Adfam at 40

Over the course of 2024, we will be releasing a series of monthly articles, reflecting on Adfam’s 40 years, where things have improved for families, and where we still have progress to make. We’ll be speaking to key people that have been active in supporting families affected by substance misuse throughout those years, including professionals, people with lived experience, academics, and policy makers. We want 2024 to be a year of conversation, where we talk openly, honestly, and freely about the impact of substance misuse on families, and to overcome the stigma.

For our first Adfam at 40 article, we speak with Adfam’s chief executive Vivienne Evans OBE, who has led Adfam since 2001 – over half of the charity’s life.

In conversation with Viv

When Viv joined Adfam as chief executive in 2001, a key feature of Adfam’s work was its projects in prisons, having teams situated in prison visitor centres, delivering support to people with a loved one that was incarcerated because of their substance misuse. This support was groundbreaking at its time and provided a vital lifeline that offered guidance and clarity to families affected in this way.

Viv’s strategy and ambition was to grow the charity further to become a campaigning organisation too, and one that influenced policy. One of the first new projects under her stewardship was the development of Guidance and good practice in working with families, which was made available to professionals in health and social care sectors. The resource was co-produced with people with lived experience, something which became a key feature of Adfam’s philosophy moving forward.

At that time, there were many smaller, local, family support groups based in most local authorities in England, largely run by people with lived experience and offering peer support to families affected in this way. Adfam gradually took on the role of an infrastructure organisation, bringing together and representing those different groups as one. Sadly in 2010, a lot of the funding for family support groups disappeared, with many either being absorbed into drug and alcohol treatment services or having to close altogether.

Adfam itself has had to navigate the ever-changing funding environment, previously receiving core funding from the Department of Health until 2007 and in 2010 losing the funding for most of its prison services. In more recent years, funding from trusts and foundations has also become increasingly harder to attain, and Adfam has adapted by offering services to local authorities whilst utilising its training offer. Despite being under pressure to survive, Adfam continues to be flexible in an increasingly difficult environment and continues to provide the vital support that families need.

Adfam’s trajectory has seen its work take various forms, from delivering direct services, influencing policy, promoting good practice, working with officials to represent and give a voice to family members, working with local family groups, promoting our training, and working in co-production with people with lived experience. Once again, the delivery of direct services has become a key part of Adfam’s work, and this has never been more evident than with our Adfam@Home service which offers family members remote 1:1 support with a trained family support professional.

Whilst Adfam is no longer an infrastructure organisation, it continues to be the voice for families within the sector and plays a key role bringing together others and campaigning for change by facilitating the Alcohol and Families Alliance (AFA), and Alliance of Family Support Organisations.

How experiences of families have changed over time

Whilst lots has changed over Adfam’s forty years, the experiences of family members affected by substance use are still very much apparent. There are still thousands of people using drugs and alcohol problematically, with many more family members who are affected by their use. The need for support for families hasn’t gone away and never will.

Viv suggests that despite this, the needs of families have become more complex and long-lasting in recent years, highlighting links with financial difficulties and the cost of living, links with domestic abuse and violence, and mental health to name but a few. What’s needed, but has so often been lacking, is an integrated approach to supporting these families, as the substance misuse almost always isn’t the only problem.

Furthermore, families’ voices continue to be stigmatised. Whilst there has been a gradual shift in recognition and understanding of the issues, there’s still not enough; more needs to be done to raise awareness of the issues facing families affected by substance use to get their voices heard. Viv stresses that the above doesn’t just apply to adult family members and friends either, we must ensure the needs of children are not forgotten too.

Adfam’s major landmarks

When asked about Adfam’s major landmarks as a charity throughout the years, Viv spoke about the ways Adfam has always tried to break new ground, by identifying the experiences of specific groups and ways people can be affected by someone else’s substance misuse and improving their lives.

Examples of this include the BEAD project supporting those bereaved through substance misuse, working with families of veterans with substance misuse problems, families of gamblers, families of people with hepatitis C or who inject drugs, those experiencing child-parent violence and abuse, families supporting a loved one with a dual diagnosis, or Foetal Alcohol Spectrum Disorder (FASD). Throughout these various initiatives, Adfam has always believed in working in partnership with others and sharing expertise and knowledge.

Adfam has consistently been an organisation that uses its expertise to share guidance and good practice around families and substance use, along with training courses that have been developed in response to the changing needs of the workforce. Adfam’s training courses often attract attendees from across health and social care sectors, and Viv believes that training on children, families, drugs and alcohol need to be incorporated into the training that’s available to all professionals, to ensure families receive the best support to meet their needs.

Furthermore, Adfam has had a high degree of success with its policy and influencing work. Viv shares recent examples of where families are now included in the Drug and Alcohol Treatment and Recovery Workforce Transformation Programme, the Commissioning Quality Standard, and in the Drugs Strategy. Previously, families would not have been mentioned or considered, but because of Adfam’s persistence and resolve in the policy sphere this is now changing.

Above all else, Viv stresses how fortunate she has been in always working with a committed group of people; committed to Adfam’s cause and committed to putting the needs of families at the heart of everything that Adfam does, which makes a huge difference.

Ultimately, Adfam has survived by being flexible, adapting to the external environment, adapting to changes in funding opportunities, but all the while refusing to be driven from its course.

Reflections for the future

When asked for her reflections for the future, and what she would like to see happen and change, Viv was reluctant to state the obvious in calling for more services for families. However, it is hard to escape the importance of families receiving support in their own right. Whilst we know all too well the huge impact substance use can have on others, we also recognise that family members contribute to and are a key component in people’s recovery, and they are a very important and cost-effective benefit to the welfare state and the economy of this country by providing support to their loved one.

Viv attains that more recognition of families is also needed within existing health services, and the specific needs of families affected by substance misuse should be integrated across all welfare services. And ultimately, we need more recognition across society, with more sympathy and understanding, and less stigma.

From a personal point of view, Viv reflects on how she has learnt such a lot since coming to Adfam and remains committed to improving the lives of families. Whilst we know there are 5 million people affected by this issue in the UK, it continues to be striking that due to the shame and stigma, all too often they don’t speak out and are hidden in plain sight.

Viv concludes by saying, ‘Whilst we’ve come a long way there’s still more to be done. Over the next year we want to give people the agency and opportunity, the courage, to speak out, because only then will we get the real change that we want.”