In the wake of cutbacks in government support, many residential drug treatment centers around the country are struggling to make ends meet.
The budget shortfalls are causing many programs to reevaluate and search for additional sources of funding – or face the prospect of shutting their doors.
The nonprofit Kayrós Foundation – which runs a modest 15-bed facility in Grecia, northwest of San José – hopes to avoid such a drastic measure.
Kayrós, though small, is hailed as a successful program by authorities for its 65% success rate, which means only 35% of participants relapse after completing a six-month stint.
Even in the face of the shortfall, Kayrós Director Roberto Castro said his staff, which treats about 50 addicts a year, will fight on.
“We’re not going to close, because of our audacity and faith,” he said. “But if we’re looking at it in black and white, if this were a business, we would already be closed. We’re not contemplating that, but we’re desperately looking for resources.”
Castro said it is unfair the government, which depends so much on the nonprofit sector, doesn’t fund it sufficiently. Currently, the government coughs up just ¢313 (about $0.60) per resident per day. Treatment costs about $10 per resident per day and is covered mostly by the residents’ families and then by private donations.
“Nongovernmental organizations (are) the arms of the state, but the support is little and intermittent,” he said.
The government’s Institute on Alcoholism and Drug Abuse (IAFA), with a current annual budget of ¢1.9 billion (about $4 million), is responsible for accrediting and funding treatment programs. Last year’s contribution from the IAFA to treatment centers was ¢1,500 (about $3) per resident per day but the 2008 figure dipped to ¢203, an 85% decrease.
The Social Protection Council, also a government agency, contributes ¢110 per resident per day.
IAFA Director Giselle Amador said most of the funding crunch is a result of plans to construct a court-ordered, state-run, 60-bed treatment facility for adolescents in the San Pedro neighborhood east of San José. She said the court ordered the construction of the facility two years ago to have a place for judges to send juvenile offenders. The IAFA’s contribution to the project is ¢200 million (about $400,000).
“There’s no way out,” Amador said. “The court ruling obligates us to build the center. The court order is already 2 years old and if we didn’t act now, we could be punished.”
Amador said it would be unfortunate if any nongovernmental organization (NGO) centers closed as a result of the state-run facility, which is under construction and scheduled to open in September.
“We’re very worried about this,” she said. “If any centers closed, it would be a disaster. But our hands are tied and there just aren’t enough resources for everybody.”
The director said her agency had already scraped its coffers to come up with an additional ¢60 million to fund the country’s 70 NGO drug treatment centers.
Of the residential programs in the country, Kayrós is considered among the best by authorities.
“It’s very successful,” Amador said. “The 65% success rate is unheard of, and many centers don’t even keep these statistics because they don’t monitor participants after they leave the program.”
Kayrós residents, many of whom said they hit rock bottom before checking in, expressed support for the program, which employs a full-time psychologist and parttime director.
“My problems were becoming ungovernable,” said Luis Calvo, 24, a cocaine addict in his first month in the program. “I needed to forget all the things I did and that happened to me, like childhood abuse, and try to find some comfort.”
Calvo, who used to snort seven grams of cocaine a day, said he had already transferred from another program in Alajuela, west of San José, and liked Kayrós better because of its focus on therapy, not just religion.
While Kayrós does have a spiritual component, residents said there was no emphasis on conversion.
Other residents said they used many drugs, which staff psychologist Marcela Castro said is a common and challenging phenomenon at the center.
Amed Bolaños, 27, in the program for four months, said he used marijuana, ecstasy, cocaine, crack and pills of all sorts while working with tourists in hotels.
“There came a time when I couldn’t stop so I had to ask for help from my family,” he said. “They were very hurt but it was the only way to get out of it.”
Bolaños said the best part of the program is the emphasis on group and family therapy.
“They make you admit your resentments and the damage you have caused,” he said. “I am trying to make up for it.”
In Costa Rica, there are three levels of drug treatment: mandatory residential (for juveniles only), residential optional and outpatient.