Friday, February 12, 2016

A SENSE OF PLACE AND DRUG ADDICTION

For The Bohol Tribune
In This Our Journey
NESTOR MANIEBO PESTELOS

As readers of this column know, the year-long advocacy that something be done about the
serious drug addiction problem in the province led in the dying hours of last year to the establishment of Bohol’s first drug rehabilitation center in Upper Laya, Baclayon. Two noted drug rehab facilities, the Family and Recovery Management (FARM) facility in Minglanilla, Cebu and the It Works Chemical Dependency Treatment Center in Ozamiz City, both of which we visited in the course of doing research on the operations of such facilities, both agreed to combine technical and funding resources to establish what is now known as the FARM It Works Balay Kahayag (FITWBK) center.

FITWBK utilizes facilities of the ten-year old Balay Kahayag Training and Retreat Center used previously by our NGO, the Bohol Local Development Foundation (BLDF), as venue for training project participants, mostly disadvantaged households and groups, from remote mountain and outer island communities. These poverty groups have been our primary targets for development information and assistance for over thirty years starting with the now defunct UNICEF-assisted Ilaw International Center (IIC) located in Bool, Tagbilaran City.

In addition to their having high levels of deprivation, these groups, mostly subsistence farmers and sustenance fisher folks, inhabit ecological sites, such as watersheds and large portions of marginal land, as well as near-shore areas, all considered as vulnerable to environmental threats and degradation due to adverse climatic changes.

This initial awareness about the role of geographic space in determining priority development targets has led me for as long as I can remember to adopt the so-called area-based perspective in my development work rather than take a purely sectoral approach. Simply put, it will not do to know only, for instance, how many are the malnourished children as part of a national database, but it is more important to go down to the local level and know the specific family to which the child belongs and the community where the family lives. Knowledge about where a problem exists, broken down to specific barangays and puroks, as well as households, is a necessary component of an area-based approach. 

Applied to our current advocacy to assist young drug abuse victims from indigent families so they can have access to treatment services at the FITWBK, it is just logical to think there is a need for a detailed database indicating where they live and other details which can help map out an effective strategy to provide a full range of pre-treatment, treatment and post-treatment services to specific individuals and groups.

All these can help the Government and other sectors to implement a comprehensive package of services for the prevention and full rehabilitation of drug abuse victims. That phrase “other details “ in the previous paragraph I may have to elaborate in the light of new learnings about how the place factor impacts on human behavior.

I read for the nth time a book, The Power of Place, written by Winifred Gallagher, and I now that phrase “other details: in a significantly different light. There is simply too much to learn about how a place influences the way we behave. Let me share a few insights from the book, which is subtitled “How our surroundings shape our thoughts, emotions and actions.”

On page 134 of the paperback edition, Gallagher writes: “Although we usually think of drugs when we hear of the word addiction, the term applies to our habitual or compulsive devotion. Much of the strength of that devotion, whether to a person, an intoxicant, or a pursuit, comes from the environments of our past and present which hover like ghosts beneath the surface of our awareness, haunting us and our behavior.”

Then the author says on the next page: “If the drug is the spider of addiction, it more and more seems that the settings in which it is used comprise the web.”

He then quotes another authority, Susan Weis, who says: “We have a lot of intricate data on drugs and what they do to this or that receptor in the brain, but very little of it helps explain their effects on abusers. . . There’s more to addiction than chemicals and personal psychology, because we can detox someone who is highly motivated to change, and he can still fail. The missing dimension is the environmental factors that precipitate drug use.”

Weis further says: “Our brains are so adapted to make associations with the environment that whether we want to or not, we think our experiences and their settings, and those two together produce the behavior.”

Author Gallagher then explains: “… the groundwork of addiction – the getting-to-like-it stage is laid in the representational memory system. Later, the associations made with drugs move over to the habit system, far less accessible to our conscious interventions. There, all sorts of sublimated cues can trigger the urge to get high, which makes kicking a drug habit difficult even for the well-motivated.”

He describes what seems to be a typical scene involving a drug addict: “He walks into a certain hangout frequented by his drug-using friends, and their faces and the music, colors, light, and smells all spell ‘high.’ Because his positive associations with these cases are locked into his brain by a potent chemical reinforcer … “ even the sight of his paycheck will prompt a powerful involuntary urge to use drugs because paychecks mean a binge,” according to Weis, as quoted by the author. The author concludes this chapter by saying: “One reason traditional addiction program have had such a poor track record is they have largely ignored the role of the environment. He then quotes Shepard Siegel:

“Treatment should involve systematic exposure to drug-related environmental cues without the reinforcement of getting the drug, so the addict’s body learns not to give the anticipatory reaction. The best treatment of all remains the geographical cure. Studies from all over the world show that after a year, most of those who don’t relapse after drug treatment have relocated. The new environment may not even be drug-free or even seem very different – it could be another ghetto, for example, but it’s free of the cues associated with use for that person.”

We hope academic institutions in Bohol with its Psychology departments will come forward and partner with FITWBK and BLDF in conducting studies on the impact of environment on the behavior of drug abusers. Researches are needed on practical issues such as  how best to manage environmental influences to ensure the full  rehabilitation of drug abuse victims and their integration into normal community and family life.

Lastly, I would like to thank Fr. Val Pinlac for being the first to visit the FITWBK and see for himself what is still needed to make the facility fully operational. He was allowed to meet with clients for what he described as a “most enlightening” session. Last Sunday, he endorsed and hand-carried a proposal prepared by BLDF for submission to an international NGO, the For A Better Tomorrow (FBT) which will provide subsidies for an initial batch of 35 clients.

I would like also to thank Luigi Rulida and three other members of his team (Jayson Rey Sayson; Isidro Macabenta; Josephine Sarigumba) all Architenture students from the Bohol Island State University (BISU) who volunteered to design a nature-friendly facility to complement FITWBK on the same location. For comments, email: npestelos@gmail.com


NMP/12 Feb 2016/5.21 p.m.                                                                                                                                                                                                                                                                                                              

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