DOH on drug addiction: Anyone is vulnerable

MANILA-- On May 21 last year, five people aged 18 to 36, fell unconscious after suffering breathing difficulties in the midst of a crowd of 14,000 people attending the Closeup 'Forever Summer' outdoor concert in a mall in Pasay City.

A few hours after the concert ended at 3 a.m., all five died in the hospitals where they were rushed. Doctors reported the immediate cause of their death as massive heart attack due to high blood pressure, kidney failure, and dehydration, which according to the National Bureau of Investigation (NBI) are telltale signs of a drug overdose.

According to social media, some concert-goers have taken green amore pills, aka fly high, a potent mix of ecstasy and methamphetamine hydrochloride or "shabu". Reports said NBI forensic analysis later showed that traces of ecstasy and methylene dioxin cathinones (bath salts) were found in the body of one of the victims.

According to an eyewitness account, concert-goers were bouncing to the beat of the music, drinking liquor and passing around and inhaling some sort of powder.

Former actress Alma Concepcion meanwhile said there were teenagers who were dancing non-stop for more than an hour during the concert, eyes rolling, teeth grinding no liquids, some wearing shades and masks to cover their faces, and some were really high. One girl's arms and legs even stiffened, she recounted.

According to the Philippine Drug Enforcement Agency (PDEA), there are 4 million drug users across the country. The report on the death of the five concert-goers however hits close to home.

Drug abuse could affect anyone regardless of age, gender, religion, profession, marital or social status, Health Secretary Dr. Paulyn Ubial told the Philippine News Agency (PNA) in an interview.

Drug abuse is a mental health problem that needs to be managed. Drug users are victims of the lure of drugs. They need help, she said.

Anyone is vulnerable, but more so the youth, who are in a stage of curiosity and experimentation, and those whose jobs need them to be awake and those who need an energy boost, like truck or bus drivers.

Program manager of the Dangerous Drugs Board (DDB), Dr. Jasmin Peralta, noted that decades of research have shown drug addiction to be a disease that alters the way brains function, resulting in a person's physical, mental, emotional or social impairment.

It starts with experimentation, and progresses to drug use, abuse and finally dependency, Peralta said.

She explained that some people are more vulnerable to drug addiction than others due to certain factors -- genes, developmental age, and such environmental factors as co-morbid mental illness, early physical or sexual abuse, witnessing violence, stress, peers who use drugs and drug availability.

Whatever factors there are, substance abuse has physical consequences -- accidental injuries and deaths, cardiac arrhythmia, hepatitis, impotence and strokes -- and psychological consequences -- anger, fatigue, anxiety, amnesia, insomnia, depression, impaired relationships, attempted suicide and suicide.

The physical consequences could lead to disability and premature death while the psychological consequences result in a host of social problems, including violence against themselves and people around them, usually women and children. The Philippine National Police has confirmed that 1,847 cases of homicide from July 2016 to March 31, 2017 were drug-related. They are investigating 5,691 more.

Peralta indicated that the country has become a haven of drug syndicates involved in the manufacture of shabu, hence its availability in the country.

According to DDB data, the mean age of drug abusers confined in drug rehab centers in country in 2016 was 31 years old and that for every 13 male users, there was one female user. Some 49 percent of them were living in the National Capital Region, 48.95 percent were single, 40.5 percent were unemployed, and their average monthly family income was PHP13,937.65. They have been taking illegal drugs for more than six years and while they stick to one kind of drug, their choices were shabu, marijuana and cocaine.

Early intervention is key before the brain changes take hold and drug abuse becomes compulsive, Peralta said.

Ubial emphasized the importance of early detection, intervention, and treatment and rehabilitation while managing other illnesses that occur with the addiction, such as mental disorders, HIV/AIDS, Tuberculosis, Hepatitis B and C.

There is hope for them through recovery so that they can reintegrate into society as productive citizens," she said, adding that the health care system should not deny drug users help, just like other patients.

We look at the spectrum of health services -- from preventive, promotive, procurative which is detoxification lasting for two weeks or more, and rehabilitative lasting six to 12 months, Ubial said. Another 18 months are spent for the aftercare program to prevent a relapse.

There are a total of 48 accredited Drug Abuse Treatment and Rehabilitation Centers (DATRCs) across the country -- 17 of which are owned by the government, and 31 by NGOs -- with a total capacity of 12,000 beds. The Mega DATRC in Fort Magsaysay in Nueva Ecija occupies 10 hectares and its buildings could accommodate 10,000 beds. As of April 13, it had 227 patients and 22 are set to graduate this month or early June. The DATRC in Bicutan meanwhile has about 1,000 patients.

Ubial noted that they have a system of assessing drug surrenderers and classifying them into those who need only outpatient care and those who need inpatient care.

Only those who are regular users or hardened users are actually admitted in our treatment and rehab centers, she said, noting that mild and moderate users are sent to attend community-based rehab programs.

According to Department of Health (DOH) spokesperson, Dr. Eric Tayag, they have also been training general practitioners to enable them to properly assess and identify patients who need rehabilitation.

As for the expenses, he said, the DOH offers free rehab for indigents and some medicines are available for free through the Medicine Access Program (MAP) for the poor.

PhilHealth also offers a detoxification package amounting to PHP10,000 pesos to help drug dependents manage the acute physical symptoms of withdrawal that come with stopping drug use. The package applies to those who use meth, cocaine or ecstasy or combinations of these.

Treatment and rehab are just part of a more wholistic approach to deal with drug addiction. According to the DDB, there is also a need to reduce the supply of illegal drugs in the market, for instance by preventing the cultivation of marijuana through the provision of sustainable livelihood programs.

The board also sees the need to reduce the demand for narcotics through policy formulation and education.

Perhaps the DDB's best advice is for parents to talk and listen to their children, and teach them how to make good choices, how to pick their friends, and how to say 'No' to drugs.

Every Filipino can take part in the efforts to address the drug menace in the country, Ubial said.

"Citizens can actually play a big role. Everybody has to join the war (against hard drug trafficking) and has to promote (the) education of people on the ill effects of drugs," she said.

Source: Philippines News Agency