MANILA, Philippines – Five days before his inauguration in June 2016, then President-elect Rodrigo Duterte said he would have drug addicts killed “if I couldn’t convince you to stop.”

“The problem is once you’re addicted to shabu, rehabilitation is no longer a viable option,” he said in an event in Cebu City.

The contradiction is that, while he considers drug addicts as beyond redemption, his administration is still building more treatment and rehabilitation centers (TRCs) to accommodate thousands of drug surrenderers needing residential services.

“Maybe, based on his experience, he really considers some cases as difficult to rehabilitate,” Health Secretary Paulyn Ubial told Rappler when asked about the President’s perspective. “But for us at the Department of Health (DOH), there is no such thing as a hopeless case.”

The President’s campaign against illegal drugs has no doubt put the spotlight on the problem of addiction in the Philippines, but it has not encouraged enough discussion on drug addiction as a health problem. In fact, his approach has put him squarely in contrast with how health practitioners think the problem should be approached.

The public health perspective is the big, missing element in the government’s campaign against drugs.

“I would say we’re about 20 to 30 years behind in our understanding of drug use,” Regina Hechanova, head of the Task Force on Drug Recovery of the Psychological Association of the Philippines (PAP), told Rappler.

She added: “The understanding that our government leaders has, that’s the understanding that other countries had in the 1970s. Maybe the attention to it has not been there, perhaps? Especially in a country like the Philippines where people are stigmatized, it’s not something that people talk about.”

Hechanova, also a psychology professor at the Ateneo de Manila University, says our understanding of drug use needs updating, especially in these crucial times.