A COALITION OF THE WILLING FOR A DRUG-FREE BOHOL

F     he Bohol Tribune

In This Our Journey

NESTOR MANIEBO PESTELOS

Events during the past two weeks have convinced me we must now vigorously move forward to form a coalition of the willing for a drug-free Bohol and that the first catalyst activity to give it momentum is to  produce a profile of each of the 31,000  drug users who have signified their intention to lead a new life without drugs.

In all our meetings which started Sunday evening, 21 August,  with consultants from the New Day Recovery Center (NDRC) from Davao City to today, Thursday, when we have continued to consult with friends from the drug addiction profession, and listened intently to discussions among social and health workers, I have become convinced that the task of profiling the surrenderees should be done first to ensure a systematic response to the needs of our target beneficiaries, the surrenderees.

If accomplished, this individual database will make it possible to provide interventions relevant to each category of drug-affected surrenderees to be classified as low risk, moderate risk and high risk. I am convinced that this task can be undertaken systematically starting at the municipal or city LGU level.

The provincial government, with its task force, can form a mobile team trained on the use of tools for determining the  extent of addiction of each surrenderee. The resulting database can be used to determine which surrenderees will be put on outpatient basis; those provided with comprehensive counselling and most likely livelihood , and others which can in-patient treatment services. This is part of the strategy proposed by the NDRC consultants as part of their

With this target-specific approach, the government need not worry about putting everybody in a drug rehabilitation center which will be costly and will take years to build taking into account the usual pace of infrastructure planning and implementation in our country.

The key questions in carrying out this important task are as follows: a) what are the tools to be used in profiling the surrenderees; b) who can be trained to administer them; c) how long will the training be conducted; d) how much will be the cost for the training of those who will administer the tools.

The tools used are as follows:

-ASSIST or Alcohol and Substance Screening Test

-ASI (Addiction Severity Index)

-Severity Index Form

-Psychology Tests

In a preliminary study conducted by a technical working group in Baclayon, the duration per training will be three days; two persons will be needed to be trained from each barangay; and that the expenses will be for training materials; meals and snacks; and transportation.

If participants will be trained on all four tools, the cost per participant will be Php 488 per day or a total Php 3,723 per participant per day.

It was the consensus of the group that ways must be found to reduce the costs of training the staff who will administer the tools, usually the health and social workers.

At this point, It is crucial to understand the difference between screening and assessment. I looked it up and I found this:

• Screening is a process for evaluating the possible presence of a particular problem. The outcome is normally a simple yes or no.
• Assessment is a process for defining the nature of that problem, determining a diagnosis, and developing specific treatment recommendations for addressing the problem or diagnosis.

Hence, in this light, since the surrenderees are identified as drug users, it may be asked whether we need still to use the ASSIST as a tool. I heard it in one of the meetings that the ASI may be the only appropriate tool to use.

The third tool may also be used but the psychological tests may be used later once the surrenderees have been categorized. If we use only two tools, ASI and the Severity Index Form, we will be able to reduce the costs of profiling the surrenderees.

During the meeting of the provincial Technical Working Group, I got the impression that the social workers and the health workers have been trained on the use of the screening tools. Hence, it is just a matter of mobilizing and training them as trainors this time by the consultants to be able to cascade the training at the municipal level.

As in practically all cases, how to fund activities is the key concern whether at provincial and municipal level. Hence, there must be a way to encourage LGUs to work closely with drug addiction professionals and find more cost-effective ways to do the profiling of surrenderees.

Yesterday, I was in Sierra Bullones in the company of former UN colleagues, Cecilio Adorna and Richard Prado,  as observer in the conduct of Focus Group Discussions (FGDs) as part of formulating the 2017-2022 Philippine National Nutrition Plan. It occurred me while listening to their quite intense discussions that the keen interest and leadership of the Local Chief Executives is key to mobilizing staff and resources to ensure that any national plan and projects formulated will get the support of the various sectors.

We have learned this lesson through forty years of working in projects implemented in partnership with local governments in various countries. Always there is the challenge to involve local political leaders so that they will help to mobilize resources for programs considered as top priority.

In Sierra Bullones, the Municipal Health Offricer and the Municipal Nutrition Officer have provided the leadership, with the support of the Municipal Mayor, to raise funds for its Municipal Nutrition Program. We hope the same tenacity of purpose will be shown in supporting the profiling of surrenderees so that the latter can eventually be provided with relevant interventions appropriate to their addiction severity status.

I learned from the MHO, Dr. Janice Belleza, that on the matter of profiling surrenderees, all ten nurses under her office have all been trained in the use of ASSIST. The next step is to decide whether they still have to be trained with the other three tools to be able to start this all-important work.

We need the drug addiction professionals to start a discussion on this vital issue. This is the time to review or evaluate the screening and assessment tools and decide which ones to use given the crucial task ahead of providing relevant services to the surrenderees.

Otherwise we may be going around in circles in planning interventions most appropriate at this time in managing the situation of having more than 31,000 surrenderees in our province. At this critical stage, we need a coalition of the willing for a drug-free Bohol but we cannot do organizing and social mobilization work if we do not know exactly the extent of the problems affecting the target beneficiaries.

For comments, email: npestelos@gmail.com ###

NMP/02 September 2016/4.11 p.m.