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I am writing in response to Chris Ford’s letter (DDN, November, page 10) about ‘misbehaving’ in order to actually give people good and safe treatment. I am afraid that Chris is correct in believing it is time to make a stand. Things will only get worse unless we resist this focus on a numbers-based ‘successful completion’ culture and return to what makes good quality individual care.
I will declare an interest at this point. I recently ‘misbehaved’ and was made unexpectedly ‘redundant’ in an urgent ‘restructure’.
The good news is that it enabled me to spend time developing a concept that I’d had in my mind for several years. There is now a (basic) website which explains it further – www.competentcompassion.org.uk
The concept is that whoever delivers whatever treatment, and wherever that is, the way to measure its quality should be ‘does it demonstrate competent compassion’? If the person delivering help isn’t competent, then disaster looms. If they aren’t compassionate then it is unlikely to be helpful, and may well be ignored. Competence and compassion are not mutually exclusive – in fact they are both essential and in one phrase they sum up the essence of good quality care.
Wouldn’t it be good if that was the first quality standard by which we measured ourselves and our services – not how many people we can get off a script (for example)?
Competent compassion rises above all the arguments about harm minimisation v recovery, NHS v non NHS, script v abstinence etc. I am looking for this to be taken up by as many people and organisations as possible – locally and nationally. I really hope that commissioners in particular can grasp and use this concept of what quality services should look like.
Please visit the website and do comment and give feedback. Perhaps we can make a change before it is too late – even if it involves some misbehaving.
Dr Joss Bray, substance misuse specialist
If funding for cancer prevention, treatment and recovery support was being cut while cancer mortality rates were rising there would be a national uproar, yet funding for the treatment of substance use disorders is being cut at a time when alcohol and other drug-related deaths are increasing.
The recently published Review of drug and alcohol commissioning from the Association of Directors of Public Health and Public Health England revealed that 48 local authorities in England will be reducing funding for drug and alcohol services either during 2014/5 or 2015/6, and 12 local authorities during both years. A further ten local authorities may reduce funding in 2015/6 dependent on local reviews and another 57 have not yet made a decision.
A third of local authorities reported uncertainty about future funding of residential services and some also reported ‘little need for alcohol and drug services for young people’. The Association of Directors of Public Health has even attempted to spin a positive narrative around this disinvestment in the report.
After 2015/6 the public health grant in England will no longer be ring-fenced and cash-strapped local authorities will be free to spend the money on anything they wish. There is no statutory requirement for them to spend it on evidence-based prevention, treatment and recovery support interventions for substance use as there is for cancer, and they need to be funded in the same way.
The UK Recovery Walk charity is the leading national recovery advocacy organisation and we feel it is our duty to speak out when other service providers and charities don’t, for fear of losing funding. We will provide support and work with any individuals and organisations who want to highlight and challenge plans to disinvest in local services. Please contact us on firstname.lastname@example.org if we can help.
CEO, UK Recovery Walk charity, www.ukrecoverywalk.org
At the RiTC conference Rowdy Yates told mutual aid fellowships, ‘Stop calling it (addiction) a disease…’ (DDN, November, page 9).
AA co-founder Bill Wilson said, ‘We AAs have never called alcoholism a disease because, technically speaking, it is not a disease entity. For example, there is no such thing as heart disease. Instead there are many separate heart ailments or combinations of them. It is something like that with alcoholism. Therefore, we did not wish to get in wrong with the medical profession by pronouncing alcoholism as a disease entity. Hence we have always called it an illness or malady – a much safer term to use.’
Clearly addiction is not healthy; but even a layperson can tell the difference between being sick or unwell – and having a disease.
Laurie Andrews, Essex
I have always admired Paul Hayes as a politician but never his policies in regard to recovery from addiction.
To spend 12 years on persuading politicians to move addicts from heroin to methadone (akin to moving whisky drinkers to free supplies of vodka) when he well knows that since 1966 there has been an addiction recovery training programme available at 169 centres (including prison units), indicates that he was either deaf to what has been succeeding in 49 other countries for 48 years, or that he had some other reason for pushing fail-to-cure ‘treatments’ in Britain.
The pretence that drug addiction is ‘incurable’ is based on the 25 to 30 per cent of heroin users with no intention or desire ever to quit their habit. But the other 70 to 75 per cent, having failed to quit on numerous – often daily – occasions, still want to quit, but just don’t know how. Their problem is not willingness to quit, but lack of training in how.
The government’s National Audit Office and Professor Neil McKeganey tell us that the average overall cost to the taxpayer of every methadone prescription user is over £47,000 per annum and also indicate that less than 3 per cent of such addicts will reach abstinence in their lifetime.
However, the cost of putting a drug or alcohol addict through a 26-week residential self-help addiction recovery training programme is under half that, and delivers relaxed abstinence for life in 55 to more than 70 per cent of cases first time through the programme, with another 5 to 15 per cent succeeding following a shorter refresher course.
Nearly four years on since psychiatric professor John Strang was appointed to run eight payment by results ‘pilots’ (which he based nearly exclusively on the OST medication principles promulgated by Paul Hayes), we have no report but only rumours that the OST gospel – according to both Paul and John – just doesn’t work to deliver abstinence, relaxed recovery or other possibilities of payment by results.
Self-help addiction recovery training delivers all those results, so why are Paul and John trying so hard to pretend it doesn’t exist?
Kenneth Eckersley, CEO Addiction Recovery Training Services (ARTS)
A prize for your thoughts
Thanks to all of you who have filled in our readers’ survey so far. We’re very grateful for all of your feedback and suggestions and will be using them to plan next year’s DDN. The closing date for winning our £50 Amazon voucher is 15 December, so visit this link now to fill in the survey and be in with a chance of the prize!
Thank you also to the truly wonderful individuals and organisations who have supported our Christmas card campaign (centre pages) to help fund this issue. With the magazine circulated free of charge to all our readers, and not paid for by subscription (not a lot of people know this, according to our readers’ survey!) we are sincerely grateful for your help in mitigating the losses from the seasonal dip in advertising which normally helps us to pay for producing, printing and posting the magazine.
A very merry Christmas from the team at DDN!