Illicit Drug use in the Asia Pacific Region - Burnet Institute

Situational analysis of illicit drug issues and responses in the Asia–Pacific region
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Health and treatment responses
The Philippines Department of Health is the
lead agency in the conduct of treatment, rehabilitation
and after-care of drug-dependent
people (Dangerous Drugs Board, 2005) . The
roles of the Department of Health among
others are:
• to participate and coordinate with other
agencies in the conduct of secondary prevention
(intervention)
• to participate in the conduct of primary
prevention in coordination with PDEA
and other NGAs; and
• to participate/coordinate with PDEA in the
prevention/control of the diversion/misuse
of medicines and legitimate production/
importation of plant sources by drug traffickers/clandestine
laboratories/users .
Number of people accessing
treatment services
As of January 2005, the number of residential
and outpatient centres for drug-dependent
people totalled 69 (Dangerous Drugs Board,
2005) . In 2004, there were 54 residential
and one outpatient facility reporting in the
Integrated Central Case Registry and Monitoring
System (ICCRMS) of the DDB . From all
reporting facilities, a total of 5787 cases were
reported in 2004 (81% new admissions; 15%
readmission; 4% outpatient cases) . From the
figures of 2003, there is a decreasing trend
in new admissions, relapse and outpatient
cases . This trend has been attributed to the
high cost of treatment, which has proved to
be a deterrent for people to undergo treatment
(Dangerous Drugs Board, 2005) . For
2004, the majority of clients were male (9:1
ratio), single (53%), aged 20–29 years (41%),
unemployed (38%) . The most commonly
abused drugs were shabu (85%), cannabis
(32%), cough/cold preparations (4%), benzodiazepines
(4%), inhalants (3%) and ecstasy
(1%) . The route of administration reported
by clients was inhalation, sniffing, smoking
and oral ingestion (Dangerous Drugs Board,
2005; United Nations Office on Drugs and
Crime, 2004b) .
The National Poison and Control Centre of
the Philippine General Hospital conducts
a census of patients admitted and detoxified
(Dangerous Drugs Board, 2005; United
Nations Office on Drugs and Crime, 2004b) .
From January to December 2003, a total of
108 drug-related cases were recorded . Drugs
identified as being used by patients were
shabu alone or in combination with other
drugs, cannabis and volatile substances .
Drug dependence, drug/chemical abuse and
drug-induced psychosis were identified as
the cases of admission for both sexes . Five
cases were recorded as drug-related deaths
among male patients (Dangerous Drugs
Board, 2005; United Nations Office on Drugs
and Crime, 2004b) .
The National Center for Mental Health Detoxification
Unit attended to 123 in-patient and
outpatient cases from January to October
2004 (Dangerous Drugs Board, 2005; United
Nations Office on Drugs and Crime, 2004b) .
Of this number, 103 were male . The highest
number of cases were diagnosed as druginduced
psychosis .
As of October 2004, a total of 249 inmates
serving sentences for drug-related cases
volunteered for treatment (Dangerous Drugs
Board, 2005; United Nations Office on Drugs
and Crime, 2004b) . The therapeutic community
program in prisons applies to inmates
who (1) volunteer for treatment, and (2) have
at least two years of their sentence remaining
to serve in the Bureau of Corrections . Based
on the intake interview of service providers
in the Therapeutic Community Center, the
commonly abused drugs of inmates prior to
their incarceration were methamphetamines,
cannabis and cough syrups .
There are also non-government treatment
centres that include outpatient and residential
treatment . Treatment fees are estimated at
75,000 peso for a 45-day treatment stay .
The government treatment centres subsidise
treatment fees . The patient typically pays for
pre-administration examination, HIV tests,
x-rays and a patient uniform .
Detoxification is delivered by some nongovernment
treatment centres, however
‘cold turkey’ is the standard approach .
The 12 Steps is the model mostly used by
government treatment centres along with
the therapeutic community model, which is
being used by a few treatment centres .
Formal schooling is provided in some government
rehabilitation centres and patients
receive skills training, and physical, mental
and spiritual rehabilitation .
Multi-disciplinary teams are used in treatment
centres .
The average length of stay in a rehabilitation
centre (government) is six months .
A person apprehended or arrested who is
found positive for illicit drug use is imposed
six months rehabilitation in a government
centre for the first offence; a second offence
requires imprisonment .
Other responses
Harm reduction
Harm reduction interventions are limited in
Cebu, Mandaue and Lapulapu Cities . In Cebu,
the organisation USPF currently conducts
a small-scale needle and syringe program
(NSP) through their community health outreach
workers . They promote the cleaning of
needles and syringes with bleach and water .
The program is unable to access many IDUs
in Cebu, so crude ways of cleaning needles
and syringes remain widespread .
Demand reduction
For programs on drug demand reduction, see
Dangerous Drugs Board (2005) and United
Nations Office on Drugs and Crime (2004b) .
Demand reduction initiatives among all age
groups consist of three approaches, according
to the DDB . The first is primary prevention
for non-users with the DDB as the lead
agency and involves collaboration with the
Department of Education, Department of
Labour and Employment, the Commission
on Higher Education, and other government
and non-government organisations . The
mass media also play an important role . The
second approach is secondary prevention for
‘experimenters’ and casual drug users . The
Department of Health is the lead agency
with support from the Department of Social
Welfare and Development, local government
units, and the Philippine National Police .
The third approach is tertiary prevention for
drug-dependent people . The Department of
Health is again the lead agency supported by
all law enforcement agencies, local governments
and NGOs .
The DDB has established drug testing programs
for schools, workplaces, the military, law
enforcement and security personel . Moreover,
guidelines have been laid out for the establishment
of Special Drug Education Centers in
every province, which will have the role of
sponsoring drug abuse prevention programs
for out-of-school youth and street children .
In an effort to bring the drug abuse fight to
the grassroots level, the Lakbay Kontra Droga
(Caravan against drugs) was initiated . Various
government and non-government entities
have been mobilised to heighten the level
of awareness among Filipino people on the
government’s current anti-drug campaign
as well as the multi-sectoral initiatives . The
project includes community anti-drug rallies
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Country profiles: Philippines