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Community-Based Drug Rehabilitation and Care in Philippine Local Governments: Enablers, Barriers, and Outcomes

September 2022
International Perspectives in Psychology Research Practice Consultation 12(2)

September 2022
12(2)

DOI:10.1027/2157-3891/a000058

Authors:

Gina Hechanova

Ateneo de Manila University

Mendiola Calleja

Ateneo de Manila University

This research examined the enablers, barriers, and outcomes of community-based drug rehabilitation programs in Philippine local governments. A multicase study research design was used in collecting and analyzing narratives from 38 leaders, program implementers, and participants in five local government units that implemented community-based drug rehabilitation. Using the World Health Organization’s Health Systems framework, the study elicited barriers and enablers in terms of leadership, financing and access to resources, information system, workforce, and service delivery. Beyond these, a unique theme that emerged was the salience of context and culture, specifically, the influence of poverty, community, and stigma. Despite these challenges, clients, providers, and leaders report positive outcomes including improved health and well-being, social/ financial protection for the clients, and access to services. The implications of findings on policy and practice are discussed.

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Article

Community-Based Drug

Rehabilitation and Care in

Philippine Local Governments

Enablers, Barriers, and Outcomes

Ma. Regina M. Hechanova, Mendiola Teng-Calleja, Nico A. Canoy, and

Judith M. de Guzman

Department of Psychology, Ateneo de Manila University, Quezon City, Philippines

Abstract. This research examined the enablers, barriers, and outcomes of community-based drug rehabilitation programs in Philippine local

governments. A multicase study research design was used in collecting and analyzing narratives from 38 leaders, program implementers, and

participants in five local government units that implemented community-based drug rehabilitation. Using the World Health Organization’s

Health Systems framework, the study elicited barriers and enablers in terms of leadership, financing and access to resources, information

system, workforce, and service delivery. Beyond these, a unique theme that emerged was the salience of context and culture, specifically, the

influence of poverty, community, and stigma. Despite these challenges, clients, providers, and leaders report positive outcomes including

improved health and well-being, social/ financial protection for the clients, and access to services. The implications of findings on policy and

practice are discussed.

Keywords: local government, community-based drug treatment, Philippines, multicase study, drug use

Impact and Implications. The importance of collectively ensuring good health and well-being was emphasized in the 2015–2030 United Nations

Sustainable Development Goals (SDGs). Included in this goal is strengthening “the prevention and treatment of substance use including narcotic

drug use....”Toward this, community-based drug rehabilitation represents a public health approach to the issue of drug use. This community-

based approach shifts away from coercive strategies to curbing drug dependence (such as incarceration of mild- to low-risk users) by making

treatment accessible as well as engaging the community in treatment and recovery. However, there is a dearth of studies on how it is being

implemented particularly in low-resource countries. This study aimed to add to the literature by describing the enablers, barriers, and outcomes

of community-based drug rehabilitation in the Philippines.

The perspectives on drug use have evolved throughout the

years. Historically, drug use was viewed from a moral

perspective with drug users seen as morally weak, lacking in

willpower, and having the sole responsibility in acquiring

and solving their problem. The Enlightenment model

suggested that only a higher power can cure addiction, and

treatment requires strengthening one’srelationshipwitha

higher entity. However, there was weak evidence of the

moral perspective, and evidence of biological and genetic

factors that may influence addiction gave way to a bio-

medical model. This led to the development of pharma-

cological treatments for detoxification and to help clients

manage withdrawal symptoms (Skewes & Gonzalez, 2013).

However, in 1977, psychiatrist George Engel argued that a

biomedical model does not account for the fact that a

person may continue to become ill even after the bio-

chemical abnormality has been corrected. He posited that

the biomedical model does not explain why among people

with the same genetic predispositions or physiological

problems, some people will get ill and others, not. Engel

(1977) calledfor the abandonment of a biomedical model in

favor of a biopsychosocial model that acknowledges that a

medical condition is a product of biological/genetic, psy-

chological, and sociocultural factors.

The adoption of the biopsychosocial model led to

changes in how drug use is treated. The traditional per-

spective was to view drug use as a disease that requires

inpatient treatment or as a crime that requires incarcer-

ation. There is also recognition that there is a continuum of

drug use and that a majority of persons who use drugs

(PWUDs) are low- and moderate-risk users (United

Nations Office on Drugs and Crime (UNODC) & World

Health Organization (WHO), 2017). Thus, current inter-

national standards suggest that drug treatment should be

International Perspectives in Psychology (2023), 12(1), 26–37

https://doi.org/10.1027/2157-3891/a000058

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