EDITORIAL: INMATE OR PATIENT?

Eight people can make a lot of smoke. Fat snakes, thin rings-the smoke
festoons the space over the heads like adult balloons. The mood is
laidback, bantering.

Somebody mentions that Arvy is taking up nursing. Lito and Nixon add that
Kathy is taking up nursing, too, as she is taking up with Arvy.

Gilby guffaws. Arvy and Kathy smile sheepishly. Arvy says he's into nursing
so he can be near the drugs 24/7. Boyax flashes a gap tooth smile. He's the
smoke machine to beat; curlicues squeeze in through the slits all at once.
When Jun-Jun comes in last, hauling his own chair like a pupil overstaying
in grade 1, the others fall on him with their razor talk and gently
floating sausage smoke.

The only one silent is John Gerald Valencia. He's preoccupied with rice and
chicken gizzard, a late lunch. But it's his job, too, to talk less, listen
more. He's their therapist.

This is one afternoon at the Psychles Recovery Renewal Retreat Center in
Basak is Mambaling. The gate is padlocked at all times. The front door has
three locks. Otherwise, it looks like an old house with student dormers and
a landlord that's none too picky.

This afternoon group is a mix of patients living at the center and those
pursuing a home based program. Kathy is one of the regular visitors. She
comes back often, she explains, to be "refreshed by the environment."

Perhaps, despite the medicine bottles and omnipresent locks, something
about the place makes people seek it, not escape from it.

Pavlovian

Last Nov. 1, 25 patients broke out of the Cebu Center for Ultimate
Rehabilitation of Drug Dependents (Curedd). A Cebu City task force is now
looking into the patients' health and the facility's setup, security and
sanitation.

Escapees recaptured or returned by their families have complained about
being treated more as offenders, not as patients. Despite monthly dues, the
food is reportedly bad or inadequate. Aside from harsh punishments and
congestion, grievances against Curedd include claims that some patients
have stayed beyond the mandatory seven months.

Curedd's punitive and disciplinary approach to drug rehabilitation may be
attributed to the Philippine National Police's (PNP) supervision. Although
the Comprehensive Dangerous Drugs Act of 2002 mandates the Department of
Health to manage all rehabilitation, the lack of implementing rules has
kept the PNP at the helm.

Valencia doubts whether the Pavlovian tradition of conditioning
rehabilitation on a rigid diet of deprivation and punishment can achieve
full recovery. "I am not in agreement that drug addicts in treatment be
imprisoned like other common criminals," believes the specialist and
recovered alcoholic and substance abuser. "Substance dependency is a
disease...one doesn't imprison a diabetic so as to make sure that he
doesn't get to get his sugar. Treatment in drug dependency is very much the
same way. You treat them like anybody with a chronic, crippling disease."

Valencia says a rehab program can coerce false surrender. But compliance
and submission are defenses resorted to by sick persons to make a surface
change for securing approval and concessions. "If the therapist doesn't see
things in the light of the disease concept of drug addiction, you lose the
patient altogether. You have no business in their treatment."

Crawl or Fly

Gilby, 21, has used prohibited drugs since he was a high school sophomore.
For three months, he was committed to a government rehab facility in Argao.

That stint was the closest he had been to hell. Manacled and routinely
beaten by fellow inmates, he said the strict regimen made him want to climb
walls. Food, even rice, was measured out. When he could not join an early
morning jog as he was confined in the infirmary for hernia, authorities
forced him to do push-ups.

After Gilby hanged himself with a pair of suspenders found in the toilet,
he was released. At the Psychles Retreat Center, Gilby says he has stayed
clean and sober. For two months now, Kathy stresses. We get to rest and
smoke, Gilby adds.

Eat all we can. As you can, Boyax punches in, his smile winking gaps that
release a pregnant python of smoke.