Sunday, 8 June 2008

The Recovery Agenda is Underway - Embrace it

In the middle of May, I launched the Wired In 'Way Forward' on this Blog, a document showing the commitment that my colleagues and I are willing to make to help improve the way this country (and others) helps people overcome substance use problems. We outlined some of the serious shortcomings of the government-led treatment system in the UK, and described major changes in approach that this country needs to adopt. 

Quite simply, we need a revolution in this field in the UK. We need to stop playing political games, cut out the 'spin', and get on with genuinely trying to help people. We need to stop defending the status quo and attacking the people who speak out, saying that they are 'threatening' the current treatment system and hurting the field. 
It would help greatly if we started to think about helping the individuals who are directly affected by substance use problems, as well as their families, rather than talking about protecting society from the crime that a small proportion of people with a substance use problem commit. Many people with serious substance use problems have other serious life problems (e.g. poor mental health, victims of abuse, social problems), which are often present before drug use is initiated. Many are very vulnerable - I often feel embarrassed how my country chooses to pick on these vulnerable people and accuse them of causing problems in society. 
We also offer them a deeply flawed treatment system, one which offers little hope of recovery - and we then blame then when they don't overcome their problem.
There are many people 'out there' who feel the same as me, ranging from senior figures in the field to individuals and families who are impacted upon  by substance use problems. Many people working in the field do not feel they can speak out because they feel their job may come under threat, or the organisation they work for may be criticised. Many people affected by substance use problems don't speak out, because they don't how, and/or to whom.
Well, it's time for all this to change. And it will change!
Wired In is calling for a treatment system that helps people find recovery from serious substance use. We are calling for a society that does not stigmatise people with substance use problems and their families. We are calling for a government that shows an understanding of what is required and does something about it. We are asking for compassion and the provision of hope, opportunity and choice.
I was recently informed that the government will spend £800 million this year on treatment. Please think how much of this money has been well spent? Ask yourself whether we have a system that actually understands how to help people move from the culture of addiction to the culture of recovery? Is it capable of doing this? And how much does it care?
Have a look at our 'Way Forward' and ask yourself whether I am right in the criticisms I have made about the current treatment system. 
If you want to see change, then please contact us. Wired In is committed to helping achieve this change - with your help. I cannot promise we will succeed, particularly as our funding has almost run out. [My personal investment has come to an end, so I need to raise funding to push the agenda forward]. But we are determined to succeed, so don't underestimate us.
And don't underestimate what is happening in this country. The recovery agenda is underway - embrace it and become part of the Movement. Join others who have already joined up with us.   

16 comments:

Anonymous said...

Thanks David. We are asking people with some of the issues you raised to be couragous, seek help and change not just thier addiction but a lifetime of related issues and concerns. The reason why I work independently in the drugs field is because if we expect clients to make big changes then we should also lead by example and be prepared to be more innovative in our approach to treatment and moreso recovery.

Peter O'Loughlin said...

David,

I enthusiastically endorse everything you say. Recovery is the way forward and for far too long those of us who actively promote it and been abused, ridiculed, accused of ideology, ignoring the evidence and in my case, publicly accused of misrepresenting the facts, none of which has or will deter me from continuing to advocate drug free recovery at every possible opportunity.

What is so difficult about understanding that the use of substitute addictive psycho active substances, legal or otherwise, will not and cannot reverse addiction, nor will it put it into remission. The most likely outcome for those who have been misled into believing otherwise, is to develop an addiction, or dependence on the substitute.

Derek Williams said...

The Prof wrote:

>>
We are calling for a society that does not stigmatise people with substance use problems
>>

I agree that needs to be a first step, but it simply isn't possible when the very basis of the drugs policy is prohibition which treats the casualty as a criminal. You're getting very close to calling for a review of our prohibition based approach, I hope you can go that extra mile and do so.

Peter wrote:

>>
Recovery is the way forward and for far too long those of us who actively promote it and been abused, ridiculed, accused of ideology, ignoring the evidence and in my case, publicly accused of misrepresenting the facts, none of which has or will deter me from continuing to advocate drug free recovery at every possible opportunity.
>>

If I've understood the Prof correctly, recovery doesn't and can't mean enforced abstinence and I would agree absolutely with that. What we have to have with a drugs policy is something which reduces the risk of drug addiction tragedies happening to a minimum, protects those at most risk from harm and supports casualties toward recovery. Prohibition of course does non of those.

People need to come to want to be abstinent for themselves, until they can do that surely maintenance of some kind is a part of the recovery process and for that to work, it has to be legally sanctioned.

Prohibition is the biggest obstacle in your path I'm afraid.

tim1leg said...

Usually when i read your blog I am delighted to be taking part in a movement that at long last advocates for the desperate change we need to see, but today, I was moved to tears by the simple honest and straigh forward manner in how you spoke for the still suffering addict. If Your compassion and understanding could be held by even a tenth of the people in our field we would see the recovery process take place qicker than the Scotland Future Forum predicts today for 2025.

The time is now.

As an advocate for moving users towards abstinece I believe that like Peter having experienced past abuse, ridicule, and narrow mindedness, that finally I will be able to contribute my knowledge and experience with the support and respect it deserves,

sara mcgrail said...

"Quite simply, we need a revolution in this field in the UK. We need to stop playing political games, cut out the 'spin', and get on with genuinely trying to help people. We need to stop defending the status quo and attacking the people who speak out, saying that they are 'threatening' the current treatment system and hurting the field. "

Couldn't agree more. We had a fabulous conference at the LDPF last Friday. Fabulous because it included voices of dissent, real debate, discussion and - yes - disagreement. We learn most when we have a dialogue.... and not one just about experimenting to see who can say the "right thing" to get the money!

Sara

Peapod said...

Shit hot blog today Prof! Couldn't agree more. Voices raised in anger against dissent from the 'norm' are always going to be there, but it is SO good to see them challenged.

We need to focus on those who suffer from addiction (and believe me, addiction is true suffering) and lets ask them what they want and find a way to help them find the resources to get there.

If we have recovery networks and treatment centres filled with positivity, hope and recovering addicts (the proof of the pudding) then more people will recover.

I don't think we need fuss to much about prohibition. People can get into recovery regardless if the pathways are there.

Let's do it.

David Clark said...

Thanks for your comments guys and girls. I'm afraid I'm so far behind today haven't had chance to reply. This blogging business could very soon become a full-time job.
I'm really touched by some of the comments - some of them bring me close to tears! (you're not the only one tim1leg). But we've got the Blogs out there more so more people read them and pass them on.
Viral marketing rules, ok!

David Clark said...

What a good point, Anonymous. We ask people with substance use problems to be courageous, but too few professionals are being that.
It's not that we are just asking then to be innovative - we are asking them to stand up for people being treated decently. Why should a person who has multiple issues, including substance use problems, be given a script with very little other help? Professionals should be speaking out against this.
I wonder if I asked people to do this, I wonder how many would.

David Clark said...

Wonderful stuff, Sara. I wish I could have been there at LDPF. Debate, discussion, dissent (we can't have that!?) and disagreement. Sound like a recipe for...
progress.

David Clark said...

Peter and Derek,
Blog on prohibition later today. Good to have you back Peter.

David Clark said...

Thank you, Peapod. I was running late so had to be written quickly. I guess it just came straight from the heart.

tim1leg said...

David Hi I have just returned from the alcohol and drugs today conference in Glasgow, a good wee day overall, but for me not enough hours and chances to speak to everyone I wanted to but hey there will be more time for talking as always soon enough. I wanted to let you know and perhaps to get a bit of debate on what one of the speakers said today, a Dr Richard Simpson MSP who was recommending what he called RETOXING prisoners who are due for release and presently clean, to be in his words retoxified on methadone before leaving prison apparently because of the risk of overdose on release.
I couldn't believe my ears when I heard this really it was a jaw dropping moment for me and one of those moments that confirms the many so called "Experts" in addiction unfathomable belief defying lack of understanding of what addiction and addicts suffer from.

Surely it would make sense to offer support to stay clean upon release instead of a pathway back to addiction. Or have i missed something?

John Arthur said...

Well done Prof
Sterling work old chap and right on the button.
Pretty much backs up what Crew 2000has said here in Scotland for ages now and the tide at last seems to be turning. In the past couple of weeks the launch of the new Scottish Drugs Strategy 'The Road to Recovery' and the publication yesterday of the Scottish Parliaments 'Futures Forum's radical report on how we should tackle substance use between now and 2025 have been breaths of fresh air. There has been a growing understanding by almost everyone in Scotland that recovery must be at the heart of all drugs policy (& crucially practice) for those addicted to substances and for the treatment of any underlying causes of their addiction such as mental ill health, traumatic experiences etc.

At last people seem to be getting the message that we have to get real about the society we live in and that substance use is here to stay and that whilst the vast majority of people will use psychoative substances recreationally and not become addicted, we should provide realistic and relevant information to everyone including harm reduction information and advice for those who choose to use.

Crew advocates a better informed populace with a range of treatment options and inerventions for wherever someone might be on a substance using 'career'. Ultimately a significant minority of people will become addicted and a variety of measures need to be in place to help them, this includes a more knowledgeable and supported workforce that understands how abstinance may be a desirable and acheivable goal and in some cases it may be the only resort for some people who cannot stabilize or use with any kind of safety.
Unfortunately (it seems for some ideologues) Recovery isnt always synomymous with abstinence and people may not be able to achieve abstinence but can achieve stability and resumtion of a relatively 'normal' life within the realm of substitute prescribing. For them this 'is' recovery from the misery of ilegal drug use and they'd be happy with it.
However, I'd agree that drug free recovery should be an option for everyone as should a maintenance programme if thats what is requested. A truly holistic service that aims for recovery takes cognisance of where the people start from and the distance travelled. Keeping someone alive long enough for them to do something about their addiction makes more sense than to force everyone into abstinence when we know that significant numbers will not achieve this (certainly not first time around).

the following passage from the Scottish Recovery Network which will be the model favoured by the new strategy has a helpful paragraph:
"International experience has identified that recovery is about much more than the absence of symptoms – it is about giving people the tools to become active participants in their own health care – it is about having a belief, drive and commitment to the principle that people can and do recover control in their lives, even where they may continue to live with ongoing symptoms."

I think recovery is the only way to go and now the task of identifiying what it means to different people at different times will come about through discusing and listening to each other. Crew advocates having humility as well as convitions when we do discuss it, and taking things one a day at a time.

more power to your pen professori!

suse said...

Hi to John
I welcome your comment: "Recovery isnt always synomymous with abstinence and people may not be able to achieve abstinence but can achieve stability and resumtion of a relatively 'normal' life within the realm of substitute prescribing. For them this 'is' recovery from the misery of ilegal drug use and they'd be happy with it. "

We need a good definition of recovery. And we need a broad understanding of what progress towards recovery can look like. This might sound simple but it isn't! I see people who can stop using on top of methadone, people who can work and function very well on methadone, and people who have got to the point where they are coming off the methadone and looking towards complete abstinence. All of them are on a path towards their own personal goals. Some of those goals might be an intermediate one, and they will move on further once they have 'rested' their quest to deal with the drugs themselves at an intermediate stage, so they can tackle other issues. In my view 'recovering' is as important as 'recovery'.

Peapod said...

I agree that we need a broad definition of recovery that takes account of the 'journey' and where people are on that journey. Let's not make it so broad that it diminishes the achievement that recovering addicts have made to become drug free.

I also endorse the fact that some people on methadone stop using on top, get back to work and re-establish healthy relationships with family, children and friends. However, my experience is that these are the exception. Most folk on maintenance treatment are still enmeshed in an addiction culture, are not working and are not living life to the full. When you ask them where they want to be in two years many will tell you they want to be drug free. When our services operate on a premise 'that significant numbers will never achieve this, (drug free recovery) then it actually becomes a self-fulfilling policy. There is a difference between pessimism and pragmatism just as there is a difference between defeatism and hope. As I said above, when services are filled with hope, recovering addicts and staff who believe that recovery is possible, it is much more likely to happen. We don't have many services like that. Indeed hope is a concept that often eludes those working in the field.

Offering people what they want (maintenance or abstinence) is a good principle, but it needs to be an informed choice. This just isn't happening in services today. People think that all that works is methadone (and by people I mean professionals and clients) and most service providers don't know how to 'do' abstinence or don't believe it is achievable. So informed choice is not happening. I agree with John that we need a workforce educated about recovery.

Let's not forget too that you don't need to be addicted to drugs to cause or suffer harm. Those regularly using 'recreational' cocaine are doing so in the reality that there is a trail of carnage and suffering from Columbia to the streets of Britain and elsewhere. Those turning up for drug advice are often in a state of denial about the harm their drug use is causing themselves or their families. The idea that recreational drug use is hunky dory is misplaced.

If we carry on doing what we are doing we will carry on getting what we've got. We need the sort of radical change that the prof is calling for to allow many more people to experience the freedoms recovery brings.

David Ryan said...

After organising/hosting and attending the 2nd North West Recovering Communities Conference last Thurs 12th March 2009 at Stockport Town Hall I am happy to say I am still buzzing off how well attended the event was and how successfully it went down!
I'm'the eternal optimist'having lived a life of addiction to heroin and crack coupled with offending and prison for 21yrs and being in recovery (total abstinent based recovery!)and working in the field for the last 10yrs! I never knew there was an alternative to
what I was doing? I'm not afraid
to speak out, infact I'll scream
from the roof tops..ANY ADDICT REGARDLESS OF AGE, SEX, CREED, RELIGION OR LACK OF RELIGION CAN LOSE THE DESIRE TO USE AND FIND A NEW WAY TO LIVE!!! There are hundreds and thousands of us out here as living proof and its us that need to instill hope in all those addicts who still suffer out there...We're the living proof