Sunday, 22 June 2008

Historical tendency to oversell what treatment can achieve

‘There has always been a propensity to oversell what treatment could achieve, both personally and socially. While such promises can help generate funding, they can create unrealistically high expectations of what treatment should achieve on a broad scale.

Jim Baumohl, in his review of the inebriate-asylum era, pointed out the danger of suggesting addiction treatment as a panacea for the cure of complex social problems. The overselling of the ways in which addiction treatment could benefit the home, the workplace, the school, the criminal justice system, and the broader community during the 1970s and 1980s sparked a subsequent backlash. When time - the ultimate leveller – began to expose the fact that these benefits were not forthcoming at the level promised, a rising pessimism fueled the shift toward increased criminalization of addiction. This recent history has underscored an enduring lesson: successful short-term strategies for generating public support for the funding of addiction treatment can have unanticipated and harmful long-term consequences.’

William L White in ‘Slaying the Dragon: The History of Addiction Treatment and Recovery in America’ (1998), pp 338.

In highlighting this quote on my Blog, I am not questioning the value of treatment. However, I am providing a word of caution to those who are trying to tell 'society' that the government-led treatment system is successful and is a panacea to some of society's problems. Those people trying to protect the NTA could ultimately contribute to a massive cutback in government funding for treatment when the true situation is realised by 'those on high'.

We must prevent this situation occurring. What we need to do is look at our current treatment system, accept the faults, and modify the system so it has a better chance of being successful. Put aside the pride, the arrogance, the fear of being accused of 'being wrong'.  There is good in the treatment system and we need to utilise this good and the financial commitment of the government - developing a system based on people finding their path to recovery. 

I go on holiday to Perth in Australia on Tuesday (leaving home tomorrow). However, I hope to maintain the Blog for part of the time I am away, whilst the team intend putting up some material for a period while I am sunning myself on a beach (I hope!) in the North West. Please bear with us if there are any delays in putting up new Blogs or Comments.

My apologies that I have not sent out a 'newsletter' before I go, to all those who are working with us or who have signed up to the Recovery Movement. It's been a bit frantic recently, but we will be in touch shortly. Lots of things are happening!

PS. New film on our YouTube channel focuses on the issues that can arise when a heroin addict tries to change behaviour - including what helps and what hinders this process.

3 comments:

Anonymous said...

I agree, while there is a lot of good happening within the treatment field we do need to be careful about the picture we are painting regarding the success of the government-led treatment system. Particularly as this picture can be enhanced by the presentation of Key Performance Indicators which are based on data that may have been subject to manipulation.

James Parker said...

'There is an art of listening. To be able really to listen, one should abandon or put aside all prejudices, preformulations and daily activities. When you are in a receptive state of mind, things can be easily understood; you are listening when your real attention is given to something. But unfortunately most of us listen through a screen of resistance. We are screened with prejudices, whether religious or spiritual, psychological or scientific; or with our daily worries, desires and fears. And with these for a screen, we listen. Therefore, we listen really to our own noise, to our own sound, not to what is being said. It is extremely difficult to put aside our training, our prejudices, our inclination, our resistance, and, reaching beyond the verbal expression, to listen so that we understand instantaneously....'.These are the words of J. Krishnamurti and whenever I feel stuck I always try to practice and apply what he said and practiced which is to endeavour to not create further division in society but to transform our thinking. I offer these words because I feel we are in danger of polarising this debate over the past few weeks and alienating different groups from the NTA through to service users, and not embracing and celebrating our diversity which is our strength.

What is our preferred outcome? That we all have choice about the treatment we offer and receive? That we treat everyone with respect and listen to what they have to say?

If these are the starting points then perhaps we will build consensus for the long-term rather than creating further division.

Peter O' said...

'There is an art of listening. To be able really to listen, one should abandon or put aside all prejudices, preformulations and daily activities.

Some listen, others wait to speak.

What is our preferred outcome? That we all have choice about the treatment we offer and receive? That we treat everyone with respect and listen to what they have to say?

Listen with respect, of course. Treatment of choice. Great! always providing that it does not ignore a 'duty of care' inasmuch as that the treatment sought by the someone suffering from addiction and the almost inevetiable comorbidity, may not be in their best interests, nor for that matter feasible or vidable. At that time does one not have a 'duty of care' to advise the client accordingly?

Is it right, or ethical, to attempt to deliver a 'treatment' which one knows is likely to increase the severity of the presenting problem, even though the client may be requesting it?