5 years into Duterte administration, facilities to treat drug users still not enough

MANILA - Five years into the Duterte administration's "war on drugs", the Philippines still does not have enough facilities to treat and rehabilitate its drug users, based on the figures revealed by the Department of Health.

During the virtual National Substance Use Science Policy and Information forum, DOH Program Manager of the Dangerous Drugs Abuse and Treatment Program Dr. Jose Bienvenido Leabres said there are only 4,840 authorized bed capacity in 64 drug rehabilitation centers around the country even though there are 16,751 individuals with severe substance use disorders.

"We need this 2021 additional 11,911 beds. Once we have the DOH accredited its own facilities, we will have to add an additional 1,282 beds, decreasing our gap to 10,629," he said.

The 16,751 persons who use drugs (PWUD) is just 2% of all the 1,679,122 PWUD in the country, based on the Dangerous Drugs Board figures in 2019.

They are defined as those who are taking drugs "regularly or compulsively using drugs, and dysfunctional already, unable to provide or go to work, go to school and with poor family conditions" and may have medical or mental conditions related to their substance use.

Around 90% of that, or 1.59 million, are considered mild substance users, while the remaining 5% or 67,000 cases are considered to have moderate substance use disorder or those persons that are considered "functional but have been regularly using drugs.

Those with milder or moderate forms of substance abuse will be treated differently or may require to go to outpatient facilities.

However, outpatient facilities are not enough as well.

"We are looking at a gap between 240 to 468 additional outpatient facilities to be able to serve more or less 60 thousand out-patients," said Leabres.

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But the health department stressed it is addressing these gaps by implementing the "Philippine Health Development Plan".

The plan includes putting up an outpatient treatment and rehabilitation clinic (TRC) per province, encourage local government units to put up their own clinics "if they can afford it", as well as putting up 1 inpatient TRC per region and 4 Apex rehab centers nationwide to cater to training of personnel, monitoring, evaluation and development of services.

The DOH also plans to incorporate the health care provider network in the Universal Health Care, and help amend the Dangerous Drugs Act to allow easier access to voluntary and evidence-based research.

ILLEGAL DRUGS PREVALENCE

Despite government efforts, prices of drugs remain stable while quality increased with the use of technology, not only in the Philippines but across the Southeast Asian region.

Even the COVID-19 pandemic has not stopped the drug trade.

"Traffickers regrouped, reorganized in identifying new roles and seizures continue. A big portion of the shabu in the Philippines.. come from Myanmar," said UN Office on Drugs and Crime senior policy officer Olivier Lermet.

Around 80% of 42,045 barangays in the Philippines are also considered "drug-affected", where 6 of every 100 Filipinos are "lifetime users".

"We need to review how issues related to the consequences of drug response solely based on conventional criminal justice and law enforcement system is holding up," said DDB permanent member Usec. Benjamin Reyes.

This includes not only full implementation of existing laws but intensifying services that would allow better treatment and rehabilitation programs for drug users. he said.

SUGGESTIONS

To enforce more effective rehabilitation programs, Family Wellness Center Foundation executive director and addiction specialist Reniel Cristobal suggested veering away from the common misconceptions of drug use like peer influence, boredom or moral failings.

"To some, this is a form of temporarily organizing an otherwise disordered life," said Cristobal.

"It is so important for us to make them feel that they are not on their own, we are not here to hurt them."

Faith, religion, new challenges, new non-using friends, new environment and providing creative challenges are some effective ways to help them overcome their addiction.

"We need to start helping these people how to start filling empty spaces in them," said Cristobal.

PhilHealth, the country's health insurer, should also provide an extensive package catered for drug users to benefit them "for the entire continuing care, from community-based rehabilitation programs to outpatient programs and to inpatient programs" while expanding "online services for concerns relating to substance use", he said.

Right now, PhilHealth provides a P10,000 worth of one-time detoxification benefit package, which includes physical, mental, neurological exams, urine tests, complete blood count, blood sugar, serum, X-ray, ECG and creatinine tests.

The DOH plans to incorporate the Health Care Provider Network in the Universal Health care, provide easier access to voluntary treatment by amending RA 9165, and continuing research.

It also developed their substance abuse helpline 1550 to provide information, referral and intervention for those who need it.

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