He started consuming to relax among friends, always at a party. It was a few months before he did it alone, at home. Then the pleasant effects of the cocaine began to last for a shorter time, and he started to take it more frequently. Before realising it, José Manuel had fallen into the spiral of self-destruction which addictions generate. He lost money, his health was affected and his relationship broke up. He touched rock bottom when he stole 300 euros of his mother's pension. Only then did he ask for help. He was "clean" for seven months but last month he suffered a relapse after a long and leisurely lunch which had gone on until well after midnight.
Psychiatrist Carlos Sánchez, of the Triora clinic, recommends that people with addictions should be admitted as a preventive measure in the most serious cases, and attributes the increase in relapses in the summer to the "therapeutic distancing" produced by travelling and holidays.
"They usually give up their treatment after a few days. Some centres close because the therapists go on holiday. All that reduces their defences and can cause them to relapse," he says.
Hashish, alcohol and cocaine are the substances which attract most patients, although in recent years there has been an increase in what the psychiatrists call "non-substance addictions," especially gambling, bingo, slot machines and sports betting on the Internet.
The addiction to betting is causing havoc, especially among young people, with thousands of new cases of gambling addiction registered. In many cases, this results in debts because they take out loans with very high interest rates which they cannot pay back.
"Addiction is an illness. These are people suffering from a mental disorder who need to be treated. They present a biological predisposition to developing addictions, whether to toxic substances or gambling, video games, sex, shopping or eating," says Carlos Sánchez.
He says prevention is better than a cure and proposes isolating people from environments and circles which pose a risk to them: "It is never easy to get over an addiction, but the success of the treatment depends on the patient's emotional and intellectual resources, their family environment, their work and other variables which make it impossible to generalise".
In the case of betting on sports, Sánchez recognises that "medicine, like the law, is behind reality". That is why policies are only starting to be introduced to deal with the problem now, when addiction is already destroying the lives of thousands of people.
"Betting has made its way into society, often in the case of young people without resources, in a progressive and silent way, to the point that it is causing a great deal of damage. Can anyone imagine a football player advertising cocaine? There is dangerous publicity which we are still seeing every day, and more frequently in the summer".
At Proyecto Hombre the therapy is based on what is called "personal growth", through programmes which are adapted to the personal and work circumstances of the patients.
"The first thing is to analyse what has been happening to someone for them to end up consuming or addicted to games, and then teach them changes in their lifestyle, healthy habits and control to stay away from risk factors and enhance protective factors," explains Escalza, who says relapses tend to be part of the therapeutic process. "We all need to feel valued and secure, and when we don't there is the possibility of finding ourselves trapped in problems of this type".
Cannabis and cocaine
An addiction to cannabis has also resulted in more people being admitted for treatment in recent months. About 17 per cent of people aged between 15 and 34 consume this substance in Spain, according to the European Drugs Observatory.
The figures are even higher in the case of alcohol, with more than one and a half million addicts, and around 120,000 are addicted to cocaine. Treatments vary, depending on the severity of the addiction and profile of the patient, from therapies which do not interfere with their professional routine to admittance to specialist centres.
Psychiatrists warn that addictions and relapses leave signs to be detected by those around the patients, such as changes in mood, irritability and depression, reduced academic or professional performance, strange behaviour, headaches, lack of appetite or uncontrollable hunger, isolation, changes in consumer habits and their relationship with money, such as unusual spending or bank withdrawals for no apparent reason.
Therapists also agree that it is essential for addicts to resume their treatment as soon as possible to mitigate the consequences of their relapses, even though these are "habitual" in the detox processes.
"And any situation which arises from an addiction, no matter how difficult it may seem, can be overcome with time and effort," says José Manuel, who has been having treatment for five weeks after his relapse in July. Those are the words of a survivor.