Pubdate: Sun, 26 Jun 2005
Source: Cyprus Mail, The (Cyprus)
Copyright: Cyprus Mail 2005
Contact:  http://www.cyprus-mail.com/
Details: http://www.mapinc.org/media/100
Author: Stefanos Evripidou
Bookmark: http://www.mapinc.org/rehab.htm (Treatment)

THE NEEDLE AND THE DAMAGE DONE

DRUG ABUSE is a big problem. Every country has it. Law enforcement agencies 
throughout the world spend millions tackling the illicit trafficking of 
drugs but there is no supply without demand.

In Cyprus there are numerous institutions, mostly in the private sector, 
that deal with the treatment of drug abusers. One such place is the Ayia 
Skepi Therapeutic Centre in Filani village, about 25km outside of Nicosia.

It is an inpatient centre with a two year programme, where addicts are 
stripped of their belongings and past lives, sequestered for at least six 
months and helped to mentally free their minds of addiction.

The aim is to help addicts acquire the self-discipline necessary to stay 
away from drugs and become functional citizens in society. This is not 
easy. Applicants range from young 20-somethings unwilling to see the 
disturbing consequences of long-term abuse to adults who have been living 
in a drug-cycle for 20 years.

To mark the International Day against Drug Abuse and Illicit Trafficking, I 
was invited to visit Ayia Skepi and chat to members of staff about the 
programme.

The 35-minute drive to the centre is quite stunning. Solitary one-lane 
roads lined with copious clusters of pink Oleanders greet you on the drive 
up to the isolated building which is literally in the middle of nowhere.

Apart from the electronic gate preventing the postman from reaching the 
front door, there is little feeling of being locked in. The walls are not 
high, there is no barbed wire or guard posts. Tina Pavlou and Vicky 
Balomenu, the psychologists who greet me, explain that a prison environment 
is not conducive to the programme. "People are free to walk in or out. 
There are no fences or guards. You can't do addiction counselling with 
barbed wire outside," said Pavlou.

The doors of the square building open up to a large garden with a 
fountain-like structure in the middle, enveloped by grass.

The centre is open to males and females from the ages of 18 to 40. Since it 
opened six years ago, 132 people have passed through its doors, mostly 
male. The centre mostly deals with long-term heroin users, though more 
recently, it has seen cases of cocaine and crack users. Before joining the 
programme, a drug user must get clean by completing a detoxification programme.

Once the drug is out of the body, the next step is tackling the mental 
addiction. 'Clients' as the staff call them, are required to complete an 
inpatient programme for six months. This is very challenging. It entails 
leaving everything behind, family, friends, possessions, lifestyle and 
isolating yourself with other users in an intense environment under a very 
strictly time-framed programme.

"People have to want to do the programme. There is no magic to it," said 
Pavlou.

People come only with clothes in their bags, and they are vetted by members 
of staff before allowed through. Everything from toothbrush to towels is 
provided by the centre.

There is no contact with the outside world for four months. Only then are 
participants allowed to make a phone call once a week and see visitors one 
hour every Sunday.

Once they complete the six-month programme, participants are gradually 
re-introduced to society with outings for work and are allowed to spend two 
nights a week at home.

In the second and final year, they spend most nights of the week at home.

The programme is very intense. Friday's programme is typical of any weekday 
schedule.

7.30-7.55am: wake up, clean room 7.55-8: coordination of groups 8-8.30: Gym 
8.30-8.50: breakfast 8.50-9.05: clean up 9.05-9.30: coffee break 9.30-9.45: 
community meeting 9.45-11: cleaning groups or craftwork 11-11.20: coffee 
break 11.20-12.45: group therapy LUNCH PREPARATION 1.20-2pm: clean up and 
coffee 2-3.30: various activities 15 MINUTES BREAK 3.45-4.45: community 
group meeting 15 MINUTES BREAK 5-5.45: cleaning chores 15 MINUTES BREAK, 
6-7: basketball 7-7.45: break 30 MINUTES FOR DINNER 8.15-8.45: clean up. 
HALF HOUR BREAK 9.15-10: last group meeting with leader or counsellor. 
10-11.30: free time. In rooms by 11.30.

The centre adopts the Bio-psychosocial therapy model based on cognitive 
behaviour. Group therapy is split up into three phases.

"The goal is self discipline. That's why we have such strict timeframes. 
You use group therapy to learn more about yourself," explains Pavlou.

"The first phase is to understand the problem: physically, mentally, 
emotionally. We help them establish themselves as members of the community 
and start expressing feelings. When you abuse drugs, you have no feeling.

"One client we had was emotionally dead. I had to seriously challenge him 
in therapy to make him angry. It was the first time he reacted. He ended up 
crying because he felt something for the first time."

Balomenou notes that the idea is to make the connection between the thought 
to the feeling and the reaction.

Phase two is to establish one's identity, goals, problems, family issues 
and roots. "You put your learning into practice. How to take 
responsibility," she adds.

Phase three is the integration process. "The biggest problem especially for 
youngsters is having fun without using. It is very difficult especially 
when alcohol is such a big part of entertainment. Also, there are financial 
problems. A lot of kids leave high school, get blue-collar jobs. They come 
from dysfunctional families but when they move out most of their wages go 
on rent," said Pavlou.

When the centre first opened it was very difficult to instil the idea of 
discipline. Staff members used to join in the cleaning chores to teach 
discipline. But now, older members of the community are there to replace 
them. "Now if someone doesn't want to clean up and sees one of the older 
long term users cleaning, it pushes him to help. There is huge respect for 
former members of the community," she said.

 From the 12 permanent and five part time members of staff, seven are 
graduates of the Ayia Skevi programme.

There are currently eight people in the closed programme at the centre and 
13 who have completed the six month session. The average age is 27, and 
most people are heroin users who have been using on average for 7-10 years.

"It's very intensive. It is about self control. The community runs itself, 
cleaning and cooking. There is an art centre, craft centre and gym."

 From the 132 people who came to Ayia Skepi, 62 are now clean from drugs, 
though not all finished the programme. A total of 48 per cent relapsed 
after entering the programme. But from the 25 who successfully completed 
the programme, only one person relapsed.

"We have a very high rate of return. Some don't come at the right time. 
They are under pressure to do it. But you have to want to do it. Ninety per 
cent of the time you can predict when the relapse is coming. There is no 
magic to it, no one can do it for you," said Pavlou.

The majority, 80 per cent, have a criminal record. Very often they go the 
centre in an effort to get a lenient sentence in an upcoming trial. So far, 
the courts have never sentenced anyone who passed through Ayia Skepi first.

The three golden rules are: no violence or threat of violence, no drugs or 
drug paraphernalia and no sexual contact. Participants are searched and 
drug screened frequently.

The biggest problem faced by the staff is trying to change the lives of 
drug users entirely. "It's hard to bring someone in at 35 and change their 
life entirely. Sometimes they have issues outside, it's not easy to 
maintain calm," said Pavlou.

"It is a mixed community which is difficult. Women users have different 
experiences. Men steal for their habit, women sell their bodies. We had a 
case of sexual abuse where the woman's abuser was in the same therapy 
group," she added.

The budget to run the centre reaches UKP 240,000 a year. The government 
provides UKP 70,000 and the rest comes from donations and friends of Ayia 
Skepi.

It was built by the Bishop of Limassol. "It's hard to raise that much 
money. Last summer we almost closed down, but something always comes up. 
It's a positive sign, I think," says Pavlou.

On leaving the centre, I realised just how exposed I felt speaking for two 
hours with psychologists who know their job very well. It is a conscious 
decision to kick the habit, but it is good to know that places do exist for 
those people who make that decision.
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MAP posted-by: Jay Bergstrom