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We report a case of repeated self-injurious behavior. Self injury to the operated eye had resulted in complete loss of vision in one eye. This case illustrates multiple challenges posed to the treating teams managing the causes and consequences of such self-injurious behaviors. [ABSTRACT FROM AUTHOR]

Opioid dependence is a significant clinical and public health issue in India. Opioid substitution therapy (OST) is the most evidence-based treatment for opioid dependence. Although available in India for about three decades now, Indian research on this treatment modality has not been adequately reviewed so far. We conducted a narrative review of Indian research on OST. We conducted an online search for relevant literature in the peer-reviewed journals as well as the general online search for books and monographs. We present the findings of the review in the form of description of literature according to certain identified themes. Considering that methadone has became available in India, only recently, the Indian research on OST predominantly features buprenorphine as the agent. Effectiveness of OST among Indian opioid-dependent patients has been well established through prospective, experimental designs as well as through naturalistic studies using retrospective, chart-review approach. Naturalistic and observational postmarketing surveillance studies have demonstrated the safety of buprenorphine and methadone when used as OST. There are certain areas in which more research on OST will be beneficial for Indian clinicians as well as policy-makers. However, the quantum of evidence base that exists in India is more than adequate to justify the scale-up of this modality of treatment. A conducive policy environment for scaling-up OST is need of the hour. [ABSTRACT FROM AUTHOR]

Introduction: Exposure to alcohol in popular movies during adolescence is associated with higher rates of alcohol use. We aimed to assess the extent and pattern of depiction of alcohol in Bollywood movies, and to analyze the trends in portrayal of alcohol over three decades selected for the study. Materials and Methods: We selected the top five grossing movies for each year of the three decades selected (1961–1970; 1981–1990; and 2001–2010). Content analysis was conducted for each scene depicting alcohol in the movie. We compared quantitative variables across the three decades to assess for any changes in the portrayal of alcohol and performed qualitative content analysis for the text description of the context, in which alcohol was depicted in each movie. Results: Of the total 150 movies analyzed, 135 (90%) movies contained at least one scene depicting alcohol. Alcohol scenes comprised 7% of the total movie time. Majority of the scenes (92.2%, n = 976) showed the substance (alcohol) itself. Spirits were the most common alcohol beverages depicted (75.1%, n = 733). Only 7.9% of scenes (n = 84) depicted alcohol brands. About 67% (n = 709) of scenes showed characters consuming alcohol or appeared intoxicated. Most scenes portrayed hero (n = 253, 35.7%) consuming alcohol. Female characters were depicted in 7.5% (n = 53) alcohol scenes. The third decade (2001–2010) had the least proportion of scenes depicting Spirits and the highest proportion of scenes depicting beer and wine. Decade three also had the most proportion of scenes set in clubs, bars, discotheques or restaurants, scenes with characters of "positive" shade depicting alcohol use, and the scenes portraying heroine with alcohol use. Conclusion: There is an increasing trend toward alcohol depiction by positive characters for fun and relaxation, and toward depiction of low-concentration alcohol such as beer in recent decades. The impact of changing trend of alcohol depiction on the Indian viewers, especially young audience, needs further study. [ABSTRACT FROM AUTHOR]

The Mental Healthcare Act (MHCA), 2017, is enacted with an aim to promote and protect the rights of and improve the care and treatment for people affected by mental illness in India. The Act purportedly includes substance use disorder (SUD) specifically in the definition of mental illness itself. However, some of the phrases used in the definition such as "abuse" are not clear, as the current classificatory systems of mental illnesses do not have any diagnostic category termed "abuse." Another important issue is the lack of clarity on which categories of SUD would be covered under MHCA. Simple reading of the text of the Act seems to suggest that SUD is a single entity for the purpose of this law. In such case, many provisions of the act such as supported admission that are meant for the treatment of people with severe mental illnesses with gross impairment may become applicable to all types of SUD. This can create potential problems for addiction treatment providers. On the other hand, certain other provisions of the Act are good news for patients suffering from SUD. The Act lays down various rights that include, among others, protection from cruel, inhuman, or degrading treatment in any mental health establishment. This is very important from the perspective of treatment of SUD in the context of India, where human rights violations in the name of addiction treatment are often reported. The inclusion of SUD in MHCA, 2017, slots SUD as a health issue, rather than a law-and-order issue alone. This displays the intent of policymakers toward SUD, which, in itself, is laudable. There are certain ways in which the potential pitfalls mentioned earlier can be addressed, which is discussed in the article. [ABSTRACT FROM AUTHOR]