For César Lara, life has come full circle.
At 36, Lara receives treatment at a drug rehabilitation center 500 meters from the corner where he first tried crack cocaine as a teenager in 1993. A friend goaded Lara into taking his first hit of crack, and he was instantly hooked.
For 15 years, Lara lived on the streets of San José, funding his drug habit by robbing houses, businesses and anyone within reach. At the height of his addiction, Lara was smoking dozens of rocks per day. During one burglary, a homeowner shot Lara three times in the leg and once in the back, rendering him a paraplegic.
Still, Lara continued to consume crack. Confined to a wheelchair and recuperating from bullet wounds while doing drugs, Lara developed open sores that eventually became infected with maggots. Doctors couldn’t do much for him. If he didn’t stop doing drugs, doctors said, he would die.
Lara admitted himself into Hogar Zoe, an all-male drug rehabilitation center in Alajuelita, a town in the hills south of San José.
The men who voluntarily check into Hogar Zoe, founded in 1982, pay nothing for their treatment.
Patting his stomach, 47-year-old Carlos Córdoba, director of Hogar Zoe, jokes about how skinny he was when he did drugs. For six years, Córdoba abused marijuana, mescaline and other drugs before seeking help at a Christian church. After managing his own drug addiction, he wanted to help others, so he started Hogar Zoe.
“Step by step, I did it,” Córdoba says, adding that “10 of the people who work with me are former addicts; four were rescued from the streets in the middle of the night. They’ve all been rehabilitated and are good people.”
For patients, having a former addict as a mentor helps them envision a future without drugs.
“Carlos has been an example to me,” says Pablo Vargas, 29, who used crack for eight years until a problem with a drug dealer escalated into a confrontation at his house. A dealer fired gunshots at his home while his family was inside.
“I want to be around in 10 years. It’s a daily fight, but my mission is to change,” he says.
Unlike rehab centers with 30- and 60-day programs, Hogar Zoe treats patients for an average of eight months. Three professionals are on hand for every 10 patients, and the total number of patients admitted is limited to 50 at a time.
Hogar Zoe is able to treat about 150 addicts a year, but because of an increase in the number of drug users, not everyone that needs help gets in.
Some men have been at the center for years because their families have rejected them. Recovering addict Alfredi Guerrero has been living at Hogar Zoe for three years, working during the day as an electrician and returning to the center each evening to sleep.
Years of abusing drugs and living on the streets have taken their toll on many of the recovering addicts and their families. In some cases, the men are the sole breadwinners of their families. One recovering addict’s wife brings the couple’s two kids to the center to eat because she has no money and the kids are starving. “When you work with addicts here, you also work with their family,” Córdoba says.
Hogar Zoe is one of many community programs managed by Canaán Christian Center Association (Canaán), an organization whose members believe that to treat drug addiction underlying problems in the community must also be addressed. In addition to the substance abuse center, Canaán provides lunch to 200 neighborhood children daily, offers art and theater on Saturdays, and free computer and English lessons to 60 local residents. The group teaches job skills to people with disabilities, runs a youth center in Pavas that feeds 150 kids, and delivers food to addicts through the Angeles de la Noche program.
Córdoba points to family disintegration, unemployment, poverty and crime as the primary issues responsible for a local increase in drug consumption.
“During an average week, Canaán cares for more than 1,000 people, including families, addicts and kids,” Córdoba says. “We work a lot in prevention. It’s cheaper to prevent drug addiction then to treat it.”
Costa Rica’s 2011 State of the Nation report indicated that 21.3 percent of Costa Ricans live in poverty, and 6 percent live in extreme poverty. According to a 2009 report by the United Nations Development Program in Costa Rica, Alajuelita has the highest poverty levels in the country. Only 64 percent of grade-school-age children attended school in 2009, and just 43.3 percent attended high school that year.
Without an education, young people have a difficult time finding work. Córdoba estimates that about 15,000 drug addicts live in Alajuelita. Each year, addicts seem to be getting hooked at a younger age, he says, and kids drop out of school to hang out on the street. Crack is not only easy to find in Costa Rica, but is also cheap at $2 per rock.
According to Córdoba, the Costa Rican government doesn’t sufficiently support
rehabilitation programs. Besides rehab centers that cater to the wealthy, treating substance abuse often is left to nongovernmental organizations like Canaán. Yet funding for these programs is hard to come by. Hogar Zoe receives donations from individuals, companies and sponsors – it’s a little here and there, but they get by.
Rehabilitation at Hogar Zoe focuses on four steps: entrance, rehabilitation, reeducation and maintenance. Proper hygiene is also incorporated into the program, since many addicts have spent several years living on the street and neglecting basic hygiene like bathing and brushing teeth.
Each patient receives a psychological analysis when they enter the center. For the first three months, patients discuss drugs, family, emotions and how to prevent using.
Hogar Zoe uses a combination of individual therapy, group therapy, psychological counseling and patience to help the men. In an attempt to prevent addicts from relapsing, groups discuss what led to use in the first place. To work off extra energy, spinning and aerobic classes are offered once a week. Keeping the men busy is key to the program.
After three months, patients are allowed to leave the grounds for an afternoon to begin the process of integrating back into society. During the fourth month, men can leave for a Saturday night depending on their family’s situation and their neighborhood.
“We teach [patients] that addiction is an illness, and once they’re back outside they need to have methods to cope with the temptation,” Córdoba says. “To suffer a relapse is part of the treatment. No one can leave and not fall.”
During the program’s fifth month, patients begin a process called “creating a project of life.” This prepares the men for finding work with job training and teaches them how to create cooperatives and small businesses. Because many men have tattoos covering their bodies, making it difficult for them to find work, Canaán set up its own cooperative.
“If I’m an addict, and I come here and am cured of my addiction problem, I want to learn something so I can find a job,” Córdoba explains. “If someone gets out and there’s no work, they’re more apt to begin using again.”
During the past six months, Juan José Rojas has trained 10 men in body-shop repair. The center also trains patients in woodworking and appliance repair.
Lara has been drug-free for two years, but his hollow eyes and gaunt appearance reveal an ongoing battle. As soon as he is healthier and cured of his anemia, he will undergo plastic surgery to close his open sores.
He is thankful that his mother was able to see that he turned his life around before she died eight months ago. “I made a promise to my mother before she died that I wouldn’t consume drugs anymore,” Lara said. “I have to live with myself and with the consequences of what [drug addiction] did to me, my family, my mother and many other people. Curiosity is something terrible when you’re young.”
Although most of the men at Hogar Zoe are recovering from crack addiction, Córdoba said that crack is already becoming passé. Soon, he predicts the center will be treating abusers of burundanga – a local term for the hypnotic plant-based Scopolamine drug – as well as LSD and heroin.
“My dream is to provide special treatment to people whether or not they have money, Córdoba says. “How else do you help an addict who lives on the street and has no money?”