Tuesday 29 April 2008

About our organisation, Wired In

Well, I have finally put various pieces of material together to tell you about Wired In, the new identity of what was once WIRED.

For those of you who don't know, I started WIRED about eight years ago as a way of empowering people to tackle substance use problems. I continued doing two jobs for six years, working as a Professor in Psychology at the University of Wales, Swansea, as my day job, and running WIRED in my spare time.

I finally thought, 'enough is enough, I'm never going to make the latter work unless I devote myself full-time', so I took early retirement from the day job. The latter had become very frustrating anyway, because I believe that many universities have lost their way getting bums on seats and forgetting to educate our young people as well as they should.

I hope you find this material of interest and help. In the first document, I describe our aims, achievements to date, and our Charter.

In the second document, I tell you our story, and introduce you to our core team and wider team of consultants, as well as our Advisory Board.

Monday 28 April 2008

Checking Blog visitors

It's been a busy day so only sat down with my Blog as evening draws in. Lucie and I finished off an article on recovery and the philosophy of Wired In, so we celebrated by me cooking Chinese, including Lucie's favourite, Chillied Chicken & Leak. An advantage of me working at home.

Then we had our first play with Google Analytics, looking at the Blog statistics over the past month. I was really pleased to see that there have been 2,250 'absolute unique visitors' to the Blog since it started a month ago. Yes, over two thousand different people appeared to have visited!

Of course, these visitors have not materialised out of nowhere. The vast majority of you were referred from Daily Dose, which just goes to show you that our news portal has more than one good function!

Of the Blog visitors, 91.8% returned a second time. And nearly 500 people have visited on eight or more occasions. I am absolutely thrilled since this shows I must be writing something of interest, at least some of the time. I certainly hope I can maintain your interest, and stimulate controversy and debate over the coming months.

Please do feel free to comment, it will really help increase discussion in this field.

I guess that there is no time to rest, I better start writing some new material for the Blog.

A very big thank you to you all.

Friday 25 April 2008

What can we do, to reduce the incidence of drug overdose?

I gave a talk at a conference in Swansea in June last year focusing on drug overdose. This excellent conference was organised by Swansea Drugs Project.

I wanted to point out that we can do a lot to reduce the incidence of drug overdoses, using an approach that involves: users and user networks; families and friends; specialist and generalist workers; commissioners and policy makers; the press, and members of the general public. I emphasised that we need an understanding and responsible society, and this can only be achieved by increasing awareness about drug overdose.

The talk focused on:

  • the incidence of drug overdose
  • risk factors underlying overdose
  • complications arising from non-fatal overdose
  • how to react to a drug overdose
  • getting the message out to users
  • helping family members
  • providing education and training to workers
  • ensuring that users get adequate health care
  • what emergency services and witnesses can do
  • importance of users having access to naloxone
  • the impact of prejudice, stigmatisation and stereotyping.
Two of our volunteers, Kevin Manley and Mark Saunders, who are recovering heroin addicts, spoke at the conference and received a tremendous reception. They brought home the reality of drug overdose and the reactions of drug users to overdose.
Not only were Kevin and Mark's talks of the highest quality, but many people commented to us that they were in complete contrast to those given by 'authority figures' who did not really appreciate the reality of the situation and the key issues surrounding drug overdose. If you listened to these 'authority figures', you would think that Wales was leading the way in tackling overdose, when we are now only doing things that have been done in Australia, for example, many years ago. And not doing many other critical things.

I hope you find this powerpoint presentation of the talk of interest and help. Please excuse the funny bullet points - the originals were converted to these by the pdf process. Strange!

Wednesday 23 April 2008

We must modify our treatment system so that it can effectively help people recover from the chronic disorder addiction

In my latest Background Briefing for Drink and Drugs News, 'Nature of the problem: Addiction as a chronic disorder', I start to look at the time course of addiction and how it influences the way that we should be building systems, including for the delivery of treatment, that help people find recovery. 

In this lastest Briefing, I looked at acute and chronic disorders and how they are managed in today's medical world. I focused on a recent key article written by two of the leading addiction scientists, Bill White and Thomas McLellan.
The issues I discussed are fundamental to the substance misuse treatment system in the UK and to the considerable amount of money the country is investing in this system. A system has been built to manage an acute disorder - but addiction is not an acute disorder. 
Quite simply, we must modify our treatment system so that it can effectively help people recover from the chronic disorder of addiction.
Do you agree?

Tuesday 22 April 2008

The need for a better trained workforce

Professor Neil McKeganey argued in Drink and Drugs News that there is an urgent need for a greater training of workers in the treatment field. He pointed out that workers need to 'understand the nature of drug dependency and the opportunities for recovery' and a variety of other complex issues to do their job well. At the end of the day, peoples' lives can be at stake.

Professor McKeganey was criticised in the letters section of the next issue of DDN. In one case, his article was described as 'extremely patronising and insulting to many of those in the field...' He and Tim Leighton, Director of the newly-formed Centre for Addiction Treatment Studies, provided sound responses to these letters in the last issue of DDN. 
From my experiences, there is an urgent and substantial need for greater training in the treatment field. It would be totally wrong for this field to feel that it is above this need. I have met treatment workers who have a poor understanding of key issues - in some cases I and others have been horrified by their knowledge and understanding  - and I have met others who know a great deal. The latter, however, are often the first to admit that they need and want to learn more. We also know that funding for training is almost the first thing that is cut. I cannot see how anyone can defend the current situation, except in some cases.
In arguing this, I am not saying that there aren't excellent and knowledgeable people in the field who haven't been well-trained. I'm not knocking the value of experience. I'm not saying that a University training is essential, although it certainly can be very good. As External Examiner for the Action on Addiction/Bath University degree in Addictions Counselling, I can vouch for the outstanding quality of this course and the considerable value it is to the field. At the same time, I have seen rubbish degrees in Universities and would seriously question their value - the old arrogant ivory tower syndrome would certainly come into play in some places.
What I am saying is that we need to greatly improve the level of knowledge and understanding in the treatment field, in particular in relation to how we help people move from the culture of addiction to the culture of recovery. This knowledge can be provided on the basis of what we know from leading scientific research, best practice, and the views and experiences of people affected by substance use problems and by practitioners. We also need a significant financial investment in training.      
We at Wired In are committed to helping improve professional standards in the treatment field, in part by providing new education and training materials.  

Saturday 19 April 2008

Take a Look

Just to remind you to look at our Blogs on the right side. We've just put up a couple more of my earlier Background Briefings from Drink and Drugs News. Also, some new photos (Our Faces) to continue the introduction of our team and friends.

Friday 18 April 2008

Wired In Aims

I continue my description of our organisation Wired In by showing you our aims.

Wired In aims to improve the lives of people affected by drug and alcohol use problems and addiction. This unique initiative has been developed as a way of empowering people to tackle substance misuse by:
1. Providing information and tools that help people better understand and utilise the options they have to overcome the problems caused by their own, or a loved one’s, substance misuse;

2. Developing education and training packages that help improve the quality of treatment services in the community provided to people affected by substance use problems;

3. Creating a supportive “Community” that helps people to find recovery, maintain positive changes in their lives, and help others if they so wish;

4. Helping reduce prejudice towards people with substance use problems and their families, to create a society that better facilitates recovery from substance use problems.

Thursday 17 April 2008

The Centre for Addiction Treatment Studies (Action on Addiction)

I sent this out tonight:
"Dear Tim, Derrick, Nick and all colleagues at Action on Addiction,
Thank you for inviting me to your opening of The Centre for Addiction Treatment Studies in 'Tim's House' in Warminster. It was an excellent launch and a great pleasure to see you all again. The building and facilities are just awesome! What else can I say?
You know how strongly I feel about the need for quality education and training in the substance misuse field. When I took on the role of External Examiner for your University of Bath Degree, I did so against my basic principals. I had vowed NEVER to be an external examiner - the job is too boring. But in your case, I knew you would do something special and I really wanted to see someone take on the challenge of developing a degree for the field. So I did it!
I did worry for you because I wondered whether you would be able to deal with all the administration a University would throw at you - particularly when they were dealing with a new scheme and an external organisation. But the University of Bath team have been fantastic and between your two groups, you made it work!  
It has been so enjoyable and rewarding being your External Examiner, particularly to see the high quality shown by so many of your students. And I have learnt so much. Being at your launch today and talking with a variety of people about the past few years, brought back to me what a fantastic journey it has been. 
I am very proud to have been part of it! And it was wonderful to meet this year's students today!!
It is onwards and upwards for you now, with your dream building being the space ship you need.
Good luck with all your future ventures.
My best,
David 
PS. When can I stay?"
I have included this on my Blog, because this was an occasion for the field to celebrate.

Wednesday 16 April 2008

Wired In Charter

Over the next couple of weeks, I am going to tell you more about our organisation Wired In, formerly known as WIRED.

As you can see from our logo, we are focused on helping people find recovery from addiction. At the same time, we believe strongly in helping people overcome substance use problems before they become serious. We work not only with people with substance use problems, but also their families and friends, as well as practitioners working in the field.

In this Blog, I thought I would introduce you to our Charter, which describes the principles on which we operate as individuals and as an organisation.

WIRED IN CHARTER

1. Wired In exists because of the problems that drugs and alcohol can sometimes cause for individuals and their families.

2. Wired In is founded upon Trust: we are independent, objective and honest. Wired In is about being creative, and having the courage to challenge.

3. We aim to create an environment of opportunity, choice and hope for people affected by substance use problems.

4. We treat people with respect and dignity, and work as a mutually supportive team, in a spirit that we hope inspires others.

5. Wired In is an inclusive, non-competitive initiative that seeks to enhance the impact and reach of the best practice of successful organisations.

6. We are not about a quick fix, but realise that positive change often takes time. Poor systems and protocols must be improved to ensure that people get the help that they deserve.

7. We challenge society over the stigmatisation and stereotyping of people affected by substance use problems.

8. We believe it is essential to provide information and support and to people experiencing all levels of substance use problems, rather than simply focusing on those with the most serious needs.

9. We do not promote any one particular philosophy or treatment intervention. We take an approach that focuses upon key principles that are known to lead to behavioural change and facilitate the path to recovery.

10. The energy and experience of people affected by substance use problems is at the core of what we do. We harness this to give them a voice, enabling them to help themselves and others, and influence practice and policy and the views of society.

Tuesday 15 April 2008

Making a Difference

Heard a lovely story a few minutes ago from my colleague Lucie. 

She was visiting one of our volunteers, Chris Ling, in Cardiff yesterday. Whilst at a meeting with Turning Point that morning Chris was talking to one of the staff members about a job interview he has on Wednesday. He was a bit concerned about what to wear as he did not have any smart clothes.
Turning Point were able to offer him a 'shopping spree' where they bought him a suit, shirt, tie and shoes. 
Chris was over-the-moon with the generosity displayed by Turning Point, and could not wait for his interview where he could show off his new kit!! What a boost to his confidence and what encouragement for him to make the important step of seeking employment!   

Sunday 13 April 2008

New Daily Dose Sponsors

A big Thank You to the continuing and new sponsors of our news portal Daily Dose. We launch the new Lead Sponsors in today's Weekly Dose and tomorrow's Daily Dose. You can also check out our Associate Sponsors in the Sponsor's Lounge. 

It is good to see our longest lasting sponsors continue, although the identity of one has changed since Euromed have been taken over by Concateno. Castle Craig Hospital of course remain under their same identity. We also welcome back the NTA and FRANK, and welcome first-timers Action on Addiction, Addaction, Ayurva, the Centre for Drug Misuse Research (Glasgow University), HIT and the Scottish Government. Other organisations are still considering signing up to this 'elite'.
For those of you who have asked, we have still not received a reply from the Welsh Assembly Government. Yes, I agree it is rude that they have not replied to several emails, particularly when we have been flying the flag for Wales so well. Ah well, that's their problem.
I want to focus on the good news. We are thrilled to have raised the necessary sponsorship to continue to run Daily Dose. Over the coming months you will see some changes in the Daily Dose service which we hope you will like. You will hopefully also see some new developments from Wired In. For now, I can tell you that the Daily Dose editor Jim Young is very happy (and mightily relieved) to see up the new list of sponsors.
Finally, a big thank you to Nathan Pitman of Nine Four who is the new man behind our websites, including Daily Dose. I cannot wait to reveal the new Wired In site he is developing!

Saturday 12 April 2008

Is the alcohol industry increasing the size of the deal ... to enhance priming?

The Royal College of Physicians (RCP) President Ian Gilmore has accused the pub industry of acting irresponsibly by increasing the size of the 'standard' measure of wine glass. The Association of Licensed Multiple Retailers has hit back saying that it is in the business of offering customers choice.

The 125 ml wine glass used to be the standard size but now, according to the BBC, only 16% of pubs and bars say it is their normal size. Some 73% say 175 ml is the new 'standard' and 250 ml (equivalent to a third of a botle) the large. 
Some 14% of licensed premises say they now only offer the 250 ml sized wine glasses.
The BBC also report that there is 'even anecdotal evidence that some pub staff were under pressure to maximise profits by encouraging customers to opt for larger drinks.'
When I am buying a drink for my good friend Simon Shepherd, CEO of the Federation of Drug and Alcohol Professionals, he always insists on a small glass of wine. Starting a couple of years ago, he pointed out to me how hard it was to buy a small glass - staff always wanted to sell you a large glass. And he was right! I really had to insist strongly at times.
Now let's get this right. We are talking about the selling of a drug here, a drug which is known to produce a strong priming effect. For many people, drinking alcohol results in a desire to drink even more alcohol. Selling larger glasses of wine increases the likelihood of the priming effect.
Now don't tell me the alcohol industry does not know this. And is not trying to benefit from this situation.
It should be remembered, however, that the tobacco industry eventually faced large very expensive court cases when it was finally revealed that they were marketing a drug knowing that it was addictive, playing down the negative effects on health.
The same could happen to the alcohol industry in the future.

Thursday 10 April 2008

The 2008 UK Drug Strategy: where is recovery?

I've had to spend less time with my Blog because my three young children have come to stay for half-term. I always forget how little spare time one has being a single dad! But it's great!!

I have been reading the recent article by Kathy Gyngell of the Centre for Policy Studies, 'The 2008 Drug Strategy: The continuing nationalisation of addiction.' She points out that an effective drug strategy needs to be grounded in the need to move people from the culture of addiction to the culture of recovery. 
Last year, I wrote a series of Background Briefings on recovery for the magazine Drink and Drugs News. I emphasised the excellent work of William White and made reference to the 'Faces and Voices of Recovery' website. I described how there was an increasing shift in the States towards the recovery paradigm, where the emphasis was on how people recover from addiction, rather than focusing on the nature of addiction.
Since writing these articles, I have read the most amazing book - 'Pathways from the Culture of Addiction to the Culture of Recovery' by William White. The book takes some serious reading because it contains so much information, but it is an essential read.
Since we are normally a decade or more behind the States in adopting new approaches in this field, it is likely that a recovery movement will take off in this country in the coming years. 
However, I recently searched for the word 'recovery' in the new UK drug strategy and found it only four times. Once in the Home Secretary's Foreword, and three times referring to recovery of assets of dealers. Given that the common factor underlying all recovery is behavioural change, I searched various permutations of these words. Check for yourself, they are rarely mentioned.
Oops, rather serious errors. I can see why Kathy Gyngell criticises the UK Drug Strategy for not demonstrating 'real skill and knowledge in relation to treatment.'
On the other hand, 'recovery' has become a focus of attention in Scotland and my discussions with major players in England suggests a recognition of the need to increase understanding of recovery.
Next week, I will discuss the Wired In approach to helping people overcome substance use problems, which will involve talking about recovery, behavioural change, harm minimisation, treatment and recovery communities.

Tuesday 8 April 2008

Trauma, drug misuse ... and bigotry

I'm reading a very interesting and important book at the moment, 'Trauma, Drug Misuse and Transforming Identities: A Life Story Approach' by Professor Kim Etherington. Kim's book looks at the lives of ex-drug users told in their words. It illustrates the links between early childhood experiences and drug misuse, and also shows pathways to recovery and transformation.

The book illustrates how some people use drugs, in particular heroin, as a coping mechanism to help them deal with traumatic experiences in their childhood. Such trauma may have involved chronic parental neglect, physical and emotional abuse by parents, sexual abuse by a family member, rape by a stranger, or racial abuse and harassment. 
Heroin and other opiates are used medically as analgesics to reduce physical pain, but they also alleviate psychological pain. It is not surprising that a traumatised person may use heroin as a coping mechanism and take up the heroin-using lifestyle. Becoming part of the heroin-using culture can also be of 'therapeutic value' because the person associates with other heroin users who may identify with their problems and past experiences. Some of these people will have had similar experiences.
Most non-drug users do not see beyond the heroin user stereotype - the 'dirty, devious, criminal junkie'. They do not stop to think that the heroin user may have experienced a traumatic childhood and have started along a path to addiction as a natural response to trying to deal with their resulting anguish and psychological pain. They did not set out to become an addict, and they very likely did not know the addictive potential of heroin and the heroin-using lifestyle.
These same non-drug users may have no problems at all with other people going to their doctor because they felt anxious or 'down' and being readily prescribed with anti-anxiety drugs (that are highly addictive) or anti-depressants. The distress these people are experiencing may be minimal compared to the heroin user described above and the necessity for prescribed drug use unjustified. However, the person wants to feel they are being 'treated', the doctor wants to keep the patient happy, and the drug company (which some people might argue is a legal drug dealer in certain circumstances) makes its profits.
We are in a hypocritical society which on the one hand demonises use of illegal drugs - without thinking about why these drugs might be used - whilst at the same  time encouraging people to take legal prescribed drugs, which are in many cases more dangerous than legal drugs.  
And we get bigoted comments like that reported to have been made by Tory MP (Monmouth) David Davies last week - 'Taxpayers will be outraged that so much of their money is going to junkies and winos who will use the money simply to fund their disgusting habits.' Such people need to move past the end of their noses and get a dose of reality - assuming that they understand or care about problems experienced by other people. They must stop making naive and nasty generalisations.  

Monday 7 April 2008

Still no response from Welsh Assembly Government

Another email, another week and still no response from the Welsh Assembly Government (WAG) regarding potential sponsorship for Daily Dose. Last year, I received no reply from the substance misuse team, this year the same from the Minister's office. Meanwhile, other UK government departments have been in contact about invoices, payments and logos.

I don't think that this lack of response is anything specific against Wired In or myself. It more likely reflects a deeper malaise. 
A large number of people have told me that their efforts to communicate with people in the WAG who are supposedly concerned with substance misuse issues have resulted in either an unsatisfactory response or no response at all. These same people have expressed concern about the quality of work conducted by WAG in this field. 
Some of these people have told me that they are frightened to speak out because they fear retaliation. They are concerned that the agency they work for may lose funding in the future. Obviously, this is a very concerning situation.
I set up Wired In to help people affected by substance use problems, which we do in part by helping practitioners working in the field. I have told people that I will speak out against what I see is wrong in this field and I intend to keep this promise. This blog will be one vehicle I use to speak out. 
If I cannot have a decent two-way conversation with WAG that results in a positive and meaningful outcome, then I will have a one-way communication from this platform. The people affected by substance use problems, their families, and the practitioners committed to helping people need and deserve this, and much more, support. If what I see happening in the substance misuse field in Wales occurred in the cancer field, there would be a major outcry.

Saturday 5 April 2008

A week on

Well, I've been doing this blog for just over a week now. It's been fun and I'm pleased with the response I've had. However, this is the sort of thing that is going to take a great deal of time to develop a large and wide audience.

I've been ambitious, of course, trying to maintain several blogs, but we'll see what happens. Please take a look down the right side of my blog and visit the other blogs. One highlight this week and well worth a read is Kerry Manley's story. 
I've been absolutely thrilled that Kevin has started a blog, one which is of real quality. The response has been super. I am really hoping he can engage other people who have been through similar experiences to his own.

Friday 4 April 2008

Motivation

I went to the gym for the first time in my life and even treated myself to a personal trainer. Need one, I can tell you! 

We were talking whilst working out (I'm not that unfit) and the topic of what I do came up. Lewis was really interested and said, 'It must give you a great pleasure helping people who have drug and alcohol problems.' I agreed that it did give me great pleasure, but I also pointed out that it could also be very frustrating - caused more by the system than those who need help!
We also discussed about the commonalities between my work and my new play (gym). Motivation is key to overcoming addiction - and motivation is key to me losing some weight and 'toning up'. And improving my mental capacity to work on Wired In matters. I'm sure we're going to be telling each other a lot about motivation. 

Wednesday 2 April 2008

Prejudice towards heroin users and ex-users

Considerable prejudice exists in society towards heroin and other drug users, which often leaves them feeling stigmatised, isolated and unwilling to access treatment.  Prejudice is also exhibited by people working in the treatment industry, as evidenced by the Mersey Care NHS Trust 'Get Clean' campaign described in Kevin Manley's blog

Surprisingly, there has been little research focused on prejudice in the substance misuse field. Whilst I was still working in Swansea University, we undertook a piece of research with 141 undergraduate students to gain insights into their views of heroin users, ex-users and disabled people. A variety of open and closed questions were used. 
Students were first asked to indicate their attitude to heroin users, former users or disabled people on a thermometer. This ranged from 100 (extremely favourable) to 50 (neither favourable or unfavourable) to 0 (extremely unfavourable). The mean scores were:
  • Heroin users   23.0
  • Former heroin users 41.5 (significantly different to neutral)
  • Disabled people 72.9
Subjects were asked about their emotions and feelings toward these three groups. The most common responses (% of subjects showing response) were:
  • Heroin users: anger (56%), sympathy (29%) and pity (27%)
  • Former heroin users: anger (45%), compassion (29%) and pity (26%)
  • Disabled people: compassion (48%), sympathy (21%), admiration (9%)
These findings not only illustrate the prejudice that can exist against heroin users, but also show that former users are not protected from this response from society. This prejudice works against the recovery process and, difficult as it may sound, it needs to be stamped out of commissioning and treatment services, as well as society in general. I'll return to this research at a later date, but you can find more on the old WIRED website.

Supermarkets and alcohol

Tesco supermarket claim they want to help create a  climate of responsible drinking. They say they want to work with government on legislation that would limit its ability to sell cut price alcohol. They point out that the government must take the lead because it would be 'commercial suicide' to act alone. They also emphasise that supermarkets can't work together to put up prices because that would be against commercial law.

I was in my local Tesco yesterday. Previously, there were two long aisles of alcohol at the most distant point to the entrance. Recently, they've introduced a long aisle (one side) full of alcohol, along with large 50% reduction signs, right at the point of entry. I came across at least one other alcohol section in another part of the supermarket - it was as if I needed to be reminded to purchase my booze.
On the one hand, we see supermarkets aggressively marketing the drug which is causing the greatest harm in this country. On the other, they want to help people drink responsibly. Well government, get to work and see whether the supermarkets will genuinely help create more responsible drinking in this country - and reduce their own sales!