THESIS SYNOPSIS

DE ADDICTION CENTER
INTRODUCTION:
Substance use disorder is best conceptualized as a chronic, non-
communicable disease. The disorder requires a comprehensive
treatment, delivered by trained professionals, belonging to various
disciplines, in a variety of settings.

In India, The drug dependence treatment sector is still developing and

undergoing refinement. The treatment services for substance use disorder in
India are delivered by three major players1. The first major player is the Non-
Governmental Organization (NGO) sector. There are around 430 drug
dependence treatment centers throughout the country, which are being run by
NGOs, supported by the Ministry of Social Justice and Empowerment,
Government of India (MSJE, 2008). Another major group is the private sector;
many doctors including a large number of psychiatrists are providing services to
people for substance use related problems. The third major group is the
government de-addiction centres2 (―DACs‖). The Ministry of Health and Family
Welfare (MOH&FW), Government of India, has established about 122 drug
dependence treatment centers (or ―DACs‖ as they are called) throughout the
length and breadth of the country (Panda, 2007). Most of these government
centers are associated with either general hospitals at the district levels or with
departments of Psychiatry at certain medical colleges.

HISTORY OF DRUG USE:

The Hindu mythology says that during Amrith Manthan , one of the “14 Jewels”
that the ocean delivered was Varuni- The Goddess of Wine.
5000 BC : The Sumerian people used the “Joy plant “, which is believed to be
Opium.

Smoking of Cannabis is known in India since 2000 BC.

The code of Hammurabi (1792-1750 BC) is the oldest known form of legal code ,
that had regulatory provisions and guidelines for preventing Alcohol Abuse.

King Hammurabi
By the middle of Sixteenth Century, drugs like Cocaine, Tobacco and
Hallucinogens were introduced from America to Europe , in exchange of Wine ,
Cannabis and Narcotics. By the late 19th Century Cocaine kits were readily
available in the western world.

Cocaine Kit

Harrison Act (1914): made the possession of Narcotics without a prescription a

criminal offence.

DEFENITIONS:
Drug use: is simply the ingestion of substance/substances without
experiencing any negative consequences. It may be social use, like in parties;
recreational or experimental use, dietary practice or maybe religious ritual.

Drug Abuse: the use of any substance for purposes other than medical and
scientific, including use without prescription, in excessive dose levels, over an
unjustified period of time.

Addiction: is defined as the repeated use of the substance/drugs to the extent

that the user is periodically or toxically intoxicated, shows a compulsion to take
the preferred substance or substances, has great difficulties in volunteering,
ceasing or modifying substance use, and exhibits determination to obtain
psychoactive substances by almost any means.

Dependence: is defined as, “the cluster of cognitive, behavioral and

psychological symptoms indicating that the individual continues use of the
substance despite the significant substance related problems.
1
2
3
4
OVERARCHING ISSUES AND PRINCIPLES
There are certain overarching issues and principles which must be adhered to
for providing the services. All the Government De-addiction centers should
strive to achieve the following:
Licensing / Accreditation: Ideally a system should be in place which provides
certification or accreditation to a Government De-Addiction centre as an
authorized substance use treatment centre. This issue has been discussed
elsewhere in the monograph. For this purpose, the senior management of the
centre / hospital should take the necessary steps.
Compatibility with existing health services framework: While
planning and implementing substance use treatment services, it is
essential to ensure that these services are compatible with the existing
health care delivery system. A situation is avoided wherein certain
policies and procedures of the De-Addiction centre are at odds with the
policies and procedures of the associated hospital.
Sensitivity and adaptability to local culture: It should also be noted
that the policies and procedures at a Government De-Addiction centre
are sensitive to the local cultural scenario. For this, it is important that
patients and their care-givers are involved not only in the process of
clinical decision making at an individual level, but their involvement
should also be sought for making policies and procedures of the clinic.
Promoting service utilization: All efforts must be made to ensure
that the services on offer are adequately utilized by those in need. List
of services and facilities available should be prominently displayed.
Additionally, opportunities for increasing the visibility of the centre
among the masses (through advertisements in local media, local events
etc.) should also be explored.
A patient-friendly atmosphere: All the services on offer should be
made available to all sections of the society without any discrimination.
All efforts must be made to ensure privacy and confidentiality of the
patients and their families. No procedure – however well-intended –
should be carried out without the explicit consent of the patient. Safety
and security of the patients, their attendants and staff should receive
the topmost priority.
Ongoing efforts for improvement: While the standards listed in this
chapter (and the subsequent ones) should be seen as ―minimum‖
standards, a centre need not stop after achieving them. There should
always be an ongoing process at work to bring about improvement in
services as per the growing experience, changing needs and
developments in the field.
Systems for accountability: Internal monitoring systems should be
developed which ensure accountability at each level. These internal
systems should be linked with the national systems for monitoring and
evaluation (described in another chapter).

THE MISSION AND THE VISION

Providing quality service with utmost dedication, commitment
Sharing skills, knowledge and expertise. Thereby equipping professionals to
spread the concept of care.
Creating awareness so that more and more people make sensible choices
and the number of new drug users comes down
This positive social change to be felt at the

family level
peer level

community level

OBJECTIVES

Providing accurate information

Clarifying myths and misconceptions

Offering methods for early identification, providing motivation,
etc
Equipping trainees with the necessary skills to become
effective trainers

SCOPE
*Aplace to give immense scope to many lost souls who
desperately need to come out of Drug-Addiction and become
normal persons with their own individuality.
*It basically understands people about their long term behavioral
observation and provides them effective treatments.

*This self reliant De-Addiction Centre pronounces to its patients,

the need of becoming a self reliant and a complete human being.

SELF RELIANCE
1. POWER(Electricity)
effectively using Solar Energy)
2. COOKING GAS
3. WASTE MANAGEMENT
4. CULTIVATION (veg/pulse)
Plant (Bio-Fertilizers)
5. FUND GENERATION
fertilizers , Agri.Produce and
6. PROCURENENT of food materials
- Solar Power (by
- Bio-gas Plant
- Bio-gas Plant
- Bi-Product of Bio Gas
- Marketing of bio-
surplus Solar Energy
- Cultivation (Organic)

METHODOLOGY
1) PLAN:
A. Research:

*Drug use and addiction

Drug and Drug use A pharmaceutical preparation or a naturally occurring

substance used primarily to bring about a change in the existing process or
state (physiological, psychological or biochemical) can be called a ‘drug’ When
drugs are used to treat an illness, prevent a disease and improve health
condition, it is termed drug use. Drug abuse and Addiction Intake of drugs for
reasons other than medical in a manner that affects physical or mental
functioning is termed drug abuse. Any abuse can lead to addiction. Tolerance
refers to a condition where the user needs more and more of the drug to
experience the same effect. Smaller quantities, which were sufficient earlier,
are no longer effective and the user is forced to increase the amount of drug
intake.

Dependence – This can be physical and psychological . The person becomes

dependent and starts feeling uncomfortable in the absence of the drug.

Withdrawal symptoms – When the drug intake is stopped, withdrawal symptoms

are experienced. Physical dependence gives rise to withdrawals such as tremors
and vomiting. Psychological dependence causes withdrawal symptoms like
restlessness or depression. The intensity of withdrawal symptoms depends on
the physical condition of the user, type of drug abused, the amount of drug
intake and the duration of abuse.

Classification of Addictive Drugs: ƒ

a. Narcotic Analgesics
b. Stimulants
c. Depressants
d. Hallucinogens
e. Cannabis ƒ
f. Volatile Solvents
g. Other drugs of abuse.

*The Government De-Addiction Centers: Functioning in India

About 122 drug dependence treatment centers (or De-Addiction Centers

―DACs‖) have been established by The Ministry of Health and Family Welfare
(MOH&FW), Government of India. While most of these government centers are
associated with either general hospitals at the district levels (district hospitals
or civil hospitals), some have also been attached with departments of
Psychiatry at certain medical colleges. It is noteworthy that the Union Health
Ministry’s contribution has been largely limited to providing one-time grants for
construction / refurbishment of the buildings. Only a few centers (about 42,
mainly those in the north-eastern states of the country) receive recurrent grants
from the union health ministry. Most others have been dependent on the state
governments for the recurring expenditure (on staff salaries, supplies etc.). It is
understandable that the state Governments may have varying degrees of
health priorities; consequently the funds provided by the state governments
have also been variable in nature.

While so far, there is no regular system in place to evaluate the functioning of

these centers, the Ministry of Health and Family Welfare has been taking steps
to conduct evaluation exercises, mainly through NDDTC, AIIMS and through
NIMHANS, Bangalore. In the year 2002 an evaluation exercise was undertaken
with support from the World Health Organization (India). Again in 2008 – in
response to a parliamentary query – another evaluation exercise was
undertaken. The findings of the evaluation exercise do not paint an encouraging
picture. The findings (see box) have revealed that there is a large amount of
variability in the functioning of Government de-addiction centers. Though, it
must be understood that in light of the factors mentioned above, it should not
come as a surprise.

The organization of health systems in various states and variability of the

available resources – there should be some ―minimum standards of services
available at these de-addiction centers. It must be understood that ―Minimum
may not mean ―Optimum and certainly does not mean ― Ideal. Even after
adoption of minimum standards there may be scope for expansion of scale and
improvement in the quality of services. However, at the least, all centers must
aspire to achieve and to provide minimum standards of care as suggested in
the subsequent chapters of this monograph.
B. Observations:

The use of drugs has a History of more than thousands of years like use of
Opium in 5000BC by Sumerians , Cannabis from 2000BC in India , Tobacco and
Cocaine from 16th century in USA etc . Even introduction of the idea of de-
addiction was introduced by king Hammurabi in 2nd millennium Before Christ.
The Harrisson’s Narcotics Act 1914 engendered it as a criminal offence to keep
drugs in hand without any prescription.

According to World Drug Report 2012 about 230 million people, or 5 per cent of
the world’s adult population, are estimated to have used an illicit drug at least
once in 2010.10-13 per cent of drug users continue to be problem users. The
prevalence of HIV (20 per cent), hepatitis C (46.7 per cent) and hepatitis B (14.6
per cent) among injecting drug users continues to add to the global burden of
disease.

Annual prevalence of the use of alcohol is 42 per cent (the use of alcohol being
legal in most countries), which is eight times higher than annual prevalence of
illicit drug use (5.0 per cent).Approximately 1 in every 100 deaths among adults
is attributed to illicit drug use
India is located close to the major illicit opium growing areas of the world, with-
“Golden Crescent” on the Northwest and “Golden Triangle” on the North–East.
Licit substances (alcohol and tobacco) are the most commonly used
substances. Among the illicit substances , cannabis and opiates are the most
frequently used ones.

“G OLDEN C RESCENT ” AND “G OLDEN T RIANGLE ”

In India , the abuse of alcohol , tobacco and cannabis is not entirely
new . With the introduction of newer drugs and medical remedies, which often
contained cocaine or heroin derivatives, were freely distributed without
prescription. Article 47 of the Constitution of India directs the State

“to regard the raising of the level of nutrition and the standard of living of its
people and the improvement of public health as among its primary duties, and,
in particular, to endeavor to bring about prohibition of consumption, except for
medicinal purposes, of intoxicating drinks and drugs which are injurious to
health.”

The same principle of preventing use of drugs except for medicinal use was also
adopted in the three international conventions on drug related matters, viz.,
Single Convention on Narcotic Drugs, 1961Convention on Psychotropic
Substances, 1971 and The UN Convention against Illicit Traffic in Narcotic Drugs
and Psychotropic Substances, 1988.India has signed and ratified these three
conventions.

Following the Convention on Psychotropic Substances (1971) The Government

of India, Ministry of Health and Family Welfare in 1976 appointed an expert
committee to examine the problem of Drug De-Addiction and suggest future
guidelines. The report of committee was submitted in 1977.The Planning
Commission and the Central Council of Health Ministers reviewed this report in
1979.The recommendations of the report emphasized the need to evolve
appropriate strategies and to bring about better coordination among different
Ministries and Departments working in this area.

The Drug De-addiction Program of the Ministry of Health & Family Welfare was
started in 1985-86 which got modified as scheme in 1994 and once again
revised in 1999.The scope of the scheme was enlarged to include assistance to
State Governments/Union Territories for developing De- addiction Centers in
identified medical colleges/district-level hospitals.

C. U NDERSTANDING :

To create awareness about the ill-effects of alcoholism and substance abuse to

the individual, the family and the society at large.

To develop culture-specific models for the prevention of addiction and treatment

and rehabilitation of addicts.

To evolve and provide a whole range of community based services for the
identification, motivation, detoxification, counseling, after care and
rehabilitation of addicts

To promote community participation and public cooperation in the reduction of

demand for dependence-producing substances.

To promote collective initiatives and self-help endeavors among individuals and

groups vulnerable to addiction.

To establish appropriate linkages between voluntary agencies, working in the

field of addiction and government organizations.

To support activities of non-governmental organizations, working in the areas

of prevention of addiction and rehabilitation of addicts.

The activities to reduce the drug use related problems in the country could be
broadly divided into two arms :

Supply reduction and Demand reduction.

 The supply reduction activities which aim at reducing the availability of

illicit drugs within the country come under the Ministry of Home Affairs,
with Department of Revenue as the nodal agency.
 The demand reduction activities focus upon the awareness building ,
treatment and rehabilitation of drug using patients.

These activities are run by agencies under the Ministry of Health and Family
Welfare, and the Ministry of Social Justice and Empowerment.

The Ministry of Health & Family Welfare is mainly involved in providing

treatment services to the addicts whereas the Ministry of Social Justice &
Empowerment deals with other aspects of the problem like awareness creation,
counseling and rehabilitation. Union Health Ministry’s contribution has been
largely limited to providing one-time grants for construction / refurbishment of
the buildings. Only a few centers (about 43, those in the north-eastern states of
the country) receive recurrent grants from the union health ministry.

Implemented by the Ministry of Social Justice and empowerment , the non-

governmental organizations have been entrusted with the responsibility for
delivery of services and the Ministry bears substantial financial responsibility
(90% of the prescribed grant amount).In case of the seven North Eastern
States, Sikkim and J & K, the quantum of assistance will be 95% of the total
expenditure. The balance of the approved expenditure shall have to be borne
by the implementing agency out of its own resources.

D. Analyze :

Analyzing the basic services, the environment surroundings, the legacy of

existing de addiction centers, etc..
Registration At a minimum level all patients attending de-addiction
treatment services should be registered in a dedicated register and should
receive a unique registration number. This service is linked to record
maintenance and thus patients‖ unique registration number should be reflected
in all the records of the patient. While most hospitals (of which the de-addiction
centers are a part) are expected to have a central registration system, the de-
addiction registration number should be separate from the hospital
registration as this would be important for monitoring and evaluation purpose.

Outpatient services
Given the dearth of the specialist medical human resources in the country, the
de-addiction services would have to be provided by doctors who may be either
General Duty Medical Officers (GDMOs) or medical specialists / physicians.
While these doctors may encounter many patients with substance use disorders
in their routine ―general‖ clinics, such patients should be referred to /
encouraged to attend, the exclusive and dedicated outpatient clinic for
substance use disorders. Thus all hospitals with Government De-Addiction
centres should offer an exclusive outpatient De-addiction clinic. The expected
patient load would determine the frequency of this De-addiction outpatient
clinic; it may vary from daily (i.e. on all working days) to once/twice/thrice a
week. Following services should be available in a De-addiction centre at
outpatient level:

Assessment: All patients should undergo clinical assessment (i.e.

history taking and examination) by a trained and competent doctor. The
assessment should be geared at making a clinical diagnosis (as per the
ICD-10 or DSM-IV guidelines) as well as formulating a treatment /
intervention plan. For the purpose, adequate infrastructure should be
available ensuring comfort and privacy for the patients.
Counseling / psychosocial interventions / psycho-education: All
patients (and their attendants, if available and only if the patients agree
to involve them) assessed by the trained doctor, should receive
Counseling / psychosocial interventions / psycho-education, as per the
clinical needs. For this purpose it would be necessary to involve a
trained medical social worker / counselor / psychologist.
Treatment prescription: Every patient should receive a prescription of
the treatment advised to him. If the procedures for dispensing involves a
dispensing slip, that may also be provided to the patient.

The outpatient services should have provisions for both – the new patients as
well as for the old patients on follow-up.

In-patient treatment Patients who require in-patient treatment

should be admitted in a dedicated ward which is exclusively meant for
this purpose. Thus, each hospital with a government de-addiction centre
should have an exclusive, 10-bedded de-addiction ward. While the
duration of the in-patient treatment may vary as per the individual
needs of the patients, all efforts must be made to provide the in-patient
treatment for an adequate length of time. During the in-patient stay,
following services should be made available to the patient:
 Assessment by the doctor(s): At least once per day during the
morning rounds.
 Availability of nursing care: round the clock
 Availability of emergency care (on call doctor): round the clock
 Psychosocial interventions
 Medicines
O For treatment of withdrawal symptoms
O For management of associated conditions / symptoms
 Food
 24 hours assistance by a by-stander
 Facility to meet visitors during the specified visiting hours
 Access to facilities for recreation: newspapers, television (if
available), indoor games

While there may be certain restrictions during the inpatient stay (i.e.
restrictions on bringing certain items inside the ward / restrictions on
movements outside the ward etc.), the whole treatment should be provided
only with the explicit informed consent of the patient. The patient should have a
right to leave treatment (against medical advice i.e. ‘LAMA’), any time of the
day.

Dispensing of medicines Pharmacotherapy plays the central role in the

treatment of substance use disorders. All the patients seeking treatment from
de-addiction centers should have access to the following medications – free of
cost – from the dispensary. In addition, the centre should strive to also make
available medications listed as ―Other medications‖, though they have not
been put on the essential list.

Emergency Services In those de-addiction centers which are a part of

the general hospital, the emergency de-addiction services may be
provided by the emergency department of the hospital. While most such
emergency set-ups have provision of doctors / nurses and necessary
supplies, these should be geared towards providing emergency services
related to substance use disorders. The emergency set-ups should be
geared to handle emergency situations commonly encountered in the
area of substance use disorders viz. acute intoxication / overdose,
withdrawal syndromes, adverse drug reactions etc. Laboratory
services All the de-addiction centers should have access to basic
laboratory services. It is not necessary that these services be
established exclusively for de-addiction patients but these services may
be incorporated with laboratory services of the general hospital.
Specifically, the facilities for the following investigations should be made
available:
 Routine Hierogram i.e. Hb, TLC, DLC, ESR, Platelets
 Liver function tests i.e. Serum Bilirubin , AST, ALT, Serum Alkaline
Phosphatase , γ-GT
 Routine biochemistry: Blood Sugar, Blood Urea, Serum Creatinine,
Routine Urine chemistry
 HIV screening: through linkages with associated ICTC
 Chest X ray
 ECG
 Additional services (if possible): Ultrasound abdomen, Urine
screening for drugs

Psychosocial interventions All centers should be equipped with

facilities to provide psychosocial interventions at both the levels of care:
Outpatient and In-patient and in both the settings: in group settings and
in individual settings. Family members must also be involved in
psychosocial interventions as much as possible. While the specialized
psychotherapies may be out-of-scope for most of the centres, trained
manpower and other facilities must be available for the following
psychosocial services:
Basic psycho-education about the nature of illness, important of
treatment adherence
=Motivation Enhancement
=Reduction of high-risk behavior
=Brief Interventions
=Relapse Prevention
 =Counseling for occupational rehabilitation

Referral / Consultation / Linkages While a comprehensive

treatment program should address multiple needs of the patient, no
single de-addiction centre alone can provide all the services a patient
requires. Consequently, it is imperative for the centers to establish and
maintain referral and consultation linkages with other facilities and
services. The important ones are:
General and specialized medical services: for associated co-
morbidities. Since the de-addiction centers are a part of the general
hospital, it is expected that many of the specialist medical services
would be available. For any associated symptoms / medical condition,
appropriate referral or consultation from the concerned speciality must
be sought. This is especially important for conditions like HIV/AIDS
(linkages with ART centre), Tuberculosis (linkage with DOTS centre) and
psychiatric conditions (linkage with nearest psychiatric facility or District
Mental Health Program – DMHP).
Paramedical staff (such as ASHA, Health worker, ANMs,
Anganwadi workers etc.): These are the paramedical staffs that are
usually expected to be in close touch with the community. If these staff
members come across out-of-treatment drug users in the community,
they can motivate the drug users to seek treatment at the Government
De-addiction centre and provide referral.
NGOs in the locality: It is well known that most substance users are
unable to access treatment services for a variety of reasons. If there are
NGOs in the locality working with substance users the centre should
strive for establishing linkages with them, so that NGOs could identify
the out-of-treatment drug users in the community and encourage them
to seek help at the Government De-addiction centre. Similarly after the
early phase of treatment is over from the Government De-addiction
centre, NGOs could help the patient in social / occupational
rehabilitation

Record Maintenance: Maintenance of clinical records is a very

important aspect of the functioning of the centre. It is not only
necessary for adequate clinical care of a patient at the individual level,
but it is also necessary for monitoring and evaluation purpose at the
program level. The following records should be maintained by a centre:
Individual patients file: This should be traceable by a unique
registration number. A system should so develop that, once the patient
is admitted and discharged, his/her in-patient treatment record is also
incorporated in the out-patient file. Thus upon picking-up a patient’s file,
one should be able to assess the entire treatment history and progress
of the patient in a chronological order. At each instance of patients‖
follow-up in OPD, the file should be retrieved, presented to the clinical
staff (doctor / counselor), in which necessary clinical notes should be
entered. All the records related to the patient (Investigation reports etc.)
should be attached to the file.
Drug Abuse Monitoring System (DAMS) proforma: At every
instance of first registration in the de-addiction clinic, the doctor /
counselor should fill up this proforma . Periodically, these proformas
would be collected by a designated central / regional centre, and would
be used to analyze the profile of patients seeking treatment.
Medication dispensing records: These should be maintained very
stringently since some of the medications used for treatment possess
abuse liability and risk of diversion. A system should be developed which
would make each unit of medicine entering into the stores accounted
for. After dispensing, the patients should be asked to sign the receipt of
the medications.

2) DESIGN :

E) Case Studies
 TTk Hospital of Drug De Addiction , Chennai
 Hope Trust Alcohol and drug de-addiction center , Hyderabad
F) Business Process
A business process is a collection of linked tasks which find their end in the
delivery of a service or product to a client. A business process has also been defined as a
set of activities and tasks that, once completed, will accomplish an organizational goal.
i. In-patient care Services
 Detox
 Comprehensive medical Assessment
 Psychiatric assessment
 Orientation
 Daily Yoga and Meditation
 Mindfulness training
 Individual counseling
 Daily AA/NA meetings
 Input sessions
 Emotional Management Group sessions
 Audio and video input
 Family Interventions and meetings
 Psychological Interventions
 Psychiatric help
 Relapse Prevention
 Psycho Education
 External Support
 Making Goals
 Communication Exercises
ii. Out- patient care services
 Marital counseling
 Parental guidance (teenage, adolescence, behavior issues)
 Pre- and post-surgery counseling
 Grief counseling
 Conflict management
 CBT for anxiety and depression
  CBT for mood disorders
 Mindfulness and meditation training
iii. Online Patients Care
The sessions are taken by our experienced and qualified therapists who are
equipped to handle issues such as:
 addictions
 anxiety
 depression
 bipolar relationship issues
 adolescence
 parental problems
 other emotional problems

G) WIREFRAME:

Wire frame represent the built form in which only lines and vertices
are represented .Here a basic sketched site plan is shown.

H) DESIGN CONCEPTS:

Designing an environment for rehabilitating drug addicts needs sensitivity and a

better understanding of their situation. Here the issues of primary concern are:

 Can our architecture contribute to this healing process? - with the quality
of our outer space helping to modify our inner psychological space and
with the help of nature
 Can our design enhance human interaction and reduce the isolation?

While discussing the brief with the clients, the clients explained the importance
of being connected for the patients there. Being isolated increases their
depression and their craving. Therefore the design attempts to create as much
transparency, openness and fluidity of space to help in the healing, correcting
process.
A small, enclosed landscaped amphitheatre in the Centre, breathes light and joy
into the building while helping the inmates to connect with each other and the
staff there.

The building is functionally easy to monitor with only one controlled entrance.
The increased visibility because of the transparency makes this supervision
easier. A balance has been struck between a sense of freedom and disciplinary
control.

This architecture attempts at raising a sense of belonging and sharing between

the users and therefore indirectly causing recoveries.

3) DEVELOP

1. DESIGN HANDOVER :

The Design Handover is the stage where client and the designer
(architect) sign the Design Transfer Agreement and the designer transfers
the finished design files to the client.

J) COMMUNICATE:

An essential communication shall be made between the architect and the

client on the basic facilitations , building design , landscape features etc..
which are important for an effective produce.

K) MONITOR:

Clear observation and checking the progress or quality of the structure over the
constructional period of time and thus ; keep under a systematic review of it..

L) VISUAL DESIGN:

Graphic/Visual design is the process of visual communication, and problem-solving

through the use of type, space, image and color. The field is considered a subset
of visual communication and communication design, but sometimes the term
"graphic design" is used interchangeably with these due to overlapping skills involved.

4) DEPLOY:
M) USABILITY TEST:

Usability Inspetion testing is a technique used in user-centered interaction

design to evaluate a product by testing it on users. This can be seen as an
irreplaceable usability practice, since it gives direct input on how real users use the
system.[1] This is in contrast with usability inspection methods where experts use
different methods to evaluate a user interface without involving users.

N) VERIFICATION:
 The verification of the Usability test is done in this process . A positive result
in the conclusion of the verification can prove the the mental feeling of an
admitted patient , his collaboration with the surroundings and the
qualitative provisional requirements.

O) DESIGN QUALITY CHECK:

The Quality or Standard of the design will be reviewed. It would be further

made clear that the basic standards of the building are compatible for the
given site and climatic conditions.

P) APPROVAL:

The approval of design gets finalized by the end of the verification and
design quality check. Once approved , it’s the permission to start building
the the structure.

DETAILED CASESTUDIES

1. TTK HOSPITAL FOR DE ADDICTION

General Features:
Location : Chennai
Founded : 1980
Area : 4.4 Acres
Address : 17, IV Main Road, Indira Nagar,
Chennai, Tamil Nadu -600020. India.
Facilitated For : Recovery of patients from
Alcoholic , Licit and illicit Drug Addictions.
Accommodation for : Almost 70 patients (in-patients)

Basic facilities provided

in the hospital
Detoxification unit
General wards
Special rooms
Family wards
Canteen
Pharmacy
Recreation center / gymnasium
The T.T. Ranganathan Clinical Research Foundation was founded in
1980 with a desire to help people struggling specifically with addiction to
alcohol. Since then, it has expanded to a 65 bed treatment facility in
1987 and has helped over 20,000 individuals with alcohol addiction and
drug addiction. The TTK Hospital’s vision is to rehabilitate patients
through in-house treatment and also focus on helping patient’s families
realize that addiction is a serious problem. Patients receive the help they
need first through detoxification, and psychological therapy, which
consists of both individual and group therapy. The TTK Hospital also has
 a unique part of the program which requires families to participate in
therapy for 14 days. After completion of the 25 day program , patients
can continue counseling multiple times a month for 2-3 years to help
with the progress of living a more healthy life.

Occupational Services provided:

Tailoring
Computer course Package services

2. Hope Trust Alcohol and drug de-addiction center , Hyderabad

General Features:
Location : Hyderabad
Founded : 2001
Area : 1.5 Acres
Address : Hope Trust , Plot No. 471,
Road No. 87,Jubilee Hills, Phase 3,Hyderabad - 500
033,Telangana, India.
Facilitated For : Recovery of patients from
Alcoholic , Licit and illicit Drug Addictions.
Accommodation for : Almost patients (in-patients)

Hope Trust is one of the Asia’s leading treatment facility for addictions –
alcoholism, drug abuse, gambling and dual diagnosis. Hope Trust rehab
has earned an international reputation for its commitment toward safe,
confidential and effective treatment. Clients and their families from all
over the world come here for treatment.
The abstinence based recovery program is 12 Step oriented, with CBT,
Yoga, meditation and expert medical and psychiatric inputs. Inpatient
and outpatient options offer intensive programs including relapse
prevention and follow-ups.
The Family Support Program provides constructive support and care for
the whole family. Hope Trust is affiliated with leading treatment providers
worldwide and works with several organizations and government
agencies in India and abroad.

Facilities
Hope Trust's facilities are housed in serene and upmarket area to make
your stay comfortable, and fruitful. We have well appointed bedrooms,
entertainment, recreational and fitness facilities to help you with
recovery without feeling removed from your daily activities. Relaxing
environments that will help you focus on getting better, happily!
1. Spacious air-conditioned rooms
2. Attached bathrooms with hot water
3. Cosmopolitan Indian Veg / Non-Veg Menu
4. Modern air-conditioned class room & seminar hall
5. Table Tennis, TV Lounges, Indoor Games
6. Laundry Service
7. Rooftop sit out
8. Gym
8. Recreation spaces
Location
Hope Trust is located in pollution-free and serene environs of Jubillee
Hills at Hyderabad, India. It is in close proximity to two major corporate
hospitals and a psychiatric institute. Hyderabad is a modern, tourist-
friendly city, well connected by road, rail and air to the rest of the
country. It has high quality and economical medical facilities.
The fellowships of Alcoholics Anonymous, Narcotics Anonymous and Al-
Anon have strong presence here, providing support for long-term
recovery. Hope Trust clients attend these meetings regularly during and
after their stay at the treatment centers.

SITE INFO:

Location : Judgekunnu , Thiruvallam ,

Trivandrum , Kerala , India
Area : 3.19 Acre
Altitude : 400 feet apprx from sea level
 SITE PHOTOS

Entrance to Judgekunnu from Thiruvallam-Karumam road

Ghat Road
Ghat Road 2

Reaching Hilltop

Village in the valley

Hilltop reached

Entrance to the proposed site

Proposed site I
Proposed site II

Proposed Site III

Zenith of the Site

Panoramic view from the hilltop

Lush Greenery Around

The city skyline

Karamana River flowing around the hill

Terrain Texture

Terrain - Laterate soil

Proximity to Airport

View from Arabian Sea

The Sunset