Some local governments find it costly to build drug rehab centers

(Editor’s Note: A hundred days after President Duterte declared an all-out war against illegal drugs, cash-strapped communities are scrambling to address a phenomenal number of drug users and pushers who have answered calls to mend their ways or die. In this series of articles, the Inquirer takes a hard look at how authorities are struggling to give them a new lease on life.)

(Second of four parts)

When President Duterte’s intensive antidrug campaign led to a massive number of surrenders, lack of rehabilitation facilities was easily identified as the gap that needed to be filled.

Some local government units (LGUs) have started to follow the initiative of Quezon City, which built its own local treatment and rehabilitation center (TRC) in 1993.

At least seven cities in Metro Manila plan to have their own TRCs: Parañaque, Caloocan, Mandaluyong, Taguig, Pasig, Manila and San Juan.  This is despite the national government’s promise to build additional facilities amounting P2 billion.

But how badly are these new centers needed?

The number of drug users who had surrendered has reached more than 669,000—a figure never before seen.

The Department of Health (DOH) estimates that 9 percent of these people require admission to a TRC. But the Dangerous Drugs Board (DDB) said it’s only .6 – 1 percent according to the World Health Report.

About 2-10 percent will have to go to outpatient care, while the biggest chunk will require community-based interventions.

According to the DOH, five regions—Cordillera, southern Luzon,  Negros, south-central and Muslim Mindanao—lacked TRCs because of funding problems.

Cities in Metro Manila usually refer their patients to government TRCs in Bicutan in Taguig City, Tagaytay City and Magalang, Pampanga province. But all three are now overpopulated.

Among them, the DOH-TRC in Bicutan is the first option because of proximity and affordability. But as of September, the facility had already tripled its admission rates.

Options for the poor

Admission to government TRCs is not free and individual cases require a court order.

Under the Dangerous Drugs Act of 2002, a subsidized payment scheme under the national government will be created for patients confined in public TRCs under the voluntary or compulsory submission program depending on economic status. LGUs also bear some of the cost.

The Parañaque City Anti-Drug Abuse Council (Adac) officer in charge, Andres Altarejos, said one of the major causes of drug addiction relapse was the family’s lack of financial means to pursue a patient’s treatment. The average cost of treatment for six months is P16,500.

The Taguig Adac head, Ben Canela, took a step ahead. He proposed that P15 million from his 2017 budget be used to cover documents, admission and monthly fees in the DOH-TRC in Taguig of the city’s 500 drug users.

In Valenzuela City, spending increase for rehabilitation assistance is inevitable.

Councilor Antonio Espiritu, the Adac chief, said the city would have to pay for the 3,200 reserved beds in Pampanga over the next six months, which will amount to P8 million.

It’s a new kind of spending that they now have to take from their health budget. Initially, the Adac budget solely comes from earnings from business plates.

While constructing local TRCs is a great help for poor patients, not all LGUs have the capacity for it.

Some think it’s not even the best option, and could be a kneejerk reaction.

An old, dilapidated building currently serves as holding and diagnostic center for drug dependents in Parañaque, shared with children in conflict with the law.

But Mayor Edwin Olivarez is now looking forward to a new 60-bed TRC by yearend.

Caloocan City took a similar step. Construction of the city’s TRC will commence next year, with a P100-million budget.

Quezon City Vice Mayor Joy Belmonte admitted that its center was now facing space shortage. Her office had to speed up the processing of additional 150 beds in the center, even if the project was originally scheduled for 2019.

But the new centers and rehab spaces will not be operational until the health department has issued a certificate of accreditation—and the process is rigid and costly.

“I always have to explain that [drug] addiction is primary a sickness… and a rehab center is like a hospital and the standards have to be high,” Belmonte said.

Sustainability

Maintaining a TRC is also a question of sustainability, especially because professional staff needs to be continuously trained to achieve the health department’s standards.

This is exactly the reason the Pasay Adac chair, Dan Alfanoso III, and Navotas Mayor John Rey Tiangco shrugged off the possibility of building a local TRC.

“We opted instead to build a recovery center with outpatient services in existing facility that can be refurbished. We don’t have the land and fund to build infrastructure for rehab centers,” Tiangco said.

The recovery center’s budget is P15 million.

For them, building and maintaining a rehab center is costly. Community-based programs, or interventions of LGUs for patients outside a residential rehab center, are deemed more feasible and more urgently needed, a sentiment that the DDB has echoed.