Therapeutic communities: the hidden evolution

Abstract

At the present time, there are 119 Therapeutic Communities in Spain that are accredited and authorised. They provide up to 3,400 places and admit some 7,000 users annually (with an average stay of between 5 and 6 months, in programmes with an average standard duration of between 7 and 8 months), of which 2,900 end by being discharged from therapy. Some 1,500 professionals work in these communities. They have undergone a most interesting and extensive transformation in the last few years, as they adapted themselves to new policies on drugs and the changes in the profile of users. This adaptation has led to a new institution, very different from the classical one, being very strong and competent, and one that is beginning to recover a certain leading role (although technical nowadays, rather than media-related) in the sphere of drug assistance. They are in addition, the most assessed subsector in drug assistance, with most services certifications (ISO and EFQM), and a significant scientific productivity. The types of users that are treated have also changed. In fact, inpatients whose principal drug is cocaine already represent 38.7% of the cases, and those on alcohol, with other problems such as gambling and the use of pills and pharmaceuticals, 22.5% In addition 26.4% of the inpatients have received a very precise double diagnosis.