My 50th Posting: Kids and friends

My three youngest - Ben (12), Sam (7) and Natasha (3) - have been staying the past week, which has meant a major change in lifestyle. One gets out of practice seeing youngsters only every other weekend, and half of the holidays, so it sometimes takes a little time re-adapting to being a single dad. But I love it.

I've been on the back-foot with my writing and other Wired In activities. In fact, they've been rightly relegated into the background. However, there has ben a lot going on so I've had to pick up the computer whenever I could. 

I had a meeting with a film production researcher (and Lucie and Kevin) on Wednesday which was very interesting. Kids had to be relegated to another table - armed with computer, Gameboy, etc - where they enjoyed their own special lunch. Rachel went on to meet some of our volunteers and that sounded as if it well really well. Certainly fired up Kevin on his Blog.

One real pleasure this week has been a regular email correspondence with Bill White, one of the leading thinkers in this field. Made me realise what little short messages can do to one's enthusiasm, drive and mood. When you're working away with just a few people and no funding, trying to help make major, much-needed changes to a field, little short messages can mean a lot. 

It's also been great communicating all week with a small core group of UK people trying to move the recovery agenda along. I'm discovering new friends, good people I know I'll be working alongside (mainly virtually) for a long time into the future. It feels good!

New Wired In Blogs

I want to introduce you to two new Wired In Blogs. Firstly, 'What I've Heard' written by a collaborator of ours, Pavel Nepustil, from Brno in the Czech Republic. Pavel is currently in Houston on a Fullbright scholarship. He is a NGO social worker and PhD student, carrying out research with former methamphetamine users who gave up using without treatment. 

'My Life' is written by one of our volunteers, David Wright from Newport. Some of you will remember David's story being told in Drink and Drugs News a couple of years ago. David starts with this story linking up to the original magazine articles. David is a prolific writer so keep an eye open for lots of future Blogs once he gets used to the system.

Meanwhile, Kevin's Blog goes from strength to strength - watch his latest 'Grease Medley' video on our YouTube channel. A real highlight today, not just for Kevin but for the whole team. A message from Bill White which said quite simply, 'Love Kevin's posts. Tell him to keep writing. We need his passion and his voice.' Kevin must be over the moon to receive such a compliment.

On isolation and recovery – an excellent article by Ian Wardle

The past few months have been very interesting times for what I can only describe as an urgently needed recovery agenda in the UK.

Yesterday, we saw published online an erudite discussion on recovery and the UK treatment field by the CEO of Lifeline, Ian Wardle. He has written an excellent article, one which should be read by all people working in the treatment field, as well as by politicians and others who impact in one way or other on our efforts to help people overcome substance use problems.

I would love to devote a good deal of time discussing this article, but my three youngsters have come to stay for a week and have left me somewhat brain-dead. However, it would be wrong of me to say nothing about Ian’s article. So, ‘please keep quiet upstairs!’

I found Ian’s focus on the isolation of the treatment field and the implications of this isolation fascinating. In my opinion, there is no doubt that embedding drug treatment in the criminal justice system is greatly hurting our efforts to help people overcome substance use problems, as I will discuss in one my forthcoming Wired In Reflections.

The field is also hurting itself by getting bogged down in arguments about harm reduction vs. abstinence, as has been discussed in some of my other Blogs.  As Ian points out, we are isolating ourselves from each other. This is unnecessary, as the recovery writings of Bill White and colleagues reveal.

Ian emphasises that we are becoming isolated from people outside this field. People from outside the field that I know (and trust) who are aware of what I am doing are horrified by some of the dogma they read in our field. They cannot believe that some people seem more interested in looking after the system than the clients.

Ian also points out that we are isolated from the new personalisation and recovery-orientated philosophies that are inspiring people in other sectors of health and social care. It has surprised me how many people in the drug field are so inward-looking – they don’t look to learn from other fields, which is naïve given the relatively new discipline in which we work.

I believe it was an excellent idea of Ian to focus on the isolation issue. It has certainly made me think about this issue more explicitly. There are a number of suggestions for the future way forward that are indicated by Ian’s article.

However, I felt that two messages may not have got come through strong enough – I apologise to Ian, if I have misread things. Firstly, there is a lot we can learn from the writings and actions of the US recovery movement. We don’t need to reinvent the wheel, but at the same time our recovery efforts in the UK will take us in some different directions. 

Secondly, we must listen much more to people who are recovering or recovered from addiction – and learn from them. We generally do not do this well in the UK.

Thanks for a very thought-provoking article, Ian.

On two Celtic fronts (Scotland vs Wales)

It's Bank Holiday here in the UK. Tomorrow will start a major week for the field in Scotland as they will be introducing a new strategy, one focused on helping people find recovery. I referred to, and complimented the Scottish Government for, the change occurring in Scotland in my Blog of March 28th, where I also linked to my Drink and Drugs News articles on recovery. If you really want to get your teeth into some good reading on recovery then turn to Bill White's page on the Faces and Voices of Recovery website.

I am looking forward to reading the new Scottish strategy and I really hope it leads to significant changes in approach, and to a massive increase in the number of people finding recovery. However, we must remember that here is a substantial difference between a written strategy on recovery and the implementation of all the changes required to make it work. There needs to be a significant change in ethos from top to bottom. Sadly, I feel sure there will be much lip service paid to the word 'recovery' (and much misconstruing of what it means) by those people who want to maintain the status quo. At the same time, I know some of the people who are totally committed to this approach - and they will work very hard to make sure that it bears many fruits. Change will not occur overnight, but it will change as long as those people supporting the recovery agenda are given the support they need to move it forward. 

Meanwhile, here in Wales, nothing much changes! Dr Brian Gibbons, the minister in charge of the substance misuse agenda - he who does not respond to important emails - has been on a week of spin during the National Tackling Drugs Week. He tells us that there have been "massive strides forward" in tackling the drugs problem in Wales. 

Utter poppycock! Unless you consider making adjustments to the English strategy, publishing a document, spending money, trying to attract people into 'treatment', and counting numbers of people going through the door, a significant advance. Anyone can do that! What is important is the provision of effective treatment that helps people overcome their problem (not just one or a few people that you trot out for the newspapers) and a system that allows practitioners to be able to do that. It also requires an understanding of what is required to help people, by those in charge of the system.

Those of us who know what really is going on in Wales know that Mr Gibbons and his team have little idea of what is required. I very rarely ever hear anyone pay a compliment about the Assembly' efforts to help people overcome substance use problems (except those people working for the Assembly) and I am always hearing criticisms. The real sad thing is that practitioners have told me that they are frightened to speak out in case their treatment agency loses money. There is a climate of fear and Wired In is not the only organisation to have heard this. 

So, Dr. Gibbons, could we please have a system that understands what it is needed to help people recover from addiction, and starts to implement what is required. Can we have less spin - remember what happened to the father of New Labour spin, Mr Blair - and less of a climate of fear? An analogy - any government can build a hospital. What is required is the building of a hospital with professionals who know what to do to help people get better and are supported in doing it by the government.

If we don't see some real action instead of spin, the people of Wales will start speaking out, despite the underlying threats. And remember, the people pay your wages and those of your staff.   

Start doing something that really matters - please!

The need to keep learning

A conversation today reminded me of something that happened a number of years ago at a conference. I was talking about how we at WIRED wanted to provide an information resource for the field to help practitioners and commissioners.

An agency boss stood up and said this would be of no value because her staff had no time to look at the internet and read because they were too busy with their clients.

I must have been feeling wimpish that day, or just in a polite mood, because I gave some bland comment about the need to keep informed. What I should have said was, "I would get rid of them because they were not doing their job properly. No one is above learning and improving their professional development and practice. No, sorry, I'd get rid of you for allowing this to happen."

Does your boss encourage you to read and keep learning. Or does he/she discourage it?

Drug and Alcohol Findings - bookmark the site and read, read, read!

I love learning about things and I love trying to solve problems, particularly difficult ones. To me, its a great joy to read what other people have tried to do to tackle and overcome a problem. Even failures teach the reader something - they show you ways that might not be productive.

There are so many things to learn in this fascinating field of substance use, so I read, read, read. And think. There are so many good books and articles that have been written about substance use and misuse - of course, amongst a mass of dross. It is the same in any field.

Every now and again, I come across a new information resource which captures my attention - big-time! This happened when I discovered the Drug and Alcohol Findings magazine edited by Mike Ashton. I was overwhelmed by the information it contained and the high quality of writing. And the different types of section.

I treasured each copy, went mad when someone borrowed one and didn't bring it back, and eventually stored them all in a box file I didn't show people.   

Now, thanks to the J. Paul Getty Jr. Charitable Trust and The Pilgrim Trust, and Mike Ashton's unbelievable drive and dedication, it is online (well, not all of it yet). I can get it anytime I want - as long as I have access to the internet. It is wonderful! Life is a beach!!

Now why not go and check what I am raving about. This is such a wonderful information resource. A huge thank you to Mike Ashton.

PS. As an aside, I've discovered I'm one of three information junkies in this field, the other two I know being Mike Ashton and Tim  Leighton of Action on Addiction. I'm sure there are more of 'us info junkies' out there. Let me know if you are one as well.

What can we learn from America?

Interesting to see Kathy Gyngell calling for us to look at the American system in helping people overcome substance use problems, following a visit to the States. Her Blog is well worth a read.

Kathy described the point made by one professional: “the recovery movement here is huge; we do not seem to make as big a deal about ‘abstinence’ versus ‘harm reduction’ as it seems the Europeans do.” She also described a programme that, ‘has significant freedom to decide its own methods and programmes. A far cry from the UK’s state directed hegemony.’

As I have pointed out in my DDN Briefings, the Americans are years ahead of us. We need to be following the example of their Recovery Movement. So few people in this country understand the concept of recovery, know the Faces & Voices of Recovery movement and website, or have heard of William L White (a new member of our Advisory Board) and his seminal work.

This needs to change – urgently. We need to stop protecting the inadequate system we have and start looking outward and forward. Keeping the good things that we have and accepting the achievements we have made. 

I have just finished reading an excellent article in the journal Counselor by Bill White on the Recovery Revolution in Philadelphia. Listen to this:

‘The behavioral health system transformation in Philadelphia started by involving everyone in the process — particularly recovering people and their families. A lot of time was spent asking questions and listening to people’s ideas about how the existing behavioral healthcare system could be changed to better meet their needs. What emerged after months of such discussions was a clear vision: create an integrated behavioral health care system for the citizens of Philadelphia that promotes long-term recovery, resiliency, self-determination, and a meaningful life in the community. A Recovery Advisory Committee clarified that vision by developing a consensus definition of recovery and by defining nine core recovery values: hope; choice; empowerment; peer culture, support, and leadership; partnership; community inclusion/opportunities; spirituality; family inclusion and leadership; and a holistic/wellness approach. Seen as a whole, these values shifted the focus of attention from the interventions of professional experts to the experience and needs of recovering individuals and families. The recovery definition and recovery core values were then used to guide the system transformation process in both mental health and addiction service settings.’

We must ask ourselves: is our system in the UK providing those core recovery values? (Hope, yes hope!) What do you think?

Jonathan Kerr-Smith film 'Last Man Out' in New York Film Festival

We are absolutely thrilled that Jonathan Kerr-Smith, who makes the Wired In films, will make his debut at the New York Film Festival. Jon's feature-length film 'Last Man Out' on William Rodriguez, the last man to leave the World Trade Centre on 9/11, has been selected to be shown at the festival in both New York and Los Angeles.   

Jon lives in Penarth, near Cardiff, and has been a life-long friend of Lucie James from Wired In. We hired him to make the 'Personal Stories' of Mark Saunders, and Kevin and Kerry Manley, as well as for several other film projects. He and Lucie have made a formidable team, and we have always appreciated Jon's considerable talents. We now want to raise funding to hire Jon for some more substantial projects we have in mind.  

We are so excited for Jon and wish we could be there!!

Why not check out some of Jon's work on our Wired In Recovery channel.

You want treatment?

I had an interesting Blog Comment from Pavel Nepustil, a Czech republic NGO worker and PhD student, currently in Houston, USA, on a Fullbright Scholarship. Pavel came over to see us in Cardiff last year and we decided we would work together. He is one bright ‘cookie’ and very dedicated to this field. He got a big thumbs-up from the team.

Pavel responded to the Wired In ‘Way Forward’ in a very positive manner. Thanks, Pavel!

Here, I quote parts of his comment, for which I would welcome responses:

‘Hope, passion, talent, change - these are the words that were missing in the drug field! The "deficit discourse" brought by medicine made us think about drug users in terms of illness, disorder, chronic, irreversible disease... and these words created our expectations and these expectations created self-fulfilling prophecy…’

‘When I was asking one former methamphetamine user who recovered without formal treatment about his ideas for the services, he told me: "...it should be designed in such a way so that people will not be afraid to go there. They should offer help, not treatment. A lot of people are afraid of treatment..."’

I have to confess I have been worried about this term ‘treatment’ because what exactly does it mean? Clearly, it means different things to different people. It means something different in the Wired In vision to what it is in today’s system.

What does it mean to a potential client and to their family? Are they afraid to go there as suggested by Pavel’s associate? We certainly know many people who have substance use problems who are very cynical and untrusting of the treatment system and what it represents.

There are many people who are very concerned to hear a senior member of the treatment commissioning system say that the government provides money for people not because of their personal problems but, ‘Because you are seen as a threat, the government is prepared to spend money on drug treatment.’ (quote from DDN, Feb 25^th issue). Would you trust such a system to help you with your own problems, or those of your child?    

You might also like to think of something else. The term ‘treatment implies the existence of an entity (such as a drug) or a procedure (such as surgery) that is being applied to something else from without.' (cf. ‘How Clients Make Therapy Work: The Process of Active Self-Healing’ by Arthur C. Bohart and Karen Tallman, pp13).

However, recovery comes from within the person. Addiction is not fixed like a broken leg. The work required to achieve recovery is ultimately done by the person, not by a treatment agency worker or doctor.

The practitioner may facilitate a process that enables the person to achieve more recovery capital (some money, a roof over their head, etc) so they are better able to concentrate on the substance use problem. They may provide methadone to help take chaos out of a person’s life, or their ‘talk’ may help the person alleviate some crisis in their life, or better understand where they are and where they need to go. 

Ultimately, good practitioners are providing or enabling support, coaching, guidance, information and resources – or some combination of these.

Is this treatment? Or help? Or what? How we should term it? Any thoughts?

Mark Saunders Personal Story - The Film

The Independent newspaper commented upon a new film on heroin addiction being shown at the Cannes Film Festival with emotional statements like 'seamy underbelly of rural England', 'unflinching portrayal of addiction' and 'features a teenager's heroin death as a central plotline' - all in the Arts & Entertainment section. 

Well, as Jim pointed out in Saturday's Daily Dose, we also use 'real-life heroin addicts' (Independent expression) in our cast - actually ours are ex-addicts. However, we use less emotional language than the Independent, like '...gives hope to others that recovery can be achieved, while also showing the real life side of addiction'.

Wouldn't it be nice to have a recovery film showing at Cannes in the future - Jon, that's your next challenge! [Jon has just had some great news about one of his films]

For now, we introduce you to the filmed Personal Story of Mark Saunders. This was made several years ago - you can tell by the colour of my hair! Mark is still one of our volunteers and you can see his written Personal Story as well. As we pointed out with Kevin and Kerry's film, we have to chop the film into sections to fit on YouTube.

Why not subscribe to the Wired In 'Our Films' Blog, as we will be putting more of our film on YouTube.

The nature of addiction: chronic or not?

I had an interesting and thoughtful comment about the Wired In 'Way Forward' from Ian Sherwood, with both criticisms and positive remarks. Just the sort of comment needed to provoke further thought and discussion. I'd like to quote one paragraph:

The use of the word "chronic" is unattractive to me and at odds with the idea of recovery, the word has strong connotations of hopelessness and failure. It is technically correct for long term medical conditions such as diabetes which may be cited as comparison cases but no one uses the term "chronically diabetic" because it is a tautology. I feel that the word needs to be replaced in such a statement because it is important to win people over and language is a very important resource."

This really is a difficult one. It's an issue I have been addressing in my recent DDN Background Briefings, the third which I have just this moment sent off to Claire. In my mind, there is no doubt that addiction is a chronic condition, at least for many people. It does not always mean that it is an everlasting condition though. I was seriously addicted to nicotine (and had what I felt were awful withdrawal symptoms - I was a wimp) for over 20 years, but I have had no inclination to smoke for many years now.  

If we do not accept that addiction is a chronic condition, then we have more difficulty in justifying the potentially greater resources required to develop chronic, versus, acute models of care.

I agree with Ian we have to be very careful how we communicate the message about the (chronic) nature of addiction. That is in fact the focus of this upcoming Briefing in DDN. Would be great to see some comments on this issue.

New Member of our Advisory Board: William L White

I am thrilled to introduce a new member of our Advisory Board, William L White, one of the leaders of the Recovery Movement in America. Some of you will know that I introduced Bill's work last year in my DDN Background Briefings on recovery and recovery communities. Exciting stuff!

I have been emailing Bill for a while, and finally asked if he would join up. He said it would be an honour and I have to confess that I was absolutely thrilled. Bill has contributed so much, including writing the two best books I have read in this field - and I have read MANY. You should check out 'Pathways from the Culture of Addiction to the Culture of Recovery' and 'Slaying the Dragon: The History of Addiction Treatment and Recovery in America'. 

As far as I am concerned, all treatment agency workers should be provided with these two seminal books to help their professional development and understanding of what they have been employed to do.  

There is a lot to learn from Bill and all the people he was worked with, at one level or other.  I leave you with Bill White's biography:

William L. White is a Senior Research Consultant at Chestnut Health Systems / Lighthouse Institute and past-chair of the board of Recovery Communities United.  Bill has a Master’s degree in Addiction Studies and has worked full-time in the addictions field since 1969 as a street-worker, counselor, clinical director, researcher and well-traveled trainer and consultant.  

He has authored or co-authored more than 300 articles, monographs, research reports and book chapters and 13 books.  His book, 'Slaying the Dragon - The History of Addiction Treatment and Recovery in America', received the McGovern Family Foundation Award for the best book on addiction recovery.  Bill was featured in the Bill Moyers’ PBS special 'Close To Home: Addiction in America' and Showtime’s documentary 'Smoking, Drinking and Drugging in the 20^th Century.' 

Bill’s sustained contributions to the field have been acknowledged by awards from the National Association of Addiction Treatment Providers, the National Council on Alcoholism and Drug Dependence, NAADAC:  The Association of Addiction Professionals, the American Society of Addiction Medicine, and the Native American Wellbriety Movement.  

The Johnson Institute recently published Bill’s widely read papers on recovery advocacy in a book entitled 'Let’s Go Make Some History:  Chronicles of the New Addiction Recovery Advocacy Movement'.    

Thanks Bill! 

The Wired In 'Way Forward'

I came into this field eight years ago, leaving a successful 25-year career as a neuroscientist, and set up Wired In. I left my day job as a University Professor 18 months ago because I knew I could not do two jobs properly - and only one mattered. 

I have been totally infected by the passion that exists in this field. I see people overcome substantial problems, and I am humbled by the incredible courage that they show. And I see the same people being unjustly stigmatised. 

I also see so much good quality work going on in this field, so many talented people, so many great ideas. But so much of this is not getting the credit it deserves, and it is not impacting to the extent that it could. One of the major messages this field must give is 'hope'. We don't do it enough, and well enough. 

All this must change! As a field, we have what it takes to do so much better and help many more people overcome their problems. Let's do it! 

Today, Lucie, Jim, Kevin and my other colleagues at Wired In commit ourselves to trying to help change this situation. Please read our strategy and tell us what you think. We'll be following up on this blog over the coming weeks, discussing various issues.

And sign up to our new Recovery Movement. The people affected by substance use problems need you! Let's make a difference together!!

Film Blog and Subscription to a Reader

You’ll see we’ve launched a new blog, 'Our films', which we will periodically update with our film material. We will be working in this way until we launch during the summer our new online recovery resource at www.wiredin.org.uk.

Since we have a number of blogs, you may find it difficult to keep up-to-date with all that we are publishing. There’s an easy way to do this - by subscribing to a reader.

When set up, the online feed reader will automatically search our blogs for new material and then put all that material in one place (a webpage) for you to read. This free service takes all the effort out of keeping up with our blogs. And you can access them from anywhere!

How to set it up - 

·      Click on ‘Subscribe in a reader’ (Right hand column).

·      Choose which application to use out of the selection shown (Google is great for beginners!).

·      Choose ‘Add to Google Reader’.

·      If you have a Google email account then just type in your details. If not, it only takes a couple of minutes to set up a Google account.

·      Save your Google Reader account to your Favourites for easy access whenever you want.

Hope you’re enjoying our stuff.

The Personal Story of Kevin Manley: The Film

Nearly two years ago, I met three special people - Kevin Manley, his mother Kerry, and Jonathan Kerr-Smith.  

Today, Wired In releases the film version of Kevin's Personal Story, made by Jonathan Kerr-Smith in association with Lucie James, which focuses on Kevin's 15-year addiction to illicit drugs and subsequent experiences in finding his path to recovery. Kerry talks about the 'hell' that Kevin's family experienced during his problems and her feelings about his recovery. 

We have had to break this 35-minute film up into eight parts to fit on to YouTube. After you have looked at Part 1 of the film, please click on ‘More From: wiredinrecovery’ just to the right above the clips. You’ll then find the other parts of our film.

You can also see a shortened version. 

Kevin is enjoying his recovery nearly two years later. He has been a long-term and valued volunteer with Wired In, and I also feel honoured in saying that Kevin and I are very good friends. He has shown a courage beyond what I think I will ever be able to achieve in my life. My young children love him to bits. He has so much to offer this field.

Jon is a talented film-maker, as you will see over time as we put up more of our material on the Wired In channel over the coming weeks. He has worked closely with our Wired In colleague Lucie James in producing these films - Lucie has discovered hidden talents. We also thank Sarah Davies for her interview of Kerry. 

As a youngster, I wanted to be a film-maker. I even got accepted on to 3-year film course, but never had the courage to take up the challenge of finding the funding. Now, I play the role of bringing these people together and financing a project. I feel so proud being able to do this, helping promote recovery, and nurturing real talent.

Please check out our personal Stories blog, to see Kevin's and Kerry's Personal Story. Also, check this blog on Wednesday when we release the Wired In 'Way Forward'. 

Lack of understanding of addiction by many treatment agency workers

A number of years ago I evaluated projects supported by the largest treatment fund in Wales. I visited a number of projects and talked with the workers, which left me with some distinct impressions. One was that despite the well-meaning nature of many treatment agency workers, they did not appear to understand addiction.

I received a comment on 'The Wired In Way Forward Blog' yesterday, in which the person states that within the 15 years they have been working in the field, little has changed 'in terms of how the majority of well-meaning, caring colleagues understand addiction. Basically they do not understand addiction.' This is what so many people in the field tell me. Please also see article by Neil McKeganey in Drink and Drugs News.

The person, who is a recovering/recovered addict, also points out that for many workers demoralisation settles in because of the apparent lack of impact of their work, and a subliminal message of hopelessness is passed on to clients. Clients are often stigmatised as 'deviant' and inherently 'criminal'. Again I have heard this so many times from practitioners and clients.

I know this does not happen everywhere, but the really good agencies I have visited say that their clients always point out how prevalent it is in the agencies they have previously been for help.

I hate to say it, but I suspect that the majority of the treatment industry is like what is portrayed here. Please tell me I am wrong.

Now please, I am not knocking the industry for the sake of it. And I know that there is a lot of good work going on, and many well-meaning practitioners. But we owe it to these people and the many thousands of people suffering from substance use problems to radically improve the treatment industry.

Please check out the two comments on my last Blog and watch this space next week.

The Wired In Way Forward

Next week, my colleagues and I will be releasing a document that outlines our views of what we think is wrong with the current treatment system, describes how we think things might be improved, and outlines what we hope to do at Wired In. You might think this foolhardy, particularly, when we currently have no money to implement our plan.

However, we believe that we will bring some clarity to the issue of how society can best help people overcome substance use problems, whilst appreciating that the state does not possess unlimited resources, and knowing that demand will always outweigh supply.

We also believe we have a strong vision! Society needs to modify the way that it is tackling substance use problems, and we think that what we will be suggesting will make a significant difference, if implemented correctly. We also know that there are senior people in this field who strongly support what we will be saying.

I've always said that it is better to have a strong vision and no money, than lots of money and no vision. Well, at least for awhile. We intend to put our vision into the public domain next week, and follow it with discussion on my Blog of a number of key points to facilitate clarity and discussion. Then we intend to go out there and try and raise the money.

Please feel free to comment, whatever you think. If you believe in what we are doing, then say so. If you want to work with us, let us know. And if you want to fund us, or know someone who will fund us, then please get in touch.

Given that our approach is client-centered and focuses on helping people find their personal path to recovery, I leave you with what I consider to be a very helpful definition of recovery, from William L White:

Recovery is the experience (a process and a sustained status) through which individuals, families and communities impacted by alcohol and other drugs (AOD) problems ulilize internal and external resources to voluntarily resolve these problems, heal the wounds inflicted by AOD-related problems, actively mange their vulnerability to such problems, and develop a healthy, productive and meaningful life."

Does the type of care system for addiction fit the problem?

In my latest DDN Background Briefing, I continue looking at the nature of addiction and the care system we have developed to help people overcome substance use problems.

I point out that whilst addiction is a chronic disorder, we have developed an acute care model. This means that the successes the treatment system has in helping people overcome serious substance use problems are likely to be limited. There are two important consequences of this serious limitation.

For the field, it means that there will be an erosion of confidence in addiction treatment as a social institution. 

For the individual, this means that they are often blamed for their relapse (i.e. showing a symptom of their disorder), rather than the system accepting there are basic flaws in the design or execution of the treatment protocol.

American addiction experts realised the negative ramifications of this mismatch between disorder and care model in the late 1990s. They argued for a shift from an acute care model to a model of sustained recovery management.

I emphasise in my BB that we need to come to the same realisation in the UK and start thinking about a chronic or continuing model of care.   

Cannabis: From Gordon Brown to James Langton

Well my piece on cannabis yesterday prompted a little discussion over bank holiday. I still stand by what I say, that you are not going to reduce the harm that cannabis causes by changing the law.

When will politicians like Gordon  Brown learn that? But I guess this is not about the harm the drug causes. It is political. And sadly there will be a fallout, which will be some young people ending up becoming criminalised unnecessarily. Come on PM, there are far more important drug and alcohol issues to get your head around than Class B or C.

Now I happen to be reading an excellent book on cannabis by James Langton, "No Need for Weed: Understanding and Breaking Cannabis Dependency". This is very well-written and takes such a level-headed approach, no moralising, straight down-the-line. The author points out that these are his views and the views of people he knows who have had problems. He does not force himself on anyone - take note, Gordon! 

I like the intro, " [the book] is designed to let you consider your relationship with cannabis openly and honestly." This book is for those who experience problems with cannabis - and there are no doubt many, as there are those who don't - and the book looks very helpful. I will be returning to it and James Langton's website on cannabis dependency shortly. 

Hysteria and hypocrisy over cannabis

Excellent article by Professor Colin Blakemore in the Observer today,  'Hysteria over cannabis is getting in the way of the truth', which is well worth reading. He points out that it is a pity that Gordon Brown has allowed his heart to rule his head in his desire to reclassify cannabis, particularly when he has been such a great supporter of science.

I have to confess that I really cannot see what reclassifying the drug will do, other than criminalise and alienate more of our young people. It won't reduce harms that the drug can cause to some people. In saying this, I am not arguing that cannabis is safe - but nor are alcohol, tobacco and a wide range of prescription drugs which are all legal. 

So what is Gordon Brown trying to do? Look strong, as stated in one of the article's comments? Or is he trying to protect the health of our young people?

If so, then why isn't he trying to reduce the harm caused by alcohol - many would say government policy has increased harm - and certain addictive prescription drugs. And why isn't he tackling major supermarkets and suppliers who many people argue are using unethical practices in relation to our food, which is creating a massive problem for the country - obesity. 

Providing opportunity, choice and hope

In November last year, I spoke at the Annual Conference of the Federation of Drug and Alcohol Professionals (FDAP). I was one of five speakers asked to participate in a symposium on the first 10-year UK drugs strategy and the future of treatment. My remit was to talk about the importance of empowerment and self-help.

I took this opportunity to put over the Wired In vision of what treatment and recovery support services should look like in the future. Please take a look at my presentation and let me know what you think.

At the start of the talk, I emphasised that whilst the system has made some significant achievements over the past 10 years, this was not surprising as a lot of money had been invested. I pointed out that if we were not careful, we faced the possibility of an American-like situation, where there was a massive disinvestment in treatment in the late 1980s-early 1990s after years of over-promising and under-delivering.  

I outlined a number of problems in the current treatment system and emphasised that we needed to change focus towards the person and towards recovery.  

I talked about recovery, recovery communities, behavioural change, principles that underlie successful therapeutic interventions, and treatment. I also emphasised how important it is to focus on 'the drug, person and social context' (drug, set and setting), rather than just 'the drug'.

A number of different key concepts were brought together into a model of how we should be viewing the process of helping people overcome substance use problems. In the time available, I could only discuss a limited amount.

Here, I give you the opportunity to read and think about what I had to say. Over the coming few weeks, I will blog on a variety of the topics and issues contained in and around this talk.

I believe strongly that we need to make significant changes in the current treatment system. I also believe that there needs to be a significant enhancement in understanding amongst the treatment workforce of what it takes to help people overcome serious substance use problems (i.e. recover from addiction). 

Background Briefings

My apologies for no posting yesterday but a lot of things needed sorting last few days. I'll be back in full flow next week, with what I hope you will find to be some interesting Blogs.

I would like to point out to you that we have now put links to all 63 of my Background Briefings which have appeared in Drink and Drugs News on another of our Blogs. Please remember they are in reverse order, with the most recent as the top Blog entry.

It's amazing to think that I have written so many. I was so chuffed one day when Professor Neil McKeganey pointed out to me that when they started he thought there would not be that many. I would run out of things to write about. It surprised him that they kept coming... and coming. 

Neil, there are a good few more to come, as long as I don't get mowed down by a bus. There is so much to write about in this field. But I really appreciate your positive  comments.

It would be really good if people responded to what I write on the BB Blog. It's always good to see what people are thinking. And please keep sending those letters in to DDN!

I have to confess that I really do find it moving when people come up to me at conferences or launches (hi you guys on the Action on Addiction/Bath University degree course) and say how much they appreciate the BBs. Thank you. 

I wonder how they know it is me, forgetting that my ugly mugshot is always there. Hopefully, there is a new one this issue. Don't forget to look, because I have written what I feel are some important insights into our treatment system.