A job, a pay cheque and a place at the family table. For most people, these may seem ordinary. But for someone rebuilding life after substance use, they mean a fresh start. Yet, the road back to a stable life is not always easy. For some, unemployment, strained family relationships and the pressure of returning to old environments make recovery harder and increase the risks of relapse.
It is six in the morning.
While much of the city tries to squeeze in an extra hour of sleep before it bustles to life, 39-year-old Wangdi is already on his feet. His first task is to wake the residents at The PEMA rehab, where he has been interning as a warden for nearly a year.
But Wangdi’s connection to this place goes beyond his work. He knows what recovery feels like. After staying sober for five years, Wangdi relapsed in 2023.
“I was mentally disturbed by all the challenges I was facing. I had no stable job. Despite this, I tried to stay sober. However, I relapsed in 2023 during the Punakha Drubchoe. During the Drubchoe, I had opened a kids’ store where I met a friend who offered me the pills. I took the pills thinking it was just a one-time thing and I would stay sober the very next day. However, the guilt of taking them after being sober for so long killed my determination and my thinking pattern had changed by then.”
Wangdi’s experience highlights a difficult reality of recovery. Completing treatment does not necessarily mean the journey is over. For many, the greater challenge begins after leaving treatment and returning to their families, workplaces and communities.
“From teaching them how to make their beds in the morning, to folding their ghos, keeping their rooms clean and monitoring them, I am learning a lot as well. It’s a win-win situation for both of us.”
But stable employment remains a challenge for many people leaving treatment.
Of the 151 people discharged from residential treatment and tracked by The PEMA Secretariat last year, 28 per cent are unemployed or disengaged. The PEMA identifies this as one of the biggest reintegration challenges.
And employment is only part of the picture
Returning to high-risk social environments, peer pressure, financial stress, lack of family support and unresolved family conflict can increase the risk of relapse.
The PEMA Secretariat describes this as the ‘cliff edge of discharge,’ when structured support can end just as people begin facing the pressure of everyday life.
“In Bhutan as well as in the region, treatment and rehabilitation generally last around three to four months. Most people think that just because someone has undergone treatment and rehabilitation, they should be recovered. But the reality is that people require structured support for a prolonged period,” said Sonam Jamtsho, Head of Reintegration and Aftercare Programme, The PEMA Secretariat.
Of the 259 people discharged from The PEMA Secretariat’s substance use disorder programmes, about 21 per cent had relapsed.
The PEMA Secretariat says relapse should not be seen as a failure of treatment but a sign that a person may need additional support.
“At the global level, relapse rates range between 40 and 60 per cent. Although our relapse rate is lower than the global average, we are concerned, and we are stepping up our measures to support people who need additional support. We want to think that relapse is just a clinical signal, not a failure per se, and it calls for more structured support,” added Sonam Jamtsho, Head of Reintegration and Aftercare Programme, The PEMA Secretariat.
The PEMA Secretariat provides structured aftercare for at least a year. This includes phone follow-ups, family check-ins, continuing-care visits and community support groups.
Those considered at higher risk can receive more frequent follow-ups, family therapy and personalised continuing-care plans.
Reintegration also means building skills and finding opportunities to earn a living.
So far, 152 people recovering from substance use have enrolled in skills courses, including Lhadri, Patra, music, contemporary art, appliqué and digital literacy.
Forty have also taken part in the De-Suung Training Programme, while five people who completed bakery and barista training are now working at cafes in Thimphu.
But several gaps remain. Support across health, employment, education, social welfare and other sectors remains fragmented, while demand for treatment and aftercare continues to grow.
For Wangdi, a stable job is more than a source of income; it is part of rebuilding his life.
And for those leaving treatment, continued support, opportunities to work, and stronger family and community connections can make the difference between returning to old patterns and moving forward.
Recovery, therefore, is not something an individual has to manage alone. Families, employers, communities and government agencies all have a role to play in helping people stay on the path to recovery.
Tashi Dekar
Edited by Sonam Pem
