The search for humane, effective, and evidence-based solutions to the drug problem

The 2016 presidential race placed the problem of illicit drugs front and center of the national agenda. Candidate Rodrigo Duterte ran, and won, on a platform of fixing the drug problem, which he claimed would “destroy the country.” According to the Philippine Drug Enforcement Agency (PDEA), some 1.8 million Filipinos were using drugs in 2015, less than 2 percent of the population. Over 95 percent of drug arrests that year were linked to the use of crystal methamphetamine, popularly known as shabu. In 2015, according to the PDEA, a third of barangays in the Philippines were struggling with the problem of drugs.1

Once in office, the Duterte administration launched a nationwide campaign against illegal drugs that was focused on law enforcement. The Philippine National Police (PNP) was deployed to implement “Oplan Double Barrel,” aimed largely at identifying and “neutralizing” users and distributors of illegal drugs at the grassroots. Police efforts were intended to address both the supply of, and demand for, illicit drugs by targeting both low-level drug users and “high-value” drug suspects.

The government reported that between July 2016 and May 15, 2018, 1.3 million drug suspects surrendered to the authorities; 143,335 “drug personalities” were arrested; 99,485 police operations were conducted; and 2,678.61 kilos of shabu were seized.2 In all, 4,279 drug suspects have been killed in police operations. In addition, there are 22,983 “deaths under investigation” by the police that are apparently related to drugs.3

The intensified campaign against illegal drugs has been controversial because of the large numbers of Filipinos killed during police operations, the spread of vigilante-style killings, and allegations of extrajudicial summary executions of drug suspects. Barangay officials, along with law enforcement agencies, have also been criticized for employing tactics that violate the privacy and other rights of citizens. These tactics include mandatory house-to-house surveys on drug use, compulsory drug tests, and the compilation of “drug watch lists” that make residents the target of arrests or killings.

There has been scant evidence-based assessments of the effectiveness of the current government’s antidrug campaign. Our aim is to assemble a multidisciplinary team of researchers to provide an evidence base to assess the economic, political, psychological, legal, and social costs and benefits of the government’s campaign. In doing so, we hope to help the public get a more informed and nuanced understanding of the complex landscape of drug policing and drug policy.

The drug problem

The Philippines has a significant level of drug use and a robust drug trade. However, there is little evidence that, almost two years into the government’s antidrug campaign, the singular focus on enforcement-led and punitive solutions is working. It is also possible that strong-arm policing may be crowding out sustainable and effective solutions such as health- and community-based approaches to drug recovery.

We highlight three key problems with the primacy of punitive approaches:

  1. There is little, if any, evidence that there are fewer drugs on the streets. Anecdotal as well as news reports say that the drug trade continues although it has been driven underground. Shabu, in particular, remains popular because it is affordable and available through a grassroots distribution network.
  2. The tactics and strategies inherent in the design and implementation of the antidrug campaign make the police and other agencies involved in it vulnerable to accusations of abuse. For sure, a 2018 Gallup poll showed that Filipinos felt safer walking the streets alone at night than they did some years ago. In 2017, a Social Weather Stations survey showed that most Filipinos supported the antidrug campaign. But more than 90 percent of them also said that it was important that drug suspects be captured alive rather than dead. They were also split on whether to believe the police when it said drug suspects were killed because they resisted arrest. Three out of four surveyed said they were afraid that they or someone they knew would be targeted by the police.4 Aggressive policing, therefore, may have added to a sense of public safety but it may also have damaged the public’s trust in institutions of justice and law enforcement. This trust will be difficult to rebuild. Internationally, the “war on drugs” has also tarnished the country’s reputation for upholding human rights, the rule of law, and due process.
  3. One of the hidden costs of the so-called “war on drugs” is the toll it has taken on poor families who have lost loved ones to the drug killings. Many of them are traumatized by having witnessed the violence done to their kin and have no means of providing for their most basic needs, as in many cases those targeted by the police are their families’ breadwinners. We have yet to fully understand the potential long-term impact of such violence on the psychological well-being of thousands of children, widows, grandparents, and entire communities that have lost their sense of safety and trust.

The solutions

By reviewing international experience and generating an empirical evidence base of credible information, the government’s antidrug policies can be monitored and evaluated for effectiveness. There is a growing body of evidence from all around the world that suggests that drugs should be dealt with as a public health, rather than law enforcement, issue. One study on 50 years of the global war on drugs says that it has failed to limit drug availability and that “global trends in drug use – particularly high-risk use – [have been] rising consistently over the past half-century and illegal drugs [are] cheaper and more available than ever.”5

The Philippines needs antidrug policies, approaches, and tactics that are responsive to the emerging evidence from around the world and to the changing contexts of drug use. Instead of punitive approaches, the following may be considered:

  1. Health-based rehabilitation programs adapted to Filipino culture and communities. These have been shown to reduce recidivism rates dramatically and to lead to secondary benefits such as community protection. These community-based programs have also been shown to be more effective in dealing with the majority of drug users who are not severely addicted to illicit substances.6 (See below for a fuller discussion of these approaches.)
  2. Enforcement actions focused on reducing supply by investing time and resources on in-depth investigations that will result in the capture of high-level drug suppliers rather than low-level dealers. Any enforcement action, regardless of its target and the nature of the violation, must be conducted within the bounds of law and due process.
  3. Reduction of demand by investing in prevention programs that are informed by a rigorous study of reasons for why individuals start and sustain drug use.

Any and all policies, programs, strategies, and tactics must be informed by a credible evidence base, conducted with respect for human rights and the rule of law, and operationalized within the context of sound governance systems. Otherwise, any gains derived from antidrug campaigns will be difficult to sustain.

The role of local governments

The government’s antidrug campaign has many moving parts, with the PNP often holding the reins at the national level and with varying roles assigned to local governments. Local government officials, including barangay captains, play a key role in the execution of the campaign. At least two provisions in the operational documents of Oplan Double Barrel, PNP Command Memorandum Circular No. 16-2016 issued by the PNP chief, suggest close and regular coordination between the police and local officials.

The antidrug campaign is clearly a central government program. Given the widespread claims and growing evidence of the involvement of both police and some government officials in the illegal drugs trade, a strong central policy has been deemed necessary. But in the course of implementing this antidrug effort, local officials, such as provincial governors, city and municipal mayors, and barangay captains and kagawad, have been tasked to cooperate with the police. Responses to this directive, however, have not been uniform.

Some barangays have very high death rates; others, far lower (in some cases zero). The varied experiences of local cities/barangays that have community-based rehabilitation programs and where killings are low or nonexistent, show that the community leaders (e.g., barangay officials, church leaders, police) can work together to pursue a more restorative approach consistent with the duty of local officials to ensure the general welfare of their citizens.

Restorative approaches to stemming drug use in communities

According to the PDEA, there have been over 1.3 million surrenderers. All surrenderees are supposed to go through assessment or evaluation and diagnosis, then referred, if appropriate, to rehabilitation facilities. Only a small fraction, a reported 189,816 of those who have surrendered, however, have undergone and completed recovery and wellness programs in community centers. The focus on enforcement and punitive strategies has crowded out solutions that have a more restorative and humane approach to drug use.

Given that the various levels of local governments have a clear mandate and directive to run their own programs against drug use in their areas, it is well within their powers to actively support community-based drug initiatives. Some local governments have implemented programs like drug education, community service, recreational activities, and counseling. Such rehabilitation efforts have been criticized by many, including President Duterte, for being not only ineffective but also too expensive. Local and international experience, however, reveals a uniform positive experience with success rates of community- and health-based drug rehabilitation and recovery programs.

Addressing drug use and dependence requires a nuanced understanding of the local situation within which substances are purchased and consumed, and a full awareness that drug users are individual people in specific contexts. Illicit drug use is often found to coexist with economic, social, and legal problems for individuals, and can be traced back to a variety of causes, including biological, social, and psychological dimensions.7 Accepting that illegal drug use is a health condition rather than simply a form of criminal offense, means that it is best addressed by the health care system.

Community-based drug treatment

The Psychological Association of the Philippines (PAP) Taskforce on Drug Recovery Support reviewed experiences and success rates of community-based drug recovery programs and similar interventions. One example is a community-based program called Katatagan Kontra Droga sa Komunidad. It starts from the premise that drug use is learned, and can be unlearned, through planned and well-suited therapeutic strategies. A 12-module program was designed based on accepted theories of motivational interviewing, cognitive behavioral therapy, mindfulness, and family systems theory.

Initial experiences from pilot-testing this program in selected barangays of Quezon City among low to mid-risk illicit drug users suggest a high likelihood of recovery. Specifically, they find an increase in coping skills of users, a decrease in symptoms of substance use dependence, and improvements in psychological well-being.

The main drivers of a successful implementation of community-based drug treatment programs are a mix of family, social, community, and spiritual support.

Research agenda for the near future

A comprehensive cost-benefits analysis of health-led versus enforcement-led approaches needs to be conducted. Any such study must take into account direct and indirect costs based on statistics from all aspects of the antidrug campaign. The following are some costs that should be imputed in any accounting of the campaign:

  • Budget allocated and spent by government (direct costs)
  • Families losing breadwinners
  • Trauma to children exposed to violence
  • Trauma to communities
  • Burden to grandparents who take care of children
  • Growing distrust of the police
  • Humanitarian costs of thousands of widows and orphans
  • Cost to international trust and reputation of the country

To do an evidence-based assessment of the antidrug campaign, the government should provide access to information on its various aspects. For the most part, the government has released only aggregate figures related to drug-related killings, arrests, and operations. The current lack of transparency translates to an absence of accountability, making it difficult to conduct an independent validation of the campaign’s effectiveness and its impacts.

1. Philippine Drug Enforcement Agency, 2015 Annual Report. http://pdea.gov.ph/images/AnnualReport/2015AR/AR2015page1to37.pdf

2. Martin Sadongdong, “Over 4,200 slain, 143 K arrested in drug war — #RealNumbersPH Year 2,” Manila Bulletin, May 29, 2018

3. Cecile Suerte Felipe, “PNP: 22,983 deaths under inquiry since drug war launched,” Philippine Star, June 11, 2018.

4. Social Weather Stations, “First Quarter 2017 Social Weather Survey,” April 18, 2017. https://www.sws.org.ph/downloads/media_release/pr20170418%20-%20Opinion%20on%20the%20campaign%20against%20illegal%20drugs%20and%20on%20EJK%20(Special%20Report_FINAL).pdf

5. “The War on Drugs: Threatening Public Health, Spreading Disease and Death,” from Count the Costs, http://www.countthecosts.org/sites/default/files/Health-briefing.pdf

6. Ma. Regina Hechanova, et.al., “The Development of Community-Based Drug Intervention for Filipino Drug Users,” Journal of Pacific Rim Psychology, February 2018.

7. The health and social consequences of drug use are discussed in United Nations Office on Drugs and Crime, World Drug Report 2017, https://www.unodc.org/wdr2017/index.html.