Beyond Loyola

Beyond ‘Tokhang’: The challenge of rehabilitation

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Published September 9, 2016 at 6:56 pm

Just 20 days into the Duterte administration, more than 114,000 people allegedly involved with drug use have “surrendered” to the police as a result of Oplan Tokhang. In this operation, individuals suspected to be involved in drugs are summoned and warned by authorities.

Rehabilitation is a crucial yet costly part of the drive against drugs. Given the sudden influx of drug dependents who need rehabilitation, concerns on the country’s readiness to meet this need have arisen.

A place like home

According to the Dangerous Drugs Board (DDB), there are 45 accredited rehabilitation centers around the country, 18 of which are government-run and 27 privately-owned.

One of latter is the Crossroads Treatment and Rehabilitation Foundation, Inc. in Antipolo. It currently serves 49 residents, all of them male. Residents stay for a minimum of eight months while undergoing the rehabilitation process. After their stay, residents are required to enter an aftercare program for two months before being considered a graduate.

Ryan* and Dave*, two residents now on the last stage of the program, explained Crossroads’ rehabilitation process.

The first stage, which they referred to as pagtanggap at pagsunod (acceptance and following), involves getting the resident to understand their current state. Both residents spoke of an activity called “pull up” where they gather, share, and discuss their personal feelings with one another. These sessions would be recorded and then passed on to the staff who would gauge over time if residents are ready to be promoted to the next stage.

Upon reaching the second stage, residents are assigned to their own mentor called “Big Brother.” Residents who have reached this stage are expected to know how to handle themselves and should be more adjusted to life in the center.

The center starts incorporating the resident’s family into the recovery process in the third stage. Relatives or guardians would be permitted to visit every Sunday for a group counseling session with the resident. A mediator joins them to guide them throughout the session. Residents are also granted minor responsibilities that they have to do on a daily basis.

In the fourth and final stage, residents are given major responsibilities to develop their leadership skills. Residents would also have to create their own action plan that they would implement once out of the center. This would help them avoid a potential relapse.

Another center in Antipolo, the Center for Christian Recovery (CCR), also has four stages in its rehabilitation process. Red Garcia, who has been a resident, described the process as “Christ-centered” and “hands-on,” saying that the center’s spiritual roots make it special. Garcia says that the center helped remind him that God exists and he is loved.

“It treats us na God exists and mahal ako ng Panginoon (God loves me). God exists, and I matter to him. Importante ako sa kanya (I am important to Him),” he shared.

The first stage, called the Primary Rehabilitation Stage, focuses on the rehabilitant’s need to find peace with God. A foundation for a peaceful relationship with God is developed and the rehabilitant eventually makes the decision to entrust themselves into his care.

Upon achieving this, they move on to the second stage called the General Recovery Stage, which focuses on establishing peace within the self. The residents are also encouraged to take responsibility for their own behavior, including letting go of past resentments.

The third stage, the Re-entry Stage, focuses on rebuilding relationships, as well gaining peace with others. Residents are granted the opportunity to practice the discipline of making amends with those they have hurt, such as family and friends.

Finally, the Aftercare Stage emphasizes the resident’s recovery of purpose. Residents are encouraged to keep and maintain the peace to avoid relapsing.

One reason for the success of both centers’ rehabilitation process is how residents are made to feel as if they were at home rather than just at a treatment center. “Para siyang bahay na nagpapahinga ka (It’s like a home where you can rest),” Dave says about Crossroads.

Lack of supply

Despite their success, privately-owned centers like Crossroads and CRR are unable to accommodate more people, especially those who come from less fortunate backgrounds.

Mahirap silang pumasok dito sa mga private. Sa public naman, di nila kaya i-accommodate. Kasi kahit sa public, meron bayad, eh. (It’s hard for them to enter private centers such as these. Even in public, they can’t be accommodated. Even public centers require payment),” Garcia said.

With rehabilitation centers generally relying on the residents’ monthly payments to cover expenses such as food and employees’ wages, Garcia says that public rehabilitation centers are all the more not prepared to accommodate the sudden increase of people in need of them.

In response, there have been initiatives proposed by government officials. AKO BICOL party-list representatives Rodel Batocabe, Alfredo Garbin Jr., and Christopher Co filed House Bill 132 which seeks fair distribution of drug rehabilitation centers around the country. The aim is to make treatment more accessible to the poor and marginalized.

Batocabe told the Manila Bulletin that only a few thousand out of the 1.3 million estimated drug users in the country fully undergo rehabilitation because of high costs, which range from Php 60,000 in a government-run facility to Php 150,000 in a private facility.

For its part, the Department of Health (DOH) aims to secure a Php 1 billion budget from the Philippine Amusement Gaming Corporation to set up more centers around the country.

According to the Philippine Star, DOH would need Php 270 million for recovery initiatives of the surrendered drug-dependents. The budget for this is expected to triple in 2017.

DOH is also planning to include the acute phase of rehabilitation as part of PhilHealth’s insurance coverage. At this phase, patients receive “active but short-term treatment for their condition.” However, it is unlikely that PhilHealth will shoulder succeeding phases of rehabilitation because of high costs.

While these initiatives are still on the drawing board, some parts of the country are already trying to come up with their own solutions. The City of Manila recently introduced a new community-based rehabilitation program in its different barangays. Tacloban City has started a five-day spiritual seminar for drug dependents in lieu of the city’s lack of rehabilitation centers.

Taking initiative

However, some drug dependents who have gone through rehabilitation still end up relapsing and being sent back. According to statistics from the DDB for 2014, 772 out of the 4,060 admitted were readmissions.

Garcia, who has been a drug dependent himself, explained that one of the many reasons why relapse occurs is idleness. Based on the same DDB report, 48% of total admissions were unemployed.

Kung wala silang trabaho, marami silang idle time. Kailangan meron kang structure (If they don’t have jobs, they have lots of idle time. You need to have a structure),” he said.

The entire process of recovery requires not just the proper rehabilitation facilities and processes but also constant support, follow up, monitoring, and more so, the user’s own will to recover.

Dave shared that while the process was able to help them recover gradually, “95%” of it came from his own personal initiative. “It’s up to you if you’ll choose to go back or to continue the life you built,” he said.

*Names were changed to protect their identities.


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