Part 1
THE government’s Nixon-like war-on-drugs stance has prompted users and sellers of narcotics to surrender.
The influx of the number has equally prompted public-health officials and executives from other concerned agencies to perform their mandate to provide treatment and rehabilitation to help drug users recover from the devastation of drug addiction.
According to physician Alfonso Villaroman, the Department of Health (DOH) has launched a series of community-based training programs for those who surrendered after Mr. Duterte declared his own version of the war on drugs.
To note, the “War on Drugs” was first used by US President Richard Nixon in 1971, who declared illegal drugs as “America’s public enemy No. 1.”
Villaroman, chief program officer of the DOH in Camp Bagong Diwa in Taguig City, said in a news briefing the agency’s role in this war began after thousands of Filipinos, mostly poor, surrendered to police and local officials.
He said in a forum, spearheaded by the Philippine College of Physicians (PCP), public-health officials held a series of meetings, led by Health Secretary Paulyn Jean B. Rosell-Ubia, to strategize plans.
The result of those meetings led to the identification of three pillars, Villaroman said at a restaurant in Quezon City. He cited these pillars as assessment, diagnosis and referral; treatment and rehabilitation, whether it be residence-based or nonresidence-based; and, after care and follow up.
The key here, Villaroman said, is the handling and management of “patients” in their respective community setting.
We need the participation of the community if we want this program to succeed, Villaroman said.
Treatment centers
VILLAROMAN said there are 44 rehabilitation centers, both private and government, nationwide. He added that there are only 14 treatment centers that are under the DOH.
Of the centers under the DOH, three provided only out-patient services “and the rest are both in-patient and out-patient.”
Data from the Dangerous Drugs Board (DDB) revealed there were 5,402 reported admitted to drug rehabilitation and treatment facilities last year.
Of this number, 4,325, or about 80 percent, were new admissions, while 1,077, or nearly 20 percent, were readmitted to residential facilities.
The majority of the total reported cases from residential facilities were males: there is only one female for every 14 male cases, the DDB statistics revealed.
According to the DDB, the mean age of these “patients” is 31 years old and nearly half (49.13 percent) declared their civil status as single. Only 28.34 percent reached college-level education, while the majority (53.20 percent) said they were unemployed.
Nearly half of these cases (43.89 percent) reported their place of residence within the National Capital Region “prior to their rehabilitation,” the DDB said. Nearly 19 percent (18.59 percent) and 17.27 percent of the centers’ clients came from Region 4A and Region 4B, respectively.
Around 49 percent (48.85 percent) of the reported cases belong to the 15 to 19 age group. Almost 59 percent (58.52 percent) have taken drugs two to five times a week, while nearly 21 percent (20.64 percent) said they take it on a daily basis.
The average monthly family income was pegged at P10,172 ($219).
Methamphetamine hydrochloride
(shabu) remains to be the primary drug of abuse among center clients, with 96.74 percent of the total admission, followed by cannabis (marijuana) at 24.94 percent and cocaine with 1.11 percent, according to the DDB.
“The nature of drug taking remained to be poly-drug user [abuse of more than one drug],” the DDB said. “The routes of administration are inhalation/sniffing and oral ingestion.”
Training trainers
VILLAROMAN said it was in 2015 when the DOH began formulating an intervention program for illegal-drug dependents.
He said the formulation of the program was in coordination with different stakeholders and government agencies, as mandated in Republic Act 9165, otherwise known as the Comprehensive Dangerous Drugs Act of 2002.
Villaroman said the first step the DOH took to address the influx of potential patients from the thousands who surrendered was to train the physicians who would handle the cases.
He said the first batch of participants in the training were doctors from local government units (LGUs) in the National Capital Region, and which was held on August 2. The four-day training sought to strengthen the knowledge of doctors in making an assessment of the drug dependent, he explained.
Besides doctors, the training program will also cover social workers so they can determine the type of assistance and referrals that should be provided among drug-abuse patients belonging to the indigent sector.
However, he said only a fraction of the 160,000 who surrendered will be covered by the rehabilitation program.
“Because if you will take probably a hundred patients, not all of them will need to be entered into rehabilitation or residential rehabilitation program for that matter,” Villaroman said. What happens is, the “bulk of these patients will not need to undergo residential treatment,” because they are either motivated or their case would not require intense rehabilitation, he added.
“These provide the rationale for the community-based training,” he said.
Identifying, intervening
ACCORDING to Villaroman, once the doctor determines the level of addiction, the physician will immediately classify what type of intervention is needed.
The assessment will also determine if the patient needs to be treated as out-patient, provided with counseling by a psychiatrist, or is required to be referred to a mental-health institution or facility, wherein his or her condition can be managed.
“It depends on the program that the treatment center implements,” he explained. “In our setup, we use the modality called therapeutic community. It is a structured type of modality using peer pressure—a way for them to mitigate [the impact of] change.”
Villaroman explained the principle behind this is to put a person in an environment that will enable him or her to act out behaviors that are socially acceptable.
“And what are socially acceptable behaviors? Waking up early, cleaning after yourself, cleaning yourself, exercising, doing job functions, working, cleaning your house and everything like that,” he said. “Kakasunod mo nang kakasunod nito, nagiging part ng iyong pagkatao [Every time you do this and becomes a routine, these things become part of your personality].”
Brain disease
VILLAROMAN said physicians and social workers would try to change drug dependents “by changing their behavior, their actions.”
“Addiction is a disease. It’s a brain disease,” he explained. “It is brought about by imbalance of chemicals in the brain because of chemicals that you put in your body. Nagkakaroon ng [There occurs a] long-lasting effect.”
Villaroman explained addiction “is not curable because once na gumamit ka, naroon na sa memory mo [Once you use it, the drug becomes part of your memory]. The chance of you using again is always there.”
He said the health workers’ purpose “is for you to be sober and for you to avoid using again.”
“When you use dangerous drugs and you became an addict, [it] does not mean you become an addict forever. You can become a normal person again,” Villaroman said. “But the chance of you being an addict again is always possible.”
Admit everyone
Ubial has said she is keen to the idea of Philippine National Police Director General Ronald M. dela Rosa to use government-owned islands for hosting victims of drug abuse.
“Madali iyong gawin ng mga military kung kailangan [The military can easily establish one if needed],” Ubial said. She added that the centers could have makeshift tents and put cot beds inside these.
These centers could also be more secure and we can focus on the patients, Ubial said.
“But whether they are on an island, we will still do our job,” she emphasized. “We will teach those persons who will be assigned in the area.”
Ubial clarified the DOH would only provide technical assistance in the centers on these islands. “We will not be there for operations.”
She added that the DOH is prepared to accommodate surrendering drug users in the government’s drug-rehabilitation facilities.
“We will not refuse any ‘surrenderee,’” Ubial said. “We [will] admit everyone and provide them with the necessary medical attention.”
Image credits: Nonoy Lacza