The venue is the very best, with a rock star stadium feel given the huge projections above the great stage Most importantly the sound system is perfect. Given the variety of accents from Indian, English, Scottish to a wide variety of ESL European, this has been crucial for me, my hearing not the best to begin with. The individual mikes have been working as well so we can actually hear the questions from the audience, a too common problem at so many conferences I’ve attended.
I love the huge Hall 1 but there are maybe a dozen smaller halls where I’ve enjoyed the more intimate setting for smaller group discussions. The lunches have been the best of Indian smorgasboard, a 5 star presentation for the taste. There have been plenty of lounge spaces for colleagial discussions, often what truly makes a conference for me. To be able to speak in person to one of the greats like Marc Galanter or RC Jiloha is so very inspirational.
That said, the real joy has been in the speakers and their presentations, their insights and the evidence based research. Therre were dozens of speakers presenting at the same time in the various venues. Consequently it’s impossible to attend them all though the desire is there. I loved the presentation on the epidemiological surveys. and extent of the problem in India.
India is 1.3 billion people, 80% Hindu but with a major mix of Muslims, Christians Sikhs, Buddhists, Jains, and others. By comparison United States is 330 million and Canada roughly 37 million. There are countless tribes and huge distinctions by areas of the north, south, east and west, with multiple languages despite Hindi being the official language. The joy for me, a Canadian, in India, is that so many speak English so fluently, not just the educated by the common people as well. I love to travel but feel so much safer and understand more when I can understand the people better.
India is a very ancient culture with generally high intelligence, highly educated with multiple languages and broad understanding. The urban centres are 21st century’s yet the rural regions are in places terribly backward.
When I was in Bombay more than 30 years ago that mixture of the space age juxtaposed with the ancient was what so fascinated me. It’s no different today as my experience in Old Delhi showed, rickshaws and motorcycles.
The presenters surpassed themselves in the most prodigious and thoughtful research. Alok Agarwal reported the problem of heavy episodic drinking in the population with it’s strong association with accidents and fighting. Cannabis use was roughly 3% of the populations but mostly men. However it commonly coupled with alcohol or other substances. Opiate use, heroin, opium or pharmaceuticals was roughly 2%. The telling news was that of those with alcohol dependence only one in 38 had received any treatment and one in 180 had received inpatient treatments. When one considers these percentages are of a billion and more, the actual numbers are staggering. The size of the problem in India as it is all over the world being recognised by government and industry. The seriousness of it as a true emergency and crisis is evidence based. The costs are overhwelming, the loss of life and productivity are profound. The surveys show that need and point to where best solutions may be found. Dr. Pramrod Singh and Dr. Atul Ambekar also contributed greatly. Dr. Ambekar pointed out that cannabis and opium had been traditional and recreational with the British regulating this hundreds of years past but things had changed dramatically. The changes in use the rise of heroin and disruption of community and family were all discussed at the conference with insights and solutions offered.
The chairs ensured the various presenters remained aware of the time. Consequently the meeting flowed like a river as compared to some meetings where the meeting has the feel of a big city traffic jam.
Psychiatry is commonly envisioned as a biological, psychological, sociological and spiritual field. So each of these areas were discussed. Advances in learning of the disease of addiction, presentation of neuro imaging and neuro pathways along with the various associated diseases ,such as AIDS, Hep C . This was where individual treatments were discussed with naltrexone, naloxones, suboxone and methadone cutting edge presentations. Psychologically the contributions were more Indian with fascinating insights based on Veda and family changes. At the Social level there were marvellous presentations of treatment centres like Shafa and the whole realm of social psychiatry were discussed. Public health was so important. There was mention of 12 step programs and the loss of the relationships and alienation along with a profound discussion of the Gita idea of ‘attachment’ by Dr. Raju Hejala. He presented that in therapy he was effective in helping his patients see the self as not the drug or the addiction and become detached in their thinking from the addiction.
Dr Khalsa formerly of the NIH thoroughly discussed the whole controversial issue of Cannabis as a medicine pointing out the paucity of research of the standard that the FDA would expect for a compound to be considered safe and effective. To be fair he presented what good had been found and the massive FDA associated research going on to find cannabinoid products that could add to our pharmaceutical tool box.
Dr. Bunt did provide the most humorous sides showing the big business of cannabis in the US with high end marketing and even a psychedelic ‘church of cannibis’ underling that often for many cannabis is more a religion than anything else.
Dr. Nady el Guebaly, Order of Canada recipient and founder of ISAM presented on the need for more research and funding and the history of the rise of the drug problems in parallel to the decline in research funding. The present president of ISAM , Kathleen Brady addressed the issues of the rising crisis..
The Indian Minister the honorable Mr. Gehlot gave a moving speech which was thoughtfully translated and provided in English as a hand out. It spoke so clearly and wisely of the problem and the government commitment
There were hundreds at the conference and I’ve only mentioned a few of the presenters , dozens and dozens speaking to different aspects of the problem of addiction. Dr. Elliott of Birmingham addressed the issue of tobacco use. Dr. Montoya was especially interesting for me in his clear depiction of the problems and solutions. I was impressed to hear the preserntations on gambling and vaping. It really was a solution focused conference. Fascinating hearing the remarkable advances in Korea, Iceland and Nepal just as examples.
I’m missing a presentation now so will shower and get down to more. So much genius in one location. So much hope too. Working in the DTES of Vancouver Canada in the midst of the fentanyl epidemic with so many young people dying despite our best efforts with opiate replacement therapies and abstinence therapies, it can be dreary. Seeing and hearing Mr. Gehlot , an Indian Minister to 1.3 billion people speak so compassionately and seriously about the government involvement was uplifting.
Also I loved seeing the World Congress of Psychiatry, Indian Psychiatric Assocition. Addiction Medicine, UN and WHO representatives at ISAM, all these organizations and more getting together to address this world crisis of immense proportion simply gave me, a lowly clinician, so much hope. I’ve also learned many things I can take back and apply immediately and perhaps make a difference in the lives of my patients who have lost everything to addiction and now are suicidal , chronically and sometimes acutely. For Suicide and Depression go hand in hand with addiction. But seeing the amazing faces of recovery and hearing the heartening successes from around the world was truly inspiring.
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