THE EFFECTIVENESS OF DRUG REHABILITATION PROGRAM IN MINDANAO

In Partial fulfilment
Of the Requirements for the Course
SW-198 (Research in Social Work Profession)
2nd Semester A.Y 2017-2018

APRIL 2018
 CHAPTER I
INTRODUCTION

A. BACKGROUND OF THE STUDY

Drug is any substance (with the exception of food and water) which, when taken into the

body, alters the body’s function either physically and/or psychologically. Drugs may be legal

(alcohol, caffeine and tobacco) or illegal (cannabis, ecstacy, cocaine and heroin). Rehabilitate

according to Webster Dictionary is to restore to a condition of good health, ability to work and

the like. Drug rehabilitation center as defined by Mosby’s Medical Dictionary is an agency that

provides treatment for a person with a chemical or drug dependency.

Drugs and drug users have been the pressing concern not just in our country but

globally. The use of drugs has been around since time immemorial. People have used drugs for

various purposes depending on culture and activities at hand. At most drugs have been known to

bring euphoric feelings that change moods of people to pleasurable feelings especially in social

celebrations and when people are operating under tension. Because of their ability to relief

tension many people use drugs and with the stressful life associated with challenges in

contemporary society the number has been on increase. Hence initiating the use of drugs is

always associated with the benefits that it brings to the users. However people who use drugs

experience wide array of physical effects other than those expected. This is due to its addictive

nature that lures the users into over use. The after effects of Drugs and the assumption that relief

can only be used in continuous use of drugs leading to increased drug abuse and dependence

with many psychosocial effects. With the continuous use of a physically addictive drug,

tolerance develop. Due to the need of using drugs again and again, many drug users engage in

criminal activity such as burglary and prostitution to raise the money to buy drugs and some

drugs, especially alcohol, are associated with violent behavior. In the Philippines, Pres. Duterte
mandates On Voluntarily Surrender of Drug Users and Dependents. Now as the campaign were

still in action in Philippines, the rehabilitation centers were now congested with patients who

seeks medical attention in treating their addiction towards drug abuse. Now in various

municipalities, the government together with the other agencies in order to answer the problem

amongst rehabilitation centers congestion of patients established its Community – based

Rehabilitation program for those drug addicts whose level of addiction belongs to mild or

moderate. Basically, among drug addicts, submission of themselves in rehabilitation program, is

a great challenge in them due to the embarrassment in their self and stigma of the society. Just

like other parts of the world, Philippines has experienced upsurge in number off drug addicts that

has forced the government, nongovernmental organizations, religious and individuals to come up

with rehab centers offering rehabilitation programs meant for behavior modification. These

rehabilitation centers over years have admitted drug addicts into their rehabilitation programs

meant to bring about behavior change among the recovering drug users. However little is known

about the effectiveness of the programs offered. This study therefore examines the effectiveness

of rehabilitation programs on behavior modification of drug addicts in Mindanao Philippines

B. STATEMENT OF THE PROBLEM

The problem underlying this study was that although there have been different programs

in different rehabilitation centers meant for behavior modification among drug addicts in

Philippines, little is known about their effectiveness. There could be instances that drug addicts

who seek rehabilitation services dropped from the rehab center and went back to drugs, however,

it is unclear to what specific issues about the program led them to pull out.
C. OBJECTIVES OF THE STUDY

This study aims to fill the gap by:

1. Examining the effectiveness of programs offered in rehabilitation centers in relation to

behavior modification of drug addicts;

2. Focusing on the existing problems faced by the rehabilitation centers during

implementation of diversion programs amongst drug surrenderees.

3. Establishing how drug rehabilitation programs can be improved to help bring about

effective treatment.

D. SCOPE AND LIMITATION

This study confined itself to the effectiveness of rehabilitation programs among drug

addicts in rehabilitation centers in the Philippines, particularly in Mindanao. Information was

sourced from surveys in every drug rehabilitation centers in Mindanao. In addition usage of

questionnaires and interviews will be the procedure of the researcher for the acquisition of data

in regards with the effectiveness of treatment in a rehabilitation program. The findings of this

study are only applicable to Mindanao or other areas with similar characteristics. The researcher

anticipated that there would be some inconsistency in provision of information and lack of

cooperation by the rehabilitees who have still been having psychological challenges in

rehabilitation centers.
F. CONCEPTUAL FRAMEWORK

- PATIENTS'S CARE
- CENTER STAFFS
ROAD TO RECOVERY RELATIONSHIP TO
AMONGST DRUG DRUG DEPENDENTS
DEPENDENTS
- PROGRAMS'
ADMINISTERED

AFTERCARE
TREATMENT

EFFECTIVENESS
OF DRUG
REHABILITATION ROLE OF THE FAMILY
PROGRAM -INFLUENCE OF THE
FAMILY
- IMPACT OF THE
FAMILY

- RELAPSE
PREVENTION
TRAINING
- COUNSELLING
- MOTIVATIONAL
INTERVIEWING
G. DEFINITION OF TERMS

a. DRUG ABUSE - when controlled substances are used in a manner or amount inconsistent

with the legitimate medical use, it is called drug abuse.

b. DEPENDENCE - in addition to having abuse potential, most controlled substances are

capable of producing dependence, either physi-cal or psychological.

c. PHYSICAL DEPENDENCE - refers to the changes that have occurred in the body after

repeated use of a drug that necessitates the continued administration of the drug to prevent

a withdrawal syndrome.

d. PSYCHOLOGICAL DEPENDENCE refers to the perceived “need” or “craving” for a

drug. Individuals who are psychologically dependent on a particular substance often feel

that they cannot function without continued use of that substance.

e. ADDICTION is defined as compulsive drug-seeking behavior where acquiring and using a

drug becomes the most important activity in the user’s life.

f. CRAVING - a strong desire or urge to use drugs, most apparent during withdrawal and

may persist long after cessation of drug use. Symptoms are both psychological and

physiological. Cravings may be triggered by a number of cues, e.g. seeing a dealer, walking

past a place where drug use occurred in the past.

g. DRUG - is any substance (with the exception of food and water) which, when taken into

the body, alters the body’s function either physically and/or psychologically. Drugs may be

legal (alcohol, caffeine and tobacco) or illegal (cannabis, ecstacy, cocaine and heroin).

h. NARCOTICS - Also known as “opioids,” the term “narcotic” comes from the Greek word

for “stupor” and originally referred to a variety of substances that dulled the senses and
 relieved pain. Though some people still refer to all drugs as “narcotics,” today “narcotic”

Erefers to opium, opium derivatives, and their semi-synthetic substitutes. A more current

term for these drugs, with less uncertainty regarding its meaning, is “opioid.” Examples

include the illicit drug heroin and pharmaceutical drugs like OxyContin, Vicodin, codeine,

morphine, methadone, and fentanyl. Smack, Horse, Mud, Brown Sugar, Junk, Black Tat,

Big H, Paregoric, Dover’s Powder, MPTP (New Heroin), Hilbilly Heroin, Lean or Purple

Drank, OC, Ox, Oxy, Oxycotton, Sippin Syrup

i. FENTANYL - is a potent synthetic opioid drug approved by the Food and Drug

Administration for use as an analgesic (pain relief) and anesthetic. It is approximately 100

times more potent than morphine and 50 times more potent than heroin as an analgesic.

Common street names were Apache, China Girl, China Town, Dance Fever, Friend,

Goodfellas, Great Bear, He-Man, Jackpot, King Ivory, Murder 8, and Tango & Cash.

j. HEROIN - is a highly addictive drug and it is a rapidly acting opioid. Heroin is processed

from morphine, a naturally occurring substance extracted from the seed pod of certain

varieties of poppy plants. Common street names were Big H, Black Tar, Chiva, Hell Dust,

Horse, Negra, Smack, and Thunder.

k. HYDROMORPHONE - belongs to a class of drugs called “opioids,” which includes

morphine. It has an analgesic potency of two to eight times greater than that of morphine

and has a rapid onset of action. Common street names were D, Dillies, Dust, Footballs,

Juice, and Smack.

l. METHADONE is a synthetic (man-made) narcotic. Methadone was introduced into the

United States in 1947 as an analgesic (Dolophinel). Common street names were Amidone,

Chocolate Chip Cookies, Fizzies, Maria, Pastora, Salvia, Street Methadone, and Wafer.
m. Morphine is a non-synthetic narcotic with a high potential for abuse and is derived from

opium. It is used for the treatment of pain. Common street names were Dreamer, Emsel,

First Line, God’s Drug, Hows, M.S., Mister Blue, Morf, Morpho, and Unkie.

n. OPIUM - is a highly addictive non-synthetic narcotic that is extracted from the poppy

plant, Papaver somniferum. The opium poppy is the key source for many narcotics,

including morphine, codeine, and heroin. Common street names were Ah-pen-yen, Aunti,

Aunti Emma, Big O, Black Pill, Chandoo, Chandu, Chinese Molasses, Chinese Tobacco,

Dopium, Dover’s Powder, Dream Gun, Dream Stick, Dreams, Easing Powder, Fi-do-nie,

Gee, God’s Medicine, Gondola, Goric, Great Tobacco, Guma, Hop/hops, Joy Plant,

Midnight Oil, Mira, O, O.P., Ope, Pen Yan, Pin Gon, Pox, Skee, Toxy, Toys, When-shee,

Ze, and Zero.

o. OXYCODONE - is a semi-synthetic narcotic analgesic and historically has been a popular

drug of abuse among the narcotic abusing population. Common street names were Hillbilly

Heroin, Kicker, OC, Ox, Roxy, Perc, and Oxy.

p. STIMULANTS - speed up the body’s systems. This class of drugs includes: Prescription

drugs such as amphetamines [Adder - all and dexedrine], methylphenidate [Concerta and

Ritalin], diet aids [such as didrex, Bontril, Preludin, Fastin, Adipex P, ionomin, and

Meridia] and illicitly produced drugs such as methamphetamine, cocaine, and

methcathinone. Common street names were Bennies, Black Beauties, Cat, Coke, Crank,

Crystal, Flake, Ice, Pellets, R-Ball, Skippy, Snow, Speed, Uppers, and Vitamin R

q. AMPHETAMINES - are stimulants that speed up the body’s system. Many are legally

prescribed and used to treat attention-deficit hyperactivity disorder (ADHD). Common

names were Bennies, Black Beauties, Crank, Ice, Speed, and Uppers.

r. COCAINE - is an intense, euphoria-producing stimulant drug with strong addictive

potential. Common street names were Coca, Coke, Crack, Flake, Snow, and Soda Cot
s. KHAT - is a flowering evergreen shrub that is abused for its stimulant-like effect. Khat has

two active ingredients, cathine and cathinone. Common street names were Abyssinian Tea,

African Salad, Catha, Chat, Kat, and Oat.

t. METHAMPHETAMINE (METH) - is a stimulant. The FDA-approved brand-name

medication is Desoxyn. Common names were Batu, Bikers Coffee, Black Beauties, Chalk,

Chicken Feed, Crank, Crystal, Glass, Go-Fast, Hiropon, Ice, Meth, Methlies Quick, Poor

Man’s Cocaine, Shabu, Shards, Speed, Stove Top, Tina, Trash, Tweak, Uppers, Ventana,

Vidrio, Yaba, and Yellow Bam.

u. MARIJUANA - is a mind-altering (psychoactive) drug, produced by the Cannabis sativa

plant. Marijuana contains over 480 constituents. THC (delta-9-tetrahydrocannabinol) is

believed to be the main ingredient that produces the psychoactive effect. Common street

names include: Aunt Mary, BC Bud, Blunts, Boom, Chronic, Dope, Gangster, Ganja,

Grass, Hash, Herb, Hydro, Indo, Joint, Kif, Mary Jane, Mota, Pot, Reefer, Sinsemilla,

Skunk, Smoke, Weed, and Yerba.

v. INHALANTS - are invisible, volatile substances found in common household products that

produce chemical vapors that are inhaled to induce psychoactive or mind altering effects.

w. TREATMENT AND REHABILITATION CENTERS - Republic Act 9165 or known as

the “Comprehensive Dangerous Drugs Act of 2002” Section 75 defines as the existing

treatment and rehabilitation centers for drug dependents operated and maintained by the

NBI and the PNP shall be operated, maintained and managed by the DOH in coordination

with other concerned agencies.

x. DIVERSION PROGRAM - a program of treatment or re-education for individuals referred

from criminal courts (criminal diversion) in lieu of prosecution or incarceration, which is

usually held in abeyance pending successful completion of the diversion program.

y. LAPSE - sometimes called a slip, a lapse is an isolated occasion of drug use after a period

of abstinence.

z. TOLERANCE - a state in which continued use of a drug results in a decreased response to

the drug. Increased doses are needed to achieve the same level of effect previously

produced by a lower dose.

G. THEORETICAL FRAMEWORK

In a study examining the effectiveness of rehabilitation program amongst drug

dependents individuals, Ouimette, Finney, and Moos (1997) stated twelve-step and cognitive

behavioral treatment, both methods of treatment were effective in treating clientele with

substance dependence. CBT represents the integration of principle derived from behavioral

theory, cognitive social learning theory, and cognitive therapy, and I provides the basis for a

more inclusive an comprehensive approach to treating substance abuse disorders CBT can be

used by properly licensed and trained mental health practitioners even if they have limited

experience with this type of therapy—either as a cost-effective primary approach or in

conjunction with other therapies or a 12-Step program. CBT can be also used early in and

throughout the treatment process whenever the therapist feels it is important to examine a client’s

inaccurate or unproductive thinking that could lead to risky or negative behaviors. Clients in both

modes of therapy reported having more success abstaining from alcohol and drugs, less

depression and anxiety, fewer legal problems, and a higher employment rate. However, those

opting for a 12-Step program yielded higher rates of abstinence at one-year follow-up. One of the

principles associated with continued abstinence in the twelve-step model of treatment (attributed

to Alcoholics Anonymous) is the correlation between an alcoholic and/or addict helping another

alcoholic and/or addict throughout the facilitation of the 12-step program, an activity known as

sponsorship. An AA sponsor is one who guides an alcoholic through the 12-steps and provides

encouragement in dealing with day-to-day challenges he or she (the sponsee) may face early in

recovery. According to Miller and Sanchez-Craig (1996), within one year of treatment

completion, the relapse rates are as high as 90%, with the bulk of these individuals continuing

the use of substances at their pre-treatment level of dependence.

 People who use illicit drugs and other substances are a heterogeneous population who

may experience multiple and complex difficulties. A model presented by Thorley1 shows that

problems’ may arise from some patterns of drug use and not just because someone is dependent

on a drug. A common misconception is to think that if someone has a drug problem then they

must be dependent. Thorley’s model explains that problems arise from intoxication, regular or

excessive use and dependency. Thorley’s model has three parts: a. problems from getting drunk

or stoned (intoxication); b. problems from using alcohol or drugs regularly (regular or excessive

use); c. problems with not being able to stop using alcohol or drugs (dependence). Problems

from getting intoxicated usually arise from the short-term effects of a drug. The problems that

people most often see are, by their nature, the most disturbing and visible and are most likely to

be social in nature.
REFERENCES

1. World Drug Report (2007 - 2016) UNDOC

2. Hubbard RL, Craddock SG, Flynn PM, Anderson J, Etheridge RM (1998) Overview of 1

year follow-up outcomes in the Drug Abuse Treatment Outcome Study (DATOS)

3. Psychology of Addictive Behaviors Chapter 11: 291 – 298

4. Raymond GM (2008) Behavior Modification: Principles and Procedures. (5th Edition)

Cengage Learning

5. Holloway KR et al. Psicothema. 2006 The Effectiveness Of Drug Treatment Programs In

Reducing Criminal Behavior

6. Liz Lazzara 2016: Does Drug Rehab Works – Success Rates and Statistics