A patient prescription for chronic addicts' recovery

road to recovery: Patients wait to be assigned their daily tasks at the House of Compassion, a rehab centre in Chom Thong district, Chiang Mai, which uses a participative, group-based approach to recovery. (Photos by Paritta Wangkiat)

'A dictatorship wouldn't work in a place like this," Sathit tells visitors at the House of Compassion, the drug rehabilitation centre where he works in the Chom Thong district of Chiang Mai.

Sathit, a 30-year-old who once struggled with drug addiction himself, doesn't make a habit of keeping up with politics. But he does spend much of his days trying to run the rehab centre according to certain political principles -- namely, those of democracy.

In the office of the concrete compound, surrounded by rice fields and plantations, one can find a box with a slot in which patients drop slips of paper throughout the day.

It isn't quite a ballot box, but rather a place to express one's social concerns -- the idea behind it is to write a message that helps members of the House of Compassion mediate conflict and communicate. No one can look into the box before the day the results are revealed to everybody at once.

Once a week, the rehab residents gather to read the messages aloud.

"Anyone who wrote on a slip of paper this week, please raise your hand," the session facilitator announces to the room. Several hands shoot up in the air.

One of the people with his hand raised is selected by the facilitator and gets up to change seats so that he can sit across from the person to whom his message is addressed.

He begins to read off his paper, expressing how resentful he has become of that person.

Others take their turn doing the same, articulating feelings of dissatisfaction stemming from experiences as trivial as seeing people fail to clean the table after meals.

The complaints may sound like no big deal. But it's not easy to air such grievances to people who live in the same residence as you, especially as they are sitting right in front of you.

These weekly sessions are called "confrontation hours" and are a part of the rehab centre's goal to help participants effectively speak their minds and deal with critics.

The idea behind the practice is for patients to examine themselves and their feelings, be active listeners and apologise when necessary.

"This is virtually an imitation of how societies work," said Sathit of the confrontation hours. "There are always different opinions."

Sathit says his previous participation in these sessions let him see himself through others' eyes.

Raised by a single mother in Chiang Mai, Sathit started using methamphetamine in secondary school due to peer pressure.

A turning point came one day when he sneaked out of his mother's house to have a cigarette with an adult neighbour. Sathit invited the man to take a meth pill with him.

When his neighbour saw him again, he sought to return Sathit's favour by offering him a bag stuffed with roughly 100 pills.

He gave 20 pills to Sathit and suggested he try to sell them at school, but slash his prices to compete with other dealers. On the next occasion he saw his neighbour, Sathit was given an additional 50 pills.

Sathit eventually struck up a reputation as the school's resident drug dealer.

Shortly after, he found an abandoned house that he adopted as his base for doing deals. When police found the place one day, they reported to Sathit's mother about his illegal activity, and he was sent to a 21-day rehabilitation programme that focused on healing through medication.

But it wasn't long after his short rehab stint that he began using drugs again, with help from a big dealer from the area's drug trade network.

"At that point, I believed that nothing could help me quit drugs," Sathit said.

His mother had nearly exhausted her bank accounts by funding Sathit's treatment before deciding to send him to the House of Compassion. He spent two stints at the centre, totalling four years in total. This is where he finally broke free of his addiction.

"Recovery was about changing myself," he says. "But it needed to be a process based on models of democracy and community because these show drug addicts how to gain values they might lose hold of through addiction."

COLLECTIVE HEALING

The House of Compassion, a privately run organisation, was established in 2011 by therapist Wanpen Amnajkitikorn promoting a "therapeutic community" method -- a participative and group-based approach to healing chronic drug addiction and mental illness.

She designed the rehabilitation programme based on democratic, community-oriented principles. The centre is currently host to around 40 male drug addicts, most of whom are in their early 20s or adolescence and come from all over Thailand.

Every participant in the programme has a designated role in the organisation's administrative structure, containing seven departments -- communication, kitchen, agriculture, maintenance, psychosocial wellness, housekeeping and environment.

On arrival, each participant is placed into a department based on their skills and interests. They are then made responsible for completing various tasks within their departments.

The tasks can vary from cooking to gardening and managing a small grocery store.

Each department is hierarchically organised, with roles ranging from general members, department head, chief expeditor and coordinator.

Newcomers start off as general members and are able to climb up the ranks by making progress in their addiction treatment, according to a range of performance measures.

Those new to the compound are allowed to participate in a casual way without answering directly to orders from higher-ranking members. Voting is required in solving problems.

"Many drug addicts come here with completely broken attitudes and distressed spirits," said Ms Wanpen. "Some have faced abuse and violence within their family and community.

"When they realise that here they have a voice and can participate in the community, they realise that they are valuable. They have responsibility. They have something to stand for."

The programme is based on the principles of democracy, helping drug addicts achieve stability and return back to society with a heightened sense of social tolerance and flexibility.

The programme takes over a year to complete, in addition to two years in which the staff monitors the participants at a distance.

Despite the growing popularity of the therapeutic community approach, it is hard to sustain these types of rehab programmes as they take more time and more costly.

Furthermore, therapeutic community is a field, with fewer experts readily available.

In most circumstances, drug addicts are sent to 21-day rehab programmes that prioritise medication instead of personal development activities and process. These type of programmes tend to suit new drug users, but for chronic addicts a processed-based approach can be preferable.

Gen Prayut Chan-o-cha's government has made it a priority to send drug users to rehab instead of sending them to jail, with one new programme offering nine to 12 days in an army camp.

Sathit went to several short-term rehab programmes while fighting his chronic addiction. However, none was successful in kicking his habit.

The facilities focused on treating him as a patient according to a set of predetermined prescriptions.

On one occasion, Sathit managed to sneak some meth pills into the rehab centre he was staying at. He was severely disciplined when authorities found out about this.

"You can't just heal people with discipline," Sathit says. "That alone won't make them better."

It was only in the House of Compassion that Sathit found a real sense of agency that let him see his own potential. The democratic structure of the compound was conducive to his experience of empowerment through participation, showing him how to be a responsible and contributing citizen.

GETTING A SECOND CHANCE

Early in the morning, patients at the House of Compassion rise and perform their various >> >> assigned tasks. Some are required to report the morning news. Others organise group discussions to address each other's issues and consult one another for advice.

Seminars are held from Monday to Friday to address issues in the compound that demand members' collective consultation, alongside evaluations of people's contributions.

Kyle, 20, is responsible for taking care of plants in the compound. He has lived there for two years. He was born to an Aka father and Lahu mother but never met his father.

His mother was arrested for possessing meth when he was only two years old.

After his mother was jailed, Kyle was sent to an orphanage.

He was born in Mae Na, a Thai-Myanmar border area in Chiang Mai province.

It is also the birthplace of Lahu rights activist Chaiyaphum Pasae, who was killed on March 17 for resisting arrest after officials reportedly found meth pills in his car.

Chaiyaphum was accused of being a major drug dealer by authorities despite public scepticism about such claims. Police forwarded his case to the Chiang Mai court but failed to disclose the CCTV camera footage of the shooting incident.

Kyle ran away from the orphanage at age 13 to live on the streets of Chiang Mai and later Bangkok.

He survived by begging for money and food, using his amassed money to purchase meth.

"I was bored inside the orphanage," he says. "I knew every square inch of it. I thought that life behind the walls would be far more interesting."

He was arrested at age 15 for drug possession while wandering a street in Chiang Mai and sent back to the orphanage where he came from.

A year later, he escaped again. He proceeded to go live with friends in a flower shop and struck up a serious addiction to inhalants that would incite long-lasting mental health issues.

One day, a social worker he knew found him on the street and sent him to rehab for a one-month long programme facilitated by the state. However, it failed to help.

Kyle was then transferred to the House of Compassion, where he successfully recovered.

After his release, he plans to look for a job in Chiang Mai or help his mother, with whom he was reunited at the age of 18. She runs her own tea plantation.

Steps away from the garden that Kyle cares for, a cook prepares lunches for the whole community. He plucks his ingredients from the Department of Agriculture of which Kyle is a member.

Another young inhabitant is stationed at the grocery store, checking off lists of goods and calculating expenses and revenue.

Others are busy cleaning the dormitories.

In the public relations room, a few men prepare for a musical performance scheduled later that afternoon when people get a break.

Buried in tasks like these, the community members start to build a sense of their own purpose. The project of healing starts with getting right to work.

FRESH START: The centre hosts about 40 male drug addicts, most of whom are in their early 20s or adolescence and come from all over Thailand. PHOTOS: Paritta Wangkiat

growing wiser: A patient helps maintain the garden at the House of Compassion.

making the cut: A patient who joined the kitchen one year ago now leads the team of cooks.

homegrown: Mushrooms grown as a part of the centre's agricultural programme are sorted.

at your service: Expenses are calculated at the centre's small grocery store run by residents.

hopeful outlook: Wanpen Amnajkitikorn, director of the House of Compassion and trained therapist, founded the centre in 2011 to heal drug addicts using a 'therapeutic community' approach.

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