Meeting a growing recovery community in the North-West of England

Had a great trip to the North West of England earlier this week. Lucie, Kevin and I went to Manchester on Sunday, where we met Geoff Allman, Director of Spoken Image, a communications design company with whom we collaborate. Geoff was kind enough to drive us around for the two days, which gave him the opportunity to see some things happening in the field.

We spent the day with Jacquie Johnston-Lynch at SHARP Liverpool, which is described as a ‘therapeutic peaceful haven for addiction recovery’. SHARP offers a structured day treatment programme, based on the 12-step abstinence-based approach. We met Mark Gilman of the NTA, a man committed to the development of a recovery culture. Also met Peter Naylor of the Spider Project, that provides a range of services for current and recovering substance users, including creative writing, art, drama and outward bound events.

We talked with the SHARP clients in a group session and Kevin and I were both greatly moved by the occasion (I had tears in my eyes). The session emphasised to me the power of the supportive community or social network. I just felt the empathy and positive feeling throughout the room.

In the evening, we met with a group in a Manchester café – Mark Gilman, Stuart Honor (researcher and recovery advocate), John Hopkins (ADAS/Acorn in Stockport), Colin Wiseley (Commissioner, Salford DAT) and Ian Wardle (Lifeline Project). I had one of those moments when you meet someone whom you immediately recognise as a kindred spirit – in this case, the beaming giant Stuart Honor.   

Two lads were sitting across from us on another table. Amazingly, they first recognised me from DDN and then Kevin from his film – and then Stuart, an old mate. We couldn’t believe that the world was so small and this wonderful coincidence has expanded our community into Blackburn – Paul (Hutchins) and Jason are working at the Thomas Project. Stuart was pleased to see them doing so well in their recovery.

We had a good dinner – thanks Ian - and I can tell you, Mark Gilman is a scream. You’ve got a role in one of our films, Mark.

The next day we went to Warrington to visit Tom Kirkwood, Director of Trust the Process, an organisation that provides a structured day care programme and community support. Spent a few hours discussing the field and strategising with Tom and Danny, a senior member of the team.

I was impressed by Tom’s insights and he talked to us frankly about his personal recovery. He is a businessman who is determined to set up a number of recovery-based centres around the country. He took us to the houses his organization provides for some of the clients. We were impressed – and they were new!

We also met two members of the Warrington DAT who were kind enough to come over and meet us. Amanda Finch emphasised to me how great it was to go into a room of happy-faced clients at Trust the Process. That’s what we want to see!

Back to Manchester for a Chinese Buffet (yummee!) and the long train trip back to Cardiff. I was pretty tired by the time I got home (21.15) and started to write this Blog after the football. However, I was Skyped at 23.15 – by Kevin. He was absolutely ‘buzzing’. He pointed out to me that we wanted to develop a recovery community here in Cardiff. There was an expression on his face I had not seen before – a sort of serenity.

It’s great fun talking to and working with people in recovery. I’m a proud man being in this field.

Check out the piccies.

You are wrong Mr Hayes: the treatment system is NOT working!

For the last few years, I've thought a lot about how to change the treatment system so that helps more people overcome addiction and gain a better life. At one stage, I had come to the conclusion that I needed to work with the people at the top, to help them understand the shortcomings of the current treatment system and see how it could be changed. 

I gave a talk at the FDAP Annual meeting last year where I described the shortcomings of the system and emphasised that unless we did something we would end up like the American treatment system in the late 1980s and early 1990s - money was slashed and the system collapsed. I also pointed out the way we needed to move forward, which I have reiterated in the Wired In 'Way Forward'.  

I had a very positive response to my talk from a senior person within the NTA and I thought that I could enter into some long-term dialogue with the NTA that would lead to positive change. A change to a treatment system that is based on people attaining recovery - and I mean a genuine recovery, not some politicised excuse of recovery - is inevitable sooner or later. I thought that I could help speed up the process.

Well, after seeing the Paul Hayes article in the Guardian today, I realise how naive I have been. I'm not going to go into any great detail about the article, but I have to confess that it has made me angry. I quote, 'Hayes dismisses his critics as a few academics, politicians and "ideologues" stocked up by the media'. This is absolute rubbish - Paul Hayes either has his head very deeply buried in the sand or he is deliberately being untruthful.

There are many, many thousands of people out there who know that the current treatment system is NOT working and is causing damage to many people. These people who know the truth come from many different aspects of life - they are users, ex-users, family members, practitioners, commissioners, members of the general public, etc. 

I've been in the North West for the past couple of days and it was quite clear to me that the people I spoke to all knew many people who know the system is not working and are tired of the NTA spin. Even some commissioners who do not really care about people with substance use problems realise that the way methadone is being used in many treatment programmes is not reducing crime and is storing up problems for the future.

Anyone can use words to create a false story, mislead people by playing with facts, and distract them by creating false concerns. Sooner or later such people are found out for what they are doing. It is time that Paul Hayes is found out for what he is doing. I encourage those people who do not believe that the current treatment system is working to write to Gordon Brown and tell him. Write and complain that Paul Hayes is misleading the country about what is truly happening. 

We are talking about people's lives here. They are far more important than defending the current treatment system. Mr Hayes may think that few people will stand up and be counted - and maybe initially this will be the case. But there is a gathering momentum in the country for a treatment system that is focused on improving people's lives - rather than giving them a pill to keep them quiet - with an increasing number of people getting fed up with Mr Hayes's spin. The day of reckoning will come.

People with substance use problems need opportunity, choice and hope. The UK treatment system is not providing these key elements. 

I leave you with a quote from Stuart Honor,

'It is no great trick to take an impoverished, unemployed individual who is addicted to heroin (and crack?) and turn him (sic) into an impoverished, unemployed individual who is addicted to heroin, crack, methadone and/or alcohol and benzodiazepines.'

Personal Story of Chris Hobbs

Chris Hobbs is a member of our Cardiff community of volunteers, who I first met when he came out with us to lunch with Pavel Nepustil, visiting from the Czech Republic.

I remember Chris really struggling to keep awake with the dose of methadone he was being given. As he points out in his Personal Story, he tried to explain to his keyworker that he wanted a lower dose because he was forever falling asleep at home. This was frustrating, since he had a new baby to be looked after, and he felt like his partner was having to look after two of them. His keyworker did not seem sympathetic and was more concerned that Chris would relapse if his dose was reduced.

The words of Kevin Manley come through here – his film is on our YouTube Blog – he emphasised the number of practitioners who just wanted him on methadone, and did not appear to be concerned with his real needs. All practitioners need to understand what treatment is about. I quote from the excellent book, ‘Treating Drinkers & Drug Users in the Community’ by Daphne Rumball and the late Tom Waller:

‘Treatment decision-making that is likely to be most successful is based on decisions made by the service user.’

‘Therapeutic help does not imply that the therapeutic helper takes over and sorts the problem out. Drinkers and drug users must do this themselves, for this not only increases the chance of a successful outcome, it also helps raise self-esteem, and the empowerment of the individual raises personal belief in his or her ability to overcome dependence (self-efficacy).

Other people, however skilled they may be, never make a drinker of drug user better. It is always the client who does the work. Helping professionals can make assessments, point the way, offer suggestions, provide interventions tailored to meet a client’s needs, give appropriate counselling, and do what they can to improve the client’s environment, but success, when it comes, always belongs to the client, never to the professional worker.’

Please spend some time reading Chris’s Personal Story. We’ve also put up some new film on our YouTube channel, which you can access from the ‘Our Films’ Blog.  We look at the physical effects of heroin addiction, including the risks and effects of blood borne viruses.

I’m off to see some treatment agencies in Liverpool and Warrington, and savour some of the recovery atmosphere that has been generated in the North West of England. I’ll try to Blog whilst away, but please bear with me if there are any problems.

PS. Awesome Bruce Springsteen & The E Street Band concert at the Millenium Stadium in Cardiff last night! A true icon of rock music!! 

A Great Book and a Great Rock Star

Just got back from the gym to find a book I've been waiting for on the doorstep, having finally arrived from the States. I have read 'Slaying the Dragon: The History of Addiction Treatment and Recovery in America" by William L White before. A copy had been loaned to me by Tim Leighton who just said, 'This is one of the most remarkable books you will read.' And he was right! 

I now have my own copy, so I can mark key passages in the text, as I love to do. It is the sort of book you pick up at any time, just to read a small passage. The book takes you on an amazing journey through the history of addiction treatment and recovery in America. I am a great believer that you can learn a lot from the past. 

This book is essential reading for everyone working in this field. And yet, I have met only two people in the UK who have read it! You must purchase this book!!

I've got to charge now, because I am the lucky holder of a ticket to see the Boss, Bruce Springsteen, and the E-Street Band tonight. The gig is at the Millenium Stadium in Cardiff, which as far as I am aware, is the largest indoor stadium in the world when the roof is closed. It's going to be awesome!!

I leave you with a quote from Bill White's book:

'What we are professionally responsible for is creating a milieu of opportunity, choice and hope. What happens with that opportunity is up to the addict and his or her god. We can own neither the addiction nor the recovery, only the clarity of the presented choice, the best clinical technology we can muster, and our faith in the potential for human rebirth.'

Wired In to Scotland

Lucie and Kevin have just got back from two exciting days in Scotland. They spent the first day in the LEAP project, led by Dr. David McCartney, in Edinburgh. As I write this, I’ve just had two emails arrive, one from Kevin himself. So I should let him describe what he thought about his visit. Please come back here after reading Kevin's Blog.

Lucie could not get over the energy that she felt in LEAP. The welcoming atmosphere was special, although clients thought that Kev and Lucie were there for their first session. Lots of people came up, and were positive and open about what they would receive at LEAP. Lucie could not get over the fact that LEAP offered a two-year aftercare programme. Now, this is a serious recovery-orientated programme, as far as we can see. They have what seems to matter, positive community spirit. Can’t wait to work with them!

Lucie and Kev moved on to Glasgow for the ‘Drugs and Alcohol Today’ conference. They were armed with lots of pieces of paper (e.g. Personal Stories, Wired In ‘Way Forward’ document), DVDs and a Mac to show the films and Blogs.

Lucie was thrilled with the response that they had at the meeting. Substance use workers really wanted to get involved with what we are doing, and wanted to be able to get their clients involved. A number of workers, as well as service users, signed up to the Wired In Recovery Movement.

Lucie pointed out that lots of people were talking about recovery, sorry Recovery. They were excited! 

Lucie also met 'tim1leg', our new close collaborator from the West coast of Scotland. She described Annemarie as a ‘bundle of passion’. You’re on board Tim, whether it is on one or three legs!!

Finally, I must get you to visit the latest Blog from our good Czech Republic friend in Texas, Pavel Nepustil. As an aside, Pavel, how do you think your football team is playing? We’ll allow you a Blog comment on football, good friend!

Risk and Substance Use: The Impact of Drug Laws

In yesterday’s Blog I wrote, ‘We are calling for a society that does not stigmatise people with substance use problems’.

In response, Derek Williams wrote, ‘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.’

I don’t get drawn into such arguments, Derek. There are plenty of people in the UK fighting hard for this policy. I want to devote my energies and time to fighting the case for improving access to recovery for people affected by substance use problems. 

I will say the following though. By making a drug illegal, society increases the risks for a person using such a drug. Whilst applying technology to reduce the risks of using legal substances, society often withdraws technology to increase risks from use of prohibited drugs. 

“We prohibit a “bad” drug on the rationale that it is dangerous, and then construct social policies that assure high risks related to the drug’s use.”  William L White, ‘Pathways from the Culture of Addiction to the Culture of Recovery’

Let’s compare legal and illegal drugs. The legal drug could be highly addictive, such as a benzodiazepine.

With legal substances, we reduce risks by ensuring that substances are not contaminated, adulterated or misrepresented. This is rarely done for prohibited substances, greatly increasing the risks associated with their use.

With legal substances, we reduce risks by packaging the substance in ‘doses’ that provide predictable and desirable effects. The person using a prohibited substance rarely knows the purity of the substance purchased – this is determined by the actions of illicit suppliers, when they cut the product – and therefore the dose they are taking.  This increases risks when using, with potential overdose sometimes being a reality on a day-to-day basis.

With legal substances, we screen out and discourage use by those people who might be susceptible to the detrimental effects of a particular substance. The packaged drug carries a message saying that it should not be used if a person has such-and such a problem, or if the person is using another particular substance. The person using a prohibited drug does not generally get this form of information, thereby increasing the risks they are likely to face.

Legal substances are administered into the body in a way that is designed to reduce untoward consequences, such as the spread of disease. Injecting drug users can contribute to the spread of blood-borne viruses such as HIV and hepatitis C by sharing needles, syringes and other injecting paraphernalia. Therefore, users in the UK are given access to clean injecting equipment – e.g. via treatment agencies, some pharmacies - to reduce the likelihood of blood-borne viruses being spread.

However, this harm reduction practice does not occur in other parts of the world, including a number of states in America. It is argued by some people that provision of clean needles and syringes encourages drug use. In essence, technology is being withheld in order to keep the risk of prohibited drug use high, in the hope it will deter use. This is morally wrong. The price of this approach is that people contract disease and die not because of the drug, but because of the social policy that prevents society from reducing risks associated with its use.

Harm reduction and harm minimisation techniques can be applied to the other points raised above, and in this country are applied to at least some extent. For example, warnings are put out if a particularly high purity sample of heroin is identified to be available on the street. At the same time, however, it is argued that if prohibited drugs were made legal, then issues of purity, adulterants, etc would become a thing of the past, because people would purchase heroin from a government-controlled source.

There is another major way that legal status affects the substance-using culture and the way that people behave and think. When a drug is classified as illegal or prohibited, a powerful social stigma develops that impacts on the emotions and behaviour of people who use the substance. This arises because of the attitudes of society towards users of prohibited drugs – drug users become stigmatised, stereotyped and prejudiced against. You can see an example of this prejudice in research that we have conducted.

Now at the end of this you may turn around and say, “Certain drugs are illegal, so people should not use them. The risks they face are at their own peril.’ On the other hand, you might be wondering why certain psychoactive drugs have been made illegal and whether the actions of the state are justified. Check out some of my early Background Briefings from Drink and Drugs News, which you can find on a related Blog.

[This Blog was inspired by a section in William L White’s book, ‘Pathways from the Culture of Addiction to the Culture of Recovery’]

New Film on our YouTube Recovery Channel

It's been a bit of a busy day, and along with a severe dose of hay fever (which slows one down) and a visit to the vet with my beloved aged Welsh collie Tessa, I've run out of time to write a full Blog.

However, I can tell you that Lucie and Kevin have loaded up on some more film on our YouTube channel which you can link to from the Our Films Blog. This section focuses on life as a heroin addict, with the same people who were introduced last week.

If you want to check out all our film material on YouTube, check out the Wired In Recovery channel, to which you can subscribe. Please send the details to as many people you can.

I can tell you that the people who participated in these film clips are really excited to know that they are being looked at by lots of people.

Just had a talk with Lucie from Glasgow where she and Kevin are attending a conference tomorrow. They spent the day at the LEAP project (led by Dr. David McCartney) in Edinburgh and had the most amazing time. They were absolutely buzzing about what they saw and the potential for a strong collaboration. 

Going to have to tell you more about LEAP in a future Blog. What I can say is that it's one hell of a recovery project (excuse the swearing) and is making a significant impact. I tell you what - it's a good job I live within 15 minutes of Cardiff airport and Kevin and Lucie live only a few minutes further away. We're going to be using the shut-eye express (07.00 flight) between the two Celtic nations quite a bit! And I love Edinburgh!