Rehab centers: Safe havens for addicts

Rehab centers: Safe havens for addicts

JAKARTA (JP): Psychiatrist Al Bachri Husin established Wisma
Adiksi (Addiction House) in late 1998 using his own money because
he witnessed an overwhelming upsurge in the number of drug
abusers that existing health facilities simply could not cope
with.

A shortage of facilities for post-detox patients and
rehabilitation centers, as well as an environment which was far
from supportive, were other reasons why Al Bachri, or Al to his
friends, set up his own institute. A previous failure in running
a similar clinic convinced the doctor that the facility should be
run professionally and profitably without becoming a commercial
enterprise and sacrificing its original altruistic goals.

Residents who come from various backgrounds pay Rp 3 million
per month -- a much lower fee compared to many other
rehabilitation centers. "If there were no operational costs, I
would have made the facility free of charge," he said.

The Addiction House is located at Jl. Jati Indah I No. 23,
Pangkalan Jati, Pondok Labu in South Jakarta. It brings together
drug abusers within a community under a special program to
encourage them to heal one another. Applying the therapeutic
community (TC) approach, rehabilitation efforts are the focus of
the Wisma's program.

The treatment methodology is also integrated with the well-
known "Twelve Steps" for drug addicts, as well as religious
counseling for residents. A number of professionals are involved:
psychiatrists, educators, social workers and religious teachers.
Even former addicts are hired to take care of the Wisma's daily
operations.

The program consists of the primary phase for three to four
months, the senior phase for two to three months, reentry phase I
for three to four months and reentry phase II for two to three
months.

The emphasis in the first phase is on recuperating through
individual and group therapy aimed at instilling discipline,
awareness of the problem and responsibility and honesty toward
oneself. The phases that follow are geared toward helping
residents make the transition and reintegration into "normal
life" in their family and the community.

In the later stages, residents are assisted in planning for an
independent future. At this stage, family members are involved so
they will be more supportive of the residents.

Nearly 200 people have been treated in the Wisma, with 65
percent of them having been declared "cured." "I don't guarantee
that everyone will be cured, but at least this method works
better than the previous one that I used," Al said.

Chilam, a former addict now working as a staff member at the
Wisma, agreed. "I feel that my life changed for the better after
I entered the Wisma," he said.

In Bogor, West Java, there is the Wijaya Kusuma Sports Campus,
a rehabilitation center run on the principle of the therapeutic
community. It is the only rehabilitation center with an on-site
24-hour doctor.

There are now 23 residents participating in the primary
program and 12 residents in the reentry program in its facility
on Jl. Hang Lekir, South Jakarta.

Wijaya Kusuma Sports Campus has eight staff members for the
primary and four for the reentry program to prepare residents to
reintegrate with society when they leave. More than 15 addicts
have successful finished the program.

The center was established in October 1999 by Dr. Mohammad
Sarengat, the fastest runner at the 1962 Asian Games who won gold
and bronze medals). His motive for opening the center was
personal because his own son, Andung Sarengat, was then a drug
addict.

Andung was at the time treated at a rehabilitation center in
Kuala Lumpur. He was later trained in the six-week program for
substance abuse counselor training at Kusuma Wicitra. He is now
the program manager of the Reentry House at Wijaya Kusuma.

"The basic program of Wijaya Kusuma is therapeutic community,
with sports being supplementary," said Andung.

"This is not a place where we force people to do sports. At
Wijaya Kusuma we can play basketball, soccer and all kinds of
sports and have fun," he added.

What exactly is the TC approach that is being used by a number
of rehab centers such as Titian Respati, Terracota and Yayasan
Sinar Indonesia (Yasin). The rehabilitation program is a four to
six- month resident treatment designed to address the behavioral
and emotional issues of drug dependency.

Residents move through four progressive phases of treatment
with the option of continuing treatment for a period of one year.

Therapeutic community treatment also offers group support to
family members who wish to be involved. Both group and individual
therapy is provided and is geared toward addressing the unique
treatment plan of each resident.

Groups are formed to discuss issues in life, concerns and
coping strategies. Treatment is further complemented by a variety
of leisure and learning activities including management, sports,
horticulture and art therapy.

Except in emergencies, residents do not engage in any off-site
communication during the first three months of care. After this
initial orientation period, communication resumes where desired
and visits by family members to the center may be arranged.

Therapeutic community treatment offers long-term residential
care which is based on the belief that addiction is an acquired
lifestyle.

Users suffering from chronic or severe addictions are offered
an alternative lifestyle where values and attitudes are explored
and challenged in an atmosphere of self-help and mutual support.
Treatment addresses the individual in a holistic fashion and is
premised on the belief that change is most effective when it is
"experienced and shared".

"However, therapeutic community treatment does not involve
physical contact," said Andung Sarengat.

Also in Bogor, there is Wisma Afiat, a facility opened two
years ago by the Muhammadiyah Islamic organization. It is still a
pilot project of approaching drug addiction through the Islamic
concept of daily life and behavior.

Psychiatrist Fuadi Yatim, who is the director of the facility,
said incoming residents were first given physical examinations.
"The magnitude of damage caused by drug use simply cannot be
emphasized enough. Drugs destroy these children's livers, hearts,
lungs, often fatally," he said.

After the physicals, newcomers are taken off drugs, known as
detoxification, for up to a week. This is where it often hurts
the most, Fuadi's deputy Izfan said. "They are in so much pain as
they go through sakau (withdrawal)," he said.

To ease the pain, the newcomers are given pain killers,
sleeping pills and other medication. At the end of this period,
the youths are again given physical and laboratory examinations.

"Then we go on to the spirituality approach," Fuadi said.
"These youths have been living so far away from what Islam
teaches us, which is why we try to bring them back."

The youths are encouraged to perform the shalat (prayers),
read the Koran and dzikir. They are awakened at night to say the
tahajud prayers and to take a predawn meal before fasting every
Monday and Thursday.

"That is actually our criteria for recovery," Izfan said. "If
the youths can stop smoking altogether, pray and fast, then insya
Allah (by the grace of Allah), they will be fine."

Both Fuadi and Izfan spoke strongly against smoking. "That is
the gateway to this vice (drug addiction or alcoholism)," Izfan
said.

"Something that damages your health is haram (religiously
unlawful or forbidden), and smoking is that," Fuadi said.

Fuadi and Izfan agreed on the importance of the therapeutic
community concept but feel that the approach has yet to target
the real root of the problem -- which is a lifestyle that is far
from pious. "TC, for instance, builds up the residents'
confidence to the point of defying them," Fuadi said.

Fuadi and Izfan, however, believe the importance of a total
change encompassing not only the residents but also the other
family members, is the key to recovery. "How can we ask the
youths to behave Islamically, to fast and to read the Koran when
their parents do not do the same thing?" Fuadi said.

So far, Wisma Afiat has treated more than 100 youths and has a
success rate of 70 percent. "Some 30 percent of them came back
because they relapsed," Izfan said.

Fuadi and Izfan believe helping drug addicts is another form
of da'wa (spreading the teachings of Islam). "They're our
brothers and sisters, and they need help," Fuadi said. (Deka
Kurniawan/Nuraini Razak/Santi W.E. Soekanto)