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Duterte's War on Drugs Stumbles in Rehabilitation Effort

23 Apr 2017 11:00 am
By Jake Maxwell Watts 

MANILA -- The government of Philippines President Rodrigo Duterte is giving up on supersize drug rehabilitation centers, shifting the burden of treating addicts to community-level programs with little medical expertise.

Rehabilitation was the other half of Mr. Duterte's bloody war on drugs, a crackdown that has claimed the lives of more than 7,000 people and targeted four million addicts whom the president has said he would "be happy to slaughter." Nearly 1.3 million addicts and dealers, told they need to surrender or face a similar fate from vigilantes and police, have presented themselves for compulsory rehabilitation.

Treating the flood of self-confessed users presents a monumental task for the government. Its retreat from supersize rehab centers, a major pillar of its rehabilitation efforts, adds to criticism that the drug war is focused on extermination rather than healing.

One reason the government is reversing course is that far fewer people than expected have been classified as sufficiently drug-dependent to be sent to the centers -- an indication to some that the president has overstated the country's methamphetamine epidemic, a drug known locally as shabu. The impoverished country has also struggled to fund its rehabilitation programs, another reason, along with the siting of centers far from patients' families, that admissions have been low.

The government's flagship facility north of Manila, financed by a Chinese businessman and intended to eventually hold 10,000 addicts, has only 179 patients. The existing building, finished last year in the project's first phase with a capacity of 500, won't be expanded, according to government officials.

"I don't suppose that we will be continuing with the concept of mega rehab," John Castriciones, undersecretary for operations at the Department of the Interior and Local Government, told local media this month. Mr. Castriciones's department, which oversees community rehabilitation, didn't respond to requests for comment on the policy change.

The government says it will still use the rehabilitation centers for the most severe addiction cases, but the vast majority of people surrendering to police will now get help from community leaders, who mental-health experts say are ill-equipped to serve them.

Ronnie Taguba, the head of a small community, known as a barangay, of about 4,000 people in Manila, is one such leader. Most Sundays, Mr. Taguba rises at 5 a.m. and goes jogging around the cinder-block and corrugated-iron houses of his neighborhood, followed by around 30 wheezing drug addicts. At other times, he holds zumba sessions, followed by a period of Bible study.

"We talk to them and say it's hard to go to jail," said Mr. Taguba, who supports the president's drug war. "We give them protection, but say if you continue to use drugs, you will go to jail."

After surrendering to police, self-declared drug addicts are triaged into groups by a medley of health workers, psychiatrists and doctors, based on their behavior during interviews. The most severely addicted are confined in government rehabilitation camps, run by medical professionals, where they participate in a recovery program involving strict daily routines.

Delfin Gubatan, who runs a government rehabilitation center in Dagupan, north of Manila, said all residential patients at his 300-bed facility complete their course and 76% of them remain drug-free in the 18 months after completion. Courses typically last six months or more.

The government said last year it would increase the budget for rehabilitation by five times to three billion Philippine pesos ($60 million) in 2017. No figures are available for the security costs involved in Mr. Duterte's war on drugs.

The president in public has largely focused on police efforts to rid the country of shabu drug addicts and dealers. Government officials routinely say the country has as many as four million drug users, although the Philippines' Dangerous Drugs Board counted 1.8 million drug users in the 100 million population in a 2015 study.

The campaign's carnage has been decried by opposition parties, the country's Roman Catholic Church and human-rights organizations, but hasn't dented the president's approval ratings, which consistently poll as high as 80%. Supporters say he is ridding the country of a scourge that has destroyed families and fueled corruption.

Guilermo Gomez, a recovering drug addict who is a program director at Bridges of Hope, a private rehabilitation center in Manila, said the government needs to broaden its approaching to treating drug abusers.

"You have to attend to the survivors," he said, noting that successful rehabilitation requires the government to deal with the social issues that lead to addiction, like poverty. "We can rehabilitate a million -- we can -- but not instantaneously. Not in three years."

Psychiatrists warn that many of the local community methods of rehabilitation such as exercise classes are ineffective when dealing with drug addiction no matter how much money is being spent.

"In the Philippines now everyone is an expert in addiction," said Fareda Flores, president of the Philippine Psychiatric Association, who said she is concerned about reports that misguided local leaders are resorting to publicly shaming drug addicts as a treatment method. "We believe that addiction is an illness, a disorder, so there is really no benefit from that kind of treatment."

Write to Jake Maxwell Watts at jake.watts@wsj.com

(END) Dow Jones Newswires

April 23, 2017 07:00 ET (11:00 GMT)

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