FOR 15 years, Patricia House has been gently weaning addicts off narcotics and other substances, mainly crack/cocaine, with varying levels of success for the different drugs.

Four in five clients of the Kingston-based residential drug treatment and counseling centre, are cocaine addicts, the majority of whom end up kicking the habit after treatment.

According to Henry Gough, psychologist and manager of Patricia House, only 30 to 40 per cent of clients revert to the drug, or put another way, 60 to 70 per cent stay clean.

On average, however, some 75 per cent eventually kick their dependency on the drug, with repeated treatment, some on the third attempt at drying out.

“The nature of crack/cocaine relapse for some clients is part of the recovery process,” said Gough.

“It (treatment) has a greater impact when they come back the second or third time.”

The successes – which Patricia House defines as ‘remaining off drugs for up to six months after exiting rehab’ – are even higher for alcoholics, at an average of 85 per cent.

Alcoholics are the second largest group of the centre’s clients.

“On an average, about 81 per cent of the persons that come here are crack/cocaine addicts, 17 per cent are alcoholics and the remainder – two per cent – is addicted to marijuana,” said Gough.

The centre has a client base of 70 to 80 persons per year; it has a staff of five, but needs 12; and gets a $5 million subvention annually from government, but needs $9.5 million, says Gough.

Like most other drug treatment programmes, Patricia House only accepts clients who decide to seek help to kick their dependency.

Clients pay $3,500 per week for two months of therapy. In the first four weeks, they are allowed no outside contact.

Addicts are required to detox, so counselling is preceded by at least 10 days of lockdown at the Assessment Detoxification and Early Rehabilitation Unit, University Hospital of the West Indies, where physicians concentrate on minimising withdrawal symptoms, which vary in intensity, from lethargy and sleeplessness to outright violence, depending on the narcotic or substance.

“Heroin has the worst withdrawal symptoms,” said Gough.

“Persons with crack addition,” he added, “normally have a sleep disturbance and have to be given mild tranquilisers. They also tend to become very lethargic.”

The Detox Unit mainly concentrates on physical and psychiatric evaluations.

“They do blood work and take x-rays to ensure that the patient is in good health while they are being rehabilitated,” said the centre manager.

“Going through withdrawal, patients can become very violent and that is something that we are not prepared to handle here.”

Admission to Patricia House is open only to persons who admit to having a history of drug abuse or use; willingness to acknowledge loss of control due to the use of mood altering drugs; and a willingness to want to end their dependency.

The centre accepts only male clients over the age of 18, though initially it catered to both genders.

When the programme first started in 1991, its male:female clientele ratio was two to one. Patricia House dropped its service for women in 2003 when the ratio moved to eight to one.

Gough explains the fall-off saying female addicts also tend to be mothers, for whom it is difficult to spend the weeks away from home that the centre’s programme requires.

He adds that female addicts tend to be those women who make their living on the streets and can finance their habits.

For example, said Gough: “Some female addicts are prostitutes and so they are able to fund the addiction that way.”

There are other rehabilitation centres in Jamaica: one in Ocho Rios called Teen Challenge and the Salvation Army Rehabilitation Centre. But the UHWI Detox Unit is now the only programme accepting females and teenagers for in-patient care.

Psychiatrist Dr Wendel Abel also runs two halfway houses in Kingston, but for mentally ill persons who are also addicts.

Patricia House is one of three programmes run by Richmond Fellowship Limited, a non-profit organisation. The rehab centre is actually named for the wife of man who sold the property to Richmond Fellowship.

The eight to 10 weeks of counselling and introspection, four of which require total seclusion, helps the patient understand his addiction, and covers issues of self-awareness, re-education, re-socialisation, social skills training, and values and attitudes.

They are required to explore their exploring their feelings – a largely alien concept for most men.

“The aim of that is to get them to focus on themselves and the group and it also encourages them share their feelings, because men were brought up to believe that they should hide their feelings, so this gives then a chance to express how they feel,” said Gough.

The rehabilitated patient is monitored for one year after release from the programme.

At the centre, clients have to adhere to strict rules and regulations.

Gough said some patients apply for an extension of their eight weeks if they believe they are not ready to handle their normal routines without help.

davidsont@jamaicaobserver.com

Treatment process

At the UHWI Detox Unit:

Patients are taken in on a voluntary basis and they spend two weeks in the unit. They go through:

. detailed physical exam;

. detailed psychiatric evaluation;

. routine blood study; and

. group therapy for introspection is introduced

Only patients who abuse alcohol normally need medication to assist with the withdrawal symptoms.

At Patricia House:

Patient is assigned a big brother and a case manager.

Week 1 – detox week: clients concentrate on diet, rest and exercise; short introductory meetings.

Week 2: similar routine, but counselling sessions intensify; a detailed drug and family history is done to develop a case management plan

Week 3: intense counselling continues; exploration and management of emotions;

Week 4: communication ban lifted and family members are allowed to visit clients. Counselling continues.

Week 5-8: clients reintroduced to society as a recovered addict; allowed to weekend at home; encouraged to find jobs and new residence, if necessary; counselling sessions continue

Week 8-10: exit interview; clients evaluated to determine if they met the goals of their programme; extension is granted for those who believe they need more time.