In November 2021, Ezekiel Ibarra He was found drowned in the community pool. Resilience San Fernando, in Pillar. The center was promoted as a space for “therapeutic and spiritual rehabilitation”, but the 27-year-old did not have problems with consumption, but rather a diagnosis of schizophrenia. when the journalist Paul Galfre heard the news asked to meet with provincial and national officials. For 14 years he has been investigating this type of center and wanted to talk to the authorities about the terrible conditions of the institution. Nobody heard it. Four months later, in that same place, a patient set fire to the facilities. He and three other people died. Galfré gets angry: “It was a massacre and the State is responsible. But the topic did not generate any repercussion. And suddenly now that the name of a famous person appears, everyone is scared ”, he claims.
Galfre hit the key. On September 22 the photo of Marcelo “Teto” Medina detained he went through all the portals. The Justice was investigating him, along with 16 other people, for the alleged aberrant crimes that would have occurred in the therapeutic community in which the former VideoMatch works, The reason to live, whose headquarters in Florencio Varela did not have any kind of authorization. The cover of the cause says: illicit association, reduction to servitude, forced labor, and abandonment of person. The researchers’ hypothesis is that, far from being a place for addiction rehabilitation -as it was presented-, the organization worked in a coercive group style.
The news exploded. At the close of this edition, the “ceiling” had been released but not removed from the investigation. However, for the specialists in problematic consumption and also for the referents of the centers consulted by NOTICIAS, what would have happened in The reason to live is far from being an exception.
In fact, although with difficulties, more and more progress is being made against this type of place. For example, on August 8, the Justice sentenced Angel Oscar Suñeza former therapeutic community employee Saint Camillusin Pilar, due to the death of a patient named Saulo Rojas. In 2013, the 23-year-old was locked in an isolation cell in the middle of a withdrawal crisis and without insulin, despite the fact that he was diabetic, and hanged himself with a belt. His suicide became a test case of cruelty and inhuman treatment.
Clandestine rehabilitation centers with medical approaches without a scientific basis or led by other patients without the supervision of health professionals are multiplying. It is enough to visit the Greater Buenos Aires and the vast majority of the country’s large cities. In the “hottest” areas, where families do not know what to do with their children’s consumption, brochures are circulated and banners are hung with similar messages: “Save your child from drugs.”
There are two key concepts to understand why it got here: the false war on drugs, which became a great slogan but never achieved its goal of eliminating the circulation of substances; and the non-application of the Mental Health Law, which was approved in 2010 and was to take effect in 2020. The legislators had decided to give the Executive 10 years to build care devices and train staff. But that didn’t happen.
The consequence? A very high social demand for treatment spaces and a lack of professionals. The dramatic situation is fertile ground for the proliferation of centers that can be, at a minimum, questionable. And, as a maximum, to be clandestine detention centers.
CIRCUIT. In the universe of addiction rehabilitation or dealing with problematic consumption there is a fierce theoretical and methodological internality. And, although in popular language it seems the same to talk about community, clinic or farms, not everything is the same and in Argentina different methods coexist. Unlike the treatment received by a cardiac patient, who is certain that he will be seen by a doctor, in the area of addictions he may be seen by a psychologist, a priest or a former addict. It all depends on where it falls.
At the head of the circuit is the National Secretariat for Comprehensive Drug Policies (Sedronar), created in the 1990s by the hand of the drug law. The psychologist Gustavo Zbuczynskipresident of the Harm Reduction Association of Argentina (ARDA) maintains that its sanction responded to the prohibitionist paradigm: “Prison sentences were established for anyone who had substances in their possession. And it was also stipulated that those who had consumption problems could undergo treatment in a community endorsed by Sedronar. That is, they came to replace prisons. Lawyers immediately began to recommend that their clients declare themselves addicts and there was a flourishing of these types of places, ”she assured.
The 1990s coincided with the explosion of the therapeutic community model with strong religious roots. In fact, “The reason for living” -the organization in which the “Teto” was medina-, San Camilo and those investigated by the journalist Galfré claimed to work under this methodology that, in short, are presented as drug-free spaces where people live together. In general, these places talk about the benefits of mutual help and many times the patients themselves manage to become tutors to the newcomers.
Zbuczynski, critical of this model, maintains that the legislation allowed its growth “despite the fact that all the scientific evidence has already shown that it is ineffective.” The psychologist went further: “In the 1990s and 2000s Sedronar paid $1,200 for each hospitalized patient. Some set up a nice business, ”he said. For him, there is the origin of a sector that -even today- hinders the advancement of other forms of work and opposes the application of the Mental Health Law.
During those years he began to work Jorge Ruiz, the current general coordinator of the National Roundtable of Organizations that Work on Addictions, a space that he himself created in 2019, when there was a year left before the law had to come into effect. “I called everyone and told them that we had to get together because they were going to wear us,” he said. That “everyone” refers to 12 organizations, including the Christian Alliance of Evangelical Churches (ACIERA), the Fonga Federation, Madres contra el paco, among others.
Ruiz defends the model of therapeutic communities and rejects any approach that does not have abstentionism as its ultimate goal. For him, comparing a community to a prison can be a “misunderstanding”: “Many look from the outside and say that in these houses they are jailers or fascists, but what is established is order. They are given a place to live and many people are so bad that they need to have responsibilities, ”he said.
Hence their doubts when it comes to harshly questioning all therapeutic communities that currently do not have authorization. Ruiz He insisted that all the organizations that are part of the Table do have them, but assured that the prohibition of the Mental Health Law on the creation of new centers from 2010 gave rise to the irregularity. “One thing is the places where there is abuse and another thing the illegal centers. Why is there so much illegality? Because the demand grows and that is why organizations appear that are in charge, some with good intentions and others that may not”, he assured. For Zbuczynski this argument is unacceptable and in no way can illegality in such a sensitive area be justified. His criticism of the law lies in its non-application, since the State had a decade to build intermediate devices such as half-way houses, day hospitals and outpatient centers.
Sedronar does not qualify, but it does have agreements with some 800 care spaces in the country. Patients who do not have social insurance or cannot afford the treatment are referred to these places, and around $40,000 per month, per person referred, is transferred to the institution that receives them.
Those in charge of authorizations are the Provincial Executives. And secrecy is a matter of concern at the institutional level. Ruiz maintained that “of each authorized community, there are four without authorization.”
In the province of Buenos Aires, they implemented a new regulation in November 2021 so that clandestine centers that meet certain requirements can start an authorization process. In theory, by December of this year, all the institutions that want to be in law must have presented themselves to the Ministry of Health.
The model of the community and the abstentionist discourse is the one that prevails. That is where the actor Gastón Pauls is located, for example, who takes the theme to TV in “Free Beings”, close to the evangelical world. It is also the position, in general, of the villero priests. “Christ’s homes” are not therapeutic communities but rather respond to another model, called Caccs, which prioritize reconnection from faith. Along these lines are also the farms that organize social movements such as El Evita. The wealthy sectors have their own options. The Avril Clinic, with medical/psychiatric roots, is the most popular because it cares for celebrities. On the other side are organizations like ARDA, which today want to dispute the prevailing paradigm and speak of harm reduction. Zbuczynski concluded: “Places without authorization do not come into the discussion. But among those authorized, we can also begin to think about other things. We see relatives who defend places where treatment is inhumane. One understands it: if for years they told us that the only way out is hospitalization and that an addict is a passive subject, the social demand in this sense will continue to exist”.
