Fellow Since 1999
This description of Remigio Muñoz's work was prepared when Remigio Muñoz was elected to the Ashoka Fellowship in 1999.
Remigio Muñoz has developed an outpatient Therapeutic Community treatment program for recovering drug abusers and dependents. His goal is to change society's understanding about why addiction occurs and how it can be prevented.
The New Idea
While working in boot-camp style treatment programs for drug and alcohol abusers, Remigio routinely saw "treated" individuals return to their old patterns of addiction after the program ended and they had been reintegrated into society. He realized that addicts need to be protagonists in their own recovery, and that during their treatment they must remain integrated into mainstream society to avoid relapse. Extracting elements of the residential "therapeutic community" model commonly used to treat substance abuse in Chile, Remigio created an outpatient treatment program that begins by identifying the factors that lead to dependence in the first place. His program has proven more cost-efficient than existing residential models, and has an equal or higher success rate. Participants are able to maintain their connection with the outside world - they live at home with friends and family, continuing to work or study while focusing on personal development. This combination of individual and group therapy builds a lasting resistance to temptations and breaks the cycle of addiction.
In recent years, drug and alcohol abuse has become one of the leading social problems in Chile. A 1996 study by the National Information System of Drugs in Chile stated that more than sixty thousand individuals per year become addicted to either marijuana or variants of cocaine. The government has recognized the alarming rise of drug abuse, particularly among young people, and is helping combat the problem. The vast majority of government funds, however, are earmarked for prevention programs. This means that more expensive treatment programs rest in the hands of private health care providers and other non-governmental organizations. These programs often have long waiting lists.Moreover, the vast majority of programs use medication as a primary method for breaking addiction or strict disciplinary measures to impart a sense of order that isolates addicts from society. While such programs are deemed necessary for the most severe cases, there is a whole class of addicts for whom alternative treatments could be equally if not more effective. Traditional treatment does not address the root causes of addiction that are often closely linked to emotional and psychological conditions.
In 1993, Remigio founded Project Ser, a low-cost outpatient care program that treats recovering addicts over twenty months using a five-step program tailored to the evolving needs of the beneficiary. A team of therapists trained in personal development for addicts treats roughly thirty-five recovering addicts between ages eighteen and forty-five at any given time. The addict must show commitment to recovering, and at least one family member must accompany the patient during treatment. The process begins with an interview during which the interviewer explains why he or she is involved in this work. The idea is to build a climate of trust and openness in which the potential participant feels comfortable telling his or her story. The interviewer then lays out the conditions of the program: zero tolerance for contact with drugs, alcohol, or substance abusers. In the beginning, patients have a 10 PM curfew, they cannot handle money, and someone must pick them up each day. The program is carefully structured. During the first month-long phase, participants spend an hour each day in therapy focused on exploring how and why he or she began abusing drugs or alcohol. At the end of this phase, there is a group interview with all program participants and the person's family. The patient talks about what he or she has learned, and the group decides whether the participant is ready to move on. Over the next twelve to fifteen months, the participant goes through four distinct programmatic phases designed to break the drug or alcohol dependence by building self-awareness, evaluating personal difficulties, and creating a sense of community and shared responsibility. Throughout, the participant continues to work or study, maintaining social ties. In the early phases of the program, participants plan their weekend activities - helped by family members and therapists - in order to avoid falling into old traps. They also attend several weekend retreats outside Santiago. As they progress, participants eventually move from intensive sessions five nights a week to one night a month. Because family involvement is crucial to recovery, regular weekly and monthly meetings for family members are held -- informative sessions about addiction and group therapy and training on how to help the addict.Project Ser techniques are already being used by other alcohol and drug treatment programs in Chile, and Remigio has trained some seventeen hundred people to date. Soon, he plans to find someone to handle day-to-day operations so he can lead training workshops. He wants to introduce the model in southern Chile, where programs are sorely lacking. Though treatment will continue to be his top priority, he has also set his sights on developing a similar initiative aimed at prevention of drug and alcohol abuse. In addition to his contacts with the Ministry of Health's Tobacco, Alcohol and Drugs unit, the National Drug Control Council, the National Youth Service, and various non-governmental organizations, another important channel for spreading Remigio's work is the Association of Chilean Therapeutic Communities and its sister organizations throughout Latin America. Remigio believes that the flexibility and low cost of his model makes it easily accessible to a variety of communities.
Though never a drug addict or alcoholic himself, Remigio has a passion for helping others. He left home at eighteen to study medicine at the University of Cuyo in Mendoza, Argentina. It was a difficult time economically, but Remigio was always willing to share his modest monthly allowance with classmates in need. While completing his degree at the University of Chile in Valparaiso, he was mentored by a young priest. He felt he had found his calling in the church and joined the Franciscan seminary. After three years, he realized that priesthood was not his vocation. He returned home and worked as a professor of religion at a low-income school in Santiago. Frustrated by the growing number of kids doing drugs, Remigio attended a talk on drug prevention that gave him new direction. The therapist who led the talk encouraged Remigio to participate in one of the weekend "therapeutic communities" used to treat recovering addicts. Intrigued by the techniques used and their effects, Remigio began studying the model. He spent seven months living in one of these highly disciplined communities in Colombia, and later went to Italy to train as a therapist. Back in Santiago, he worked as a therapist and later general coordinator of the "Santa Ana" residential therapeutic community. Remigio was dismayed that drugs still dominated patients' every thought and word - a sign that the treatment simply wasn't working. After five years, Remigio left to start Project Ser, which has already changed the face of how addiction is perceived and treated in his native Chile.