Indian J Psychiatry Close

Figure 1: The structural, state-level, "Pyramid model" of de-addiction services in the health sector proposed for the State of Punjab (the "Punjab model"). The "pyramid" has a broad community base for early identification at the primary care level, detoxification and relapse prevention at the secondary care level, and comprehensive management for more difficult cases at the tertiary care level. It is important to note that a patient can enter the system directly at any of these levels. The three tiers of the system must have continuous "cross-talk" and communication up-and-down the pyramid ("vertical communication," represented by the vertical arrows) as also parallel linkages with other agencies and organizations whenever available or feasible ("horizontal communication," represented by the sideways arrows) at all the three levels.

Figure 1: The structural, state-level,