Addressing Psychoactive
Substances Use in the
Philippines in the context of
Universal Health Care
Rodley Desmond Daniel M. Carza, MPH, RN
OIC - Chief, Policy, Planning, Standards and Research Division
Health Promotion Bureau
rmcarza@[Link]
We need to strengthen public health approach in drug policy
POLICY FRAMEWORK EFFECT SERVICES AVAILABLE
Republic Act 9165 Transfer of mandate and existing Court-ordered confinement for
Comprehensive Dangerous government-operated drug abuse treatment and inpatient treatment and rehabilitation
Drugs Act of 2002 (Repealing rehabilitation facilities from Philippine National
Dangerous Drugs Act of 1972) Police (PNP) and National Bureau of Investigation
(NBI) to Department of Health (DOH)
Dangerous Drugs Board (DDB) Guidelines provided on rehabilitation of drug users Court-ordered enrollment into an
Regulation No. 1, who are not drug dependent outpatient rehabilitation program
s. 2009
DDB Resolution No. 4, Establishment of pilot community-based recovery Voluntary enrollment into an
s. 2018 clinics outpatient rehabilitation program,
sans interface with law enforcement
DDB Regulation No. 4, Guidelines provided on screening, treatment, and General interventions and
s. 2020 rehabilitation services for low-risk drug users, Community-Based Drug
including the provision of Certificates of Completion Rehabilitation Programs
for submission to Local Government Units’
Anti-Drug Abuse Councils
[Link]
Existing legal frameworks limit access to substance use services
Court Catchment
Risk Level Intervention Facility Type
Order Population
Severe 66 DOH, LGU, or private Residential ~16,752
Inpatient Yes
SUD Treatment and Rehab Facilities (RTRF) (1% of PWUDs)
High Yes 7 DOH, LGU, or private Non-RTRFs
Moderate ~16,752
Risk Outpatient
SUD (1% of PWUDs)
No 6 LGU Recovery Clinics (RC)
~31,828
Mild SUD Yes
Community-Based (1.9% of PWUDs)
10 LGU CBDRP ℅ City/Municipal
Drug Rehab
Anti-Drug Abuse Council (ADAC)
(CBDRP) ~162,487
Moderate Risk No
(9.7% of PWUDs)
General 333 Accredited Physicians and Drug ~1,447,306
Low Risk No
Interventions Rehabilitation Practitioners (86.4% of PWUDs)
[Link]
The Philippines passed a Universal Health Care Law
Health Promotion in RA 11223
(Universal Health Care Law)
Section 30 Universal Health
Care Law
“The DOH… shall strengthen national efforts in reaffirms our
providing a comprehensive and coordinated commitments to a
approach to health development, with an emphasis human
on scaling up health promotion and preventive
care…
rights-based
A framework strategy for health promotion shall
approach to health
be formulated, which shall serve as the basis for focused on
DOH programs in increasing health literacy with population-based
focus on reducing non-communicable diseases, interventions
implement population-wide health promotion
programs and activities across social determinants of
health...”
[Link]
Health Promotion
Framework Strategy
2030
Provides the framework, direction, and
strategies for the planning, development, and
implementation of health promotion policies,
programs and activities for the period
2021-2030.
Life Stage Approach Settings-Based Approach
Implementation
Approach
Pregnancy,
Infancy and
childbirth, Childhood Adolescence Adulthood Older Adult
early years
neonatal Healthy Healthy Healthy
Communities Schools Workplaces
Priority Areas
Diet and Environmental Immunization Substance Mental Health Sexual and Violence and
Physical Health Abuse Reproductive Injury
Activity Health Prevention
Action Areas
Developing Creating Supportive Developing Personal Strengthening Reorienting
Healthy Public Policies Environments Skills Community Health Services
Action
[Link]
Life Stage Approach Settings-Based Approach
Implementation
Approach
Pregnancy,
Infancy and
childbirth, Childhood Adolescence Adulthood Older Adult
early years
neonatal Healthy Healthy Healthy
Communities Schools Workplaces
Priority Areas
Diet and Environmental Immunization Substance Mental Health Sexual and Violence and
Physical Health Abuse Reproductive Injury
Activity Health Prevention
Action Areas
Developing Creating Supportive Developing Personal Strengthening Reorienting
Healthy Public Policies Environments Skills Community Health Services
Action
[Link]
These are the targets for 2024 to fulfill Human RIghts Council Resolution 45/33
AREA SPECIFICS COUNTRY ACTIONS
Improve evidence-based prevention of drug abuse Development of Clinical Practice Guidelines for
Psychoactive Substance Use Disorders
Develop comprehensive, integrated, voluntary, and Institutionalization of pilot Recovery Clinic model as apex
evidence-based treatment of drug use disorders, of Local Government Unit (LGU)-led service delivery for
rehabilitation, recovery, and social reintegration drug abuse treatment and rehabilitation under the
Health Care Provider Network (HCPN)
Institutionalization of Community-Based Drug
Rehabilitation Programs (CBDRP) to secure and
Drug Demand
propagate public health approach in LGU Anti-Drug
Reduction
Abuse Councils (ADAC)
Domestic cooperation for consistent, holistic, integrated drug Co-chair with the Department of Social Welfare and
strategy, including academic/scientific/community/civil Development of the Rehabilitation and Reintegration
society-led forums, research, and policy conferences Cluster of the Inter-Agency Committee Against Illegal
Drugs (ICAD)
Prevention, treatment, and care of HIV/AIDS, viral hepatitis, Participation in Technical Working Group on Human
and other blood-nature infectious diseases via development RIghts-Based Approach to Drug Control
of treatment, care, and support packages
[Link]
These are the targets for 2024 to fulfill Human RIghts Council Resolution 45/33
AREA SPECIFICS COUNTRY ACTIONS
Alternative or additional appropriate measures on Chair Technical Working Group on Rethink of Legislation
incarceration in accordance with the Tokyo Rules (Standard and Policies for Psychoactive Substance Users with
Minimum Rules for Non-Custodial Measures) including participation by the Department of Justice and civil
public health crisis prevention, mitigation, and society organizations
communication strategies
Enhancement of access to treatment for Persons Deprived of Localizing CBDRP to prison settings to provide
Liberty (PDL), addressing specific needs of women in prison immediate relief to incarcerated PWUDs and equip them
through: family skills-based prevention training; for reintegration on release
Cross-Cutting
telemedicine for PDLs, training for jail and prison personnel
Issues
on HIV management in closed settings; connecting released
prisoners to community health providers
Proportionate and effective policies/responses, legal Lobbying for a public health focus in the development of
guarantees, and safeguards to criminal justice proceedings Senate and House Bills on institutionalization of ADACs
and the justice sector, including training on patient rights for
Anti-Drug Abuse Councils (ADAC), jail and prison staff, and
Persons Who Use Drugs (PWUD) under treatment and care
in prisons
[Link]
Key messages
● There is a shift from the criminal justice framework of 1972 to public health in
2002. However, we need to strengthen public health approach in drug policy in
the Philippines.
● Given the expansion of services from 2002-2017, the requirement of court
orders to receive and be released from treatment and rehabilitation may form
some barrier to health care and can be a source of stigma.
● Transition to deinstitutionalization begun with international partner-assisted
development of voluntary, community-based treatment and rehabilitation
modalities in 2018.
● Philippine co-sponsorship of United Nations Human Rights Council Resolution
45/33 provides action points for the country in achieving Human Rights-Based
Approach to Drug Control by 2024.
[Link]
Let’s work
together!
Addressing Psychoactive
Substances Use in the
Philippines in the context of
Universal Health Care
Rodley Desmond Daniel M. Carza, MPH, RN
OIC - Chief, Policy, Planning, Standards and Research Division
Health Promotion Bureau
rmcarza@[Link]
