their age spanning between 15 and 30 years. They come from all strata of the society. The average age of the drug addicts is 22.

There are many reasons behind drug addiction. Main reasons are given below:

Anxiety

Curiosity and excitement about the drug

Frustration

Try to follow the western culture

Poverty

Rejection in love

Mental stress due to family

problem

Substance use disorders (SUD) can have a significant effect on one’s function in all areas of occupation. Physical and psychosocial issues due to SUD can impact occupational performance. Unfulfilled life roles and disruption in meaningful activity can result from lack of structure or routine, poor motivation, limited skills, and poor social networks.

These deficits may also contribute to stress, affecting the ability to cope with challenges. While SUD can affect a client’s participation in therapy and ability to follow recommendations, occupational therapists are trained to facilitate occupational participation and performance. Occupational Therapist have a great role to rehabilitate these substance use disorder.

Case Scenario: Mr. H, a 14 years boy comes from Shawrapara, Dhaka. He has 4 brothers, he is the third one. He was read in class seven. He comes from a middle class family. His family expects to continue the study and become an educated person and will get a good job. But he was irregular in his study. He didn’t like to go to school as a result most of the time he runs away from school.

He suddenly developed some symptoms as unrealistic thoughts with irrelevant speech, aggressive behavior, didn’t like to talk with anybody and passed whole time in outside of the home with bad company who motivated him to smoke and use other drugs such as ganja, sedative drugs.

He didn’t perform self-care activities e.g. brushing teeth grooming, bathing, however in 20.12.17 he was admitted at National Institute of Mental Health (NIMH). Then he is diagnosed as conduct disorder with substance use patient.

The responsible registered doctor also notified client’s problem in self-care activities, behavior. She recommended occupational therapy in his medical note and discussed it with multidisciplinary team (MDT) during ward visit. They referred the client to the Occupational Therapist for proper rehabilitation.

Occupational Therapist provides treatment in following process:

According to problem list Occupational Therapist provide following therapy:

Group Therapy

Individual Therapy

Relaxation Therapy

Social skills training

Assertiveness training

Reality Therapy

Family Therapy

Life skills training

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Occupational therapist work in different country and they carefully treat the mental illness patient. But in Bangladesh occupational therapist only works in physical health sector. They have limited

opportunity to work in mental health sector.

The big problem is people and government not aware about occupational therapy. They only think only psychiatrist or psychologist can solve this problem. But, besides this occupational therapy and clinical social worker also needed in this setting.

If we work in a MDT team then we can get a good result. According to WHO report on mental health in Bangladesh, we need qualified manpower where occupational therapist also placed.

Only 0.002 occupational therapists for 1 million people, which is very limited. So, government should take steps to solve this problem and also need to increase the qualified manpower in mental health settings.