An Analysis of the Drug Treatment Situation in the Philippines and the Role of the Parole and Probation Administration in Developing a National Model of Community-Based Drug Program

By Dr. Fernando B. Perfas

Recent statistics on drug prevalence and the number of drug users in the Philippines placed the figure to be about 1.8 million. Other authorities dispute this figure claiming that the number is too conservative. For a country with about 80 million people there are roughly about two drug users for every one hundred Filipinos, an epidemic proportion. Like its Asian neighbors, amphetamine type substances (ATS), in combination with marijuana and other psychotropic drugs, are the drugs of choice among users.

Let us assume that of the total number of drug users about a million require formal intervention in the form of custodial care and rehabilitation services. Even with a conservative estimate, the available beds in government-operated rehabilitation centers are just a drop in a big bucket. Treatment beds in the Philippine National Police’s (PNP) NARCOM center in Metro Manila, Cebu City, and other satellites could, at most, accommodate 2,500 clients.  The National Bureau of Investigation (NBI) centers in Tagaytay, Cagayan de Oro City, and Cebu have approximately a combined 600 beds. The rest of the available beds are from a small number of provincial government initiated treatment centers which have a total of about 300 beds. There are treatment services offered in some prisons operated by the Bureau of Prisons (BUCOR) and the Bureau of Jail Management and Penology (BJMP) with an estimated 200 beds. These programs, however, suffer from chronic lack of funds and adequate facilities and administrative support from the prison authorities. A very optimistic estimate provides only about 4,000 beds in various government agencies including the prisons and jails. Of course, there are several privately operated drug treatment centers that offer good services, but for a good amount of money much beyond the reach of the average Filipino family. These programs have, in general, small bed capacities.  

Here are the sobering realities, which many of us are aware but tend to overlook in making a bold analysis of the drug problem:

1. Many, if not the majority of chronic drug users, end up in the criminal justice system either through incarceration or probation. The majority of them have brushes with the law not once but multiple times as long as their drug habits continue. The implication: one will eventually find most chronic drug users in jails or prisons or on probation.

2. The magnitude of the drug problem requires the mobilization of both government and the community to make an adequate response to face the threats posed by this problem to the security, economic, health, moral, and social wellbeing of the country. The situation is grave, but the government is bogged down by political, economic, social, and rampant problems of corruptions in all levels of government. This leaves the common people to take action.   

3. The majority of probationers or parolees who continue to engage in drugs and crimes will eventually go to prison. Again, only drug treatment intervention in the prisons and jails can drastically reverse this situation. However, our prisons and jails are not equipped to provide drug rehabilitation services. In most cases, jail or prison experience only exacerbates and escalates drug abuse.

4. The development of adequate and meaningful rehabilitation services in the Philippine Prisons and Jails lags light years away from what is needed now to stem the tide of drug abuse. Even when the prison and jail authorities finally decide seriously to implement treatment in prisons, the logistics, administrative, and personnel constraints are simply beyond their organizational capabilities.

5. The PPA has the largest captive drug users living in the community among its clientele more than any other agency, a significant vector of intervention. This is a silver lining because the PPA, as an arm of the criminal justice system, is one of the most developed in Southeast Asia. It also has the legal and social responsibility to serve justice, protect society, and restore offenders their rightful place in society. Its community-based approach to treatment of probationers and parolees will skirt the often suffocating bureaucracy, corruptions, and inefficiency that characterize most institutional services.   

6. The magnitude of the long-term consequences of this crippling problem on the youth and the country’s ability to compete in the world market are beyond us to prognosticate. For sure, the serious drug abuse problem will continue to render the poor poorer and drain the economy for lost work and productivity, opportunities, human resources, crimes, medical costs, and human lives.

U.S. Funded Training

Since the early 1990’s, the U.S. government through the U.S. Department of State’s Bureau for International Narcotics and Law Enforcement Affairs (INL) has been providing funding for Daytop International to conduct training on the applications of the therapeutic community in drug treatment. In the first four years, the Dangerous Drugs Board (DDB) coordinated the training of personnel selected from various government and non-government agencies.  The planning for this training was somewhat diffused resulting to very little observable impact among recipient organizations.  In the latter part of the 90’s, a training agreement was made between Daytop International and the Philippine Parole and Probation Administration (PPA) with the participation of the DDB to coordinate a training program to introduce and bolster the TC in several government agencies that included the PNP NARCOM, NBI, BUCOR, BJMP, DSWD, and the Parole Board.  A handful of selected personnel from privately operated TC’s were included in this training. As a result of the training, several frontline staff from government operated drug programs learned how to operate a TC program and improved the treatment implementation of TCs in their agencies. In addition, TC programs were started in some   prisons and jails. Perhaps the greatest beneficiary of the training is the PPA, which adopted the TC in their outpatient operations and incorporated TC principles in their work with probationers and parolees.

Impact

Cursory assessments of the impact of the INL/Daytop training indicate that existing TC programs in government agencies, such as the PNP and NBI received a needed boost but still require regular monitoring and support to continue the effort to adopt the TC and supply trained personnel. TC’s that were started in the prisons and jails, likewise, suffer from shortage of trained personnel, adequate facilities, and unequivocal support from prison authorities. Government practices of constant personnel reshuffle and career advancement through various avenues, except the TC, has hampered development and constantly depleted TC personnel.  The impact of the TC on the PPA has a different effect. The introduction of the TC is harmonious with the PPA’s requirement for a treatment and change model that can be adopted easily as part of its intervention strategies to minimize recidivism among parolees and probationers. Faced with a large number of offenders whose cases were drug-related, PPA found the treatment mission of the TC compatible with its own. The TC approach is consistent with PPA’s overall organizational goal and field mission. In a move to institutionalize the TC as part of its treatment and supervision strategy, it issued a series of policy directives aimed at formalizing the adoption of the TC and providing support for personnel who were eager to adopt the TC within the framework of their operational mandate. Several innovations were developed to meet the requirements of the TC and adapt to specific locale, organizational, and technical constraints.  The variations in the implementation to the TC in various PPA locations have positive consequences because it afforded itself with tremendous personnel expertise and models to choose from.          

Where do we go from here?

There is a relevant need to continue to support and develop the residential applications of the TC in government-operated centers. However, the greatest challenge facing the country is to respond with a coherent strategy to meet the gravity of the drug abuse situation. Corollary to an adequate response to drug abuse is the development of a treatment approach capable of meeting the tremendous need to provide treatment to an overwhelming number of drug dependents both in residential and outpatient settings. This is where the PPA could play a pivotal role.

The legal framework of the new Philippine drug law provides the mandate for the Department of Health (DOH) to supervise and operate existing government drug programs, which mostly operate residential treatment centers. There is a big policy gap when it comes to the provision of adequate community-based (outpatient) drug treatment services. The PPA’s mandate, historically, is the provision of assessment, recommendation, supervision, and follow-up of prospective probationers and parolees under the criminal justice system. These functions are subsumed under an over arching goal of serving justice and reducing recidivism among offenders. And by extension, and part of its assessment, supervision, and follow-up functions and to meet its ultimate goal, are the provision of interventions and services on its own or in conjunction with available community resources. Implicitly, imbedded in its functions and goals, the PPA’s mandate includes a treatment component to reduce criminal recidivism and restore offenders as functioning members of society. The treatment implications in the PPA’s mission become salient if one considers the overwhelming proportions of drug-related offenders among its clientele.     

Given PPA’s accumulated expertise through its years of operations and experience as a result of the Daytop training in the implementation of community-based program using TC treatment principles, it could help replicate the community-based model started in Danao City in early 2005. PPA’s national presence and established credibility make it the ideal government agency to push for a strong community-based and grassroots response to the serious drug problem in the Philippines.  While maintaining organizational identity, PPA offices in different regions can supply the necessary expertise to local community-based programs through the local government. The general mission of these community-based programs is compatible with the PPA’s mission. The overlap in goals and mission can occur with synergic consequences.

The Model

Let me outline briefly the model that was started in Danao City. It was by no means planned for it to come the way it did. A series of fortunate events led to these positive consequences. The Mayor’s Office invited Daytop to send a consultant to provide a five-day training on the TC under the advice of CPO Jeorgette Paderanga. Upon arrival, the Daytop consultant found that Danao did not have any existing residential program. So it was decided to change the plan with the Mayor’s and the participants’ consent to help them develop a community-based model suitable for the needs of Danao City. Everybody agreed. It so happened that the type of participants invited was perfectly suitable for the plan. Among 61 participants most were key players in an ideal community-based drug program, i.e., PPA, DSWD, DepEd, TESDA, BJMP, PNP, DOH, PTA, Barangay Captains, Barangay Yourth Leaders, Student Leaders, College Students and Professors, Teachers, City Council Officials, City Officials, Women’s Council, etc. Half of the training time was spent in explaining the TC and general treatment principles, and the other half in helping the participants develop a community-based drug program model suitable for Danao. At the end of the five days, a plan of action consisting of the implementation of the community-based program was produced and presented and approved by the Mayor. It was also made very clear that the project will dissociate itself from any law enforcement activities to make it inviting for drug users to seek help. This too was acceptable to the Mayor. To handle the tasks of assessment, referral, and case management of clients, a coordinating center named Community Life Enhancement Center (CLEC) was established. The center will coordinate the network of services to be provided by various government agencies involved in the project, i.e., DSWD, DepEd, DOH, Barangay, etc.  The idea is to organize and link the various city agencies and create a network of service providers already existing in the community to support the community-based program. 

Five days was too short to provide the participants and actors with adequate skills to carry out the project successfully. The success of the project hinges on several variables such as continued interest and support by the Mayor, willingness and motivation of the key players, level of service utilization by the community, expertise and technical know-how by the key players. This particular project may or may not succeed but the model is sound and seems to have all the necessary elements of a good community-based program. If PPA will utilize its expertise and experience in community-based programming to advocate for projects such as the Danao initiative, the project can be replicated in several regions of the Philippines. Additional elements such as organizing community volunteers, civic organizations, private enterprises, family associations, and regular training to increase clinical skills by community-based workers, will make this model a very strong response from the community and grass roots level.

Right now, the PPA is poised to take this role. The idea is to exploit this position to create a strong response to the serious drug problem in the Philippines. In some regions, the PPA has been able to advocate successfully to provincial and local governments to organize treatment programs. Some of these places are already useful platforms to launch a two-prong approach of community-based and residential programs. If a rational analysis of the Philippine situation is made, the conclusion would lead to a two-prong approach to developing treatment or drug demand reduction strategy: (1) the continued development of residential-based drug program, (2) and investing on the development of community-based or grass roots approach to drug demand reduction.  If INL decides to continue providing training funds for the Philippines, it is most likely to fund its program for the DOH. It is wise that PPA should continue to develop its community-based approach with or without INL funding in order to maximize the impact of previous training and continue its important role in drug demand reduction.   

Recommendations

1.      Replication of the Danao City initiative. Instead of one municipality, PPA could organize a similar training consisting of provincial and municipal governments or a total of five target areas of relative size each comparable to Danao City. Cost sharing will drop the cost and will make it affordable. Priority might be given to areas where local governments have expressed interest in developing both residential and community-based programs. A comprehensive training module can be developed to address both modalities.

2. The project will operate as a separate project from INL funded training and should operate parallel to the goals of residential drug treatment. 

3. An effective and replicable community-based drug treatment model developed in the Philippines will benefit not only the country but the region as well.

4.     A training module lasting two-weeks will be developed for the introduction of community-based model and providing specific clinical skills, i.e., interviewing, counseling, group therapy, assessment skills, etc.