A Statement on Promoting a Scientific and Humane Approach to Addiction and Substance Use

We in the Psychological Association of the Philippines (PAP) oppose the current approach of criminalizing drug use, with its attendant programs that vilify drug users, violate human rights, and disregard legal and due process. Criminalizing drug users has been shown in other countries to be ineffective in solving the drug addiction problem.

We present the following evidence and inferences from psychological, clinical, and social science research:

  1.  Addiction or substance use disorder (SUD) is a mental disorder (DSM-5,     2013).        It    is defined by the Philippine Mental Health Law as a “primary chronic relapsing disease of brain reward, motivation, memory, and related circuitry” (Sec. 4.a., RA 11036).

 

  1.  While SUD is a serious and complex problem that is caused and maintained by multiple factors (Klostermann and Kelley, 2016), people can recover from and manage their addiction with appropriate treatment and support (UNODC, 2003; NIDA, 2014). Addiction can be successfully dealt with using both residential and non-residential or community approaches (DOH “Manual of Operations for Drug Abuse Treatment and Rehabilitation Centers”, 2003).

 

  1.  High relapse rates may be due to the lack of a systemic approach that  addresses poverty and extreme economic deprivation (e.g., Robins & Ratcliff,1979), as well as the proliferation of centers that do not use evidence-based approaches and that do not address relapse prevention, family support, and aftercare.

 

  1. The approach of criminalizing drug use violates the human rights of drug users   and runs counter to the prevailing scientific view of addiction that is articulated in the new Mental Health Law. The United Nations and international human rights organizations have condemned this approach (hrw.org, 2018; Gavilan, 2017). 

 

  1. The criminalization approach distorts ordinary citizens’ and law enforcers’   perceptions of addiction. By exposing people to frequent occurrences of “tokhang” and vigilante-style killings, it desensitizes them to violations of human rights and reinforces the view that the lives of innocent people are mere collateral damage.

 

  1.   Countries that have tried the criminalization approach but have found that it   ineffective have changed how they address the problem. An example is Portugal, which has now adopted strategies based on scientific evidence and which are proving to be more effective in reducing deaths due to illegal drugs and improving indicators related to different patterns of drug use by different clinical populations (Thornton, 2015; Szalavitz, 2009; see also Greenwald, 2009).

 

Given these, we recommend the following in place of a criminalizing approach:
 

      1.1.   Amend Republic Act of the Philippines 9165,  or the Comprehensive Dangerous Drugs Act of   2002, to make it more consistent with a                               scientific  and humane approach to dealing  with drug abuse  problems;

  1. 2.  Study how we could adapt and use in the  Philippine context the best practices in  policies and programs  of countries that have                             effectively   used a non-criminalizing approach  to addiction;
  2. 3.  Identify evidence-based and evidence-informed approaches in managing  and treating SUD, and employ mental health professionals                   qualified to do assessment, treatment, rehabilitation and after care;
  3. 4.   Allocate adequate funds for developing preventive community-   and  outpatient-based programs
  4. 5.   Evaluate recovery facilities to ensure that service users are protected from  unscientific and unethical treatment programs;
  5. 6.   Allocate adequate funds for innovative   research on addiction    management;
  6. 7.   Address social issues that perpetuate   addiction, such as poverty,  unemployment, etc. (Center for Substance Abuse Treatment,  2006;                Barnett, 2009);
  7. 8.  Partner with civil society groups in developing programs that support post-rehabilitation care and re-integration;
  8. 9.  Conduct sound information dissemination   campaigns to help  citizens   develop healthy   attitudes and views regarding addiction;
  9. 10. Train the police force in a humane and   compassionate approach to   dealing with   people with   problems     related   to SUD.

 

REFERENCES:

Barnett, R. E. (2009). The harmful side effects of drug prohibition. Utah L. Rev., 11-34.

Center for Substance Abuse Treatment. (2006). Substance abuse: clinical issues in intensive outpatient treatment. Rockville, MD: Substance Abuse and Mental Health Services Administration.

Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (2013). American Psychiatric Publishing: Washington, D.C. and London.

Gavilan, J. (2017). Countries call for end to killings in PH drug war. May 9, 2017. Retrieved from https://www.rappler.com/nation/169269-united-nations-countries-call-for-...

Gaviria, C. (2017). President Duterte is repeating my mistakes. Opinion editorial dated February 7, 2017. New York Times. Retrieved from https://www.nytimes.com/2017/02/07/opinion/president-duterte-is-repeatin...

Greenwald, G. (2009). Drug decriminalization in Portugal: Lessons for creating fair and successful drug policies. Washington, D.C.: Cato Institute.

Ilas, J. (2016, September 22). Health department to construct more rehab centers. CNN Philippines. Retrieved from https://goo.gl/MBs3ri

Klostermann, K. and Kelley, M.L. (2015/16). Substance-related and addictive disorders. In Maddux, J. and Winstead, B. (eds.). Psychopathology: Foundations for a contemporary understanding. Routeledge: USA and UK.

NIDA. (2014). Drugs, Brains, and Behavior: The Science of Addiction. Retrieved February 23, 2017, from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction

No author. Manual of Operations for Drug Abuse Treatment and Rehabilitation Centers. (2003). Department of Health, 17-20.

No author. Philippines: Endorse UN inquiry into “Drug War” killings. Independent Investigation Needed to Clarify Death Toll, Promote Accountability. Human Rights Watch. February 1, 2018. Retrieved at https://www.hrw.org/news/2018/02/01/philippines-endorse-un-inquiry-drug-...

No author. Republic Act 11036. An act establishing a national mental health policy for the purpose of enhancing the delivery of integrated mental health services, promoting and protecting the rights of persons utilizing psychiatric, neurologic and psychosocial health services, appropriating funds therefor, and for other purposes.

No author. Republic Act 9165. An act instituting the comprehensive dangerous drugs act of 2002… Retrieved from http://pro10.pnp.gov.ph/index.php/download/finish/10-republic-act/40-ra-...

Orford, J. (1985). Excessive appetities: A psychological view of addictions. (New York: Wiley)

Robins, L. N., & Ratcliff, K. S. (1979). Continuation of antisocial behavior into adulthood. International Journal of Mental Health, 7, 96-116.

Szalavitz, M. (2009, April 26). Drugs in Portugal: Did Decriminalization Work? Time. Retrieved from Time: https://goo.gl/F27n5n

Thornton, M. (2015, July 10). Portugal’s experiment in drug decriminalization has been a success. Mises Daily Articles. Retrieved from https://mises.org/library/portugal’s-experiment-drug-decriminalization-has-been-success

Tuchfeld, B. (1981). Spontaneous remission in alcoholics: Empirical observations and theoretical implications. Journal of Studies on Alcohol, 42, 626-641.

UNODC. (2003). Drug abuse treatment and rehabilitation: a practical planning and implementation guide. New York: United Nations.

Walters, G.D. (2000). Spontaneous remission from alcohol, tobacco, and other drug abuse: seeking quantitative answers to qualitative questions. American Journal of Drug Alcohol Abuse, 26 (3), 443-460. Abstract retrieved from https://www.ncbi.nlm.nih.gov/pubmed