Hello I am 23 Year old male. I used to to chew gutkha but now I want to quit it. I used to chew 20 to 30 packets a day but from last 2 days I only used 2 to 3 packets in a whole day. I do not want to chew that too but one of my friend told me that leaving completely will do side effect is this right? And the other question is that I have some white cuts or only marks on both side in my mouth. But do not have any type of pain or any difficulty in talking or eating. Do I need to worry about that or is it normal? Thank you waiting for your response.

Dr. Sajeev KumarGeneral Physician32yrs exp

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These white patches are warning signs of trouble and you must stop gutka and can chew bubble gum when you feel the craving 

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Dr. Jagadeesan M.S.Psychiatrist13yrs exp

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The white marks are early signs of mouth cancer, called leukoplakia. Kindly stop gutkha immediately. Consult a psychiatrist so that while stopping you do not develop withdrawal symptoms and to treat the craving. All the best, do not delay. 

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Dr. Chayanika SarmaPsychiatrist10yrs exp

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Gutka is a substance of abuse. It is a dry preparation, that consist of betel leaf, areca nut, tobacco, catechu (extract of the acacia catechu tree) & slaked lime, with sweet or savory flavorings. Due to its stimulant activity, gutka is used as a recreational drug. As it is a harmful product & do not have any beneficial effect on the body, you better quit it as early as possible. Now-a-days de-addiction treatments are available for quitting all substances of abuse including gutka. Such treatment includes detoxification & rehabilitation program. Consult a psychiatrist & start your treatment at the earliest. With treatment you can quit the gutka immediately & you will not require the gradual reduction of the quantity of gutka, as advised by your friend. Medical detoxification is the first stage of de addiction treatment, when the addicted person is treated with medicines. The withdrawal symptoms which occur on sudden stopping of an addictive substance are managed through detox treatment. Medical detoxification systematically and safely will withdraw you from the gutka. The next phase is the Rehabilitation program which includes counseling sessions & other behavioral therapies. These sessions have important role in the de addiction process. Counseling sessions will help to enhance your motivation skills to stay sober, build skills to resist gutka use, replace gutka-using activities with constructive and rewarding non gutka-using activities, and improve problem-solving abilities. Behavioral therapy will work on interpersonal relationships and your ability to function effectively in the family and community. Detoxification is usually completed within 7-10 days & can be done both on out patient basis & as in patient. Rehabilitation program usually ranges between 30-90 days. Along with, mentally prepare yourself to stay away from gutka. Following measures will help you to prepare yourself mentally against the substance: oEducate yourself adequately regarding gutka & its ill effects. Acquire the required information by reading books, going through internet or talking to a professional trained in de addiction. OKeep reminding yourself of the benefits you will achieve after quitting gutka: ?After quitting you will have reduced risk of the many diseases caused by gutka including oral cancer and a variety of other medical conditions like heart attack, respiratory, cardiac depression, hypertension, reproductive health dysfunction etc. ?Your teeth will be saved from the unpleasant stains. ?Your mouth will be saved from the bad odor caused by gutka. ?Any sores or ulcers in your mouth will heal well. ?You can focus more on your relationships. Taking gutka might have affected your relations if your close ones were against it, or because you were so preoccupied with the substance, your relations suffered. ?You can participate actively in social gatherings as you will not have to stay away to hide your habit nor have to come out frequently to chew gutka. ?You will save the money you were wasting on gutka & use them for better purposes. OImagine & create a picture of a beautiful future in your mind of a life without gutka. Imagine how much you will benefit in your new life. In between your beautiful imaginary picture also imagine that you started to take gutka again. Then imagine how one by one the beautiful picture will shatter. Once you become aware of the consequences of relapse, you will also develop fear of relapsing. You will then stay more cautious not to start it again. OCount the first day of your quitting as day of a new start & from that day, live one day at a time. It is helpful if you can relate this day to some important events in your life like your birthday or birthday of someone close, anniversary, day of some achievements etc. On the morning of the second day, tell yourself that you are starting the second day of your substance free life & by night time thank yourself that you stayed substance free whole day & encourage yourself to stay gutka free in coming days too. Celebrate your victory of staying sober on completing 1 week, 2 weeks, then 1 month, 2 months, 3 months, and on completing one year celebrate the first birthday of your sobriety. This will encourage you to stay sober further. OAvoid triggering factors that may tempt you to take gutka. For example if the triggering factor was internal say some stress for which you got inclined to abusing substance, then work on the stress to remove it or take help of a counselor to overcome the stress. If the triggering was external, like some friends persuaded initially & you could not say no, in some specific event or situation you started taking gutka etc, then stay away from those situation. OImmediately after quitting, craving will be intense. But gradually with time it will reduce. So the initial days you have to be very careful. Keep yourself busy & diverted. OThrow away all gutka you have with you. Having them within reach may increase your temptation. You can use alternatives like lozenges or chewing gum. OStart new healthy habits & opt for a healthy lifestyle. OEat healthy diet. OJoin a support group comprising of people who came out of addiction & had undergone the same situation as you. You will get a platform to discuss your queries & together can motivate each other to stay sober & also help others to overcome addiction. Start your effort to quit gutka at the earliest. All the best. Regarding the white marks on your mouth, get yourself examined by a doctor. He will advice you the necessary investigations & give treatment if required. 

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