Jasper Joy M. Dumaguing, Marivic P. Sonido, Eliza A. Quimque, Mark Gilbert S. Milallos, Jillian A. Bejoc
College of Nursing, Cebu Normal University, Philippines
*Corresponding Author’s Email: markmilallos@outlook.com
The purpose of this study was to describe the experiences of persons undergoing the community- based drug rehabilitation program in the City of Bogo, Cebu, Philippines. The focus was to uncover the stories of these people in order to gain a better understanding of their journey. The study was utilizing Husserlian’s descriptive phenomenology design. Using purposive sampling, seven (7) informants were identified. An interview guide was developed and validated; afterwards, a semi-structure one- on-one interview was conducted.
Four main themes emerged with theme 1: Wrong Turn with subthemes: (a) Curiosity, (b) Peer influence, (c) pleasure and desirable effects of drug use, (d) relapse before RERE continuing or long term drug use and (e) life issues; theme 2: Road Bumps and Blocks with subthemes: (a) interpersonal impact of drug use, (b) interpersonal impact of drug use and (c) extrapersonal impact of drug use; theme 3: Road to Recovery with subthemes: (a) acceptance of the existing problem,(b) reason for entering RERE, (c) intrapersonal challenges while on recovery process, (d) interpersonal challenges while on recovery and (e) extrapersonal challenges while on recovery process; and theme 4: Walking on the Right Path, with subthemes; (a) perception about RERE program, (b) perseverance to change,(c) renewal of intrapersonal aspect, (d) renewal of interpersonal relationship and (e) renewal of extrapersonal aspect: modelling and offering help to others.
The informants described their chaotic experiences of addiction and their decision and motivation to change. An increased in understanding of the life of addiction and struggles and hardships in recovery can guide nurses, social workers, policy-law makers, other LGU members and future researchers in dealing with this phenomenon.
Keywords: Drug Addiction; Recovery; Rehabilitation; Role Modeling
INTRODUCTION
Drug abuse and addiction increases worldwide and is defined as a chronic, relapsing brain disease that is characterized by compulsive drug-seeking and use, despite leading to the harmful effect as seen in people who abuse drugs (National Instituite on Drug Abuse, 2018). Its prevalence is continually high around the world (World Drug Report of the United Nations Office on Drugs and Crime, 2015). Around 246 million people slightly over 5%of those aged 15-64 years worldwide used an illicit drug in 2013 (UNODC, 2016). Many crimes are associated with drug use and the relationship between substance abuse and crime is constant in almost everywhere (Rafaiee, Olyaee & Sargolzaiee, 2013).
Illegal drug use is a significant problem due to corruption and poor law enforcement and appears to be on the rise in the Philippines (American Addiction Centers, 2019a) that the national government directed to incarcerate if these individuals and encourage them to undergo voluntary rehabilitation (UNODC, 2016). In effect, there is sudden influx of individuals in the country, who surrendered. Police arrest a total of 53,025 drug personalities, and a reported 1,189,462 persons “surrendering” to authorities, including 79,349 drug dealers and 1,110,113 drug users (Bueza, 2016). The influx of surrenderees and the cost for in-patient treatment and rehabilitation paved way to the community-based treatment approach among drug abusers. The researchers developed interest in the stories of drug surrenderees and discover deeper into their struggles and support system that motivates them to maintain drug-free days.
There is inadequate information about the experiences of the drug users, the effect of drug dependence, and their perspective on the Rehabilitation and Reintegration (RERE) program which was designed to help them holistically and specifically to maintain sobriety without any medical intervention. This also hoped to provide empirical inputs towards policy enhancement pertaining to drug rehabilitation.
METHODOLOGY
Husserl’s descriptive phenomenology design was used as an approach to explore and understand one’s everyday life experiences. Moreover, the methods of phenomenological inquiry seek to describe the meaning of experienced phenomena (Polit & Beck, 2008). This primarily described the experiences of persons enrolled in the Rehabilitation & Reintegration (RERE) Program managed by the LGU of the City of Bogo, Cebu, Philippines. Data saturation was reached with the 7th informant through an in-depth, face-to-face, and semi-structured interview. Interviews were audio- recorded, transcribed and translated to English. Collaizi’s method was used in data analysis, culling out, organizing and analyzing the narratives (Shosha, 2012).
RESULTS AND DISCUSSION
Table 1 shows the profile of the key informants. The average age was 42 years with 50 as the oldest and 31 as the youngest. Six out of the 7 key informants were male, 4 were already married and 3 were single, moreover, 6 of the 7 already have children. The average age of the start of drug use is 21 years old with 32 as the the oldest and 15 as the youngest. The average duration of drug use is 17 with 21 being the longest and 12 as the shortest. All key informants reported to be clean and sober for more than 1 year at the time of their interview.
Informant | Age (years) | Sex | Civil Status | Children | Age (in years) started Drug use | No. of Years in Drug use | Time sober (during time of interview) |
Informant 1 | 31 | Male | Single | 0 | 15 | 14 | 1 year, 6 months, 27 days |
Informant 2 | 46 | Male | Married | 2 | 16 | 12 | 1 year, 10 months, 21 days |
Informant 3 | 33 | Male | Married | 5 | 19 | 13 | 1 year, 9 months, 9 days |
Informant 4 | 46 | Male | Single | 2 | 17 | 27 | 1 year, 10 months, 4 days |
Informant 5 | 43 | Male | Married | 1 | 23 | 15 | 1 year, 6 months, 14 days |
Informant 6 | 50 | Female | Married | 10 | 23 | 23 | 1 year, 1 month, 16 days |
Informant 7 | 48 | Male | Single | 0 | 32 | 15 | 1 year, 3 months, 15 days |
Thre were 268 significant statements and 20 formulated meanings identified from the transcripts of the seven key informants. Four (4) clustered themes and 19 subthemes emerged: Theme 1: Wrong Turn, with subthemes: (a) Curiosity, (b) Peer influence, (c) pleasure and desirable effects of drug use, (d) relapse before RERE continuing or long term drug use and (e) life issues; Theme 2: Road Bumps and Blocks with subthemes: (a) interpersonal impact of drug use, (b) interpersonal impact of drug use and (c) extrapersonal impact of drug use; Theme 3: Road to Recovery with subthemes:
(a) acceptance of the existing problem,(b) reason for entering RERE, (c) intrapersonal challenges while on recovery process, (d) interpersonal challenges while on recovery and (e) extrapersonal challenges while on recovery process; and Theme 4: Walking on the Right Path with subthemes;
(a) perception about RERE program, (b) perseverance to change, (c) renewal of intrapersonal aspect, (d) renewal of interpersonal relationship, and (e) renewal of extrapersonal aspect: modelling and offering help to others.
This encompasses the start and reason for drug use where it was discussed that it started through curiosity and peer influence and because of the euphoric state produced by the prohibited drugs, they continue to drown in this pleasure and desire. Realizing after that drug use is not the answer for everything but can be the culprit of all the mishaps in life. Some realized that the effect of drugs does not only reflect internally; but also, echoed externally on their family and society. They tried to forget these unwanted experiences of life and start a new one, but temptations and cravings were always present that relapses. Guilt and frustration kicked in making them helpless. They were used to a life of obsession to drugs that made them indulge a decade or more of blaming it to the life issues they have.
Curiosity was the ignition that started as wondering on what drugs can do and eventually trapping themselves. It started as questioning how it feels and what it is like. The normal drive in children and youth to simply try whatever they see others doing is enough to account for the actual initial drug experience. Curiosity, a personal problem and recognition among peers are often the cause of initial drug use (Mesic et al., 2013).
Informant 2 narrated, “Permiro tilaw-tilaw nahimong bisyo” (At first I just tried it until it becomes a vice).
Additonally, Informant 4 discussed on how he started using drugs. “Naa toy bisita gikan sa syudad nisulti “hubog namo tanan, kinahanglan na ninyu pasuyupon ug shabu inyong driver para malikayan ninyu ang aksidente pag pauli. Unya curious pod ko unsa nang shabu” (There was this visitor from the city telling us “You’re all drunk, tell your driver to use shabu to prevent any accidents on the way home. Then, I got just curious what shabu is.”
A peer is someone whom you share the same beliefs, likes, hobbies; a companion during times of challenges. Peer influence directs an individual to follow their peers by changing their attitudes, values or imitate those of the influencing group or individual. Others have low self-differentiation which makes them vulnerable to take unwanted things such as illegal drugs. Foo, Tam, & Lee (2012) said peer influence is one of the factors causing drug abuse that starts with suggesting and persuading into trying out the substance and providing them with the source. Some try out drugs in many different ways in a group too. Adolescents and young people from juvenile gangs have a higher risk of consuming addictive substances. (Facundo & Pedrão, 2008).
Informant 2 narrated, “Barkada ang naka impluwensya nako pag-permiro na musuyop” (My friends first influenced me to sniff).
Also, Informant 4 relayed, “Gi-mpluwensyahan ko sa akong mga amigo, sila ang nakaingon. Kanang ma safety daw mikong ang driver (informant) makagamit ug shabu ug nakainum nasad mi tanan, mao tong nakatilaw jud ko” (My friends influenced me, they are the reason. That we will be safe if the driver (informant) has taken shabu and we are all drunk, that’s why I was able to taste it).
People continue to use drugs because it gives comfort, confidence and other emotional completeness. It gives them the physiological and psychological relief and they keep on wanting and experiencing it and escapes from the reality of life. Certain drugs can cause temporary pleasing side effects if it is used continuosly; specifically, methylenedioxymethamphetamine (MDMA) can increase ones socianility and amphethamines has stimulant effects that can improve attention, memory and concentration (Morgan et al., 2013).
Informant 6 stated, “Mao nato nga time nga mawala akong depression kay naa ko sa lingaw lingaw so dili ko kahuna huna sa akong problema, so inig gamit namo among kalingawan ato kay mag- inom, manisco”
That’s the time that my depression will be gone because I am in happy spree so I cannot think of my problems, so when we use drugs, we get drunk, go to disco.
Relapse happens because peers and stress as narrated by the key informants and also due to susceptibility. Relapse is common for drug users (Chie et al., 2016) and that peer pressure is the most common cause of relapse (Sau et al., 2013). Chie et al., (2016) added that lack of family support and lack of self-efficacy are other common causes of relapse. During emotional relapse, individuals are not thinking about using and often recall their last relapse and they don't want to repeat it; however, emotions and behaviors would push them back. Moreover, denial take a big factor of emotional relapse (Melemis, 2015).
Informant 4 said, “There was a time na akong amigo nibisita ug nanghutana “kumusta ta?” Unya paglakaw sa ako mama kay mupalit ug prutas, niana pod ning isa sa akong mga amigo “kung ok T, naa ko dala diri isa”. Unya tungod sa akong pagkadisperado na mag undang pero wa pa koy kusug muundang ug idiya unsaon pag undang, natintal nasad ko na mugamit ug shabu. Bisag na admit ko nigamit gihapon kog shabu.” (There was a time that my friends visited me and asked, “how are you ta?”. Then when my mother left us to buy some fruits, one of my friends said “if okay Ta, I have brought here one” (referring to drugs). Then out of my desperation I want to change but I still don’t have the strength to stop and the idea how to stop. I was again tempted to take shabu. Even I was admitted I still use shabu).
Drug addiction is a life-long experience by the key informants. Drug abuse among teens and college students has a detrimental effect on academic performance. Young people are more susceptible to the short- and long-term cognitive effects of drug abuse while the social and emotional consequences further increases risk factors for problems in school (American Addiction Centers, 2020b). A person addicted to illicit drugs will at some point find it difficult to maintain their responsibilities. Addiction affects people in all age demographics and in every walks of life (Silvermist Recovery, 2018). Eventually, educational background of the victims were affected and many opportunities were lost.
Informant 1 relayed, “14 Years sa pag gamit ug drugs. Tungod sa ako-ang pagka addict Ma’am naabot ko ug napulo ka tuig sa akong college ug upat ka courses ma’am. In my 14 years sa akong pagsuyop maam, naa sad tuy time nga nakarealize ko nga sayup akong gibuhat.” (I’ve been using drugs for 14 years. Because of me being an addict Ma’am, I reached ten years with my college and four courses ma’am. In my 14 years of snorting ma’am, there was also a time that I realized that I was doing wrong.)
Certain life issues can push one to take take illegal drugs. A bad family relationship pushed the key informants towards drug addiction. Having bad familial relationships can often lead to drug addiction as an escape from reality due to the relaxing psychological effects of drug use (Pathak & Pokharel, 2017).
Informant 6 stated, “Nigamit lang jud ko ato kay tungod sa situation sa among family ba, broken family man mi from the start,” (I was able to use drugs because in my situation of our family, from the start I came from a broken family).
Theme 2: Road Bumps and Blocks
This focused on the consequences faced in relation to drug use in matters of intrapersonal, interpersonal and extrapersonal factors. It affects the comprehensive aspect of an individual which includes person’s perception, psychological, physiological aspect of a drug user, family and socioeconomic aspect. Drug abuse injures the individual life and can lead to dishonor, distrust and loss of self-discipline. It comes to a point that key informants were frightened of their lives and are depressingly shaken by family connections. Loss of trust and respect, poor economic management and self-centeredness and indulgent to drugs tears down their family bonds. Drug addiction controls on financial features among informants. Stealing, loss of job and unpaid necessary bills were experienced.
Intrapersonal impact of drugs on an individual affect his perception and how he sees things. It is how situations inside his mind is undertaking and his awareness within himself were disturbed. It has affected his physical, al and socioeconomic features as an individual (The Cabin Group, 2015).
Informant 1 stated, “Kay kanang everytime mosaka akoa cravings ma’am and wala ko’y kwarta, manghagis man ko sa balay.” (Because every time my cravings raise ma’am and I don’t have money, I would spoil for a fight at the house.)
Informant 4 also narrated, “Ni surrender ko atong time-ma para lang malimpyo akong ngalan sa mata sa mga pulis kay naa naman ko sa wanted list og drug pusher pod ko. “Nisurrender lang ko para lang malimpyo akong ngalan pero nig uli nako mugamit gihapon kog drugs pero wan-a ko mamaligya” (I surrendered that time just to have my name cleaned in the eyes of the police because
I’m already on the wanted list and I am a pusher. I just surrendered just to clean my name but when I get home, I still use drugs but I don’t sell anymore).
Drug addiction depressingly upsets family connection, and this discusses on how familial relationships were negatively affected. Drug abuse not only harms the addict; but it destroys relationships and create emotional turmoil for significant others as they witness and experience a family member’s drug dependence (The Cabin, 2015). Coming down from drugs can be compared to an alcohol hangover because as the substance leaves the body, the user may experience uncomfortable physical, mental and emotional withdrawal symptoms wherein users may experience a spike in pains accompanied by queasiness or nausea, and a change in mood state, among other symptoms (Alta Mira, 2019). Moreover, drug use may cause aggressiveness such that significant others can be subjected to abuse from them (Holloway, 2018).
Policies related to the War on Drugs have caused the number of people arrested, convicted, and incarcerated for drug-related crime to increase drastically (The Center for Prisoner Health and Human Rights, n.d.) Half of all the individuals arrested for a serious crime, such as, murder, robbery, and assault, were under the influence of an addiction, and usually illegal, substance. Society then must pick up the cost for the law enforcement, court, and incarceration (The Cabin, 2012). Those who were detained experienced depression and having troubles with judgment and mental condition of an individual is challenged. Additionally, the loved one living with an addict may have an increased level of frustration, causing them to express anger or act out violently against the substance user (Patterson, 2019). Sharma (2009) said that this can destroy relationships between family and friends.
Informant 1 expressed, “Nya sauna ma feel na gyud nako nga ako na’y kahadlukan sa among balay, dili na akong papa. Akong papa mahadlok nas ako-a, kanang masuko ko. Gawas sa ilang pagsalig nga nawala, ang worst gyud nga nahitabo, akong respeto sa ilaha (ginikanan) nawala.” (Before I could feel that I was being scared of in our house and not anymore, my father. My father is already scared of me, when I get angry. Aside from the trust that was lost, the worst that happened, my respect from them (parents) was gone).
Informant 3 narrated, “Akong mama nawad-an pagsalig sa akoa, naguba ilang pagsalig sa akoa. Naa koy akong own family, naa koy lima (5) ka anak sa iyaha, nagbuwag mi mao nay worst thing na nahitabo sa akong druging time. Nabuak akong pamilya, mao nay usa sa epekto” (I lost the trust of my mother in me, their trust in me was broken. I have my own family, I have 5 children, and we broke up with my wife that is the worst thing that happens during my drugging time. My family broke, that is one of the effect of drugs).
Drug addiction affects individuals financially due to the eagerness to use drugs, as a result they tend to use the money which was intended for other family needs and bills. This leads to problems at work, including decreased productivity, inefficient work and job loss. In the long run, persons engaged in illicit drug use, will be financially burdened. Hence, to sustain their habit, they may resort to stealing money or anything of value from their family members or anyone. Ultimately, this will lead to strained family relationships, loss of property or breadwinners having difficulty in providing basic needs for their respective families (The Treehouse, 2018; The Cabin, 2015).
However, reality shows that society is not always kind to people who suffer from addiction. People wrongfully believe that those who abuse alcohol or drugs are “less-than” and often view them as disgraceful, moral failures or weak. Ultimately, the stigma of addiction has the potential to adversely affect a person’s self-esteem as well as damage relationships (Clearview Treatment Programs, 2019). People are significantly more likely to have negative attitudes toward those dealing with drug addiction than those with mental illness (Desmon & Murrow, 2014).
Informant 2 stated, “Lahi, mga silingan lain na gyud ang tan-aw sa imuha. Kanang murag wala najuy salig sa imoha unya likayan ka. Lain man ilang huna huna. “Even sa amo-a sauna nganlan mig adik masuko gyud mi.” (Even my neighbors look at me differently. Seems they don’t believe you anymore and avoid you. They think differently. Even in our place before, when we were called as addict, we then get angry).
Informant 7 expressed, “Sukad nako pagsurrender niundang naman ko kay mauwaw naman ko mobalik.” (From the time that I surrendered I stopped working because I feel embarrassed).
Theme 3: Road to Recovery
Turning point in drug addiction could be influenced by both internal and external factors that starts with personally admitting existence of the problem and contemplating to change. According to Turnbridge (2019), the time in which an addict hits the bottom can be the most memorable point of his journey. It is in this moment that he will be in a dilemma. At one point, he realizes he can no longer exist under the influence of drugs, but at the same time he feels helpless without them. In the end, their motivation towards change will be at a crossroad as they would feel having no one to turn to and assist them to change.
Simply acknowledging a problem creates a room for a positive mindset towards behaviour change. The person is open for ways on how to solve those problems. Recovery from drug addiction is a time to self evaluate oneself. Building self-awareness helps make the recovery from drug use more lasting change in behaviour. Stokes, Schultz, & Alpaslan (2018) explained how accepting the ‘disease concept’ or having ‘a lifelong illness’ allowed them to start taking responsibility for change.
Informant 1 said, “First step kay acceptance. Kinahanglan nimo dawaton nga naa kay sakit. Unsaon nimo pagkaayu sa imong sakit kong dili ka mudawat nga naa kay sakit.” (First step is acceptance. You need to accept that you have a disease. How will you heal from your disease if you won’t accept that you are sick)?
Informant 4 shared, “Kondisyon ni siya na ikaw ray makaayu. Sakit na wala juy tambal na mapalit sa mga botika pero ikaw rajud ang makaayu sa imo kaugalingon.” (It’s a condition that only you can cure. Disease that doesn’t have any medicine that you can buy on drug stores that can ease those cravings. You can’t buy any medicine but only you can heal yourself).
Being self aware of the wrongdoings it is difficult for substance abuser, but it is also another daunting task for them to actually consider. Informants look up to other substance abusers enrolled in RERE program who successfully rebuilt life, family and community relationships and made it their personal strongholds in their journey to sobriety. Informants were motivated to change seeing other RERE members to have restored and ironed up interpersonal and family relationships. Other informants shared that the ill effects of drug use in their family made them realize that a need to change is substantial in order to maintain the family strength and stability. Learning and making decisionare is usually based on what we’ve seen among peers or role models. The ability to abstain from using is either built up or weakened by how individuals see other people resisting or giving into drugs (American Addiction Centers, 2020b). Negative consequences and its consequences of being a drug user served as reminders and strategy in sustaining recovery (Stokes, Schultz, & Alpaslan, 2018).
Informant 3 shared that, “Na-realize nako nga gusto ko mobarog, gusto nako ma-completo ang pamilya. Didto ko naka-realize nga magbag-o ko, mag sogod ko, naa pa koy mga anak, kay among mga anak naa man sa akoa, mao to nisud kog RERE.” (I realized that I want to stand up, I want my family back whole again. That was the time I realized that I needed to change, I will start again, I have children because our children were with me, that’s why I entered RERE).
Informant 4 stated, “Naluuy ko sa akong mama kay permi lang siya nerbyuson. Usahay magpanic na sya. Usa nas mga rason na niundang kog shabu ug niapil og RERE para mausab ko.” (I felt pity on my mother because she is always nervous, sometimes she would panic. That is one of the reasons that I stopped shabu and joined the RERE for me to change.)
Recovery from addiction is not an easy task. It is an on-going effort of giving in and resisting the use of drugs. One of the hallmarks of drug addiction is cravings. Having a strong desire of using drugs among participants made them feel vulnerable. On the process of recovery, the informants narrated how temptations from old acquaintances lured them and how they felt about it. They also openly discussed their feelings when they relapsed. Physical and psychological withdrawal symptoms were felt by the informants in the early phase of their recovery. It is evident that while recovery is still on-going struggle and relapse is more of a reality for some (Fredericks & Samuel, 2014). According to Wiendels (2017), withdrawal management is crucial for individuals who are trying to enter recovery, and the probability of maintaining sobriety increases significantly when clients receive supportive treatment sessions during this time.
Informant 2 stated, “Pero ang temtasyon naa jud na permi mam samot na anang makita nako akong mga barkada sa una.” (But temptations are always there, ma’am, especially when I see my old friends).
Informant 3 mentioned, “Niabot sa punto nga, ang wala nako na bukton dili na nako maisa, dili na kadaog og kutsara katong 1st month na wan-a ko mugamit. Inig uli nako mam balik nasad ko og alone, lonely ko” (It comes to a point that I cannot lift my left arm; my hand cannot hold a spoon during the 1st month that I didn’t use (drugs). Every time I went home, I felt alone, I felt lonely).
The informants commented on how they feel when their family has doubts on their journey to recovery. Family support is vital in recovery of drug addiction. Family is the basic source of attachment and provides emotional needs to every member. The addiction has had an impact on on the drug users. As addiction is a family problem, recovery has to include the whole family on the journey together, whenever possible, in order to beat the addiction (Clancy, n.d.). The impact that a family member’s drug use has on the whole family and every aspect of family life is profound. The general impulse to manage and contain the problem was almost always found to create more problems than solved and most usually led families to the distressing position of having to exclude the drug user whether temporarily or permanently (Barnard, 2005). Re-establishing relationships and direct family involvement in treatment is rare as this may be linked to participants’ feelings that they still had some way to go to convince family members despite their positive progress (Duffy & Baldwin, 2013).
Informant 2 stated, “Unang buwan, akong anak babae dili jud mutuo nga nag attend ko ug RERE. Lunes ug Huybes mukuha jud oras namo pero nag- attend gihapon ko sa program bisag nagduda akong anak. Mao to katong akong anak niana na “di ko mutu o nimo ui na niapil ka sa RERE, nisuyup gihapon ka” (On the 1st month, my daughter doesn’t believe me that I am attending RERE. Monday and Thursday, it would take time from us but I still attend the program despite the doubt of my daughter. My daughter said “I don’t believe you joining the RERE, you still use drugs).
The following statements among informants narrates their experience of rejection and stigma in the community where they lived. Stigma on people who used illegal drugs is very high as they are always viewed as dangerous and unpredictable, unable to make decisions about treatment or finances, and to be blamed for their own condition (Yang et al., 2017). Furthermore, stigma can lead to to negative emotional reactions like pity, anger, fear, and a desire for social distance resulting to force treatment on individuals and restrict them from responsible societal roles (Yang et al., 2017).
Informant 1 expressed, “Ahh I really hope nga naa say lugar ba nga maapply ni nila nga program. Bisan asa ka ma’am, I know kung unsa ka paet ang life sa usa ka adik. Unsa ka lain ang feeling nga e-deny ka sa community.” (Wherever you are ma’am, I know how hard a life of an addict is. How strange the feeling is to be denied by the community).
Theme 4: Walking on the Right Path
This talks about how the informants remain to be sober. It tackles about their perception about the RERE program, their perseverance to change, the renewal of intrapersonal, interpersonal and extrapersonal aspect and how they modeled their life to the community.
This talks on the different perception of the informants about the RERE Program. Informants have different views about the RERE program. Hesitation to join the program were felt by some informants. The RERE program was perceived by the informants as the necessary support, guidance and strengthens them in avoiding use of drugs again. The informants found a new bond of relationship while in the program with same goal and that is to change their addiction. Support system is necessary in the recovery process among drug addicts. Social support can be very powerful and beneficial force in the recovery process. The benefits include (a) a sense of belongingness and inclusion, (b) sense of safety and security, reduced stress, (c) decreased isolation and loneliness, (d) an enhanced sense of meaning and purpose, (e) hope and optimism about the future, (f) the opportunity to escape the narrow of one’s concerns, and (g) it can counteract shame, isolation and secrecy (Horvath et al., 2019). It has been their source of support when they are weak, it provides them help and guidance on recovery, their sobriety holds longer because of the program. By the help of RERE they now don’t crave for drugs. They are counting on their clean time or the absent of drugs in their body. The RERE program motivates the informants to embrace changes through the regular conduct of drug test.
Informant 1 stated, “Ang RERE maam nagtabang sa usa ka adik ug pag-bag-o through support group Ma’am. Nagsuporta sa usag-usa para sa pagbalik sa community.” (The RERE maam helps an addict to change through support group Ma’am. Supporting each other for reintegration to the community).
Informant 5 added, “So swerte lang nga naa ang program karon nga niagak nako so sa hinay-hinay nausab gyud.” (So, I am lucky that the program is there to guide and slowly changed me).
Addicts start getting better when they take responsibility for their own sobriety. Notably, the regular drug test in the RERE program has been considered as one of the motivational factors for change among key informants. Motivation involves recognizing a problem, searching for a way to change, and then beginning and sticking with that change strategy. There are, it turns out, many ways to help people move toward such recognition and action; furthermore, the treatments centers on the clients' motivation to change has often been the focus of clinical interest and frustration. Motivation has been described as a prerequisite for treatment, without which the clinician can do little (Center for Substance Abuse Treatment, 1999). Addiction is a complex but treatable disease that affects brain function and for this reason, abusers are at risk for relapse even after long periods of abstinence. Willingness and perseverance to change is central to addiction recovery. Recovery requires a leap of faith, backed by the willingness to admit a problem and take responsibility for your choice along with motivation to work a program or recovery (Sack, 2012).
Informant 1 stated, “Sa ako kaugalingon, sa akong pag usab. Wa ko mag usab para maprove sa ubang taw nakaya nako. Nag usab ko para sa ako kaugalingon. Daghan kaayo ko butang gihunahuna ug kong maghunahuna pa ko sa mga gipangstorya sa mga taw, it will make things complicated.” (Within myself, with the change I had. I didn’t change to prove other people that I can. I changed for myself. I am thinking of many things and by thinking what other people say it will make things complicated).
Informant 7 stated, “Sa RERE gyud Maam noh, ang para nako effective kay kanang regular nga drug test. Ang drug test ang nakatabang sa akoa Maam nga di mugamit ug drugs” (In RERE Ma’am, for me the most effective is the regular drug test. The drug test helps me Ma’am in not using drugs).
The action stage of recovery is challenging one. This is the stage at which real change starts happening. With the help of RERE program the informants were able to start anew with their life. Change can happen and this is what the informants is proving. That recovery from addiction can happen just like them. Drug abusers don't recover from an addiction by abruptly stopping or withdrawing from it. Recovery is by creating a new life which has ultimately motivated them to shun away from drug use (Melemis, 2015).
Informant 1 stated, “Feeling nako normal na ko nga tao nga, dili pareha sauna, wala na’y gikahadlukan. Nindot gyud kaayo siya pero dili ingong nga perfect nga kinabuhi kay wala man gyuy perpekto nga kinabuhi and nakanindot karon kay nadawat nako ba ang nahitabo nako sauna. One day at a time hangtod nga hinay-hinay lang ma’am. Wa nako kabantay gani nga nausab ko.” (I could feel that I am a normal person now, not the same as before, fearless. Now, though it is nice. It is very nice but not that perfect life because there is no such thing as perfect life and what is good now is that I was able to accept what happened to me before. One day at a time, slowly and slowly only ma’am. I didn’t notice that I have changed already.)
The informants stated that changes happened with his relationship to his family after participating in the RERE program. Substance abuse has an impact on interpersonal relationships. It can destroy family relationships and causes disharmony at work. When an addicted person starts on the road to lasting sobriety and is recovering from a pattern of drug abuse, he also needs to restore his/ her interpersonal relationships. He/ she needs to renew his/her relationship with his/ her family and friends. This is needed in order to be successful in recovery (American Addiction Centers, 2020).
Informant 1 said, “Dayun, sa family aspect sad nindot na kayo, dili na sama sauna nga gubot kaayu.”(Then family aspect is already very well not like before which is very chaotic).
Informant 5 also added, “So karon kay lipay na gani kaayo ang bata kay… murag lambing baya gyud kaayo nang bataa sauna, nalipay siya nga nausab gyud ko. Labi na kay naa na ko’y trabaho ba nga matawag nato nga tinarong na gyud ba” (Right now, the child seems happy. Happy because I changed. He is sweet even before. Especially right now that I already have a proper work).
Role modeling, drug symposium among youths and offering a helping hand are the intent of the mission. Job availability and recovery of lost properties were experienced by the informants on their recovery process. Finding value and purpose through experiential sharing was added up to the motivation to change among the informants. Sharing the recovery story with another person make the story more real. This has been the strategies of the peer group to encourage and support other recovering drug addicts (Gallagher, 2017).
Support groups and restored relationships can be great ways for people to find an encouraging community in recovery, but these communities also allow recovering addicts to return this encouragement to other people who need it (Foundations Recovery Network, 2014). Recovering addicts and alcoholics are held accountable by their peers which is key to maintaining sobriety. Once the victim become willing and able to be of service to the community, they in turn, develop a greater sense of purpose and belonging. Sharing his or her experience, strength and hope with others in need becomes the greatest gift of sobriety for the recovering person (Clancy, n.d.).
Informant 1 stated, “Na tungod na pag ka adik nimo. Kadtong nawala nga support sa akong pamilya ma’am diri to nako nakita sa akoang pamilya sa RERE. Pinaka-importante siguro na nabuhat namo, para lang nako is to hatag ug drug awareness for those sa wala pa gyud nakasuway, sa mga teens maam nga wala pa kasuway. Dili mi related kanang sa medicine, dili mi nurses, dili mi doctors nga makahatag ug unsay mga explanation in science but through our experience nga dili ingon anah ka nindot. Hinaut nga makatabang ang among mga bati nga experience sa katong mga drug dependents karon nga nag undergo ug drug rehabilitation but the best gyud siguro is to end drug addiction. Kadtong drug awareness sa others, sa uban kay the more nga e-share nimo ang kuan. ang imong kinabuhi kay the more nga ipagawas nimo ang imoha mga past ma’am, the more nga makamove-on ka. Imong secrets. Mga secrets nga nag burden sa amoa.” (Those lost support from my family ma’am, I saw it here in my family in RERE. The most important thing that we have done, just for me is to give drug awareness for those who have not yet tried, to the teens ma’am who have not yet tried. We are not related with medicine, we are not nurses, we are not doctors, who can give the explanation in science but through our experiences which is not that good. Hope our bad experiences would also help those current drug dependents who undergone rehabilitation, but maybe the best thing to do is to end drug addiction. That drug awareness to others, for others the
more you share your life the more you expose your past ma’am. The more you can move on. Your secrets. Secrets that burdens us).
Exhaustive Description
Drug addictions brings chaos to one’s life and the recovery is a long path ahead with tons of challenges. Experiences on addiction and recovery offers an eye-opener as key informants narrated, “we have work in progress and not in perfection.” This covered experiences from the start of drug use to the current state while being in the RERE program.
The ignition of drug use was due to curiuosity and peer pressure and it continued due to the pleasure and other euphoric effects that lead to addiction that slowly consumed their lives. Drugs use created a huge wall that separated them from reality which was then taken down as undesirable effects kicked in like destroyed social relations between families and friends and the stigma felt from their communities. The road to recovery was a huge struggle as cravings and temptations feed their thoughts. Being susceptible and helpless, multiple relapses occur as they drown into the lies of drug use. Struggling with the addiction, they want to start a new life, but the shadow of yesterday’s memories keeps them from moving forward. They then embrace addiction for a long time.
The consequences of drug use affected them holistically. Families were distressed that lead to depression and suicidal attempts. Aggresiveness affected their entire environment. Some challenges included the stigma faced, distrust, and loss of self-discipline. Others confessed to a life of crimes to feed one’s craving. Socioeconomic status becomes unstable due to drug effects and stigma. The fear of incarceration and being killed became the the voice that keeps on knocking their soul and mind, knocking to stop and start a new life but they were directionless.
Recovery started when addiction was recognized as a problem that became one factor in enrolling for RERE. Once realized that recovery can restore personal, family and community relationships, determination and motivation flourished. Members of the program are very helpful and supportive of each other especially when tempations and withdrawal sypmtoms appear. The loving support of family is profound in one’s intention to get clean. Social stigma and preconceived judgments were one of the obstacles felt while on the process of becoming sober.
Choosing sobriety every day was one impactful step. Doubts and confusion about the program were then replaced with high hopes. The conduct of regular drug testing made them to persevere towards recovery. They felt that being whole again and with the help of the program, a new meaningful life is about to start. The program aided in mending broken relationships that were once shattered. Experiences were shared among them as a source of motivation during group discussions. The program initiatives supported the recovery and role modeling among enrollees. Maintaining sobriety and helping other became a key outcome.
CONCLUSION
Community-based Drug Rehabilitation was questioned in terms of sustainability, effectiveness, impact and success. Yet, the experiences of the informants show that it can be done. The road to recovery is a long process, starting from acceptance to maintaining sobriety while facing different challenges including stigma, relapse and fragmented relationships. However, the desire to change can help the recovery process. Like any person, these individuals may sometimes fall, then find the strength to stand up again and continue while some would choose to give up and let go. Despite hindrances, being hopeful, positive and grateful of the program helped them in their quest to sobriety. Hence, they end up victorious in their journey. The support and encouragement of their family, friends, and the community plays a vital role for them move towards change. Support received from their co-recovering drug addicts and family can help them grasped that they are not alone in the journey.
Recommendation
Based On the Study Findings, The Following Recommendations Can Be Made:
Local Government Units (LGUs) or surrounding towns or cities need to benchmark on the good practices of the RERE program.
Monitoring of the clean time of the informants was found to be effective in motivating sobriety of the recovering drug dependents.
LGUs and Rural Health Units should also strengthen drug awareness campaign to prevent susceptible individuals from dwindling to addiction, prevent stigma and encourage community support.
Furthermore, Future Researchers Can Focus on The Following:
Conduct evaluation studies to determine areas in the program that could be improved further.
Explore the sobriety of recovering addicts who engage on other substances such as alcohol, marijuana and the likes.
Expand study to community - based drug rehabilitation program in other communities.
Conflict of Interests
The authors declare that they have no conflict of interest.
ACKNOWLEDGEMENT
The authors are thankful to the institutional authority for completion of the work.
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