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RAPID, A Momentous Event

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Rehabilitation, Alternative Programs, Interventions for the Treatment and Prevention of Illegal Drug-Dependence (RAPID) Response Summit was a 2-day event proposed and organized by Civil Society Organizations (International Youth Council, Lingkod Bayani, Civika Institute, Bridging Cultures) and the Asian Development Academy. These partnered with government institutions (the Department of the Interior and Local Government, the Philippine National Police, the Local Government Academy), and the Philippine Business for Social Progress, a corporate-led social development foundation. The forum was conducted at the Philippine National Police Training Center in Camp Crame, Quezon City on September 13 and 14, 2016. The Director of the PNP Training Service, PC Supt. John Sosito gave the welcome address. Most of the participants were Police Officers 3. There were only a few non-police participants.

Joey dela Cruz, a student of the Bachelor of Science in Social Work program had invited us to the event. Four Asian Social Institute (ASI) professors and heads of units participated. Dr. Erlinda Natocyad (Kahingalay and Research), Dr. Erlinda Natulla (Master in Social Services and Development), Dr. Susan Reyes (Kahingalay), Dr. Elsa Ruiz (Master of Science in Social Work, Master in Science of Social Work Transnational Education in Vietnam) attended together with some of the Master in Social Services and Development students (Hasna Adang, Robert ZawZaw Aung, Tual Sawn Khai, Kem Sarom, Nhory Saratt, Swe Zin Oo and Sr. Vincentia). We had looked forward to an informative and inspirational program. We were not disappointed. The Summit was referred to as “a leadership module.” The policy theme referred to especially for the government agencies was the response to the concern about the use of illegal drugs as “a war to be pushed to its utmost bounds” from July 1 to December 31, 2016 (a period of six months).

The Hon. Secretary Benjamin Reyes, the Chair of the Dangerous Drugs Board (directly under the Office of the President) who gave the first talk informed us that as of 2013, 92% of the Philippine barangays were “affected.” That is, these villages had drug-users and also in some, drug-pushers who are also drug-users. The latest information was that there were already 700,000 plus drug-users who surrendered all over the country. Sec. Reyes clarified that some 1% of these figure would require in-patient services while some 2% would need out-patient programs. The majority (some 90% plus) are assessed as needing community-based programs. He referred to drug addiction as a chronic and relapsing disease that includes brain disease (brain cells are destroyed). He referred to the existence of 16 government and 27 non-government treatment and rehabilitation centers. Five regions have no rehabilitation centers at all. The major government centers are in Bicutan and in Tagaytay, both of which are overpopulated already. He outlined intervention as detox, then a primary program, aftercare, and other support services. He identified four modalities for helping drug dependents: a therapeutic community program, the Minnesota model which also has 12 steps and would have 12 participants per group, a faith-based approach, and possible combinations of the three modalities.   The algorithm for intervention is Initial Screening using standard guidelines for cases of simple drug abuse and this is done by the Rural Health Units at the level of the Local Government Unit. For medium risk cases, intake is done. If assessment shows low behavioral risk and would not really be problematic, community-based intervention is to be done. Some 1% would be high risk (violent to themselves and/or to others) and would need a second assessment by a team which would include a physician, a psychologist, and other professionals). These are the ones who need to be in special in-patient facilities.

Sec. Reyes also referred to some other developments as the Department of Interior and Local Government about to launch the formation of antidrug councils starting from the lowest political unit this month of September. The Department is also planning to put up four mega rehabilitation centers. Since this is not practical, these can be divided into therapeutic communities and groups. For minors, 15 years old and below, their first contact should be the local Department of Social Welfare and Development units or its local equivalent. The Department of Health also has already downgraded funds to the local government for the concern.  The police should have the lists of drug users who are to be convinced to undergo rehabilitation programs. He underlined the nurturing role of the policemen that they are to provide help as well as challenge and hope.

PC Sup. Rene Pamuspusan gave some updates announcing the increase of patrol operations. He mentioned that there are now 144,202 persons who are in the watch list, a list that is constantly updated. He referred to illegal drugs as one of seven focus crimes. He identified the police strategies as demand reduction, supply reduction, community involvement, legal offensive, and international cooperation. He explained the PNP’s “double-barrel” approach. The upper barrel is “Project Tokhang (Toktok – Hangyo or Knock – Persuade / Request)” the focus of which is to obtain biographic data targeting both user and pusher, using persuasion, then to refer to the Local Government Unit. The second barrel is to focus on High Value Targets who are pushers whose area of operation transcend more than one municipality; and is purely a police operation. He mentioned these figures: 6,256 arrested users and 10,372 arrested pushers giving the figure of 16,628 as total arrests. A total of 1,496 were killed during operations.

Two professional social workers contributed to the formal sharing: a social worker from the Tagaytay national government facility and one from the Caloocan City local government social services unit. The Tagaytay facility is now serving 300 drug dependents. It uses a tripartite approach, one that encompasses the body, the mind, and the spirit. The therapeutic community is the key agent for healing where there is peer transformation along the lines of a self-help model. There is 12 months residential treatment with 2 months for adjustment. Four to six months is used for individualized approach starting with focus on why the person became an addict. A multi-disciplinary team composed of physicians, psychologists, social workers and counselors work in the facility. They also have Alternative Learning System from elementary to high school. In fact, the patients also do outreach to orphanages and attend concerts. Part of the preparation for re-entry is family counseling and trial entry to the person’s original community which is a probationary period. After-care program includes vocational training from TESDA. There is also experience enhancement using religion and deepening of moral values. The Caloocan LGU has 2,000 surrenderees to get amnesty. They get profiled by the daycare teachers, and then there is drug abuse screening (history, physical exams, and mental status evaluation) by a team of helping professionals. The individual assessments are the bases for recommendations whether they are to be sent to the Tagaytay Rehabilitation Center or are for other interventions.

One of the most instructive sharing came from a client of the Tagaytay facility, now an adult volunteer who started use of shabu when he was only 12 years old. His initial entry into the facility dormitory was involuntary due to a court order from the Regional Trial Court. After almost a year he was discharged, but after a week he was using drugs again. His peers in their neighborhood were also drug users and drugs were easily made available to him. He would abuse his wife who was his co-dependent. Finally, he feels he was actually graced when his eldest 15-year old son begged him to go back to the facility. He asked for God’s intervention and finally made a choice, a self-decision to go through further treatment and rehabilitation. Finally, in 2012, he decided to also volunteer to counsel and motivate other patients in the facility. When asked what he perceived as the cause of his drug addiction, he was very clear that it was his nuclear family dysfunction – a father who was an overseas Filipino worker and who would come home but would go first to his other family before he was somehow available to their family. He had craved for his father’s warmth and love which was not available for him. His peers who were drug users were just enabling factors in his immediate environment. The primary cause seems to always start in the immediate family while factors in the environment are only secondary. He has seen a 20% relapse rate at the facility whose policy now is only to accept the patient at most two times. The spiritual program is being intensified and during the recovery portion, the family is also included.

One of the speakers, a clinical psychologist defined addiction as a craving to the sensations associated with the use of a drug or substance that s/he is addicted to. Being a cognitive behavioral therapist, she has opted for the use of alternative state of consciousness through breathing and meditation exercises, an approach she also demonstrated with us (an approach quite familiar in the ASI community).

A speaker from Caritas Manila was also listed in the program, but was unable to come. A member of the Makati City Anti-Drug Council also spoke. Also as a member of the Christ Commission Fellowship, he discussed their program in partnership with the Department of Interior and Local Government, Simula ng Pag-Asa (SIPAG) for both dependents and co-dependents. He pointed to the addictive use of computers, drugs, and alcohol as coping mechanisms. He also named family dysfunction as the main cause of addiction. They use a faith-based approach within the framework of Restore – Reconnect – Release which is some 70% successful. It has 4 sessions for family-focused topic, 4 sessions for recovery, and 4 sessions for overcoming temptations.  In these sessions (using the large group and the small group), forgiveness is worked out, relationships are strengthened, and realization that drug addiction is just a by-product of a dysfunctional family is evolved. Value formation is along the lines of God’s design for families, forgiveness, and rebuilding trust in the family. Realizing the need for God,¬¬ the approach also transforms the family and community from spiritual poverty and moral corruption.

Dr. Elmer Soriano of Civika Institute was the over-all facilitator and took over the latter part of the Summit. He used structured learning exercises such as scenario building. His synthesis included underlining the leadership roles of the participants beyond their work area. A hopeful result of the Summit is that participants were motivated to get more involved in efforts to help out in the efforts regarding drug addiction, a national concern.

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