War On Drugs: Public Health

Perspective.

(CDR,Res) MA.VILMA V. DIEZ, MD, MHA, PHSAE, MNSA, CESO IV Director III, Office for Special Concerns

Dangerous Drug Abuse Prevention and Treatment Program

Introduction

• As of 9/22/2016:

712,730 surrenderers

• 1.8M - 3M dug users:

0.6 - 1% (18-30k) will be inpatient 99% (2.9M) will be out-patient (CBRP)

• 92% NCR Barangays affected

• 44 DATRCs: 15 DOH,>5.5k beds; 29 NGOs, >1.7k beds

Total = 7-10K beds

VISAYAS Western Visayas: . POTOTAN, ILOILO**

Cebu: ARGAO, CEBU / . MANDAUE CITY

Eastern Visayas: DULAG, LEYTE

NIR_______

MINDANAO Northern Mindanao:CAG. DE ORO Davao: DAVAO

CARAGA:SURIGAO CITY

Zamboanga: __SOCCSKSARGEN:___ ARMM:____

LUZON NCR: BICUTAN, TAGUIG CITY ** Ilocos Region: . DAGUPAN, PANGASINAN

Cagayan Valley: ILAGAN, ISABELA Central Luzon: PILAR, BATAAN Calabarzon: TAGAYTAY**

Mimaropa___________ CAR: __________

Bicol: SAN FERNANDO, CAM. SUR** MALINAO, ALBAY**

DOH Residential DATRCs in the PHIL.

GAPS

• for 99% (2.9M) outpatient: CBRP tru BADAC

• for 1% (30K) inpatient: lack 20K beds

• Priority policy recommendations:

–court order for surrenderers ?

- Monitoring CBRP & After Care

- Land ownership of DOH DATRCs

- Halfway house in LGUs, DATRCs/region

- For Mega TRCs: 100 beds/team, better manage

- SDN (continuum of care) /LGU or ILHZ

1.) DOH thru ROs & DATRCs:

- NCR trained MDs/district, - Reg.1 devised good algorithm,

- Reg.5 very good inter-agency collaboration

- DATRCs doubled, tripled their capacity

We meet RDs & DATRC Chiefs once/month to report

responses, plans, needs

Immediate Responses

2.) Inter-Agency Convergence

3.) Standard guidelines on voluntary surrenderers of drug users & dependents

http://www.ddb.gov.ph, email: Info@ddb.gov.ph

http://www.ddb.gov.ph/http://www.ddb.gov.ph/

4. Distribution of Manual

4. Temporary DATRCs in Military Camps

• Luzon: Fort Magsaysay, Nueva Ecija

• Visayas: Camp Gen.Macario Peralta Jr., Jamindan, Capiz Camp Rajah Sikatuna, Carmen, Bohol

• Mindanao: Saranggani

5. ADVOCACY

What to do with surrenderers?

6. Harmonization/Standardization of: Trainings, Algorithms, Forms, Halfway

houses, Standard Treatment Program for Mega TRC; Policy Recommendations

Activities • Every Tues.: TWG meet for establishment of Mega

DATRC

• Every Wed.: inter agency convergence meet

• 1st wk of the month: 2 days meet with ROs & TRCs;

• 1st wk Oct: IEC Materials Development; Museum contents

• 4th wk Oct: Develop Info System;

• 1st wk Nov: Train 1 MO/DATRC in Meth & alcohol detox

• 2nd wk Nov.: Strategic Planning

• 3rd wk Nov.: Review Standard lay out of DATRCs

• 1st wk Dec.: Plan to institutionalize DDAPTP

Plans

• Goal: Prevalence of drug abuse & its health-related effects are further reduced.

• Mission: Lead in the implementation of a unified & rational health response in the fight against drug abuse, through a more effective drug abuse prevention, treatment & rehabilitation.

What we want to achieve: 1. More effective leadership & governance for

drug abuse prevention, treatment & rehabilitation;

2. Provision of comprehensive, integrated

health care services in TRCs & community-based

settings;

3. Implementation of strategies for health promotion &

drug abuse prevention;

4. Strengthened information systems & evidence based

research.

We need to take an eye to the real target !

Abstain

Tx,

Rehab,

After-care,

& other

ancillary

support

services

Functional in

family, School

or work

& community

At Risk Population

3 Strategies Strategy 1 Establishment of additional facilities to improve

accessibility in areas without DATRCs & provide wider

coverage of service for clients with “severe substance

use disorders”

DOH 4 DATRCs in regions without rehab facilities

With Private

With LGUs

4 temporary Mega DATRCs in military camps

Halfway House to decongest regional DATRCs with

outpatient & after care services

Strategy 2 PhilHealth coverage to lessen burden of facilities & reduce out of pocket expense. Patients can avail of variety of evidenced-based tx programs not offered by government.

PhilHealth structured 2-mos. or 45 days program (required by IRR of RA 9165) for P40,000 tru PhilHealth… (for 20,000 patients, it will cost the government P800M/year

Strategy 3 Incorporate Drug Abuse Intervention in PHC Program - encourage participation of all sectors at the community to provide early interventions & advocacies that will prevent progression of drug user to drug dependent. Institutionalize DDAPTP in the community.

Activate ADACs & Mobilize LGU Health Units

-Capacity building of ADACs & LGU Health Center staff on: a) Community mobilization & networking b) Knowledge on addiction & tx c) Mapping & referral system for service providers d) Screening & assessment of clients e) Data management & monitoring of clients -81 Provinces, initial 50 LGU paramedics to be trained x 3 days (81 provincesx50 x3dxP1,800/day = P21,870,000.00) -Provision of Com-based manuals & IECs (81 provinces x 50 staffxP1,000 cost of manuals & IECs = P4,050,000) -Travel & other incidental expenses of resource persons (P1,000,000)

-Total Cost to prepare communities = about P26,920,000 Mobilize Stakeholders

Faith-Based & Private Organizations at the community knowledgeable in providing behavioural modification & value formation initiatives. Advocacy can be charged from LGU IRA (Sec.51, RA 9165)

How can we assist LGUs?

Through our Regional Offices:

• Technical assistance on:

- training of personnel

- establishment of DATRCs ( 1 / region)

- establishment of halfway house in areas near DATRCs

- admission to DOH DATRCs

- Community Based Rehab Program (CBRP)

• Policies/guidelines/standards

- Permit to Construct, License to Operate

- Algorithms (guidelines), Training Manuals, MOP

- Lay out, Staffing standards, Costing

- New Issuances e.g EO, MOA, DDB

100 Beds: P 248,194,800

• 1.5 hectares

• Master Site

Development Plan =

P158,263,200

• Land Development =

P10,800,000

• Medical Equipment &

Furnitures =

P79,131,600

Dormitory

Admin Bldng

Multipurpose Covered Court

Visitor Staff Building

Motorpool

Laundry Building

Kiosk/Canteen

Solar lighting

Entrance Powerhouse

Hydrotherapy

Landscape

Sewage Treatment plant

Halfway House: 50 beds satellite of DATRC

• Dormitory = P 8,424,000.00 • Multi-purpose Covered Court/Hall = P 9.9 M

Total: P18,324,000.00 Operationa annual cost: P 10 M

ACHIEVE!

`

Salamat po