Thursday, July 28, 2016

FROM SURRENDER TO RECOVERY


        For The Bohol Tribune
In This Our Journey
NESTOR MANIEBO PESTELOS

Judging from Facebook posting and emails from friends and colleagues, keen public attention has shifted from the rampant killings going on in Bohol and the country as a whole to concern about what to do with the hundreds of drug users  who have surrendered to the police and turned over to their respective families.

In Bohol, some 23,000 surrenderees were reported as of this week,  but no plan has been announced so far on how to handle this number of drug users so that they can be given appropriate treatment to prevent them from reverting to their old ways. The same waiting-game situation seems to exist in other provinces. Aside from the announcement by Pres. Duterte that military camps will be used as drug rehabilitation centers, no detailed plan has been presented yet at national and sub-national levels.

 It is obvious that making drug users sign a pledge not to sell or use drugs will be ineffective if steps are not taken to provide them adequate psychological inputs or the necessary treatment protocol to ensure that brain damage which results from repeated drug use will not lead to their committing crimes or anti-social acts.

In previous columns, I have reported on suggestions given by drug addiction professionals who attended a series of consultations we have arranged on how to deal with this increasing number of drug users turning themselves in to police authorities. Just based on common sense, drug abuse therapy being not our field of specialization, we have suggested the need for assessment of each drug user’s status to determine appropriate intervention required.

Now we continue to report on feedbacks or suggestions received from our friends through FB and email as response to our appeal for more information on how to deal with surrenderees, a matter of concern to LGUs, civil society organizations and many individual families in the province.
We have posted on FB and make available through individual emails to friends in Government and NGOs, including faith-based organizations and academic institutions, a summary of suggestions given by friends and development colleagues.

I have reprinted in full the strategy proposed by Miriam Peguit-Cue, Chairperson, Professional Regulatory Board of Psychology, Professional Regulation Commission (PRC), and made it available to others through social media and emails. In last week’s column, however, I dealt only with the section on recovery supports, where she talked about what could be done at community and family levels.

I assumed that her recommendations on what to do at national and provincial levels were read by those concerned for possible inclusion in the strategy being formulated on how to deal with the 23,000 drug users and pushers virtually given provisional amnesty by the police and the national government.  

In an earlier email dated 14 July 2016, Miriam Cue, who is also consulting psychologist at the New Day Recovery Center (NDRC) in Davao City, gave a list of what could be done at municipal level while waiting for a national program to be put in place to complement the current drive to plush out drug users and pushers and get them to pledge to change their ways.

1.       Information drive. Conduct advocacy campaign to build awareness and concern. Destigmatize addiction and mental health issues. Help local residents understand that these people [drug users] need help, not condemnation to enlist their support.  Work out a platform to build a real therapeutic community where community members help each other and all those who surrendered towards wholeness and wellness. 

2.       Mapping. Identify the community's treatment capacity.  Identify and determine the needed resources and what can be provided by the LGU and the community itself in terms of treatment services and psycho-social support. She says they have  few "graduates" of NDRC who are now in recovery, and have reintegrated themselves into the community. They can be trained them to become support buddies and recovery coaches.

3.        Outreach Services. Make contact. Build linkages. Reach out to the clients and identify essential support services in the locality. Establish directory of resources and services. Connect client, support groups and service provider(s). Identify local resources we can tap and facilities we can use for outpatient treatment.

4.       Client Registration and triaging, including the screening and assessment of those who surrendered. We already translated ASSIST (a screening tool for alcohol, smoking and substance use) into the vernacular (local dialect) to facilitate more efficient and effective use. We need to triage the client population to determine the type of treatment they need.

For those considered to be in the low to moderate risk and addiction severity, brief intervention will be provided. Those found to be of high risk and addiction severity will be subjected to more thorough assessment using the Addiction Severity Index (ASI) which we are also translating for trained workers to use. She says she will conduct the training myself.

5.       Expand Brief Intervention in the Primary Care Setting. Many of those who surrendered may not require intensive treatment or psychosocial report in a residential or outpatient facility.  Many will only require brief interventions. Nurses and other medical professionals in the municipal health clinic can be trained on screening and intervention... Young entry psychologists and counselors can be trained and enlisted to assist with the case loads. Consider to enlist and engage volunteers from the church and civic-religious organizations to build on the momentum of these people who are seeking change.

6.       Capacity building of workers and volunteers to provide brief intervention, coping skills training, coaching and guidance, psycho-education, and support to families. This will be provided by NDRCs trained clinical staff with me and Jay coordinating things.

Separate trainings should be provided for those involved in a) primary care (case managers, counselors and clinicians);  b) screening, assessment and brief intervention (nurses, social workers and other professional volunteers);  c) psychoeducation and information drive (teachers, church workers and other volunteers) and d)  for recovery coaches as well.

I think this proposed actions are doable at municipal or city levels if there is sufficient political will and available funding to carry out the specific activities required. Perhaps, with Miriam’s support, a pilot project in several municipalities can be implemented and documented to formulate the tools and approaches and the various systems required to cope with the overwhelming number of surrenderees that we have all over the country today.

Our resource person, who is originally from Baclayon, recommends the holding of a conference “to unify professional trainers, clinicians and service providers along with concerned government bodies towards one direction... one end.”

I think this recommendation can be done as a national initiative if the Government will identify the lead agency for this  program to address the overwhelming number of identified drug users waiting for interventions either by way of counselling or outright rehabilitation program.

Meanwhile, a network of 7 drug rehab centers in the Visayas and Mindanao will hold a conference in Bohol on 01 August, Monday, to formulate strategies to work effectively with LGUs and other sectors in addressing the recovery needs of the surrenderees. Also in the agenda are matters related to the operations of the FARM It Works Balay Kahayag (FITWBK) Chemical Dependency Treatment Center jointly managed by Rene Francisco of It Works Chemical Dependency Treatment Center in Ozamis City and Jimmy Clemente of Family and Recovery Management (FARM) center in Minglanilla, Cebu.

I continue to receive feedbacks from friends mostly through Facebook encouraging us to go on with this journey to help address the challenge of having this great number of identified and self-confessed drug users in our midst.

We all lack resources but I think we need not wait for the big program to come to be able for us to help. What we need at this stage will be a mobile team trained to work with drug users and their families, help establish family bonding, facilitate assessment of the drug user’s condition and help provide appropriate services and interventions towards recovery.

Perhaps the drug rehab centers, the Government, as well as bilateral and multilateral donors, can help relevant Government agencies and NGOs recruit and train such mobile teams as initial efforts to move the current process from surrender to recovery.

 For comments, email: npestelos@gmail.com.


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