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Turning Point unveils wide-ranging hep C strategy

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DDN
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Turning Point has launched its own hepatitis C strategy setting out how it intends to support the World Health Organization’s aim of eliminating the virus as a major public health threat by 2030.

The charity will provide testing and specialist treatment, as well as use staff training and the sharing of harm reduction information to help eradicate the condition.

Victor Adebowale
‘We are proud to be playing a part in eliminating the virus as a public health threat,’ said chief executive Lord Victor Adebowale.

Turning Point has already offered dry blood spot testing to 95 per cent of its service users who have ever injected drugs. It now aims to reach the remaining 5 per cent, with clients at risk of infection offered a re-test every year as a ‘minimum standard’. More than 58,000 people accessed the organisation’s substance misuse services last year, with two in five who have injected likely to be infected and many unaware that they are living with the virus. 

Service staff will be trained to ‘myth-bust’ client perceptions that treatment still involves older methods with their attendant side effects, while peer mentors and volunteers will be trained alongside staff to deliver ‘effective and evidence-based’ hep C interventions. Each service will also have its own hepatitis C champion. 

‘We are proud to be playing a part in eliminating the virus as a public health threat,’ said chief executive Lord Victor Adebowale. ‘As an organisation we have excellent reach into the populations most affected by this devastating, but entirely treatable, illness. By providing access to testing and treatment in all of our substance misuse services across the country, we will be playing a crucial role in eliminating Hep C.’

Strategy at www.turning-point.co.uk

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DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

 

Richmond Integrated Recovery Service is leading the way in the diagnosis and treatment of hepatitis C

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DDN
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CGL Richmond Integrated Recovery Service is leading the way for drug services across the country in the diagnosis and treatment of hepatitis C.

Jennifer Hannon, the Lead Nurse in CGL Richmond
Jennifer Hannon, the Lead Nurse in Change Grow Live Richmond

NHS England aims to eliminate hepatitis C as a major public health threat by 2025. Change Grow Live aims to eradicate hep C in our drug and alcohol services by 2023. To help break this down locally, we are using a new approach called ‘micro-elimination’. This will apply to any service user who has ever injected a drug, and involves:

  • 100% of service users offered a test
  • 90% accept test and are tested
  • 75% of those diagnosed start hep C treatment

Jennifer Hannon, the Lead Nurse in Change Grow Live Richmond, has a background in Hepatology/Liver Transplant nursing and joined the service in 2016. When she started, there were 26 people using the service who were known to have active hepatitis C. The most common route for transmission of the hepatitis C virus in the UK is through intravenous drug use.

Jen and the Service Manager, Simon Holmes, developed a working relationship with St George’s Trust and Queen Mary’s hospital, which are both local to the Richmond service. Led by Consultant Hepatologist Dr Daniel Forton and Viral Hepatitis Clinical Nurse Specialist Beverly Edwards, St George’s Trust treated 16 of the 26 patients in the hospital. However, treatment within a hospital setting can prove challenging for people with drug or alcohol addiction. To treat these people, Dr Forton, Beverly and Jen joined forces to set up a hepatitis C clinic based at Change Grow Live Richmond. This onsite clinic is one of the first of its kind, and began in May 2018. Since then, 164 people have been tested for hep C, with 29 being found to need treatment.

Guide to hepatitis treatment
DDN Guide to Hepatitis C and Health. Read it online and order free print copies for your service.

 The team then used a method of capillary blood testing championed by St George’s Trust which is quick and non-invasive, a huge bonus for the patients. This onsite service virtually removed the need for people to be seen in the hospital.

 More patients were diagnosed, and everyone who needed treatment and remained engaged with Change Grow Live for drug/alcohol treatment were successfully treated for their hepatitis C. Only one patient re-located, and continued their treatment with a different Trust.

 This partnership between a Change Grow Live service and the NHS is an example of how much we can achieve when we work together. Change Grow Live now have onsite hep C clinics in over 85% of our services, and aim to repeat the success of Richmond for the benefit of their service users and communities.

Come and visit the team in Richmond on Friday 26 of July. Contact Jackie.Howe@cgl.org.uk for details.

 

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

 

 

World Hepatitis Day 2019 DDN Round Up

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DDN
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World Hepatitis Day (WHD) is held each year on 28 July to raise awareness of viral hepatitis and to find undiagnosed patients and promote testing and treatment.

 

DDN Hepatitis C Guide

DDN produced The Hepatitis C and Health guide to help recognise stages and symptoms and offer people the targeted help they need.

You can download it here and also order free printed copies of all our wider health guides.

Let us know what you are doing to eliminate Hepatitis in your service.

Here is a round up of what’s happening for World Hepatitis Day and how you can get involved.

Social media icons

Get involved on social media by following the hashtags #findthemissingmillions and#worldhepatitisday and you can download images and graphs for your posts here.

 

WHO LogoWorld Hepatitis Day is one of WHO’s seven officially mandated global public health days.

Visit www.worldhepatitisday.org to find out more, view global events, and download materials.

Hepatitis C Trust LogoThe Hepatitis C Trust is the national UK charity for hepatitis C. View their map of events taking place around the country.

 

In DDN Magazine..

Hepatitis Peer SupportIn our July/August DDN Magazine Ignatious Harling shares his progress as a hepatitis C peer educator.

You can view more DDN coverage of Hepatitis in DDN magazine here.

From our partners…

Turning Point unveils wide-ranging hep C strategy

Victor Adebowale Turning Point CEO
‘We are proud to be playing a part in eliminating the virus as a public health threat,’ said chief executive Lord Victor Adebowale.

Turning Point has launched its own hepatitis C strategy setting out how it intends to support the World Health Organization’s aim of eliminating the virus as a major public health threat by 2030. The charity will provide testing and specialist treatment, as well as use staff training and the sharing of harm reduction information to help eradicate the condition.

 

Find out more here.

 

 

Jennifer Hannon, the Lead Nurse in CGL Richmond
Jennifer Hannon, the Lead Nurse in CGL Richmond

CGL Richmond Integrated Recovery Service are leading the way for drug services across the country with a recent achievement in Hepatitis C diagnosis and treatment.

  • 100% of service users offered a test
  • 90% accept test and are tested
  • 75% of diagnosed start Hep C treatment

Find out more here

 

NHS Substance Misuse Providers Association talk about their plan to eliminate Hep C across their services.

Find out more here.

Services failing vulnerable people with alcohol problems

By
DDN
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Vulnerable adults’ alcohol use is frequently being ‘missed or poorly managed’, says a report from Alcohol Change UK. Mismanaging severe alcohol problems among people with complex needs is increasing their risk of harm and even death, says Learning from tragedies: an analysis of alcohol-related safeguarding adult reviews.

The report analyses eleven different safeguarding adult reviews from 2017 where alcohol was identified as a significant factor, and ‘charts the stories of people who died in the most tragic of circumstances at a time when they were at their most vulnerable’.

All professionals working with alcohol-dependent people should be fully trained to recognise the ‘complicated role that alcohol plays in adult safeguarding’, says the document, and stresses that a person’s refusal of care needs to be ‘constantly challenged’. The refusal of alcohol treatment should not lead to someone being deemed beyond help, it says, and treatment services may need to adapt their models, for example through home visits.

Training of social workers, paramedics, police and others should also challenge the view that alcohol misuse is a ‘lifestyle choice’ that must be respected. Many of the people described in the report had ‘dozens or even hundreds’ of interactions with professionals who failed to recognise the risks posed by alcohol and treated dependency and self-neglect as personal choices. Professionals also need more guidance to help them use legal powers to mandate alcohol-related interventions, says the report, with the recent Mental Capacity (Amendment) Act 2019 an opportunity for change.

Dr Richard Piper: These recommendations are workable and urgent.

‘Our report reveals the tragic stories of lives lost in some of the most terrible of circumstances,’ said Alcohol Change UK chief executive Dr Richard Piper. ‘We as a society owe it to the memories of the people who have died and their families to make the most of the learning from this review to prevent such tragedies in future.

‘The recommendations that we offer are workable and urgent, especially for those people who are alive today and are at risk of being the subject of a future safeguarding adult review. Most importantly, professionals who are working hard in the most difficult of circumstances need to receive proper legal backing and much better training in how to handle the genuine complexities of an alcohol problem when it is entwined with other challenging issues.’

Meanwhile, the government’s new Advancing our health: prevention in the 2020s green paper states that alcohol care teams will be ‘fully established’ in hospitals with the highest rates of alcohol dependence-related admissions over the next five years. It also aims to encourage people to switch towards low-alcohol products by looking at increasing the descriptor threshold of what constitutes an alcohol-free drink from 0.05 per cent ABV to 0.5 in line with other European countries, and sets an ambition for England to become ‘smoke-free’ by 2030. This includes an ultimatum for industry to ‘make smoked tobacco obsolete’, with smokers either quitting or using less risky products like e-cigarettes instead.

Chair of the Alcohol Health Alliance Sir Ian Gilmore said it was ‘strange’ that the document was inconsistent. The government wanted the UK to ‘lead the world in tobacco control but won’t apply pressures to alcohol harms. Like tobacco, alcohol causes cancer; like tobacco, alcohol can have serious effects on the health and wellbeing of children; like tobacco, alcohol leads to early avoidable deaths. So it’s shocking that the only proposal in the paper is to relax the rules on what constitutes an alcohol-free drink. Once again, the government puts the alcohol industry first and consumers last.’

Learning from tragedies: an analysis of alcohol-related safeguarding adult reviews at alcoholchange.org.uk and here

Advancing our health: prevention in the 2020s – consultation document at www.gov.uk and here

DDN Advertising Information

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DDN
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Please find some information on advertising with DDN.

DDN has been established for fourteen years and in addition to the print has 18,000 online readers a month, 4,500 email subscribers, and an active social media presence with over 9,000 twitter followers. This circulation ensures that we are available not just to those working in specialist treatment but are also read by the wider health and social care sector, housing, mental health services, prisons and criminal justice. You can see from our jobs page, the type of post we carry.

 

You can click here for a media pack with more information and our rates.

If you are interested in long term advertising or our November print issue. Please email your details to ian@cjwellings.com And one of the team will come back to you. The November issue is out on Monday 11 November, the final print deadline is Friday 8 November.

If you want to place an online recruitment advert this can go live straight away.

The cost for an online recruitment advert is £495 (reduced to £395 for a registered charity), which includes it staying on the website until the closing date and being promoted via email and social media. 

To go ahead simply email the text that you would like to use, a logo, and an order number if required to ian@cjwellings.com . Myself or one of my colleagues will add the job to our site and email you a link. You can then make any changes or amendments you need. You will be invoiced later.

If you need to speak to someone urgently please contact claire@cjwellings.com or 07711 950 299

 

 

 

 

 

 

Making digital services more human

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DDN
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How we’ll use digital to make services more human — and help more people overcome addiction

Good help is too hard to reach. We want to change that.

By Laura Bunt – Deputy Chief Executive at Addaction.

When you walk into one of our services, chances are you’ll get a warm welcome from an experienced member of our frontline team. They’ll have worked with many different people from many different walks of life, and will quickly be able to connect with you and understand what’s going on. At our best, we work with kindness, firm boundaries and love. Teams will try to find the support that’s right for you, whether that’s clinical treatment, counselling, support from peers or getting into housing, work or education.

For the 1 in 6 of us who experience issues with drugs, alcohol or other mental health problems, access to this kind of help can be life saving. But it’s too hard to reach. If you live far away from a service, or have mobility issues, the costs and complexities of travel can be prohibitive. If you’re working or have caring responsibilities, it may be hard to find and book an appointment that works around your commitments. If you are from a community where even talking about drugs, alcohol or mental health brings shame and disapproval, walking into a service may be more than you can cope with.

This challenge is why we’re so pleased to have received funding from the National Lottery Community Fund’s Digital Fund to use digital tools and technology to change how we work with people and run our organisation. Over the next two years, we’re building an in-house team of people with digital, data and design skills to work with people who use (or might use) our services and different teams to reimagine and redesign the ways we help people to overcome addiction. We want to do this in a way that helps communities and individuals shape their own experience, recovery and support.

Read the full article on Addaction’s Blog.

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by Addaction, and first appeared on

https://medium.com/addaction-voices/

Scotland’s drug death toll at record high

By
DDN
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Scotland has yet again recorded its highest ever number of drug-related fatalities, with 1,187 registered in 2018.

Silhouettes to illustrate anonymous drug related deaths

The number, which was described as ‘shocking’ by public health minister Joe FitzPatrick, represents the fifth consecutive increase and is almost 30 per cent higher than 2017’s record figure of 934 (DDN, July/August 2018, page 4) and nearly double that of a decade ago. The death rate is almost three times that of the UK as a whole and remains higher than anywhere else in the EU.

More than 70 per cent of the deaths were males and more than a third occurred in the Greater Glasgow & Clyde NHS board area. One or more opioids including heroin, morphine or methadone were implicated in, or potentially contributed, to 86 per cent of the total. Worryingly, methadone was implicated in, or potentially contributed to, 47 per cent of the deaths, and benzodiazepines to 67 per cent. Deaths involving MDMA and cocaine were also the highest since records began. People aged 35-44 accounted for 37 per cent of the deaths, and those aged 45-54 for 29 per cent.

Only 40 per cent of people with a drug problem in Scotland are in treatment, the Scottish Drugs Forum (SDF) points out, with some areas seeing poor retention rates and waiting times for OST of up to six months. A large proportion of people are also on ‘sub-optimal’ doses of methadone, SDF adds, in contravention of clinical guidelines and WHO recommendations.

‘The number of people who have lost their lives because of drug use is shocking,’ said Joe FitzPatrick. ‘It is vital this tragedy is treated as a public health issue, and we are prepared to take innovative and bold measures in order to save the lives of those most at risk. Last week, I gave evidence to the Scottish Affairs Committee and I asked for help in persuading the UK government to either act now to enable us to implement a range of public health focused responses – including the introduction of supervised drug consumption facilities – or devolve the power to the Scottish Parliament so that we can act.’

Release called on the government to make sure that treatment was properly funded and that initiatives like peer naloxone programmes were adequately resourced.

‘The UK government has continuously blocked the establishment of an overdose prevention site in Glasgow,’ said executive director Niamh Eastwood. ‘This decision by Westminster has contributed to the increasing drug related deaths in Scotland and has tied the hands of Holyrood and drug treatment experts in Scotland. With drug-related deaths at an all-time high in Scotland the UK government must now give the green light to the establishment of an overdose prevention site or risk responsibility for further deaths.’

While Scotland prided itself on having ‘an equalities and rights-based approach’ to policy and service provision, the figures suggested that the country’s self-image was a ‘dangerous self-delusion’ stated SDF CEO David Liddell. ‘NHS patients are receiving treatment that does not meet standards laid out in national and international good practice guidance. With any other patient group, this would rightly be regarded as both scandalous and a national priority for action.’

The number of deaths involving methadone were ‘of particular concern’, he stated. ‘If people are not getting the substitute medication dose they require then it is no wonder they “top up” with street drugs and get involved in polydrug use – which is a huge feature in these figures, accounting for the vast majority of deaths. The obvious question we need to ask is why are NHS patients being treated in ways that are clearly contrary to the good practice recommended in the guidelines? Why is this being allowed to continue?’

The belief that the lower the dose the better someone was doing ‘flies in the face’ of decades of evidence, he said, while stigma also continued to be a key issue.

‘We have stigmatised drug use and people with a drug problem and also a life-saving pharmaceutical treatment. The government and politicians, the NHS, drug services, the media and wider society have a part to play in this. We can prevent drug deaths – as stakeholders we all need to do what we can to reverse this national scandal – that responsibility lies with us all.’

Drug-related deaths in Scotland in 2018 at www.nrscotland.gov.uk. Read the report here

Drugwise – Promoting evidence based information on drugs, alcohol, and tobacco

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DDN
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Drugwise logo

 

As well as updating our drug information and writing new reports, Drugwise provides a full range of DrugScope archival materials and all Druglink articles back to 1986.

DrugWise also has an international dimension which is not restricted to drugs, but includes alcohol and tobacco where the advent of e-cigarettes is causing as much controversy as that surrounding the conflicting views on drug policy and practice.

There are many robust international and internationally-relevant national reports and reviews in all these areas. The problem is that they are not all in one place. So Drugwise have created I-Know, the international knowledge hub which will build up a library of information, policy and practice material stored on our server so that they will always be available. 

In addition Drugwise produce DS Daily a daily email round-up of the latest news, reports and blogs related to substance misuse. You can subscribe here for free.

Find out more at www.drugwise.org.uk

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by Drugwise, and first appeared on

www.drugwise.org.uk

Naloxone overdose reversal medication

By
DDN
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Naloxone is a medication used to reverse the effects of an opioid overdose.

Naloxone Kit being held
A naloxone kit

Known as an ‘opioid antagonist’, it counteracts the depression of the central nervous system and respiratory system and allows the person to breath normally again. If someone is experiencing an overdose from opiates – such as heroin, fentanyl, methadone and morphine – having a naloxone kit handy can mean the difference between life and death. It will reverse the breathing difficulties caused by an overdose.

Naloxone can be injected into a muscle or vein, or under the skin (at a concentration of 0.4mg/1mL) or sprayed up the nose (at a higher concentration of 2mg/2mL).

When injected into a muscle it will take effect after about two minutes and will last for about 20 minutes – crucial time while an ambulance is called.

When someone has overdosed they might be impossible to wake or not appear to be breathing. They might also be making gurgling or snoring noises and have a blue tinge to their lips and fingertips.

Call 999 and ask for an ambulance. Check that nothing is obstructing their airways, then place them in the recovery position. Inject naloxone into their thigh muscle or upper arm – through clothing if necessary. If the person doesn’t respond after three to five minutes, give a second dose.

When they wake up, explain what happened – they may be confused, angry or be experiencing mild withdrawal symptoms. Stay with them until the ambulance arrives.

Naloxone Campaigners
Campaigners for naloxone distribution

Naloxone kits are available to anyone who is at risk of an overdose, as well as their family and friends. They are available from drug services, needle and syringe programmes and pharmacies that provide drug treatment. Learning how to use the kits only takes five minutes.

An opioid overdose is simple to reverse. Kits are easy to use and should always be at hand.

Read more on naloxone in DDN Magazine

 

Read background on the evidence base behind naloxone distribution

Turning Point Suffolk Family Carers win the GSK IMPACT Awards 2019

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DDN
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Q&A session with Terri-Ann Perkins, Mental Health & Substance Misuse Team Manager at Suffolk Family Carers, a charity providing support for family carers and overall winner at the GSK IMPACT Awards 2019, the first time a charity from the East of England has won the prestigious award.

Suffolk Family Carers at the GSK IMPACT Awards 2019
Suffolk Family Carers at the GSK IMPACT Awards 2019

 

Can you tell me a little bit of background about Suffolk Family Carers, what do you do, who are the people you support?

Suffolk Family Carers began over 30 years ago to provide information, advice and support to thousands of family carers. Our credible representation of family carers’ needs and our valued work in supporting family carers enables us to campaign on issues that affect family carers to ensure their voice is heard.

We look after carers from the ages of five upwards. These are people who are unpaid and caring for somebody else; they could be a family member or a friend. We have young carers, young adult carers and adult carers. We talk to them and support them – they can ring up and chat to an adviser, and can request a call on a regular basis so that we can assist them in their caring role. We have about 70 staff and then we have around 60-plus volunteers that help us out – we could not function without our volunteers.

What services to you run?

We run courses such as Caring with Confidence and Wellbeing for Me, we also run Navigating the Road to Recovery, which is for carers of those dealing with substance misuse. We also have community connectors that go out to rural areas on our bus. There are some people who have sometimes travelled to another area to meet up with the bus because they don’t want people in their village to know that they’ve got a problem with their caring role. We have a dedicated team that goes in and regularly speaks to schools, and helps staff to identify carers.

We do one-to-ones. We also provide peer support via SAGES, which is Suffolk Advice, Guidance and Emotional Support. We also do moving and handling – we’ve even got a caravan that carers can rent out, so they get a break!

Turning Point addiction treatment

We’ve got an advice line but we’re not a crisis service though, we are here but we’re not 24/7 currently.

Read the full interview here

 

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DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by Turning Point, and first appeared on

www.turning-point.co.uk

Can Housing First help homeless people address their drug and alcohol use?

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DDN
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A new project in Dundee gives homeless people unconditional homes and support. What impact has it had on the ‘drug death capital of Europe’?

Housing first image

By Nye Jones, Editor and Features Writer at Addaction

Down the quiet backstreets of Dundee, a world away from the flashy new V&A museum, Angie opens the door to an unremarkable domestic scene. She’s lived in her flat for nearly three months and has decided it’s “time to put my stamp on it.” Her cousin is lending a helping hand repainting the living room while Angie talks of planning to create a feature wall in her bedroom. She cooks a mean Spaghetti Bolognese, although she won’t reveal her secret recipe, and is a soap connoisseur who can discuss the finer details of everything from Eastenders to Hollyoaks through to Casualty.

But not so long ago Angie’s life was very different. She grew up in care before spending years in and out of “toxic relationships”, sometimes sleeping rough when they broke down. At the start of 2019 she found herself living in one of Dundee’s homeless hostels. It was from there that her key worker referred her into the city’s new Housing First program.

The Housing First approach to tackling homeless was first developed in New York in the 1990s. It aims to support people with multiple complex needs such as repeated homelessness, mental and/or physical health issues and substance use. Traditionally, homeless people have to work their way through a ‘staircase’ of supported housing such as hostels until they prove they’re ready to manage a tenancy on their own. Instead, Housing First moves people straight into their own home and wraps intensive, personalised support around them. It’s based on the premise that everyone has a right to housing while the security and stability it provides helps people address long-term issues such as drug use.

Read the full article on Addaction’s Blog.

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by Addaction, and first appeared on

https://medium.com/addaction-voices/

CZAR GAZING – A hopeful sign

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DDN
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Concluding his theme of how to rejuvenate the sector, Mike Trace sees opportunity in the appointment of the recovery champion.

Read it in DDN Magazine 

Mike Trace is CEO of Forward Trust

Central government has been happy to allow the drug/alcohol treatment sector to drift and suffer cuts over the last six years. But the appointment of a government recovery champion, Dr Ed Day, gives some hope that a coherent national strategy can re-emerge. The role has no salary and no budget, but Dr Day will report directly to ministers so has the opportunity to articulate a strong case for rejuvenating the sector.

 

Of course ministers currently have a life span of one to three months, but we have to hope that a stable government emerges in the autumn – one with the bandwidth to think seriously about social justice and social inclusion.

By that time the recovery champion should be prepared with a concise set of data and arguments that will persuade the government to re-invest in treatment for drug and alcohol problems, and to ensure that investment is properly targeted. Here are a few ideas of what his advice should include:

Remind the government why this sector is important

Substance misuse care and treatment is one of the strongest social inclusion weapons the government has in its armoury. Hundreds of thousands of the most marginalised people in our society – struggling with homelessness, worklessness and alienation, and unwilling to engage in mainstream services – decide to make contact with drug/alcohol services, presenting an opportunity to improve their physical and mental health, and start a journey towards recovery and reintegration.

When this works, the government reaps rewards in terms of reduced crime, improved public health, reduced homelessness, reduced benefit dependency, and improved family and community relationships. There is also the added bonus of undermining the power and reach of illegal drug markets.

Provide the data to back up arguments

I know from experience that treasury officials need to see credible calculations of benefit before the purse strings are opened. Numbers in contact with treatment, and numbers leaving treatment and not returning, will not cut it. Neither, I am afraid, will a reduction in the risk of drug-related deaths, as long as the total number continues to increase. We have to show that our efforts deliver real outcomes for government and communities.

One of the biggest failings of the NTA, and my office before it, was not to have put in place longitudinal research that showed the sector’s impact on crime, health, employment and family/accommodation. We do have a number of small-scale studies that show positive results – Dr Day needs to compile these into the best current evidence base, and make arrangements for much more meaningful evaluations in the coming years.

Give them a clear description of what recovery looks like

The sector can continue debating its definition of recovery – does it require abstinence, can you be ‘in recovery’ and still drink or smoke problematically – but government needs a clear ‘mission’ to buy into. The UKDPC definition works best for me: voluntarily-sustained control over substance use which maximises health and wellbeing and participation in the rights, roles and responsibilities of society.

But government needs to have a way of recording when someone can be considered to be ‘in recovery’. We can’t run client surveys to answer this question, nor can we define it in terms of the nature of their contact with services. For me, if someone is not committing crime, is in positive contact with family/significant others, and is engaged in work, study, or other positive activity, then this is a pretty good proxy measure of recovery.

Bring back the pooled budget

Everybody agrees that the behaviour change that can result from drug/alcohol treatment has benefits for many government departments, but since the demise of the pooled budget, the funding burden is falling on the NHS and local authorities, while other departments such as the Home Office, DWP, and justice, are taking a back seat. (This is happening right now with the redesign of probation, where the Ministry of Justice is simultaneously saying that drug/alcohol treatment is essential to its objectives, but that local authorities must pay for it.)

The drug treatment pooled budget that was in place from 1999 to 2012 balanced this shared interest and responsibility and gave all departments an interest in contributing to shared costs and shared outcomes, at a level that no department would shoulder on its own. We need to get back to that system – with all departments contributing to programmes and pathways that deliver personal development and recovery.

A new crop of ministers needs a new vision for drug/ alcohol treatment and recovery – it lies in a positive investment in the potential of people who, for most of their lives, have been neglected, abused, stigmatised and punished. If we are to take social inclusion seriously, providing support to recovery and reinte­gration for these people is one of the most humane and cost-effective policies a government can take.

Time to investigate Duterte for crimes against humanity, says Amnesty

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DDN
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The UN Human Rights Council should immediately open an investigation into Rodrigo Duterte’s ‘war on drugs’, states a report from Amnesty International.

The Philippine president’s violent anti-drugs campaign should be investigated for gross human rights violations and ‘possible crimes against humanity’, according to They just kill.

The report identifies 20 cases that saw the deaths of almost 30 people in what in many instances appear to be extrajudicial killings. While the Philippines government has acknowledged at least 6,600 killings by police, ‘evidence points to many thousands more killed by unknown armed persons with likely links to the police’, says Amnesty.

The report ‘joins a growing volume of evidence that the human rights violations committed in the Philippines’ murderous “war on drugs” constitute crimes against humanity,’ the human rights NGO states.

Duterte was elected in 2016 after promising on the campaign trail to ‘fatten the fishes’ in Manila Bay on the bodies of dead criminals (DDN, October 2016, page 8).

Amnesty regional director for East and Southeast Asia, Nicholas Bequelin
Nicholas Bequelin: ‘not safe to be poor in President Duterte’s Philippines’

‘Three years on, President Duterte’s “war on drugs” continues to be nothing but a large-scale murdering enterprise for which the poor continue to pay the highest price,’ said Amnesty regional director for East and Southeast Asia, Nicholas Bequelin. ‘It is time for the United Nations, starting with its Human Rights Council, to act decisively to hold President Duterte and his government accountable. It is not safe to be poor in President Duterte’s Philippines. All it takes to be murdered is an unproven accusation that someone uses, buys, or sells drugs. Everywhere we went to investigate drug-related killings ordinary people were terrified. Fear has now spread deep into the social fabric of society.’

 Report at www.amnesty.org.uk – read it here

Another Story – Social media is stigmatising drug users

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DDN
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Another Story

Social media is full of stigmatising language about drug use. We should be using powerful first-person stories to create a more positive picture, says James Armstrong.

Social media and stigmatising drug use
Social media and stigma – Read the full article in DDN Magazine

Subscribe to email updates for more stories like this.

As a charity Phoenix has been actively using social media for around eight years. It offers us an opportunity to share knowledge and experience about drugs and alcohol away from the sometimes suspect agenda – or poorly informed opinions – found within more traditional forms of media. Over this time, we’ve developed a highly engaged group of followers and friends, and a compassionate community of support.

James Armstrong director of innovation and marketing at Phoenix Futures
James Armstrong is director of innovation and marketing at Phoenix Futures

However, none of us need spend long on social media before we encounter what inventor of the world wide web Tim Berners-Lee described on its 30th anniversary as the ‘unintended negative consequences of [the web’s] benevolent design, such as the outraged and polarised tone and quality of online discourse’.

Often the online discourse on drugs and alcohol is prompted by news stories that set the tone for outrage and conflict. Just as angry and provocative headlines stir the emotions of the public in order to sell papers, there can be a similarly attention-seeking approach online.

It’s hard to shake the underlying feeling that this polarised online discourse of anger and outrage is driven by stigma. So in response to this, late last year we started to think about how we could shed light on the stigma that is at the root of how drugs and alcohol are presented in British social media, and how having a clearer idea of this could ultimately help the sector combat it effectively.

There are various types of stigma, and all create barriers to treatment and support. We know that self-stigma breeds feelings of guilt and shame in people who need help and delays their accessing of treatment, so prolonging harm and suffering for them and their loved ones. Societal stigma, meanwhile, limits access to resources such as funding for treatment, access to jobs, homes and social engagement, and structural stigma influences the multiple social policies that discriminate against the people who use our services and their families.

Stigma has the potential to invade all forms of social interaction because it exists, perhaps unconsciously, in the minds of so many people. However, people’s minds can be changed if we start to understand how the feelings and attitudes that lead to stigma are formed.

Stigma can be seen as a mental short cut. It bypasses nuanced understanding of complex issues and, upon hearing the word ‘drugs’, leads our thought processes directly to a sense of threat and danger. This creates social distancing between the stigmatiser and the stigmatised, and contributes towards the dehumanisation of the latter, painting them as something to be feared.

We all, to some extent, fear what we do not understand. People with little or no experience of drug and alcohol issues have no other information to draw on to temper their fear, and are therefore particularly susceptible to this mental short cut.

The notion of attribution error tells us that people tend to unduly emphasise other people’s character, rather than external factors, when explaining their behaviours. This effect has been described as ‘the tendency to believe that what people do reflects who they are’. This is especially likely to occur when someone has little experience of the external factors that drive addiction. The mental short cut of hearing the word ‘drugs’ and immediately associating this with fear leads people with drug and alcohol problems to be personally blamed and shamed.

As people learn more they are less likely to blame an individual, and more likely to seek an understanding of the complex social drivers of the harms of addiction, such as poverty, deprivation, childhood experiences, poor health, social policy and lack of social mobility and opportunity. Gaining knowledge and experience means the mental short cut is interrupted by a more thoughtful consideration. However, as Tim Berners-Lee observed, the benevolent design of social media, which offers the promise of a collective considered judgement on the world around us, so often presents simple, quick and shallow mistaken thinking that reinforces prejudice instead.

With this in mind, we set out to analyse all public UK social media posts on the subject of drugs and alcohol over a two-month period between December 2018 and January 2019. Unsurprisingly, we found more than 75,000 uses of stigmatising language, as well as evidence that stigmatising tweets/posts are highly likely to ‘go viral’. The vast majority of these stigmatising social media posts were focused on drug use, and were not apparently intended to be directly malicious or abusive. There was a high percentage of people using stigmatising drug-related terms to be humorous in order to reap that coveted social media reward – getting attention.

However, discussion of alcohol problems and homelessness was much more compassionate. Here we saw the more benevolent design of social media coming into effect, with more discussions of an empathetic nature involving broader social context and social policy implications. This suggests that the more familiar issues of alcohol problems and homelessness reduce the tendency to blame the individual, and increase the likelihood of consideration of the context of the issue. We also saw these more considerate messages gaining the reward of online attention in the form of likes, shares and retweets.

So, what can we do to encourage the benevolent design of social media to reduce stigma? Our sector has a longstanding, strong tradition of sharing life stories as a means of reducing blame and shame. One strategy that has potential is to tap into this tradition of story sharing through social media.

Social media post challenging stigma around drug use
Thomas reached more than 17,500 people on Facebook alone with almost 1,000 people engaging with his story

First person stories told by people with first-hand experience convey the reality of addiction with nuance and context. Internal thought processes are explained and the reader has the opportunity to connect with the issue on a deeper level than purely observed second-hand behaviour. Through stories, the reader/viewer can get to know the storyteller and connect on an emotional level with their hopes and fears, vicariously experiencing the way the storyteller sees the world in which they live. Storytelling breaks down the shallow polarisation of ‘us and them’, and brings people together as a shared ‘us’.

What we have seen, then, is that stories can combat stigma by activating social media’s benevolent design potential to create a compassionate community of support. We encourage others to explore this potential in a manner that is creative, engaging and respectful to the storyteller.

 

Read more on from Phoenix Futures on social media story telling and it’s role in tackling stigma.

You can read the Phoenix Futures report Care to share – social media conversation about addiction, recovery and stigma at www.phoenix-futures.org.uk

 

DDN Magazine July/August 2019

By
DDN
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Facing the facts

It’s time to challenge stigmatising language on social media

Back in 2010, the UK Drug Policy Commission analysed newspaper coverage and produced a report, Representations of Drug use and drug users in the British Press. It highlighted negative reporting, condemnatory attitudes and pejorative labelling, and contributed to some valuable work around stigma, including the guide for journalists that the UKDPC’s former CEO Roger Howard mentions in his piece on page 14.

Since then, the presence of social media has been a complete game changer. As James Armstrong explores in our cover story (page 6), online stigma can all too often ‘go viral’ with the coveted social media reward of getting attention. While we can’t control the internet, what we can do is encourage those with first-hand experience to tell their stories, breaking down the polarisation of ‘us and them’.

The internet is shaping every area of our work and Kevin Flemen gives invaluable insight to what’s happening on the ‘darknet’. International policing operations may be enjoying successes in closing down online market places – but have we thought about the impact on the UK drugs scene? Are such operations feeding customers to dealer networks and county lines gangs? And, crucially, will the quality of drugs suffer, with all the implications for compromised safety?

We hope you have a good summer as we go into the break – the new issue will be out on 9 September. In the meantime keep in touch with your contributions and feedback – we’ll be here!

Read the full issue as a mobile magazine or download the PDF.

 

Claire Brown, editor

Keep in touch at www.drinkanddrugsnews.com and @DDNmagazine

Hepatitis C Peer Education

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DDN
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Vital bonds

Ignatious Harling shares his progress as a hepatitis C peer educator.

Ignatius Harling Hepatitis C peer educator at Addaction Bournemouth
Ignatius Harling is a peer educator at Addaction Bournemouth – Read the full article in DDN Magazine

I caught hepatitis C back at the start of the ’80s and didn’t get treatment until 2010. I wasn’t always treated particularly well by the medical profession back then. It was clear they thought I’d brought it on myself and weren’t going to offer treatment unless I was abstinent for a year. There was’nt the hepatitis C peer education around then and also a load of misinformation; they used to tell me not to worry as I’d probably die with it rather than from it.

These days, it’s different. Everyone gets treated whether they’re abstinent or not, there’s specialist support, and the testing and treatment is far quicker and more effective. But not everyone knows things have changed. And a lot of people lost trust in the system because it didn’t support them when they needed it.

That’s where I come in. I go to different support groups and talk to people about hepatitis C, dispelling the myths. I chat about my own experience and offer to give them the test there and then. There’s something about it coming from me, someone who has been there and got through it, that makes a connection with people.

It’s that connection, which I can’t quite put into words, that drives me in this role. It has a wider impact on people that goes beyond a simple test in the fight to eliminate this virus. It is a psychological step to opening up, a footstep on the road of self-care, a toe back in the water to test whether the medical world will accept them now. It’s the invisible benefit of doing this kind of work and it’s hugely motivating.

Unfortunately, people who need testing the most are those who have a history of injecting drugs and they still expect that old-style approach. They’re surprised to hear that these days they’ll be treated as human beings first with a recognisable health issue. There’s a lot of relief when they find out it doesn’t matter what they’ve done or are still doing, that they’re still entitled to be heard, seen and treated for this life-threatening illness.

Some have also ignored the idea they may have hepatitis C because they don’t want to think about it when life is too stressful in other ways. It’s known as the silent killer as there are apparently no real symptoms. I think that’s particularly true when you’re using drugs or alcohol. It wasn’t until I became abstinent that I noticed I had chronic fatigue and some cognitive difficulties. Up until then I just thought that was caused by age or substances.

The treatment I went through almost ten years ago was using the drug interferon which is very aggressive and hammers your immune system, with a 70-75 per cent chance of clearing the virus. It’s an elephant drug to shoot a butterfly. The new treatment is very targeted, much less aggressive so there’s a faster recovery time, and it’s 98 per cent effective. It’s a complete game changer.

My long-term hope is that we achieve the goal of eradicating hepatitis C altogether. It’s achievable and with peer educator projects like this, there’s the chance to do so much more along the way. There’s a good recovery community here in Bournemouth – I’ve bumped into lots of people I’ve tested now and it’s created a sort of bond. Someone else took a step to help them and that’s planted an important seed. You can almost see it growing, and it’s beautiful to watch.

World Hepatitis Day is on 28 July. Let us know what you are doing to raise awareness of testing and treatment.

DDN Wider Health Guide on hepatitis C.
The Hepatitis C Guide is part of the DDN Wider Health Series, which also covers alcohol, end of life care, and residential rehab. Click to find out more

The DDN Wider Heath guide to Hepatitis C and Health will help you to recognise stages and symptoms and offer people the targeted help they need. The guide is aimed at drug and alcohol professionals, support workers providing hepatitis c peer education, and wider health and social care professionals working with peopel with drug and alcohol issues.

Find our more and request free copies here.

 

Roger Howard pens an open letter to the new recovery champion Ed Day

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DDN
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Letter to drug recovery champion Dr Ed Day
Read Roger’s letter in full in DDN magazine

Dear Ed…

Roger Howard pens an open letter to the new recovery champion Ed Day, in response to our interview with him last month.

All of those working in the treatment and indeed the wider peer-support field must have read your DDN interview last month (June, page 8) and silently wished you ‘good luck’. I remember when the idea of a national recovery champion was first mooted thinking, ‘what’s the added value the role will bring?’

Then I saw the role detailed in September 2017 and it said, ‘The champion will be responsible for driving and supporting collaboration between local authorities, public employment services, housing providers and criminal justice partners… provide national leadership, advising government on where improvements can be made to the existing system of drug treatment… encourage greater partnership working at a national level, as well as facilitating multi-agency collaboration locally…’ And I thought, phew, that’s some ‘ask’ for a volunteer!

Roger Howard is chair of Build on Belief and former CEO of the UK Drug Policy Commission, DrugScope and Standing Conference on Drug Abuse (SCODA)
Roger Howard is chair of Build on Belief and former CEO of the UK Drug Policy Commission, DrugScope and Standing Conference on Drug Abuse (SCODA)

Don’t get me wrong. We’ve had drug czars, drug action teams, ACMD, National Treatment Agency and assorted others including think tanks seeking to address the systemic challenges of improving policy, practice and collaboration. However, let’s not ignore some of the lessons from these. The drug czar got the heave-ho when he fell out with ministers over cannabis rescheduling and how to tackle drug policy. Professor David Nutt was dismissed as chair of ACMD over his comments about the relative risks of ecstasy. Paul Hayes ‘took a bullet’ for the rest of the NTA team to smooth its transition into the new PHE.

Speaking ‘truth to power’ is like walking a tight-rope. Another lesson is that initial patronage by an enthusiastic and supportive minister can rapidly change once events and personnel change – or if they don’t like your advice. So, for all of us willing you to succeed, what can we realistically expect?

My advice would be threefold:

First, ditch any idea that you can make any significant impact on local collaboration. There’s some great collaborative work going on locally, but financial resources are the lubricant to keep the wheels oiled. We know the dire financial situation for local councils, mental health services, police commissioners, criminal justice and social housing. So, unless you want to be sent to The Tower for heresy, no doubt you will be advised by the civil servants to tread carefully when giving advice to the Ministerial Drug Strategy Board about the very real impact of cuts and changes like universal credit on recovery prospects.

Second, yes you can (and must) champion evidence-based practice, including peer-led services. You have ACMD and PHE efforts to back you up. When John Strang, Eric Appleby (Alcohol Concern) and myself (DrugScope) helped Mike Ashton to set up Drug and Alcohol Findings some years ago (still going strong) it was with the explicit aim of underpinning treatment, criminal justice and prevention practice through a one-stop easy access portal to the evidence base. But let’s be realistic. It’s a mammoth and ongoing task, akin to painting the Forth Bridge.

Which takes me to my third piece of advice and one you have already identified as a critical challenge.

The barriers to the process of sustainable recovery are considerable. So perhaps side-stepping the obvious ones of collaboration and good practice and addressing the largely unchallenged issue of stigma is a pragmatic way forward. However, you will need to tread carefully with some ministers and practitioners. When I discussed ‘stigma’ with them, and ways to tackle it, I recall one minister saying that ‘stigma was a good thing’ as it sent a message.

*****

The research and policy development the UK Drug Policy Commission undertook on the challenge of tack­ling stigma remains highly relevant (see: www.ukdpc.org.uk). The mountain to climb, among professionals, media and those using social media is considerable. UKDPC worked with the Society of Editors to facilitate their 2012 joint-publication, Dealing with the stigma of drugs: a guide for journalists. I’m sure this could be built on to take account of new media platforms.

You could do worse that cast your eye over the anti-stigma initiatives championed in the mental health field. The Time to Change campaign and subsequent off-shoots have gradually help shift public perceptions about mental ill-health. Enlisting high profile public figures’ support has been invaluable. It has also engaged thousands of local people and organisations, building on social-contact theory and evidence to chip away at damaging perceptions and portrayals, including in the helping and caring professions. But I have to say this has been achieved over two decades and with substantial financial backing running in to tens of millions of pounds from the DoH and bodies like the former Big Lottery Fund.

A real achievement for the national (drug) recovery champion would be to persuade ministers and especially the Treasury to hand over some of the proceeds from drug-related crime and unexplained wealth orders to kick-start a new recovery anti-stigma programme. That might stimulate the National Community Lottery Fund to come on board.

Then we’d know after three years that the recovery champion has made a real impact. Good luck Ed!

A Tangled Web: drug purchasing on the darknet

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DDN
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Darknet drug purchasing image
Read the full article in DDN Magazine

The ‘darknet’ online marketplace has experienced significant turbulence lately, affecting the availability of different drugs. Be ready for the impact, says Kevin Flemen.

Kevin Flemen from the drugs education and training initiative, KFx – www.kfx.org.uk
Kevin Flemen runs the drugs education and training initiative, KFx – www.kfx.org.uk

A series of international policing operations has made a significant dent in darknet drugs market places. While it’s inevitable that new models and markets will emerge, in the short term these changes will have a significant impact on the UK drug supply. Drug services should be aware of this now so that they can respond promptly to the shifts in availability.

Darknet drugs markets have been around for a few years now. The most famous early example, Silk Road, was shut down in 2013 and its successor, Silk Road 2.0, closed a year later. Predictably, more darknet drugs markets emerged to fill the void, including Agora (shut in 2015) and Alphabay.

Alphabay was shut down through an FBI operation in 2017 – but importantly, this was part of ‘Operation Bayonet’, a two-pronged attack. Many people trading on Alphabay migrated to another market, Hansa, which had already been infiltrated by Dutch Police. This allowed international law enforcement to identify both buyers and sellers, resulting both in prosecutions and wariness about the safety of other markets.

While these other darknet sites were either voluntarily closing or being shut down by enforcement, one, Dream Market, continued to function and grow. Originally established in 2013, it had risen to being the largest darknet drug market place. In March 2019 it had some 120,00 market listings, more than ten times its nearest competitor. It was easy to use, had a large number of vendors apparently located within the EU, a lot of vendors with long selling histories, and was as ‘trusted’ as any darknet marketplace can be.

Then in March 2019, Dream Market suspended trading. After logging in, customers were told that the market would close in April 2019, and a new operation with a new partner would be launched.

Dream Market had been subject to intense denial-of-service attacks, making it harder to trade on the platform. But the abrupt suspension of trading came out of the blue. There was an opportunity for people to extract any bitcoins lodged with Dream Market, dispelling myths that it was an ‘exit scam’ where the site ran off with the money. But the orderly suspension of Dream Market couldn’t disabuse people of fears that the site had been infiltrated, or that any successor site wouldn’t be another ‘sting’ like Operation Bayonet.

As before, people flocked to the next functional market, Wall Street Market. This was then probably part of an exit scam, and new subscribers lost money. Wall Street Market was then shut down.

In order to find the next reliable darknet drugs market, the easiest directory to use was DeepDotWeb which linked to the main markets, offered reviews and provided updates on their status. In May 2019 this website was seized by the FBI and the people behind it arrested for allegedly receiving kickbacks for sales generated via the drug markets to which they linked.

Alphabay Shutdown
The largest two darkweb drug markets have been shut down. It was the drugs equivalent of Amazon and eBay being taken out within weeks of each other – then Yellow Pages being closed down too.

So, since March this year the largest two darkweb drug markets have been shut down, and the directory site that pointed people to these sites and any future ones was also shut down. It was the drugs equivalent of Amazon and eBay being taken out within weeks of each other – then Yellow Pages being closed down too.

It’s almost inevitable that new markets will emerge and grow. There’s a new directory service running, and emergent markets trying to fill the gap. But it will take a while for any newer site to build up the confidence that Dream Market enjoyed with vendors and buyers. Such trust isn’t born overnight. The key issue in the meantime is, how does all this impact on the UK drugs scene?

Some drugs markets such as the UK homegrown cannabis market or the more ‘traditionally’ smuggled drugs such as heroin and cocaine will probably experience less disruption from these darknet closures. Indeed, closing down the online competition effectively ‘gifts’ a large market to the existing street suppliers – a position that the ‘county lines’ gangs are well placed to exploit. It’s a bonanza for traditional drug gangs and emergent dealer networks.

SO WHERE IS DISRUPTION MORE LIKELY TO BE EXPERIENCED?

The hidden population buying pharmaceuticals and other substances for medical or quasi-medical use.

As UK prescribers have started to clamp down on benzo, opiate and pregabalin prescribing, a cohort of people have been sourcing these off the darknet. There are also people buying THC for medicinal reasons and people microdosing on mushrooms, LSD or ketamine. We have no idea how large this market was.

With the demise of Dream Market, anyone reliant on this market place and possibly physically addicted to the substances they were purchasing will need to access treatment. They may not be able to wean themselves off their own stash – their supply just vanished. This will be a key concern for those who have been sourcing Xanax (alprazolam) off the darknet. I suspect a degree of scarcity as stocks already in the UK dwindle.

Recreational club and party drugs on the darknet

Dream Market had made it easier to buy a range of club drugs, from obscure psychedelics to MDMA, with a better chance of getting some product that was reviewed by other purchasers. With the summer festival season upon us, a host of recreational users will be obliged to go back to suppliers in clubs and festivals, with all the elevated risk that this entails. Granted, there was always a level of uncertainty with any pill, as the escalating potency of pills on the market shows. But even the modicum of safety provided by the darknet sites has now been removed.

Synthetic cannabinoids.

My suspicion is that it will be harder for the smaller city-level dealers who have been buying in SCRAs (synthetic cannabinoid receptor agonists) – for onward sale to prisons and the homeless population – to source products. Granted, some will buy directly from manufacturers in Asia. But low-level suppliers were buying from importers and redistributing to prisons and the street, and it is at this level I think availability will go down. While less ‘spice’ is no bad thing, the obvious drug of choice, especially for the street homeless SCRA users, is heroin. Anecdotal feedback from training says that this has already started to happen in some areas.

**********

Any changes will take a while to trickle through to the street drugs market as existing stocks of drugs are used up. If laws of supply and demand hold true, cost may well go up, and quality may also suffer. The relative ‘power’ of buyers, provided by the choice the darknet markets offered, is replaced by the risks of the normal street drugs market.

It is impossible to be certain what will happen over the next six months, but we can be sure that you can’t remove two huge pillars of the darknet drugs market without some impact on end users. It will certainly be an interesting few months.

More drug facts, resources and briefings at www.kfx.org.uk

Read more DDN articles by Kevin Flemen here

 

Helping families of former members of the UK Armed Forces

By
DDN
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Family Force

A new project is reaching out to families of former members of the UK Armed Forces with substance use problems, as Rob Stebbings explains.

Rob Stebbings, policy and communications officer, Adfam - talks about a new project supporting members of the armed forces with substance misuse issues.
Rob Stebbings, policy and communications officer, Adfam

It’s no secret that substance use often affects the lives of former members of the UK Armed Forces. This can take many forms – from self-medication to help come to terms with a traumatic experience to difficulty transitioning from the heavy episodic drinking culture. It’s a serious issue that needs addressing.

However, there is another group of people affected by this issue. The families are a hidden group whose voices are seldom heard, with little or no support available and barely any recognition or research.

Thanks to funding from Forces in Mind Trust (FiMT), Adfam and the University of York are working together to understand the experiences and needs of families of former members of the UK Armed Forces with substance use problems and what can be done to support them.

To help us achieve this we are grateful to have vital input from three family members with lived experience, and four partner organisations—the Armed Forces charity SSAFA, HMP Parc in Wales, Tom Harrison House in Liverpool, and Bristol Drugs Project.

Amanda, one of the family members supporting us shares her experience:

I became involved in this project when I read an email from Adfam and thought, ‘I want to know more about this’. The topic is close to my heart after seeing my brother-in-law’s deterioration from a proud warrant officer class 2 in the British Army who lived for his job, to his ultimate death from alcohol addiction after he had left the forces. This has impacted on my family’s everyday life in so many ways and whilst we remember him fondly this is often tainted by the frustration of not being able to prevent his death. I am also the mother of a rifleman who at 25 is also very aware of the pitfalls of army life, but in listening to his stories of the young men he works with I see that the cycle of coping through the use of substances continues. I am hoping my involvement with the project will provide families with the support they need and believe that Adfam and the University of York can deliver this for them.

At the beginning of July we launched an online survey to hear from families first-hand. Findings from the survey and the other parts of the research will be used to develop a peer support intervention.

If you’re a family member affected by these issues, please do take part in our survey and circulate information about it to your networks. All participants are in with a chance of winning one of two £50 high street vouchers.

Take part here: http://bit.ly/family-veterans-survey

To find out more about the project contact Lorna Templeton, senior research fellow, University of York – lorna.templeton@york.ac.uk; or Rob Stebbings, policy and communications officer, Adfam – r.stebbings@adfam.org.uk

Read more DDN articles on substance misuse problems among armed forces veterans here.

Back to Nature: Recovery Project at Phoenix Futures Shipley Park

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Recovery from Drugs in nature
Read the full article in DDN magazine

Phoenix Futures describe how guests at their recent Shipley Park open day were able to witness the positive impact a beautiful natural setting can have on recovery.

Phoenix Futures’ Shipley Park project hosted an open day on 27 June to showcase the project and demonstrate how it’s supporting people on their recovery journeys. The day was very well attended, with more than 80 visitors accepting our invitation – with the help of glorious sunshine!

Our guests had the freedom of our site at Shipley Park estate for the day, while our service users split into small groups and positioned themselves around the site offering guided tours of the various projects and discussing future plans. They were also on hand to discuss the positive impact of the project on their individual recovery journeys.

Our visitors were able to witness how those accessing the project have taken ownership of it and how they have not only experienced a positive approach and positive outcomes to their substance use but in many cases how the project has supported their mental health as well. We managed to showcase the importance of nature as an additional opportunity in treatment – who doesn’t enjoy a walk outdoors in nature?

The fact that natural settings are less and less accessible to those who live in cities or towns should be a cause for concern, especially with respect to overall health and wellbeing. Research continuously shows that nature has multiple benefits for our wellbeing, and our guests went away seeing first hand how this is proved through our own ‘Recovery through Nature’ project.

Guests were treated to a BBQ lunch, in which many took advantage of the green space to experience the therapeutic value of our natural setting. There were lots of positive discussions during the day, with a range of valuable networking opportunities. As such we can only grow in strength as we expand the opportunities we can offer to our service users.

In turn these opportunities will increase the positive experiences of all who attend. We are planning more open and activity days at Shipley Park in the near future. This means more people will be able to visit us and experience the positive impacts on treatment and, as our networking increases, we can continue to break down the stigma around substance misuse.

Find out more at

www.phoenix-futures.org.uk

Accuracy and detail are key for CQC Inspections

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DDN
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For the record

Accuracy and detail are key for providers, says Jenny Wilde.

It is difficult to overstate how important good record-keeping is within health and social care settings. Good record-keeping ensures that relevant information is captured for use by carers and other professionals. That information may be needed for a variety of reasons including:

• identifying trends for use in risk assessments

• monitoring changes in medical conditions

• providing evidence that appropriate care is being delivered

All too often we see care records that use shorthands such as ‘all care given’. A rule of thumb that carers may find useful is ‘if it isn’t recorded, it didn’t happen’. All care, all responses to particular incidents, all discussions with professionals and other stakeholders – anything at all that is done or said about a service user – MUST be recorded.

Poor record keeping generates serious risks. First, and most importantly, service users are potentially at serious risk if important information is not captured and communicated effectively. That can lead to anything from failing to identify service users’ lifestyle preferences to mistreating medical conditions in a life-threatening way.

There is, however, also a serious risk to carers and other professionals of poor record-keeping. In any investigation into the treatment of a service user – for example a safeguarding investigation or a compliance review by the Care Quality Commission – the care plan is the first document that will be looked at. Applying the rule of thumb identified above, investigators will be very slow to accept that appropriate action was taken if it was not contemporaneously recorded. Those with professional registrations, such as nurses, also risk disciplinary action if they fail to meet professional standards about record-keeping.

Writing reports requires even more care as they are bound to be scrutinised carefully.

Senior management or legal advice should be sought in appropriate cases.

Jenny Wilde director at Ridouts solicitors
Jenny Wilde is director at Ridouts solicitors

In a nutshell, when it comes to record-keeping be thorough and seek help if you need it. The CQC will rely heavily on records during inspections and will not hesitate to criticise a service that shows flaws in its record-keeping processes.

 

 

Jenny Wilde is director at Ridouts Solicitors

The Recovery Street Film Festival – The bigger picture

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DDN
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Junaid tells us how he became involved in making a film for the 2017 Recovery Street Film Festival.

In 2015 I was using crack cocaine and daily endangering my own life. I was involved in car crime and mentally and physically not in a very good place.

The first time I got arrested and went to prison I stopped using but when I came out I was putting myself in more risky and dangerous situations. The last time I was arrested I was in a really dangerous car chase and ended up crashing into a lamppost. I think I almost did it subconsciously – I wanted to get caught.

In prison I had some contact with support services and found out about the damage that crack cocaine does your brain’s dopamine receptors. I learnt that they needed to heal and that’s when I realised that rather than keep going back, I needed to be patient and give my body time to repair. When I left prison I recognised I couldn’t do it on my own and went to R3 to get support. I am so fortunate that I got help because with the road I was on someone could have got seriously hurt and I don’t know where I would be today.

Creating the film Making up 4 lost time was a great experience and a really relevant theme because I lost a lot of time in addiction. Our aftercare group made the film, and working on a project together gave us an opportunity to socialise and combine our skills. We all found it a cathartic process and really helpful. Plus, at the end it was great fun going to the Curzon and seeing our film shown on a big screen.

We used the instructions on the Recovery Street Film Festival website to help us get going. We started with a storyboard and then went out and filmed. An American rapper gave us permission to use his song which was about a mother addicted to drugs and we used this as a basis for our story.

If you’re thinking of entering, don’t be shy. Whatever your idea is or how obscure, just tell your story however you want to. There is no harm in doing it – just go for it!

Two years on, I have just started volunteering with Humankind. I want to get some qualifications and then hopefully work in the field. I am also working on my film for this year!

Recovery Street Film Festival

The closing date for submissions to the 2019 Recovery Street Film Festival is 1 August. The theme is ‘My Recovery Connections’ – who were the individuals, people and communities that have supported you? How did these connections help you on your recovery journey?

More information and tips for making your film at www.rsff.co.uk. Watch Making up 4 lost time on the Recovery Street Film Festival YouTube channel.

Media Savvy

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DDN
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The news,
and the skews,
in the national media

 

Michael Gove is a man who invites a number of opinions, a great deal of them unflattering, even within the Conservative party, but I am yet to meet a Tory MP who sincerely believes that it would have been better for anyone had he spent a decent chunk of the early noughties in prison. Yet the official position of his party, and that of the main opposition, is that it would.

Stephen Bush, Observer, 9 June

Eight out of the 11 Tory leadership candidates have at various times admitted to taking illegal drugs. But all politics is hypocrisy, an edifice of pretence, insincerity and deviousness. The art lies in how you pull it off… The regulation – or non-regulation – of narcotics is quite simply the greatest social curse in modern Britain. It blights every corner of society. Gove should lead a campaign to end the indefensible 1971 Misuse of Drugs Act, and set Britain on the road to reform now being pursued by governments on both sides of the Atlantic. As a former justice secretary, and former drug user, he would be uniquely qualified for the task. At present, eight out of 11 candidates for British prime minister are criminals on the run.

Simon Jenkins, Guardian, 10 June

In this day and age, many people from all walks of life and in all levels of seniority, have experimented with drugs – and politicians are no different. But it shows a certain hypocrisy when they lecture the rest of us about the dangers of substance abuse. However, their experiences will not go to waste if whoever wins No10 launches an open and honest debate about drugs in our society… Only a Royal Commission examining all the facts can establish the right policy for this country. And the next PM should set one up without delay.

Mirror editorial, 9 June

Opponents of legalisation are fond of taking the worst drug scenarios and saying, ‘So you want to legalise that, do you?’ To which the answer is, ‘no’. Much is made of the link between potent strains of cannabis and psychosis, for example, but the fact those strains have spread owes much to their illegality. You could say similar things about crack cocaine and heroin, or Spice, the horrible synthetic cannabinoid that now saturates our prisons. Legalisation of cannabis in some American states has, admittedly, led to a free-for-all, with little focus on regulation of any sort. Starting later, this country could do something more controlled.

Hugo Rifkind, Times, 3 June

Your letters

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DDN welcomes your letters. Please email the editor or post them to DDN, Romney House, School Road, Ashford, Kent TN27 0LT

From the letters page DDN July/August 2019

Welcome dialogue

Molly Cochrane raises some challenging questions around legalisation and regulation in her letter ‘Awkward Facts’ (DDN, June, page 17). Coming up with models for the legal regulation of risky drugs is certainly difficult. My colleagues and I at Transform Drug Policy Foundation have worked for over two decades to try and meet this challenge in a series of detailed publications that outline a range of possible options.

Steve Rolles, senior policy analyst, Transform Drug Policy Foundation
Steve Rolles, senior policy analyst, Transform Drug Policy Foundation

In considering how regulation might work, Molly rightly notes the delicate balance that would need to be struck between keeping prices high, and restricting availability, to dissuade use, and keeping prices low enough, and availability high enough, to dis-incentivise a parallel illegal trade. These are challenges facing both tobacco and alcohol policy and there is no perfect answer. Neither, however, is it beyond resolution: fiscal policy is based precisely on establishing taxation thresholds that achieve precisely this balance for a range of goods.

Transform advocate for optimal legal drug regulation models that minimise social and health harms. In our view, legal regulation – for all its challenges – would achieve this far more effectively than prohibition, whose failures are evident all around us. But that is not to say the regulation of currently legal drugs, such as alcohol, is perfect. Far from it. Indeed, it is entirely consistent to call for better regulation of legal drugs (such alcohol MUP and plain packaging for cigarettes – both of which we support) as well as effective regulation of currently illegal drugs. The destination of optimal regulation is the same, even if the starting point is different.

Finally, Molly cites the case of mephedrone. The unregulated legal NPS market (before the PSA 2016) was nothing like the strictly regulated model we advocate. Furthermore, mephedrone’s emergence was not just because of its legal status (although that was, no doubt, a factor) but significantly due to an MDMA shortage following the ‘successful’ interdiction of almost the entire global supply of a key precursor in 2008. A new illegal MDMA production method was discovered in 2010 – coincidentally when mephedrone was banned in the UK – and by 2011-12 high purity MDMA pills and powder returned to the market. Following this, MDMA’s user base, many of whom were previously displaced to mephedrone, largely returned, both in the UK and elsewhere, even where mephedrone remained legal.

Problems such as those identified by Ms Cochrane are difficult, but they become less awkward when, rather than ignoring or simplifying, we look at them more closely. I and Transform welcome the kinds of challenges that Molly raises in her letter and we look forward to further dialogue to help put in place measures that afford the highest level of protection to consumers using the best regulatory tools we have available.

Steve Rolles, senior policy analyst, Transform Drug Policy Foundation

Counselling credentials

It was a disappointing surprise to read the article on FDAP (DDN, June, page 10), which inaccurately stated that FDAP is the only professional registration body for drug and alcohol workers. This is incorrect. There is also IC&RC UK and Europe, a body that certifies drug and alcohol counsellors in the UK and has done so for over 20 years. It is a UK branch of the worldwide IC&RC 50,000-strong credentialing body and members may apply for reciprocity throughout the world.

We can be contacted at: IC&RC UK, 33 Thurloe Place, South Kensington, London SW7 2H or at info@icrcuk.org

IC&RC UK and Europe Board members

County lines gangs recruiting ever-younger children

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DDN
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Children as young as seven are being exploited by county lines drug gangs, according to a new report from The Children’s Society. While those in the 14 to 17 age range are the most likely to be exploited by the gangs, children of primary school age are being ‘increasingly targeted’, the charity warns.

The number of 10 to 17-year-olds arrested outside London for intent to supply drugs increased by 49 per cent between 2015-16 and 2017-18 to more than 500, while respondents to the report described seven- and eight-year-olds receiving support from the authorities. The number of children trafficked to sell drugs away from their home doubled from 69 to 132 across just 11 police force areas over the same period, figures that were very likely ‘the tip of the iceberg’, said the charity.

While young boys are most at risk, nearly one in six children referred to the National Referral Mechanism for potential victims of modern slavery are now girls. Perpetrators look for children ‘perceived as being naughty’ and who are likely to be ‘easily convinced’, as well as those excluded from school, living in poverty or experiencing family breakdown.

‘Anyone who wants to fit in, to feel less alone or to make money can be at risk,’ says the Children’s Society. The grooming process will usually start with children being asked to look after drugs, weapons or money or to keep watch, it adds, with the gangs increasingly using ‘shift’ patterns to avoid the children arousing suspicion by being missing for too long.

Many police forces and local authorities are failing to record data about exploited children, the charity states, and almost two thirds of councils have no strategy in place for addressing child criminal exploitation. It is calling for more funding to help early intervention and for the children to be treated as ‘victims rather than criminals’. It also urges the Home Office to amend the Modern Slavery Act 2015 to include the definition of child criminal exploitation.

Nick Roseveare: criminals are stooping to new lows in grooming young people

‘This shocking report reveals how cowardly criminals are stooping to new lows in grooming young people to do their dirty work and in casting their net wider to reel in younger children,’ said Children’s Society chief executive Nick Roseveare. ‘Children are being cynically exploited with the promise of money, drugs, status and affection and controlled using threats, violence and sexual abuse, leaving them traumatised and living in fear.

‘Yet the response from statutory agencies is too often haphazard and comes too late and a national strategy is needed to help improve responses to child criminal exploitation. This should mean better early help for children and training for professionals, access to an advocate to ensure all children are supported as victims, and a greater focus on disrupting and bringing to justice the perpetrators who are exploiting them.’

Counting lives: responding to children who are criminally exploited at www.childrenssociety.org.uk – read the report here

Broadreach House announces closure

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DDN
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It was announced that Broadreach House in Plymouth was to close due to lack of funding on 5 July 2019.

The facility had launched a crowdfunding campaign to raise £250,000 to ‘enable us to continue to provide excellent and effective support to those in greatest need facing addiction’, but had fallen short of the amount needed. 

Broadreach House Rehab which closed on 5.7.2019

A statement on the Broadreach House Facebook page read that ‘it is with the deepest regret that we write this post to inform you of the closure of Broadreach House, including Broadreach our male only detoxification and residential service and Longreach our female only detoxification and residential service.’

Broadreach House had ‘survived many years of turbulence due to underfunding’, it said, but had finally ’found ourselves in a situation where we have no other option but to close our services’.

Staff had forfeited part of their salaries ‘in a concerted effort to continue trading’, it continued, with the added irony that the facility was currently at full capacity, with demand for its services greater than ever.

Read a selection of the Facebook comments on the closure of Broadreach House below: 

Rose Chitseko Very sad and also angry that such a valuable service, which literally saved my daughter’s life, is having to close. What an enormous waste of extremely talented, compassionate staff and wonderful people generally, needed as much now as ever.

Sally Pullyblank So sad to hear this news, broadreach helped my family when we were in such a desperate time with my mum, unfortunately she never recovered but I will never forget the place as a young teenager and the support that was offered to her I felt it was our only chance at the time. What happens now to all those families who are desperately seeking help for their loved ones! So very very sad. 

Amy Schmamy I did my student placement at Broadreach in 2011 then worked as a support worker for a year. Still one of the best jobs I’ve ever had! I learned so much and loved all the staff. Met some really brave, interesting and inspirational residents too. So sad to hear you are closing, your work is so valuable – you’re saving lives. 

Nik X Read this is such sad news, I had the pleasure of working at BR and thoroughly enjoyed my time with all the caring staff & have some great memories – this is a loss of a quality facility for so many service users who rely on this rehab centre to rebuild their lives.

Shelby Sheridan Absolutely devasated to be told this news. I’ve been here over a year and have loved every moment. I’m gutted that both units are closing and I wish everyone there – staff/clients – all the best. x

Ivanna Bedani I’m absolutely heartbroken. This wonderful organisation saved my life, saved and healed my family’s pain and helped me make the best start possible to build a happy healthy and productive life. I am forever grateful for the hard work care support and effort of everyone who worked there. Xxx

Kelly Budd I honestly feel sick reading this – I can’t believe that such an amazing service has fallen by the wayside this way. The staff are (and always have been) truly amazing, and the number of incredible individuals who took their steps on the path to recovery at this service should be proud of themselves and the changes they made. It is such a shame that no more clients will pass through its doors. Goodbye Broadreach!

Mandy Lea So sad to hear this, you saved my life along with many others. Will never ever forget, so sad. xx

Find out more at www.broadreach-house.org.uk

Mount Carmel Chairman awarded Rehab Chair of the Year

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Bill Hughes, the Chair of the South London alcohol rehab Mount Carmel, has been honoured as ‘Rehab Chairman of the Year’ at this year’s UKESAD Addiction Recovery Conference.

Bill Hughes and fellow award recipient Huseyin Djemil
Bill Hughes and fellow award recipient Huseyin Djemil

The ‘DB Recovery+ McLean Deconstructing Stigma Awards’, were given at a glitzy, invitation-only dinner at the Tower Hotel. The awards went to, among others, a member of the House of Lords, a US Professor, an eminent psychiatrist, the government Recovery Champion – and the Chair of Mount Carmel. 

Bill Hughes told us: ‘I felt very honoured to be among such names, and I’m very grateful to the organisers, Deirdre Boyd of DB Recovery and Jim Holsomback of the McLean Hospital. I think it’s hard to split me out from the rest of our management team, and we are a team, so I take this award on behalf of all of Mount Carmel. I got sober there, I’ve been doing what I can there for 25 years, so I know what great work we get the opportunity to do.

‘And I also accept it on behalf of all the small, independent, affordable, not-for-profit residential rehabs who are working very hard, putting the clients first, and dedicated to their abstinent recovery. There are many approaches to addiction treatment across the UK, but I am very pleased to be working in this particular sector.

‘We’ve never faced a greater existential threat than we face now. The reduction in local authority funding caused by “austerity”, has already closed some 50 rehabs like ours in recent years, and it’s very sad that one more closed this week. At the same time, we have never been faced by a greater need for treatment than we face now. Addiction is a health issue and not a moral issue, yet treatment in the UK is now inaccessible to many who need it.

‘The country depends on residential rehabs to be there when other interventions fail. There are interventions that are less intense than ours that can be used to address alcoholism – drink diaries, controlled drinking, attendance at day centres. Many of our clients have been through these, and they have not worked for them. When all else has failed, it’s been proved that the only solution is intensive residential rehab. After that there are no more answers. We are the last hope for the helpless.

‘One glimmer of light at the end of the tunnel is that more people are funding their own treatment. In some ways this is wrong, in that addiction should be funded as a public health issue. But that’s not how it is, and in reality some people can get treatment only if they fund it themselves. And the good news is that people often find treatment is more affordable than they feared, that they can raise the funding, and we see this happening more and more.’

‘The final point that I would make is that recovery, solid, abstinent, progressive recovery, is wonderful. It reaches every part of the recovering alcoholic’s life – family, friends, work and the rest. We don’t just get better – we get better than better!’

Find out more about the work of Mount Carmel at www.mountcarmel.org.uk

Delivering the DARS service at HMP Liverpool

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DDN
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Sandra Dutton, Prison Manager at the Change Grow Live Drug and Alcohol Recovery Service, (DARS) shares the highlights of her first 12 months working at HMP Liverpool. The service is delivered in partnership with Spectrum and Mersey Care under the banner of Better Health Liverpool.

Change Grow Live Drug and Alcohol Recovery Service has come a long way in the last 12 months, with a new staffing structure and new roles including Connecting Community Engagement Worker, Engagement Recovery Coordinator, Service User Involvement Lead, Peer Mentor and Volunteer Coordinator. 

These roles are linked with all departments across HMP Liverpool. As a busy local prison, we focus on service users whose behaviour may be difficult to manage and need additional support on release. Our workers are on hand at reception and on the segregation unit, offering help to people who often have long histories of substance misuse and offending.

We have encouraged the whole team to help shape our service; through running workshops and groups, family remembrance groups – providing space for close families to spend quality time together, community engagement and increased service user involvement.

Find out more and read the full article at www.changegrowlive.org

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by CGL, and first appeared on www.changegrowlive.org

 

Optimising our work in an uncertain time

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DDN
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How treatment systems can respond more effectively to the needs of people who use opiates

Paul Townsley, Humankind Chief Executive
Paul Townsley, Humankind Chief Executive

On the 14th June I had the privilege to speak on a webinar at the Expert Faculty Academy on how treatment systems can respond more effectively to the needs of people who use opiates within the context of the current challenges we face; so that we can continue to modify our approaches based on what we know works and making full use of the new medications becoming available.

Put simply, I believe that we badly need stable funding and commissioning so that we can provide much more effective interventions to the people who need our services.

A critical part of this process requires us to properly articulate how the challenges we experience affect the communities we serve; once this shared understanding has been reached, we can transparently agree and prioritise what we can deliver to as many people as we can.

In recent years, Humankind have managed multiple integrated drug and alcohol systems. There are some areas where we have been working for a long time and other areas where we have come in as a new provider. Often implementing significant changes to the services being delivered at a time of considerable reductions in funding. In real terms, we have been working with 25 to 50% reductions in funding for our services, but as importantly are the similar cuts being imposed upon other essential health and social care services. It’s generally agreed by most people of any political persuasion, whether they are the general public or in decision-making roles, that the reductions have gone too far, and, furthermore that we desperately need to facilitate our communities and service providers to be able to work differently to have a much greater impact.

Read the full article on Humankind’s Blog.

 

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by Humankind, and first appeared on 

www.humankindcharity.org.uk

 

Why I run a support group for LGBT+ youth

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DDN
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“This is necessary because they tell us it’s necessary”

Why I run a support group for LGBT+ youth.

By Phil McClure, Multi Skill Young Person Worker at Addaction Halton

One of the people I work with, a young trans woman, initially came to us in year 10 and was having a terrible time at school. She struggled with all the issues you often read about young trans people facing — the girl not allowed to wear a dress to her prom.

She’s attended GLOW, our LGBT+ youth group in Halton, for longer than I’ve run it. My background is in youth work, often working on projects aimed at tackling prejudice and discrimination. But mostly it was that I had Tuesday nights free.

Every week we run two back to back sessions at the local youth and community hub, one for 11–16 year olds and one for 16–24 year olds. For the first half hour people drift in. They get a cup of tea or some toast, chatting about their week. Often we do much of our best work in this time. It gives young people the chance to talk about things that matter to them, as well as for staff and other young people to provide support.

This peer to peer support is really important. Many young people attend for the first time because they feel isolated. We notice they’re generally really supportive of each other and happy to share their experiences. Some topics come up time and again — I can’t tell you how often we respond to conversations about inflexible school uniform policies or gendered changing facilities. Where we can we listen, support and encourage young people to build their own strategies for dealing with the challenges they face.

Read the full article on Addaction’s Blog.

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by Addaction, and first appeared on

https://medium.com/addaction-voices/

‘Biased’ classification fuelling drug problem, says Global Commission

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DDN
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Biased historical classification of psychoactive substances has been a significant contribution to the world drug problem, according to a new report from the Global Commission on Drug Policy (GCDP).

While drug classification remains the ‘cornerstone’ of the UN Conventions underpinning international drug control, it continues to be influenced by ideology, political gains and commercial interests, says Classification of psychoactive substances: when science was left behind.

The international classification of drugs now has little or no correlation to scientifically assessed harms and needs to be ‘urgently reviewed’, the document states. While drugs should be classed according to their potential for dependence and other harm this is ‘not the case today’, it says. The fact that substances such as alcohol are ‘culturally important’ means they are legally available, while others are strictly prohibited with ‘tragic consequences’ including executions, organised crime and blood-borne viruses.

The international community needs to recognise the ‘incoherence and inconsistencies’ in the drug scheduling system, it says, and launch a critical review. The commission is calling on governments to ensure that their classification systems are pragmatic and based on science and evidence, and also allow for ‘responsible legal regulatory models’ to control drugs.

Ruth Dreifuss: Drug classification does not represent current knowledge.

‘The international system to classify drugs is at the core of the drug control regime – unfortunately that core is rotten,’ said GCDP chair and former president of Switzerland, Ruth Dreifuss. ‘Some drugs were evaluated up to eight decades ago – which does not represent current knowledge – and others have never been evaluated.’

‘The European colonial powers resisted the imposition of stricter prohibition because they had profitable monopolies in the trade of opium, coca and cannabis in their overseas territories,’ added former President of Brazil Fernando Henrique Cardoso. ‘It was only when they “lost” their colonies and that trade that a global regime focused on prohibition was established under US pressure. Traditional uses of opium and coca were no longer profitable to the western world and therefore forbidden – often disregarding centuries-old practices and the cultures behind them, and criminalising the behaviour of millions of citizens.’

Report at www.globalcommissionondrugs.org – read it here

 

NHS to open young persons’ gambling clinic

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DDN
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The country’s first NHS gambling clinic for children is to open this year, NHS England has announced.

The move is a response to ‘growing concern that the scourge of problem gambling is being fuelled by online gaming sites and targeted adverts’.

According to the Gambling Commission, around 55,000 children can be classed as having a gambling problem, while 450,000 are regular gamblers – a higher number than those who have drunk alcohol or taken drugs (DDN, December/January, page 5).  

The clinic will form part of a growing network of services for people with gambling issues being developed as part of the NHS Long-Term Plan (DDN, February, page 5). So far, specialist face-to-face treatment for gambling addiction has only been available on the NHS in London, but the plan will see the establishment of up to 14 new clinics, starting with the NHS Northern Gambling Service in Leeds, and followed by services in Manchester and Sunderland. London’s National Problem Gambling Clinic will also offer specialist help to young people aged 13 to 25 as well as expanding its services for adults. The services will each have psychiatrists and clinical psychologists, and will offer ‘faster access to specialist, evidence-based services’.

‘This has the potential to be a major turning point and it is all about making sure the NHS does everything it can to help people of all ages, who are seriously addicted to gambling,’ said NHS England’s national director for mental health, Claire Murdoch. ‘There is already a big push to transform mental health services across the board for children and young people and the specific focus on gambling-related addiction is the logical next step, particularly given the explosion of online gambling.’

‘The links between problem gambling and stress, depression and mental health problems are growing and there are too many stories of lives lost and families destroyed,’ added NHS England chief executive Simon Stevens. ‘This action shows just how seriously the NHS takes the threat of gambling addiction, even in young people, but we need to be clear – tackling mental ill health caused by addiction is everyone’s responsibility – especially those firms that directly contribute to the problem. This is an industry that splashes £1.5bn on marketing and advertising campaigns, much of it now pumped out online and through social media, but it has been spending just a fraction of that helping customers and their families deal with the direct consequences of addiction.’

NHS England chief executive Simon Stevens
NHS England chief executive Simon Stevens

A recent paper in the BMJ called for a compulsory levy to be placed on the industry to fund support for those needing help, as well as responsibility for gambling issues to be transferred to the Department of Health and Social Care (DDN, June, page 5).

‘The sums just don’t add up and that is why as well as voluntary action it makes sense to hold open the possibility of a mandatory levy if experience shows that’s what’s needed,’ Simon Stevens continued. ‘A levy to fund evidence-based NHS treatment, research and education can substantially increase the money available, so that taxpayers and the NHS are not left to pick up a huge tab.

 

 

 

We’ll introduce mandatory alcohol labelling, says Labour

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DDN
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Alcohol labelling that includes up-to-date drinking guidelines and nutritional information would be mandatory under a Labour government, according to shadow health secretary Jonathan Ashworth. ‘Tackling alcohol abuse must be at the heart of the prevention agenda yet there’s more nutritional information on a carton of milk than a bottle of wine,’ he told Alcohol Change UK’s annual conference.

Despite being introduced three and a half years ago (DDN, February 2016, page 4) as of last year only 16 per cent of people were aware of the government’s revised low-risk drinking guidelines (DDN, February 2018, page 5), with many products still referring to outdated limits or having no guideline information at all.

Research by the Alcohol Health Alliance last year found that 67 per cent of people thought that the government should be responsible for ‘communicating the health risks and harms associated with alcohol’, whereas under the current system labelling information is subject to self-regulation by the alcohol industry.

Jonathan Ashworth: voluntary approach is not fit for purpose

This voluntary approach was ‘simply not fit for purpose’, said Mr Ashworth. ‘The industry hasn’t moved at a pace to keep up with consumers’ expectations. It’s an utter abdication of responsibility for government to task the chief medical officer with updating the guidelines and then not oblige the industry to display this vital information on their products.’ Alongside the guidelines, a Labour government would also make labelling information on unit content, pregnancy warnings and nutritional information compulsory, he said.

Richard Piper: Alcohol industry is being allowed to pick and choose on labelling

‘Alcohol producers are being allowed to pick and choose what information to include on their labels, and it is consumers who lose out, as we are not being given the information we need to make informed decisions about our drinking,’ said Alcohol Change UK chief executive Dr Richard Piper. ‘The alcohol industry’s interests are being placed above the health of citizens. We hope that the government also makes the common-sense commitment to make improved alcohol labelling mandatory.’

Meanwhile, a new report from the Monitoring and Evaluating Scotland’s Alcohol Strategy programme (MESAS) shows that the percentage of alcohol sold below 50p per unit in Scottish off-licences and supermarkets last year was half that sold in 2017. Minimum pricing of 50p per unit was finally introduced in Scotland last May, following a lengthy legal battle.

Last year also saw the lowest total volume of pure alcohol sold per adult in Scotland since records began in the mid-’90s, at 9.9 litres per week or 19 units. However, this still remains almost 10 per cent higher than figures for England and Wales.

‘With the implementation of minimum unit pricing in May 2018 we’ve seen a substantial fall in the volume of alcohol being sold at very low prices, along with the biggest rise in the average price of alcohol sold through supermarkets and off-licences in a decade,’ said public health intelligence adviser at NHS Health Scotland, Lucie Giles. ‘The report also shows that population level alcohol consumption, based on sales, is at an all-time low in Scotland.

Alcohol off-sales in Scotland have been declining since the start of the decade, however. While it was not possible to ‘quantify the full contribution’ of minimum pricing there were ‘encouraging’ early indicators, said Ms Giles. ‘We know that alcohol remains a significant public health issue and people in our poorest areas continue to experience the most harm. This is unfair and it is preventable, like all harm caused by alcohol. By monitoring and evaluating Scotland’s alcohol strategy, we can continue to gauge progress, and understand what works to reduce the harm it causes.’

MESAS monitoring report 2019 at www.healthscotland.scot/

 

 

 

 

 

Number of over-40s in opiate treatment triples in a decade

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DDN
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The number of people aged over 40 in treatment for opiate use has tripled in little over a decade, according to a report from the ACMD. The number has risen from approximately 25,000 in 2006 to more than 75,000 last year.

However, the number of under-30s in opiate treatment has fallen from around 60,000 to just 13,000 over the same period, the document states. By 2017-18, only 9 per cent of ‘treated opiate users’ were under 30, while 38 per cent were in their 30s and 53 per cent were over 40. ‘Notably’, 16 per cent were over the age of 50, the report states. The rise in over-40s seeking treatment is ‘raising fears that ageing opiate users with complex needs will come to dominate demand on substance misuse services in future’, says ACMD.

Owen Bowden-Jones: ageing cohort is likely to dominate future demand

Despite having ‘multiple additional risk factors’ as a result of worsening  physical and mental health, ageing opiate users are less likely to have access to the resources they need, the document says. Reasons for this can include difficulty in navigating complex health and social care systems and experience of stigma, raising concerns that the group is being failed by services.

‘Specialist community drug services are insufficiently prepared to manage the complex needs of this ageing cohort, despite the increase in older drug users attending for treatment,’ says ACMD.

The council is calling for a comprehensive assessment of the ‘current skills, treatment and support’ to address the complex physical and mental health needs of this cohort, as well as ongoing analysis of treatment demographics and drug use patterns among older people.

‘This ageing cohort is likely to dominate future demand on substance misuse facilities, which is why more needs to be done now to help these people access services that meet their needs,’ said ACMD chair Dr Owen Bowden-Jones. ‘Government, commissioners and services need to urgently re-assess how to best manage the complex needs of this ageing group.’

Ageing cohort of drug users at www.gov.uk – read it here

 

 

 

 

Camino Recovery – A view to recovery

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Camino Recovery proudly celebrate ten years on the Costa del Sol this year in their new home – a stunning cortijo in the Andalucian hills around Velez-Malaga.

Comino Recovery
From left to right: Loren Eden, administration manager; Meena Lavender; Ameet Braich and Don Lavender.

Borne out of family experiences and a desire to be unencumbered by anything other than the wellness of their clients, Meena Lavender and husband Don – together with Meena’s son Ameet and daughter Tanya – established Camino Recovery Centre on the Costa del Sol, and its doors opened on 1 January 2009.

The centre’s first home was in San Pedro, West of Malaga and the driving force was to create somewhere that was different. It was important that the experience for their clients was intimate and safe.

The family brought a wealth of experience to the table. Don has nearly 40 years experience in the field and was an early pioneer of Equine Assisted Psychotherapy (EAP) in both America and Europe. He has worked in some of the leading treatment centres worldwide.

Ameet Braich was trained at the world-renowned Hazelden Centre in Minnesota and passed his addictions counselling masters summa cum laude. He has spent the last ten years nurturing Camino and developing it into what it is today.

Meena Lavender brings a wealth of personal experiences and is the business acumen behind Camino. She specialises in supporting families throughout the process and also in Eye Movement Desensitisation Reprocity (EMDR).

Together they have created a unique family atmosphere among staff and clients alike. The intimacy and size of Camino means that a bespoke programme is created for each client that is best suited to them achieving recovery.

Camino’s new home affords clients a level of comfort conducive to their healing.  The team has brought together a collection of experts in their field, from the chefs and the yoga instructor to the masters qualified clinician.

Find out more at www.caminorecovery.com or call +34 951107195

Don’t release prisoners on a Friday, urges ACMD

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DDN
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The UK’s prison services should take steps to avoid releasing prisoners with complex needs on Friday afternoons, says a new report from the Advisory Council on the Misuse of Drugs (ACMD).

More than a third of prisoners are released on Fridays, which makes it more difficult for them to access drug treatment or stable housing, or make connections with probation services or job centres, says Custody-community transitions. It also increases the risk of relapse or overdose, which is particularly high in the first weeks after release.

More than 11,000 people were released on a Friday from prisons in England and Wales in the first six months of 2018, as this includes prisoners whose release dates fall on a Saturday, Sunday or bank holiday Monday. ‘People often have to attend several appointments on their first day of release,’ the document says. ‘If these appointments are missed on a Friday, then the person may be left for the weekend with no housing, no money and no drug treatment. These are circumstances in which relapse to drug use and offending are highly likely to occur.’

In 2017-18, just 12 per cent of prisoners with an opioid problem left prison with naloxone, the report adds, while more than a third of prisoners were released without settled accommodation. Less than a third of those with substance issues entered community treatment on release.

The prison and probation service should improve levels of individual, face-to-face support available to those prisoners preparing for release, the ACMD urges, while government should also take steps to reduce the number of transitions from prison, including by cutting short sentences.

Owen Bowden-Jones: ‘Substantial harms’ occur between custody and community

Adults serving sentences of less than a year in England and Wales had a reoffending rate of more than 64 per cent between April and June 2017, with rates likely to be ‘even higher among those with a drug problem’. The opportunity of custody to ‘reduce drug problems and offending’ was often being ‘squandered’ by failure to provide support on release, the council adds.

‘This report identified the substantial harms suffered by those with drug dependency as they transition between custody and the community,’ said ACMD chair Dr Owen Bowden-Jones. ‘It is paramount that the government makes sure more is done to help prevent vulnerable people from relapsing after their release from prison.’

Read the report here at www.gov.uk

More on prisons here

 

Five things we did to help more people carry naloxone

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DDN
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Putting naloxone at the forefront of everything we do has saved lives

Naloxone packaging

By Caroline Liney, Operations Manager at Addaction Cornwall

The opioid overdose reversal drug naloxone saves lives. It’s vital that anyone who’s at risk of overdose, or who interacts with people who are, carries naloxone and is trained in how to use it. But during 2017 and early 2018 people who used Addaction’s services in Cornwall were much more likely to reject carrying the drug than accept it.

Since then we’ve ripped up our old methods. We’ve put naloxone at the forefront of everything we do, resulting in our highest acceptance rate ever. Based on what we learnt along the way, here are our five tips for any drug treatment service looking to do the same.

Make people opt out rather than opt in

Previously we treated naloxone as an added extra to treatment. Staff would ask clients and family members questions like, ‘would you like naloxone?’ or ‘would you like naloxone training?’.

Now anyone who’s at risk of an opioid overdose, or knows someone who is, is given naloxone when they interact with us. Staff say, ‘here’s your naloxone and this is what you do with it’, rather than waiting for some to ‘opt in’. Recently, a staff member joked that our slogan should be — ‘naloxone, naloxone, naloxone’- a testament to how it’s now an essential part of our service.

Read all five ways and the full article on Addaction’s Blog.

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by Addaction, and first appeared on

https://medium.com/addaction-voices/

NHS Substance Misuse Providers Alliance 2019 conference

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DDN
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NHS SMPA Conference 2019: Alcohol Treatment Reduced Demand or More Hidden Harm?

 

9th September 2019 – Sheffield Hallam University

Price: NHS Substance Misuse Providers Alliance  Early Bird Ticket price of £60 special will be available until the 21st June, 2019.

After this date, Standard Entry tickets will be available for £80 per person. Tickets include lunch, refreshments, access to all talks and the opportunity to attend one of the three workshops.

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This year’s conference will bring together a range of expert speakers who will be sharing their innovations and expertise, offering insight and reflections on how we can more effectively engage and then provide support and treatment for those negatively affected by their use of alcohol. This includes those directly affected, but also people who are affected by someone else’s drinking.

Looking at this from both the perspective of the population and as individuals, how do we address the fact that we know the number of alcohol users who access services is far less than we would expect and how do we reverse and ensure we have the capacity to meet this need?

This NHS Substance Misuse Providers Alliance conference will include presentations and workshops from experts in this area of work alongside examples of best practice.

NHS Substance Misuse Providers Alliance conference booking button

Read the report of last year’s event in July 2018 DDN Magazine.

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by NHSSMPA, and first appeared on www.nhssmpa.org

 

Addiction Awareness Week: Sixty per cent of Britons know someone with addiction issues

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DDN
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Sixty per cent of British people know someone with an addiction problem, according to a YouGov survey commissioned by Action on Addiction and published to mark Addiction Awareness Week on 10-16 June (DDN, June, page 17). More than two thirds also believe there should be more support for people with addiction issues, and 70 per cent that there should be more support for their families.

Graham Beech: Most people know someone who has suffered with an addiction.

More than a quarter of respondents said they had a relative who had suffered from an addiction, while of all those who knew someone with a problem, alcohol was the most cited substance (73 per cent of cases). This was followed by nicotine (40 per cent) and illicit drugs (35 per cent), while almost a quarter of respondents knew someone with a gambling addiction.

The research also highlights how spending on drug and alcohol treatment has fallen from £877m in 2013-14 to £716m in 2017-18, with the reduced funding levels ‘estimated to have contributed to a rise in addiction-related deaths’.

‘This poll highlights the widespread and far-reaching impact of addiction,’ said Action on Addiction chief executive Graham Beech. ‘The survey shows that most people (60 per cent) know someone who has suffered from an addiction – a relative, a friend or a work colleague – and think that more support should be done to support people affected by this life-stopping condition which appears to be growing in both scale and complexity.

‘Unfortunately, this comes at a time when society’s ability to address the problems associated with addiction is diminishing and people are finding it more and more difficult to access the treatment they need.’

Read Graham Beech’s article in the latest issue of DDN

Addiction Awareness Week is from 10-16 June. Share your events on Facebook and Instagram with the hashtag #addictionawarenessweek.

 

 

 

DDN Conference 2022 Programme

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DDN
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DDN Conference 2022 – Programme and timings

Please see below for details of speakers and session timings for this year’s conference. We hope you will enjoy the presentations and find them interesting and informative. There will be chance to ask questions and find out more about all of the projects both during the sessions and in the exhibition area.

9.00–10.00am registration and refreshments

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10.00–11.30am Session one

The state of the sector: Rosanna O’Connor, OHID

An update on the impact of the Carol Black report and recent funding announcements, and the implications for people with lived experience.

Female focused services: Nic Adamson, executive director, Change Grow Live 

We need to listen to women to understand the barriers they’re facing – and to see the things we can all do to make a difference.

Engaging BAME communities: Sohan Sahota and David Thomas, BAC-IN

Sharing the innovative work of BAC-IN, a grassroots service inspired by lived experience, to engage BAME communities. 

Fairness at work: Rebecca Odedra, head of reintegration at WDP, and Kim Archer, health and employment programme commissioner at West London Alliance

Getting back into paid employment through the right support, using the Individual Placement and Support (IPS) model. With filmed contributions from service users, Rebecca and Kim explain how their project supports people to enter a competitive job market and overcome barriers to employment

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11.30–12.00pm Tea, coffee and refreshments

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12.00–1.00pm Session two

THE POWER OF COMMUNITY

Together for wellbeing: Social Interest Group’s Roots Project

Looking at ways that a community garden project has helped bring people together and improved individuals’ wellbeing and mental health.

Call for unity: Ed Day, recovery champion

Ed Day is a clinician, researcher, expert advisor – and the UK government’s recovery champion. He believes strongly in a united approach and that there is no one path to recovery.

Lived experience matters: The College of Lived Experience (CLERO)

CLERO share their work in creating a network of lived experience recovery organisations (LEROs) based on quality standards, which equip members to overcome stigma and have equal opportunities in the workplace. Featuring a presentation by Peter Yarwood of Red Rose Recovery.

1.00–2.30pm Delicious lunch, networking, and a chance to enjoy the exhibition

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2.30–5pm Session three (with tea/coffee available)

PEER POWER

Dynamic outreach: Medway Hope

How partnership working between services and peers has delivered naloxone and other vital harm reduction interventions in the community and increased engagement with treatment services.

A hand up: The Hepatitis C Trust

Sharing how their peer-to-peer education (P2P) programme delivered by people with lived experience of hepatitis C increases testing numbers and the likelihood of diagnosed patients going on to access highly successful treatment. 

In it together: Sandwell Project SCORE

How outreach work by active drug users and people with lived experience and local knowledge has been highly effective in engaging hard to reach groups.

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Peer-led partnerships for people who use drugs

A dynamic session led by Mat Southwell of EuroNPUD, who are coordinating this initiative on behalf of drug user groups in England, Scotland, Wales, and Northern Ireland.

The session will focus on the development of quality standards in different areas of peer-led harm reduction. The goal is to create a common set of quality standards that providers, commissioners and peer teams will all commit to work to, regardless of who holds the local contract.

Panel – 30 mins:
The panel of speakers introducing the session will be short 5 minute stimulating opening reflections intended to open working group discussions:

1) George Charlton – Building peer work teams that distribute Naloxone
2) Magdalena Harris – crack pipes and stimulant harm reduction. 
3) Danny Morris – Hep C Elimination and increasing access to P2PNSP 
4) Duncan Hill – OAT Client Guide (Adam Winstock – SODA)
5) Global Peer Work Consultation video  –  cartoon description of event process and recommendations.

Working groups – 30mins:
  1. Building on P2PN to create P2P low threshold access to drug services
  2. Stimulant harm reduction
  3. The role of peers in HCV elimination – testing, treatment and prevention 
  4. OAT Literacy and Rights – new tools to support therapeutic alliance and rights in drug treatment
  5. Working towards the GPWC recommendations in the UK
Feedback from working groups
Chaired by Mat Southwell

 

All welcome, and all encouraged to participate and help mobilise a vital upgrade in harm reduction through peer networks.

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5.00pm Conference Close

Seizures of cocaine at ‘record levels’ in Europe

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DDN
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Europe is seeing record levels of seizures of cocaine, says the latest European drug report from EMCDDA. Availability of the drug is continuing to increase, along with that of other substances. Over 1m seizures of illegal drugs are now reported on the continent each year, with 55 new NPS also detected for the first time in 2018, bringing the total number being monitored by EMCDDA to 730.

CocaineBoth the number of seizures of cocaine and the quantities being seized are at record levels, with more than 140 tonnes seized in 2017 – double the previous year’s total. The growth in large-volume trafficking via maritime shipping containers is ‘a major challenge’, says the agency, with the drug’s purity at street level now also at a record high. Cocaine remains the most commonly used illicit stimulant in the EU, with around 2.6m 15-34-year-olds using it in 2017.

The number of people accessing treatment for cocaine for the first time also increased by 37 per cent between 2014 and 2017, and cocaine is now the substance most commonly reported in drug-related emergency hospital presentations in Europe.

EU seizures of heroin also increased in 2017, while the following year saw 11 new synthetic opioids detected, six of which were fentanyl derivatives. ‘With only very small volumes needed to produce many thousands of street doses, these substances are easy to conceal and transport, representing a challenge for law enforcement and customs,’ says the agency.

Alexis Goosdeel: ‘challenges continue to grow’

‘The challenges we face in the drugs area continue to grow,’ said EMCDDA director Alexis Goosdeel. ‘Not only are there signs of increased availability of established plant-based drugs like cocaine, but we are also witnessing an evolving market where synthetic drugs and drug production within Europe are growing in importance. This can be seen in problems associated with the use of highly potent synthetic opioids, in new production techniques for MDMA and amphetamines, and in recent developments in the processing of morphine into heroin inside Europe’s borders.’

 European drug report 2019: trends and developments at www.emcdda.europa.eu

Read more on increase of cocaine use in DDN.

 

 

Prison safety under threat from rising NPS use

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DDN
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The rise in NPS use in prisons has had a serious impact on safety, with increasing rates of violence and self-harm, says the annual report of the Independent Monitoring Boards (IMB). As well as their impact on health and behaviour, drugs have produced an ‘alternative power structure, based on debt, bullying and intimidation of prisoners, their families and sometimes prison staff’, the document states.

NPS packages of the type used in prisonThe prison system in England and Wales is now in a state of ‘fragile recovery’ following a lengthy period of increased drug use and violence combined with staffing problems and inadequate rehabilitation opportunities, it says. While some new measures such as the government’s prison drug strategy (DDN, May, page 4) were showing ‘signs of promise’, it was too early to say if they would have any sustained impact, said IMB chair Dame Anne Owers. There were also significant concerns around the number of prisoners with serious mental health conditions who were being held for lengthy periods in prison segregation units.

Every prison has an IMB, with boards ‘across all kinds’ expressing serious concern about the availability of drugs, particularly NPS. HMP Guys Marsh in Dorset saw an average of one NPS-related incident per day last year, while HMP Humber had an average of ten per week in 2017. In one month at HMP Wayland 41 prisoners were under the influence of NPS, of whom 26 self-harmed and five needed to be taken to hospital. At HMP The Mount in Hertfordshire, a drug recovery wing had to be shut down because there were ‘too many drugs’ – when it was moved to another wing, ‘the drugs, bullying and violence moved with it’.

Dame Anne Owers talks about prison NPS
Dame Anne Owers: Decline in prison safety has ‘seriously hampered their ability to rehabilitate prisoners’.

Incidents of reported violence have also increased in ‘every part’ of the closed prison estate, the report notes, from local prisons to high security establishments. Boards in almost all local prisons had reported significant rises in violence and assaults, and rates had doubled in Bedford, Belmarsh, Durham and Wandsworth. Birmingham, meanwhile, had ‘stabilised’ at the level of 120 assaults per month. Boards at women’s prisons were also reporting more problems with synthetic cannabinoids, though to a lesser extent than NPS use in men’s prisons.

‘There is no question that IMBs are still reporting some serious and ongoing problems in prisons,’ said Dame Anne Owers. ‘The decline in safety, conditions and purposeful activity in prisons over the last few years has seriously hampered their ability to rehabilitate prisoners. This will take time to reverse, and will require consistent leadership and management both in the Prison Service and the Ministry of Justice, as new staff, policies and resources bed in.’

IMB national annual report 2017/18 is at www.imb.org.uk – read it here

 

An interview with John Kneale – Volunteer at Achieving Change Through Employment

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DDN
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John Kneale

 

How do you help the Achieving Change Through Employment (ACE) project?

I help refugees to integrate into their new community. I do this by helping them learn the language and get used to talking in English. I help my mentee by providing professional and friendly face-to-face contact. By helping my mentee improve his English it has had a variety of benefits. He is now confident and able to access local services, go shopping, send a letter, go on a bus and more. Hopefully, with some more support, he can get work. These benefits help my mentee to feel independent again.

What does your role involve?

I meet my mentee every week. I support him by helping him practice conversational English. He learns at college, but he practices away from the classroom with me.

How would you describe the team?

The ACE team recruited me and trained me and now offer ongoing support. They have all been fabulous, extremely supportive, cheerful, positive and helpful. I get regular supervision which reassures me that I am supporting my mentee well. It also means I and get help to improve my own skills and abilities.

Read the full interview at www.changegrowlive.org

 

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by CGL, and first appeared on www.changegrowlive.org

 

The hidden generation of drinkers

By
DDN
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People over 50 are using alcohol as a way of dealing with factors like divorce and bereavement. We need to show them they aren’t alone.

By Nye Jones, Editor and Features Writer at Addaction

Growing up in South Wales, alcohol has always played a part in Vince’s life. Initially it was a supporting role, drinking when going out in Cardiff on a Saturday night or a couple of beers to unwind after working long shifts as an Aerospace technician. But after suffering a traumatic knee injury playing rugby, alcohol started to take centre stage. Despite having two operations in the early noughties his knee continued to give way when working long shifts, with the pain getting worse. It was at this point the “dynamic changed from social drinking to having a drink to deal with the pain”.

Eventually in his early 50s Vince left his job and faced with long lonely days at home, his alcohol use increased. “It was mainly drinking at home, having a drink at lunchtime to get through the afternoon and then drinking in the evening to numb the pain”.

Read the full article on Addaction’s Blog.

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by Addaction, and first appeared on

https://medium.com/addaction-voices/

A day in the life of a Volunteer

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DDN
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A day in the life of a Volunteer – Catherine from South Yorkshire Appropriate Adults

“I received a call from the Appropriate Adult Scheme Project Manager, at 11am regarding a request from South York’s Police. An Appropriate Adult needed to attend Doncaster Custody Suite to support a 39-year-old male (Brian*) with autism and learning disabilities. He had been arrested on suspicion of Criminal Damage and Section 4 Public Order Act.

At first, I thought it would be pretty straight forward. Then I was informed that Brian had told custody staff he would assault the adult and solicitor and had been hostile and aggressive. I was starting to worry about how I would handle the situation.

My Project Manager and I discussed strategies to minimise the risk of harm to ensure my safety was paramount. For example, I would not have a private consultation with Brian – but introduce myself briefly and explain my role with police officers present. Although I had been through the risk assessment, I still felt anxious but was grateful I had the time to think things through and think of possible situations that might arise.

Read the full article at www.changegrowlive.org

 

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by CGL, and first appeared on www.changegrowlive.org

 

Brand New Day

By
DDN
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Dr Ed Day has just been appointed as the government’s drug recovery champion. He talks to DDN about the challenges and opportunities of the new role.

Dr Ed Day Recovery Champion UK. DDN Profile
Read the full profile in DDN Magazine

‘If I was going to pick one thing, it’s still the stigma of drug use,’ says Dr Edward Day of the challenges that his new role as the government’s drug recovery champion will need to address (see news, page 4). ‘There’s a real job to do to break down the prejudice against people who’ve had a drug problem.’

A 20-year veteran of the field, Dr Ed Day started out at what was then the regional addiction unit in Birmingham while still a junior doctor training in psychiatry. ‘That really sparked my interest,’ he says.

‘It was a very different world back then – a 25-bed unit with an outpatient bit attached in the grounds of an old psychiatric hospital, and we had probably a couple of thousand patients who came from the whole of the West Midlands. You got a detox and relatively little else. But that patient group really spoke to me, and I decided that this was what I was going to do.’

After completing his PhD he became a consultant in an NHS drug service in Birmingham, and worked there until he started his current role as consultant psychiatrist at the Birmingham and Solihull Mental Health NHS Foundation Trust five years ago. He’s also clinical reader in addiction psychiatry at the University of Birmingham, and now drug recovery champion on top – isn’t that a lot to take on?

‘Well, I’ve always had a clinical/academic role, so I’ve always juggled those two things,’ says Dr Ed Day. ‘Half my week is spent doing hands-on clinical work and the research I do is all patient-centred, so the two feed off each other. It can be a challenge at times but the two sides of the job go hand in hand.’

He’s also been heavily involved in shaping national policy, including the NICE guidelines for methadone and serving on the two ‘orange book’ working groups, as well as a substantial amount of teaching and stints as a trustee of Action on Addiction and Changes UK.

'orange book’ on clinical drug guidence
Dr Ed Day served on the two ‘orange book’ working groups

While juggling all this can be difficult, it’s also advantageous, he says. ‘I’m quite often the only person in the room who can see both sides of the fence – academia and clinical services.’

‘Recovery is defined by the person –
I don’t think it’s my place to put a definition on it’

The word ‘recovery’ is something that people have argued over – how would he define it? ‘Recovery is defined by the person – I don’t think it’s my place to put a definition on it,’ he says. ‘But I’d go along with the various attempts that really focus on trying to achieve control over substance use, good mental and physical health and, for want of a better term, citizenship – something to get up for in the morning, friends, family, job.

‘I guess the contentious bit is whether the control over substance use means abstinence or not. If you want a straight answer then I do think the best outcomes I’ve seen are when people get abstinent, but to say recovery is only about abstinence is to dismiss all the other stages on the way to that, and I think that’s one of the difficulties.’

The field does seem to be less polarised, however, with some of those barriers breaking down. ‘Definitely, and I think perhaps the key task of this role is to try to move that forward. In those 20 years of my career, for the first ten years we went from a very low level of service – where people saw someone for maybe ten minutes every six months – to a lot of investment.

‘The professional services really developed, and there was a lot of very good evidence-based practice that went in. I think the British system stands up around the world as one of the most evidence-based.’

While recent years have meant less money, one positive has been the ‘shift in emphasis towards peer-led abstinence-based recovery’, he states, ‘which I think was an element missing in the system in those early years’.

He’s always held the view that ‘the professional part is the base that sorts out the basic needs, keeps people alive, links them into services’, but the real achievements come when people leave those professional services and become independent.

‘That’s where the peer-led recovery community comes in – the best system needs both of them talking together. They are two separate worlds, and they have to be, but we need to work together to get a recovery-orientated system where people can see the way out when they come in. That’s the key.’

In terms of people becoming independent, one part of the role is to support effective joint working between treatment, housing, criminal justice, local councils and other agencies. Has this been falling short? ‘I think it probably has – not through want of trying but it’s quite a difficult thing to do, and this role is very much set up to address that. I report to the home secretary’s drug strategy board which brings the ministers from the key agencies together, so I’ve got a platform to talk about what needs to be done to improve that.’

One early goal is to speak to as many people as possible and get a view of where this is working well. ‘Obviously you’ve got areas where it does and others where it doesn’t, for a variety of reasons, but I think if we can develop a series of models that work then different areas can choose from those. That’s perhaps a more effective way of doing it.’ One crucial element is the interface between substance treatment and mental health services, he says. ‘We definitely need a more joined-up approach there.’

‘There was a lot of energy five or six years ago,
so maybe it’s my job to go in and make some noise
and bring it up the agenda again’

When it comes to working closely with ministers, there’s a fair amount of political upheaval at the moment, to say the least. There’s going to be a new prime minister, possibly a general election, and there’s Brexit. How is all this going to affect the role? ‘Who knows? It’s all been so unpredictable, so I’ve had the same thoughts.

‘But in my early interface with the Home Office I’m quite impressed. There is a drug strategy, and it has some really good stuff in it – it’s still committed to evidence-based treatment and trying to integrate these different parts, and to helping people recover in their communities. I think all we can do is take that and keep plugging away.’

It could be that now is the time that this role is really needed, he says. ‘There wasn’t a voice in the government, and if there isn’t a voice then other issues will happily take over. There was a lot of energy five or six years ago, so maybe it’s my job to go in and make some noise and bring it up the agenda again.’

The service user voice is also something that hasn’t been heard enough, he believes. ‘I don’t think it ever is. One of the problems in our field is that if you say “service user”, it depends what you mean by the service. With users of professional services, particularly drug users, I think there’s always been a slight fear of, “if I speak out, I’ll lose the service”, which is a problem.

‘The abstinence-based recovery group is very articulate, and that voice definitely needs to be heard more, but we need both. The user voice needs to be there in policy, but it also needs to be there in treatment services. I do think service users need more say in what treatment they’re getting, and the types of treatments available to them.’

While stigma remains the ‘overarching’ challenge, there are clearly a host of others facing the sector, not least funding. ‘I think one of the worries is the public health grant and the potential loss of the ring-fenced money,’ he says.

‘A lot of money’s gone out of the sector in recent years and we have to make sure that doesn’t continue. Going hand in hand with that is the loss of skill and experience and I’d be quite keen to look at that. My particular area is psychological/ psychosocial treatments, and I think that’s the bit that’s suffered and needs a voice to articulate.’

Training pathways to becoming an addition specialist via medical schools are also under threat, which could mean ‘no one articulating that this is an issue and that we can help people move on’ he says. ‘That’s all part of that stigma question – if you aren’t taught about it as a doctor or nurse or in social worker training then you form certain views which perhaps aren’t the most helpful.

‘There’s a lot to do, but there’s also a lot of positive things going on. In some ways that’s the quick win – to put a bit of wind behind the sails of some of the really good projects, look at what we can learn and try to make sure that’s available across the country, rather than just in certain areas.’

So when it comes to the thorny issue of stigma, what’s the answer – is it simply about raising awareness and setting out to educate people like employers and housing providers? ‘Very much – that’s one part of it,’ he says.

‘I’m very impressed when you get people in recovery who can demonstrate that, despite those barriers, they’ve got to where they are. I never cease to be amazed by how often people in HR departments in big companies or wherever have never even considered that. They just automatically assume that if you’ve had a drug problem you must be bad.’

When instead they could be thinking, ‘this is exactly the sort of person we should be looking for – someone with that sort of determination and commitment’? ‘Precisely. You’ve been through this incredible struggle and you’ve come through the other side.

‘Going to AA or NA meetings and hearing
people talk, you can’t fail to be impressed
by the power of those stories’

You can appreciate what you’ve got in finding recovery, but also you’ve seen a lot of life and the difficulties people face. Going to AA or NA meetings and hearing people talk, you can’t fail to be impressed by the power of those stories. The trouble is they’re still too few and far between.

‘We need to get that message out there, because it does change people’s minds. Many of the people we’ve cast to one side would make fantastic employees and could achieve great things. We need to keep articulating that.’

Hole in the soul – can philosophers teach us about addiction?

By
DDN
-

Looking to the philosophers can give us valuable understanding of the nature of addiction, suggests Albert Yates.

Albert Yates discusses what philosophers teach us about addiction?
Read the full article in DDN Magazine

On the face of it, Classical Greek philosophy and the psychology of addiction are not natural bedfellows. Bringing both disciplines together to produce a plausible theory of addiction might seem unlikely. However, this is less so when addictive behaviour is seen for what it is: human behaviour.

To better understand human behaviour, we would do well to acknowledge the work of our intellectual ancestors – Socrates, Plato, and Aristotle. These Classical Greek philosophers spent their lives trying to understand the way human beings behave. Choice, motivation, personal responsibility, desire, and excess are but a few aspects of human action they explored. In modern times, these are among the areas of human behaviour that practitioners in the field of addiction seek to understand.

In this article I offer a brief insight into how we may account for addiction (or to be precise, an excessive appetite) by understanding the characteristics of the soul as represented by Socrates.

What I propose is:

‘Addiction is a disorder of the soul characterised by the excessive use of psychoactive substances, or the excessive involvement in certain non-substance related activities.’

The way in which Socrates defined the soul in mid-fifth century BC is very different to the way we think of it today. In modern times, the soul is more likely to be thought of as a non-secular entity, relating to religious or spiritual matters. The idea that we are embodied souls, and more than just physio-chemical organisms, does not accord with current intellectual thinking. To consider the soul serving a practical purpose by moving us into action would seem incongruous to most people.

Socrates thought differently. For him the soul was life itself. The soul takes primacy and should be cared for over the body. It is the soul that governs the body. It guides us into action and carries us wherever we go. Reason and intellect constitute the essence of the soul, which is perceptible by reason alone. Socrates believed that the soul is something that keeps bodily desires and affections in check. These are the bare bones of Socrates’ conception of the soul. They permit us to consider the soul within the context of addiction.

Through Plato’s writing, Socrates tells us that the soul is made up of three parts. There is ‘appetite’, which can be thought of as base physical craving. Then there is ‘reason or logic’, the faculty that takes a considered view, and sets the right course of action. The third part is spirit, not to be confused with ‘spiritual’. Spirit can be seen as anger, indignation, often an ally of knowledge.

When appetite is kept in check by reason, the soul is in a state of balance, a state of harmony. A happy and flourishing life can be expected when the soul is in this state. On the other hand, when appetite rules the soul and defeats reason, the soul becomes disordered. Appetite becomes unruly and if it is not checked, addiction ensues. A miserable, unhappy life, dominated by excess can be expected.

What has happened here is that the soul has become undisciplined, instigated by an excessive appetite. This reveals itself in the many problems commonly associated with addictive behaviour. We should bear in mind that each one of us has a worse and better element within our soul.

We might reflect on those occasions when we have allowed our desires or emotions to lead us to behave in a way that is out of character and not in our best interest. It may have been nothing more than a momentary lapse in an otherwise disciplined existence. There is nothing remarkable about this. Socrates believes that ‘…the mass of mankind lives an intemper­ate life because of ignorance or lack of self-control or both’. When this happens, it is because the worse part of the soul (appetite) has been permitted to overwhelm and control the good (knowledge and reason).

Appetite can develop to the point of excess, not because the individual is a moral failure, or is in the grip of a disease, but because they are human beings like the rest of us. The development of an excessive appetite could happen to any one of us.

Bust of Socrates the classical Greek philosopher credited as one of the founders of Western philosophy linking to what philosophers teach us about addiction?
Socrates was a classical Greek philosopher credited as one of the founders of Western philosophy

Socrates tells us that the force that leads a person to develop an excessive appetite is the ‘power of appearance’. The power of appearance fools us into believing that something bad is good. It has the capacity to encourage a person to do something, that, all things considered, they would not ordinarily choose to do. In other words, it persuades them to act against their better judgement. Think of being tempted into eating a cream cake when dieting, or being persuaded to have that last drink. When we succumb to such temptation the power of appearance has diverted attention from reason and logic, and set the soul on a course of fulfilling the senses.

The power of appearance can exert its influence on the imagination. Aristotle says that ‘the soul never thinks without an image’. He adds that ‘for the most part imaginings are false’. The choice between a good and bad course of action is offered by the imagination. From such an image the body is moved to act, which could lead to an unwelcome outcome for someone with an addiction. Aristotle’s treatment of imagination helps us better understand why, in the event of the bad course being chosen, relapse in addiction occurs without any obvious triggers being present.

As human beings we are fallible, we are not perfect. Socrates tells us that the desires we experience can sometimes overpower reason. For someone trying to end their addiction, the inner conflict they experience between wanting to quit, but finding it difficult to do so, can be characterised by the struggle in the soul between knowledge and appetite attempting to assert control over the other. Such conflict can only be resolved if the soul is disciplined. For Socrates, discipline takes the form of ‘fair words’ or ‘charms’. He sets great store by the therapeutic use of words. Today, we might draw parallels between fair words or charms and the talking therapies.

The bottom line is that the Classical Greek philosophers warn us that we cannot trust the body. As Socrates says:

…the body fills us with desires and longings and fears and imaginations of all sorts, and such quantities of trash, that as the common saying puts it, we really never have a moment to think about anything else because of the body.

Dr Albert Yates talking about what philosophers teach us about addiction?
Dr Albert Yates is author of A theory of addiction founded on classical Greek philosophy, a thesis at Manchester Metropolitan University

The Classical Greek philosophers tell us that if we are to check unruly bodily senses and realise the truth, we must turn to the soul. A soul that is cared for will not deceive. It will not engage in excessive behaviour. Addiction is a disorder of the soul – a disorder that we can all succumb to if we care more for the body than the soul. That we fill the body with desires and longings, false imaginings, fears, and quantities of trash is perhaps a metaphor for addiction in the 21st century?

 

DDN Magazine June 2019

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DDN
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Greeks bearing gifts

DDN Magazine June 2019

Twenty years ago substance misuse treatment was a government priority, with a 400 per cent increase in investment (page 16).

A decade ago the government- funded Drug Interventions Programme was diverting many people away from the criminal justice system and into education and treatment programmes (page 14). Since then disinvestment has become the norm.

So where does that leave us? In dire need of a clear harm reduction led strategy to replace a ‘tough on drugs’ approach that is unfit for purpose in every way, according to a parliamentary meeting that included senior police and highly experienced policymakers.

The government’s newly appointed drug recovery champion is a welcome arrival, promising a listening ear, a strong voice, and a commitment to tackling stigma and prejudice around people who have had problems with drugs (page 8). His professional experience will certainly bring an informed view to the home secretary’s drug strategy board, and it is encouraging that he is already a keen supporter of service user involvement and peer-led recovery communities.

Meanwhile, far away from Westminster, we’re continuing our quest for new and interesting approaches to understanding addiction and in this month’s cover story Albert Yates offers a fascinating journey into Classical Greek philosophy. Could Socrates teach us a thing or two about nurturing the soul?

Read the full issue as a mobile magazine or download the PDF.

 

Claire Brown, editor

Keep in touch at www.drinkanddrugsnews.com and @DDNmagazine

Emotional intelligence – Inner strength

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Emotional intelligence can be a potent tool for recovery, says Derek Fredericks.

Talking heads representing therapy and emotional intelligence
Read the full article in June DDN Magazine

One hot summer’s day 13 years ago, I remember sitting alone on the 192 bus to Stockport. Clutching a satchel to my chest, my thoughts swirling, I was struggling to breathe. I caught one of the thoughts: ‘They are not going to like you.’ Then another: ‘You’re going to fail’, coming at me like blows from a heavyweight boxer. I felt hopeless.

It had been a tough six months – no drugs, no alcohol, no release and no escape. I thought about the 20 years of drugs, crime and prison, and now at 38 years old I was going to college to sit in class with ‘normal people’, to study Health and Social Care Level 1. What did that even mean?

As the bus stopped, I spotted three men huddled together, talking excitedly. I looked closer and realised I knew them all and had used drugs with them. As a BMW stopped, they all ran towards it. ‘THEY’RE SCORING!’ Standing up with a start, I thought: ‘God! That looks attractive.’ No sooner had I had the thought and sat back down, I began to question it. What’s attractive about sitting in a crack house? What’s attractive about prison? What’s attractive about not seeing my sons?

This was one of the pivotal moments in my life, when unwanted and intrusive thoughts could have changed not just my own destiny, but that of my sons and countless other people. This was when I started to become aware of my thoughts. I didn’t know it at the time, but this was the beginning of the development of my emotional intelligence; the beginning of my empowerment – of learning to use a dormant skill that I wasn’t even aware existed.

I stayed on the bus and I passed the course, and the next, and the next. I began to question negative thoughts and emotions and started to practise not succumbing to them.

What is emotional intelligence?

Emotional intelligence (known as EI or EQ) is a term created by two researchers – Peter Salovey and John Mayer – and popularised by Daniel Goleman in his book Working with Emotional Intelligence.

Daniel Goleman author of Working with Emotional Intelligence.
Daniel Goleman author of Working with Emotional Intelligence.

It refers to the ability to identify and manage one’s own thoughts and emotions, as well as those of others. Goleman cites the Harvard Business School research that determined that EQ (emotional quotient) counts for twice as much as IQ (intelligence quotient) and technical skills combined, in determining who will be successful.

Being addicted to any substance indicates a person’s refusal or inability to process thoughts and emotions, especially when the consequences become severe and the person finds it difficult to halt the process of ‘fixing feelings’. As time goes on, it becomes more difficult to identify and manage emotions.

My first recollection of a drug fixing my feelings was when I was nine years old. It was the morning after I was taken from the family home and put into a care home. I was distraught at being taken away from my family, and I screamed the place down. I remember waking up the next morning, hearing birds singing and being very calm. It was almost as if the trauma of being taken away had vanished overnight.

I found out years later that I was given diazepam to calm me down – my first experience of my emotions being ‘fixed’. A pattern was set; I then knew, subconsciously, that I didn’t have to experience uncomfortable emotions.

We are told we are addicted to whichever drug we are taking when, in reality, we are addicted to not feeling – we just choose different vehicles to get to the same place. I had a lot to relearn. I had to recognise the difference between a feeling and a thought. We have all heard people say ‘I feel like a pint’ or ‘I feel like a failure’. These are not feelings – these are thoughts. When I work with clients or students, this is one of the first things I ask them to investigate.

When I started using drugs in the 1980s, the only help that seemed to be available was Nancy Reagan’s advice, ‘Just say NO!’ Very good, Nancy, but how do I do that? Although simple in theory, recovering from addiction or from unprocessed emotions is fraught with obstacles, dangers and, mostly, the negative ‘self’ that will try to take us back to misusing substances again. We need to become aware of our emotions and thoughts, so we can better accept and challenge them. We need defences and protection. This is why I think enhanced emotional intelligence is essential for successful recovery.

Can we teach emotional intelligence?

I am frequently asked the question, ‘can you teach emotional intelligence?’ and the simple answer is no. However, what we can do is make each other aware of the barriers that stop it developing naturally. There are proven ways to help this, such as the ‘Johari window’ – a simple tool to help with self-awareness.

Maslow’s Hierarchy of Needs also helps with experiencing self-actualisation. It’s funny how I thought a speck of powder could destroy my life, when in fact the risk was from unmet basic needs – lack of connection, poor self-esteem and, most of all, not enough experience of triumphs. Emotional intelligence can help develop skills relating to assertiveness, maintaining safe boundaries, developing and enriching relationships, dealing with change, taking calculated risks, and many other areas of personal growth.

In a lot of ways, I am just as scared as I was back then. My esteem can still be low, but the difference now is that, through an awareness of my thoughts and feelings, I am able to challenge my emotional and mental state and not give it power. With fearful situations, I do it anyway – at least sometimes.

For eight years, I worked with people who were still using drugs in a group setting and, each day, the objective was always to enhance their emotional intelligence, empowering them to have more choices. Today, I teach counselling and addiction awareness to people in recovery, as well as teenage schoolchildren, corporate managers, nurses, perpetrators of domestic violence, addiction workers, therapists and anyone who wants to be the best they can be.

Derek Fredericks Acorn recovery talks about emotional intelligence
Derek Fredericks is academy manager at Acorn Recovery Projects, www.acornrecovery.org.uk

At the Calico Group, where I work, our chief executive Anthony Duerden ensures that training around emotional intelligence is delivered across the organisation.

As therapeutic workers striving to help the wounded, I am convinced that we become more potent at what we do when we ourselves strive to enhance our own emotional intelligence.

 

 

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Karl’s journey

Learning about emotional intelligence gave Karl the techniques to begin living life the way he wanted to.

Karl had been addicted to heroin since the age of 17 and came into treatment aged 34. He was home­less, with destructive behaviours and a chaotic lifestyle. He had contracted hepatitis C and had turned to crime to support his drug habit. He was also selling himself.

These behaviours went against all his morals, beliefs and values. He had attempted suicide numerous times. His mother had committed suicide while he was in addiction. Karl thought he was ‘worthless and better off dead’.

client in therapy looking at emotional intelligence techniques

Through a therapeutic process Karl was able to look closely at his thoughts, behaviours, and actions in a safe environment. He was able to improve his self-awareness through enhancing his emotional intelligence. With this process came the development of certain key skills to move on with his life.

Karl reported that since putting down the drugs it had all become about living his life. This meant managing himself, his thoughts, emotions and relationships. He began to manage his emotional state by being aware of his negative self-talk, and with this awareness he began to challenge himself to go further. His self-control was improving and through the techniques of emotional intelligence he began to get experience of achieving.

His relationships also began to improve, which he felt was a massive part of his recovery. He began to form boundaries and become more assertive, allowing his relationships to flourish, and he began to get in touch with his natural empathy for others.

Karl is now helping other people develop and enhance their emotional intelligence through his work as a tutor and counsellor.

Rising tide

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DDN
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The ‘tough on drugs’ approach is impractical, outdated and costly in every sense, according to a meeting of the APPG for Drug Policy Reform.

Considering pieces of evidence from home and abroad – including Germany, Portugal and the Czech Republic, where legislation had decriminalised drug consumption – the group discussed how the lack of a clear national strategy was resulting in inconsistent law enforcement relating to drug possession and consumption in the UK.

Breaking Waves
Read the full report in DDN Magazine

A decade ago we were familiar with arrest referral schemes and their successor, the Drug Interventions Programme. This government-funded programme was used in courts and custody suites to divert people who had been arrested in possession of drugs into education and treatment programmes, rather than prison. With funding withdrawn, drug-related crime rates were rising as fewer offenders with drug problems were being referred into treatment.

Furthermore, the group was concerned at the ‘postcode lottery’ playing out – in some areas people might receive a warning or a fine; in other areas they would receive a short prison sentence for the same offence. Those on the receiving end of harsher punishment, it was noted, were more likely to be from poor areas and minority ethnic groups.

Mike Trace, ex deputy drug czar
Mike Trace, ex deputy drug czar

Mike Trace, ex deputy drug czar to the Blair government, said that in the UK we used to be very enthusiastic about diverting people into treatment, but that this had declined over the last ten years. However, he believed the Ministry of Justice was now interested in diversion and deflection as it was cost effective.

Some police and crime commissioners were running early stage deflection schemes, referring people into education and treatment programmes. Among them, chief inspector Jason Kew had become increasingly convinced of the value of this approach in the Thames Valley. ‘We have had nothing but private engagement and support and acknowledgement that we need to reform,’ he said. Pre-arrest diversion was ‘as close to decriminalisation as you can get in the current framework’, but it was a postcode lottery. Two miles down the road you could end up in custody.

‘If we were using decriminalisation [a system like in Portugal] we wouldn’t need to be talking about diversion,’ he said, adding ‘We are trying to evolve and innovate, but are also having to deal with the effects of austerity on drug services.’

Despite the constraints of the current legislative framework, there had been an opportunity to give evidence to the Home Office independent review of drug markets and violence, led by Dame Carol Black. The National Police Council were contributing, said Kew, and Kirstie Douse added that Release were submitting a full response.

The review would be looking at drug harms – an opportunity, the meeting agreed, to provide strong evidence on harm reduction that should pave the way for legalisation. Evidence would include detail and working practice – such as in Switzerland – on heroin assisted treatment (HAT) and drug consumption rooms (DCRs).

While evidence was being collated and debated there was an urgent need to engage now with people about their drug use, as Fiona Measham explained.

Fiona Measham - The Loop drug Testing project
Fiona Measham – The Loop drug testing project

Her service, The Loop, had been bringing a mobile drug testing service to outdoor events, with a great deal of positive engagement – from local police as well as festival-goers. It’s a model that has become a much-valued part of the festival scene – ‘one in five people hand over their drugs when they find it’s not what they expected,’ she said.

But there was now a major obstacle to operating the service: the Home Office had announced they would be licensing mobile testing (previously ‘a bit of a grey area’, as there wasn’t a licence that fitted a mobile lab situation). The application would take at least 12 weeks, meaning The Loop was ‘on hold’ until then.

‘So the concern is, we’re moving into the summer season and have had to cancel presence at imminent events,’ said Measham. ‘We’re all in limbo waiting for the licence, but don’t want to endanger the support of the Home Office long term.’

Members of the APPG hoped there would be a way around this. ‘We can’t let bureaucracy make this a lost summer,’ said Trace.

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Border intelligence

The Drugs, Alcohol and Justice Cross-Party Parliamentary Group also met in May to discuss what England could learn from drug and alcohol strategies in Scotland and Wales.

 A new strategy for Scotland, Rights, respect and recovery had the aspiration of putting recovery at its centre, said Andrew Horne, director of Addaction Scotland and an advisor to the Scottish government for the last 14 years.

Andrew Horne, director of Addaction Scotland
Andrew Horne, director of Addaction Scotland

There were now at least 120 organic self-starter recovery groups, which were ‘about people taking back their own recovery and not led by services’.

Scotland had 60,000 dependent drug users and a predicted 1,000+ drug-related deaths in 2018 – three times the rate in England. There had been recent rises in HIV and hepatitis C, in both the chemsex and mainstream using community. Horne mentioned the ‘Glasgow effect’ – the drop in life expectancy by seven years for residents, irrespective of their social group, age or ethnicity.

The news was that there had been a mind shift, said Horne. Scotland was now treating substance misuse as a health and social issue – a health issue first, rather than a criminal justice issue. ‘People have the right to be safe and well,’ he said.

There was a ‘big need to address stigma’ in personal and media references. ‘Stigma stops people from entering treatment,’ he said. Service users were still a very disempowered group that needed more advocacy to help challenge decisions about their treatment. Scotland still had health boards, ‘which can be clinical and consumer led and seen to lack compassionate care’, he explained, and it was important to listen to what peer-led groups had to say.

Drug treatment in Wales was health led and there was an holistic approach, but it could get lost in the ‘huge portfolio’ of devolved responsibility, said Caroline Phipps, CEO of Barod, a third sector organisation for adults and young people.

It was an interesting time, she explained, as Wales was coming to the end of a ten-year strategy that had started to see a reduction in harms. The strategy review was showing evidence of short-term impact and the value of a harm reduction approach, but intelligence was missing on longer-term impact and whole-population intervention.

Caroline Phipps, CEO of Barod
Caroline Phipps, CEO of Barod

One of the main concerns was that those with the most complex needs were being failed, often because of stigma. ‘We need to review concerns around OST, waiting times and access to services,’ she said, as well as looking at some of the criticism being levelled at commissioners and services.

‘People die of stigma – it’s the biggest issue,’ she said. Well-being of Wales gave a policy framework that needed to ensure service user voices were heard.

An ageing population, strong drugs, lack of funding and a spike in drug-related deaths gave the ‘most challenging conditions of the last 20 years’, underpinned by county lines, alcohol-related harms, hepatitis C rates, poverty and isolation.

In positive news, there was a ten per cent increase in funding for the sector in Wales, with a focus on harm reduction, protecting families and reducing drug-related deaths. There were good projects on distributing naloxone, said Phipps, as well as effective service user involvement and a pragmatic approach to patient choice. There was now a need to be ‘brave and bold’ with DCRs, diversion schemes and decriminalisation.

Keeping clients moving

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Making sure our clients have the right skill sets for the workplace is vital to their social mobility, says Asi Panditharatna.

Read the full article in DDN Magazine

Asi Panditharatna divisional director of employment services at The Forward Trust
Asi Panditharatna is divisional director of employment services at The Forward Trust

The recently published report Social Mobility in Great Britain – State of the Nation 2018-19 has highlighted a number of concerns for those from disadvantaged backgrounds. We believe this applies to many of the clients we support who are in substance misuse recovery – particularly those from low-skilled, unemployed, NEET (not in education, employment or training) backgrounds.

The report confirms that people in low paid roles tend to get stuck there and are more likely to be from lower socio-economic backgrounds. Connected to this, those with the least skills are unlikely to get training and higher or degree level apprenticeships.

This is against a backdrop of two-thirds of the reported growth in UK employment (with around 75 per cent of people aged 16-64 now in work) having been in ‘atypical’ roles such as zero-hours contracts or agency work that do not provide job satisfaction, security or contractual rights. Such roles can make it hard to plan for the longer term, such as obtaining a mortgage.

The report also highlights that those with fewer skills are the least likely to get the training they need to support their progression in the workplace. The new apprenticeship standards led by employers have the potential to be a powerful vehicle for social mobility, but the reality is not as clear cut; those from lower socio-economic backgrounds are clustered in lower-returning and lower-level apprenticeships and are not benefiting as much as their more affluent peers.

As automation changes the world of work, these divides could worsen – workers in low-paid roles with low qualifications are most at risk of their work being automated but least likely to access training to reskill.

This may seem like a bleak outlook, but the solution lies in establishing a firmer foundation for the future – access to skills, training and job opportunities with a clear career trajectory.

At The Forward Trust, our approaches to achieving this include focusing on promoting talent with employers so they are not just looking at managing risks with people in recovery. We also make sure employability and vocational training support is aimed at people having maths, English (contextualised for work) and the digital skills to find a job and then succeed in their role.

The solution also includes helping clients to access higher-level government apprenticeships that offer progression and promotion routes. We are focusing on progressing people into higher level qualifications, for example our new ESFA ESF contracts are training people in customer service diploma level qualifications, so they can access higher paid roles in the digital sector in London.

As younger people from disadvantaged backgrounds do not necessarily have the support networks to give them a leg-up in their career, another component for success is giving them access to a network of peer support – so that clients, learners and service users can also draw on one another for help, as well as tapping into each other’s networks for jobs.

In essence, it’s about creating a range of different pathways for people to access better-paid employment – including jobs, apprenticeships, traineeships, self-employment and setting up a business/social enterprise – as well as the support networks to bolster this and ultimately drive social mobility.

To celebrate Employability Day on 28 June, we are planning an employers’ roundtable to discuss these issues around talent and progression.

For more information about Forward Trust’s employment services, see www.forwardtrust.org.uk/our-services/employment-services/

 

Your letters

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DDN welcomes your letters. Please email the editor or post them to DDN, Romney House, School Road, Ashford, Kent TN27 0LT

From the letters page DDN June 2019

APPALLING OVERSIGHT
Thank you for publishing the article ‘System Failure’ about the lack of support for people who’ve experienced childhood sexual abuse (DDN, May, page 10). While I’m glad that this issue is finally getting some attention, the fact that it seems never to have been properly addressed in most services is an astonishing oversight. I was also shocked to learn that there’s not even a system in place to collect this sort of data in the first place.

The article quotes Chip Somers saying, ‘We all know the numbers are immense, yet this is an issue which still gets sidelined.’

Chip Somers clinical advisor at helpmestop.org.uk
Chip Somers clinical advisor at helpmestop.org.uk

I can attest to this, having raised the subject more than once in my previous job only to essentially get fobbed off. It seems a wasted opportunity of immense proportions, particularly at a time when funding is becoming ever more scarce.

If someone has an entrenched drug or alcohol problem because they’re self-medicating to numb the pain of an underlying issue as serious as this, what on earth is the point of not properly addressing that issue or not referring them on to qualified, professional help? They’ll finish treatment, relapse sooner or later, and be right back where they started. It’s essentially the equivalent of giving a cancer patient some heavy painkillers but no treatment for the condition itself.

The need for ‘better joined up working’ has become a mantra in this field, as it has in many others, and we all know it’s often just something to say. But all services should have an effective process in place for referring the people who need it to specialist support, as they should when it comes to the – clearly not unconnected – area of mental health. Otherwise we’re letting our clients down appallingly, and basically just wasting our time.
Name and address supplied

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AWKWARD FACTS
Your ‘Media Savvy’ section very often features national newspaper columnists opining that the ‘war on the drugs’ has been lost and the only sensible solution is legalisation and regulation. This is now pretty much mainstream thought in broadsheet newspapers across the political spectrum, the most recent example being Christine Jardine of the Independent (DDN, May, page 13). Young people are ‘pushed towards dealers, and dangerous unregulated backstreet drugs’, she tells us. Would the drugs be less dangerous if they were bought on a main road then?

Vice also had a handy article a few days ago called ‘How to legalise every drug’. Here, Steve Rolles of Transform pops up to tell us that for cocaine, for example, a ‘licensed user pharmacy’ model would be the best option.

Steve Rolles of Transform Drug Policy Foundation proposes a ‘licensed user pharmacy’ arrangement for drug sales
Steve Rolles of Transform Drug Policy Foundation proposes a ‘licensed user pharmacy’ arrangement for drug sales

People would have to pass an assessment to buy a ‘rationed amount – say a gram a week’, and the price would also need to be kept high enough to ‘avoid encouraging use’.

Am I missing something here? If you have any kind of a cocaine problem then a gram a week isn’t going to be anywhere near enough, so you’ll be straight back round to your dealer. Ditto if he can offer a better price, which he will – obviously. So how is this going to take the market out of the hands of dealers and criminals?

And wait, I thought part of the argument about legalising and regulating drugs – especially heroin – was that people wouldn’t then be driven to acquisitive crime to fund their habit because the prices were too high? So the price needs to be high enough to discourage use, but not so high that they encourage crime? How much, then? To add to the confusion, it’s often the same people calling for legalisation who also want to see minimum pricing introduced for alcohol to discourage harmful use, because the prices for that are too low.

One can only wonder how they manage to square that particular circle in their heads.

The elephant in the room is of course the US, where the overdose rate quadrupled in the first 15 years of this century as, coincidentally, did opioid prescribing levels. That’s half a million people dead, a lot of it from legal, regulated drugs. And then there’s mephedrone.

Before it was banned it had very high rates of use among students and other young people who’d never taken drugs before but thought this was OK because it was a ‘legal high’. When it was made illegal, rates of use fell off a cliff. But those sort of facts are a bit awkward, aren’t they? So let’s just ignore them.
Molly Cochrane, by email

A call to engage

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DDN
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Action on Addiction’s chief executive Graham Beech introduces a new Addiction Awareness Week on 10-16 June.

Where did the idea come from?
Everyone knows the problems associated with addiction are growing and becoming increasingly complex. At the same time, society’s capacity to deal with these issues is diminishing. People are finding it increasingly difficult to access the treatment they need and are facing sizeable barriers linked to stigma.

We’re hoping Addiction Awareness Week will play a key role in raising awareness of the far-reaching negative effects of addiction and providing a platform for focused conversations about the wide-ranging benefits of community-led recovery. We’re also looking to share inspirational stories so that people feel inspired to seek the help they need, and more is done to help them achieve a rewarding and stable life in recovery.

What will happen?
The week is a great opportunity to put the spotlight on addiction and for people to connect and to challenge stigma and discrimination. The conversations which will take place, in Westminster and Whitehall, in cafés and bars, and around people’s kitchen tables, will help bring addiction out of the shadows and in front of the public eye.

In addition to organising our own events throughout the week, we’ll be working with charities and other organisations who have timetabled their own initiatives and social media activity. The idea is that by working together during a week focused on addiction, we’ll be able to cut through the news agenda and engage many different audiences.

Action on Addiction's treatment centre - Clouds House
Action on Addiction’s treatment centre – Clouds House

How will it support other initiatives?
There are already a number of fantastic campaigns and initiatives that challenge stigma and increase knowledge about addiction, in many of which Action on Addiction participates. An awareness week that focuses on the subject and becomes an annual event should add significant weight to these activities. Substantial headway has been made in recent years on raising awareness of issues associated with mental health, and we’re hoping for a similar shift in relation to addiction.

Changing hearts and minds can never be achieved through one campaign in isolation, it always requires a groundswell of activity from multiple organisations who are able to engage clients and service users, ambassadors, donors, and high-profile supporters.

How do people get involved?
We’ve received an overwhelmingly positive response throughout the sector. The week is also being supported by those operating in related services and arts organisations, from MPs, policy professionals and in the media. We’d love people to share their stories throughout the week on social media and via their own communications channels. Our email address is: hello@addictionawarenessweek.org.uk

For more information visit www.addictionawarenessweek.org.uk

The place to grow

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FDAP has been refurbished and offers much in the way of professional support, says Kate Halliday.

Read the full article in DDN Magazine

Kate Halliday SMMGP/FDAP executive director
Kate Halliday is SMMGP/FDAP executive director

When the Federation of Drug and Alcohol Professionals (FDAP) was taken over by SMMGP in 2017 we worked hard to ensure a smooth and immediate transition for all FDAP members, and this meant continuing the existing systems of membership and registration.

Moving is chaos and once the dust had settled we were able to see what needed refurbishing. The process of registration for FDAP members was ‘old school’ in that a form had to be downloaded, printed, completed, and posted, together with a cheque.

The SMMGP website was also being renewed so it made sense to bring the FDAP information into a new combined website, launched in January 2019. FDAP membership applications – including payment – can now all be done online, contributing to a big jump in membership this year.

Why become a FDAP member?
FDAP is the only professional registration body for drug and alcohol workers and now that it’s under the SMMGP umbrella, there is access to expert guidance and high quality CPD via the SMMGP Premium Membership programme – all included in the FDAP membership fee.

With affiliation to several universities that offer addiction graduate courses such as London South Bank University, Bath and University of West London, FDAP’s assessment board is drawn from senior lecturers and course leaders. We offer affiliate membership to providers, with benefits to nominated employees, and all FDAP members benefit from discounts on conferences and access to training.

FDAP offers a range of specialist accreditation. The National Counsellor Accreditation Certificate (NCAC) is for counsellors who work with people who are using alcohol and other drugs problematically, as well as other behavioural addictions; the Drug and Alcohol Professional Certificate provides a competence-based certification for alcohol and drug workers, including volunteers; while the Drug and Alcohol Family Worker certificate (with Adfam) is designed for practitioners who work with families affected by addiction.

We are proud of the strides that we have made to upgrade FDAP and keep our members happy. The professional body was established, and continues, to uphold standards of competency and professionalism specific to our sector.

We invite you to visit our new website and browse what’s on offer:

www.smmgp-fdap.org.uk

 

Staying ahead

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Changes from CQC have felt demanding. Let’s see inspections as an opportunity, says Jay Stewart.

Read the full article in DDN Magazine

Jay Stewart - director of public health and substance misuse at Turning Point
Jay Stewart is director of public health and substance misuse at Turning Point

Last year, the Care Quality Commission (CQC) began rating substance misuse services publicly. The sector is no stranger to inspections, but publishing results means there’s greater transparency of services delivered. The good news is that the sector is performing relatively well so far, with many receiving good or outstanding ratings.

Inspections have been the norm for quite a long time now, but years ago our experience of them was inconsistent in terms of their depth, breadth and quality standards.

Over recent years we’ve seen CQC changing. It’s very welcome that there’s now a framework guiding what ‘good’ looks like, and there are specialist advisers and experts by experience taking part in the inspection process. Equally, we’ve seen an increase in knowledge and experience among inspectors as they have examined services across the country.

I appreciate that this is not a view shared by everyone in the sector. As with any human system, you can have variations in judgements and in application of the regulations, but one cannot deny that the robustness and transparency of the inspection process is improving.

I’ve been involved in the health and social care sector for more than 30 years, so I know that it’s not easy to receive an inspection that points out inadequacies in a service. Indeed, it can be a painful blow for the staff and peer mentors who give their all to help support people through recovery. However, we exist to deliver quality services and I know that we all strive to ensure that they are the best they can be.

CQC Inspection
We’ve seen an increase in knowledge and experience among inspectors as they have examined services across the country.

At Turning Point we’ve spent years investing in our clinical expertise, governance processes and support systems, as well as in our leadership team. All of this is essential to ensuring that quality services are delivered and that learning processes are embedded into the fabric of our systems.

I know that the CQC can be minimised by some who do not want to accept that the services they are responsible for need to improve. In addition, I’ve no doubt that there may be occasions when the CQC gets it wrong. But we would do better to focus on what we can learn from inspections and what we can improve.

For me, one of the hallmark principles of good clinical governance and practice is being open to learning and continuous improvement. CQC inspections are much more than meeting basic regulations. Anyone who has experienced a comprehensive inspection will appreciate the depth of inquiry that happens in many inspection scenarios. As such, I think the sector has much to gain from each other through CQC inspections if we maintain an open approach to learning.

There are still many more services to inspect and no doubt areas for improvement. However, the sector should be proud of the results so far, which are quite remarkable given the fiscal pressure that we’ve been under. I think it stands as a testament to the value we place on quality within services.

I’d agree with those who say that quality does come with a cost. But I would also say that not providing quality services would come with an even greater cost – to a council’s reputation, to real sustainable outcomes and, more importantly, to the individuals who we all seek to support in their recovery.

The new published reports give an opportunity to ensure that quality standards and investment are maintained. We should continue to challenge the imperfections in the system and do as we have always done – to strive to improve, learn and be the best we can be.

 

CZAR GAZING – How do we harness political support?

By
DDN
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How do we harness political support when priorities lie elsewhere? In the sixth of his series of articles, former deputy drug czar Mike Trace sizes up the challenge…

Read it in DDN Magazine 

Mike Trace is CEO of Forward Trust

Twenty years ago, the Labour government positioned substance misuse treatment as one of its key social policy priorities and increased central government investment by more than 400 per cent. These were the golden days of political support, but we are now in a period of central government indifference, linked to significant budget reductions.

When the NTA closed down, I remember Paul Hayes and Department of Health officials urging the sector to work hard to convince ministers, local councillors, and directors of public health of the financial and policy merits of substance misuse treatment.

This was reasonable advice, as it was clear that we were leaving a period when policy support and generous budgets were assured, and our sector would have to compete with more mainstream concerns, within the context of a local government financial squeeze.

But it was also a bit of a cop out – the big decisions that affect the level of focus and investment in the sector had already been made: the closure of the cross-government agency set up to act as a custodian; the end of the central government drug treatment ‘pooled budget’; the incorporation of that money into a wider local authority public health grant; and the removal of the ring fence on that grant.

The period since those decisions were made has seen politicians at local and national level talk widely about the value of substance misuse treatment, but no serious attempts to reverse the decline in resources or develop new or expanded services.

So what ‘big wins’ can the sector offer to policy makers to rejuvenate the sector? Unfortunately, not all of the benefits we see from the treatment system can be translated into political support and increased budgets.

Substance misuse treatment reduces blood borne infections?
The fear of drug-related HIV and hepatitis infections has receded as transmission rates have declined and treatments have improved. The cost/benefit analysis of public health prevention measures remains positive, but there is no sense of the crisis that is needed to stimulate policy action.

Substance misuse treatment reduces drug-related deaths?
The shocking level of drug-related deaths has also not been enough to trigger a significant reaction. It seems true that drug users’ lives are seen as less important – if we had more than 3,000 early deaths per year due to traffic accidents or knife crime, we would be witnessing national campaigns and bold new investments. We also have a problem in claiming treatment can significantly reduce deaths. Policy makers will ask why the death rates have gone up throughout the period when the number of people in treatment expanded massively.

Substance misuse treatment reduces crime?
This was the argument that most interested ministers when I was in government. And the theory was largely proved correct, with the types of crime most associated with dependent drug use declining significantly between 2000 and 2010. Whether it holds the same potency now – when volume crime rates are lower, and enforcement priorities are moving more towards violence reduction and organised crime – is questionable, but the financial case remains compelling; treatment reduces offending, which in turn significantly reduces criminal justice expenditure.

Substance misuse treatment reduces social exclusion?
This has in my view always been the sector’s trump card. Our sector deals with a high proportion of the most socially marginalised individuals. They experience, and cause, multiple problems beyond drug and alcohol dependence. If our interventions can reduce those problems – homelessness, family break-up, unemployment, low-level mental health problems – then it is meeting the objectives of many central government departments. Unfortunately, we have not been very good at demonstrating our impact in these areas – research has been patchy, and our commissioning data sets do not provide sufficiently clear results.

Substance misuse treatment reduces health service utilisation?
This seems plausible, and there is some research to show reductions in, for example, A&E presentations, GP appointments, or liver failure. But we still do not have any comprehensive data on the impact we have on our clients’ use, and costs of other NHS services. I would imagine that such research would demonstrate a strong case for substance misuse treatment as a cost-effective prevention measure within NHS strategic plans.

There is a pathway to re-energising political support for our sector, but I fear that we have not been making the right arguments, or assembling and presenting the right evidence. The scramble for resources in a time of austerity is brutal but inevitable – to protect existing budgets, or gain support for new developments, the substance misuse treatment sector needs to offer big gains in a policy area that the politicians and public care about.

While our public health achievements are worthy of celebration, they will never rise to the top of local authority or NHS priorities. It is more likely that rejuvenated interest will come from the social inclusion agenda – helping people to move from positions of deprivation and dysfunction into work, stable accommodation, and positive connections with family and community. And while it is true that the current national government is not at all focused on social inclusion, it will not be in power much longer.

Local governments will always see the benefits of moving people into jobs, and helping them off homelessness or social service registers. We need to offer them a clear, and evidence based, vision of what can be achieved. The long overdue appointment of the government recovery champion – Dr Edward Day – presents an opportunity to articulate this vision at the highest levels. My next article will contain some suggestions for how he can go about this task.

 

Addiction Treatment Directory

By
DDN
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[icon name=”home” class=”fa-2x”] DDN [icon name=”address-book-o” class=”fa-2x”]Addiction Treatment Guide

Addiction Treatment Directory

Routes to Recovery – The DDN addiction treatment guide, contains listings and contact details for treatment services. Cover of the DDN addiction Treatment Guide

The guide also contains more details of certain services and helpful editorial to guide you through the process of choosing the right service for you.

Services change and new services open. We aim to keep the guide as up to date as possible but have also included details of the services below listed in alphabetical order.

Some organisations have included more details on the services they offer, to help you make your choice.

If you run a service and it is not listed please fill in this online form  

If you would like to upgrade your listing or change your details, please get in touch.

 

UK DIRECTORY LISTINGS (overseas listings are at the base of the page)

Abbeycare www.abbeycarefoundation.com

Acorn Recovery Drug Treatment Logo

 

 

Acorn Recovery Projects

www.acornrecovery.org.uk • Manchester • Eclectic

Our innovative recovery services enable individuals and their families to break free from drug, alcohol and other addictions. We support people throughout their recovery journey in a compassionate way, focussing on the long term solution, even beyond treatment.

Clients can live in our supported housing for a temporary time with full support for a move back into the community for independent living. We also run a thriving volunteer community with in-house training schemes also on offer.

Acquiesce www.acquiesce.org.uk

Action on Addiction Drug Treatment Logo

 

 

 

Action on Addiction

www.actiononaddiction.org.uk • Wiltshire • 12-Step

Clouds House has provided detoxification and residential treatment for addiction since 1983. We treat all forms of addiction in our private and tranquil setting in the heart of Wiltshire. Our specialist GP, consultant psychiatrist and 24-hour nursing team ensure safe, medically-supervised withdrawal, while our interpersonal group therapy model, alignment with the 12-step fellowships and complementary therapies help clients address the underlying causes of addiction and build a secure life in recovery.

Our aftercare programme and family work ensure clients stay connected to their recovery. Owned and managed by Action on Addiction, our services are rated good by the CQC.

Addaction Drug Treatment Logo

 

 

Addaction Chy

www.chy.addaction.org.uk

Truro, Cornwall • Eclectic

A 17 bed Adult Residential centre for men and women. Based on a person-centred approach, our experienced and dedicated team will develop a tailor-made programme to support the individual within a structured package of group programmes, 1:1, life skills and drama based therapeutic intervention (RAFT). Dogs welcome. Aftercare Provision. Move on flats available. CQC rating: Good

Addiction Recovery Centre www.arcproject.org.uk

Amber Foundation (The) www.amberweb.org

ANA addiction Treatment service Logo

 

 

 

ANA Treatment Centres

www.anatreatmentcentres.com • Portsmouth • Eclectic

Set by the Solent in Portsmouth, Hampshire, ANA offers residential treatment for drug and alcohol addictions and associated disorders. We provide excellent, accredited, caring, tailored programmes for men and women who want a life free from addiction and we also work closely with families. We offer three stands of services; therapy, health & well-being & life skills.

Ark House Rehab Ltd www.arkhouserehab.co.uk

Assisi Community Care www.francishouse.com

BAC O’Connor www.bacandoconnor.co.uk

Birchwood Residential Treatment Centre www.birchwoodtreatment.com

Bosence addiction Treatment service Logo

 

 

Bosence Farm Community Ltd

www.bosencefarm.com • Cornwall • 12-Step

Bosence Farm is a CQC registered (rated GOOD) charity providing residential treatment from three distinct services:

Detox and stabilisation for adults and 17 year olds who are in need of a medically led detoxification or stabilisation from illicit drugs, alcohol or prescribed medications.
Rehabilitation for adults who wish to address their drug and alcohol misuse utilising the 12-step model.
Young People offers a bespoke treatment programme for young people experiencing issues with substance misuse and related needs.

Bridge (The) www.thebridge.uk.net

Broadreach House addiction Treatment service Logo

 

 

 

Broadreach House

Broadreach closed on 5.7.2019

Read more here.

Broadway Lodge addiction Treatment service Logo

 

 

Broadway Lodge

www.broadwaylodge.org.uk • Weston-Super-Mare • 12-Step

Established in 1974 Broadway Lodge provides 12-step abstinence based treatment supporting people into recovery from a wide range of addictive behaviours including substance misuse, sex, co-dependency, gambling and gaming; also supporting clients with secondary issues such as self-harm and eating disorders

Detoxification can be provided for alcohol, illicit drugs, novel psychoactive substances and prescribed medication including pain relief and benzodiazepines.

Brynawel addiction Treatment service Logo

 

 

 

Brynawel House Alcohol and Drug Rehabilitation Centre

www.brynawel.org • Wales • Eclectic

We are a secular organisation delivering evidence based interventions primarily as part of a residential treatment programme.

Brynawel has a unique position as we are the only residential rehabilitation centre in Wales with

a programme which has Cognitive Behavioural Therapy and Social Learning at the core of its treatment programme, which includes psycho-social interventions, is client centred and offers a holistic approach. We therefore offer individuals a real choice.

Choices addition treatment advert

CAIS Parkland Place www.parklandplace.co.uk

Carlisle House addiction Treatment service Logo

 

 

Carlisle House

www.carlislehouse.org • Belfast • Therapeutic Community

Carlisle House is a residential substance misuse treatment centre situated near the centre of Belfast.

We aim to provide a safe and therapeutic space for individuals who have substance use difficulties. A space that provides structure, enabling new choices to be explored and a rediscovery of self without the substance. This opportunity is offered within an ethos of acceptance, respect and compassion.

The Programme offers a range of interventions including – Structured Living, Individual Therapy, Group Therapy, Family Therapy, Art Therapy, Eco Therapy, Personal Development, Complementary Therapies, Peer Support, and Post Programme Support.

Castle Craig Hospital www.castlecraig.co.uk

CGL addiction Treatment service Logo

 

 

 

CGL Park House

www.changegrowlive.org • Birmingham • Detox Centre

Park House is an 18-bed unit staffed by an experienced team of specialist doctors, nurses, healthcare assistants and group work specialists. The detox centre is staffed 24 hours a day, 7 days a week and supported by clinical and operational on-call systems. Park House has beds allocated to both Birmingham residents and non-Birmingham residents.

CGL addiction Treatment service Logo

 

 

 

CGL St Thomas Fund

www.changegrowlive.org • Brighton • Eclectic

St Thomas Fund is a residential rehabilitation service based in Brighton and Hove that offers a safe place for adults wanting to become free of drugs and alcohol, and make positive steps towards recovery. It is a

free service for adults over the age of 18 with a local connection to Brighton and Hove; places are agreed with all parties following referral and assessment.

ChangesUk addiction Treatment service Logo

 

 

 

Changes UK

www.changesuk.org • Birmingham • Eclectic

ChangesUK, Clarity House provides an opportunity for detox for people to work towards abstinence and begin their recovery journey. They are supported by our Peer Mentors and specialist medical practitioners in safe and comfortable surroundings. It is an intensive residential programme with a person- centred approach to achieve a state of mental, physical, emotional, social and spiritual wellbeing. All of our homes are fully equipped and furnished to an excellent standard.

Charterhouse Clinic www.charterhouseclinic.com

Druglink www.oxygenrecovery.co.uk

East Coast Recovery Ltd www.eastcoastrecovery.co.uk

Framework addiction Treatment service Logo

 

 

Edwin House

www.frameworkha.org • Nottinghamshire • Therapeutic Community

Edwin House is a unique, modern CQC registered care and reablement centre that provides high-quality, dignified care to people with complex health needs related to long-term misuse of alcohol and/or drugs.

Located in a quiet corner of Nottingham, we provide high quality care, nursing and recovery-orientated treatment and support people living with chronic physical, emotional or mental health issues.

Our home, which can accommodate up to 63 people, is made up of 48 care and reablement beds. Located within the service is a smaller 14 bed inpatient detoxification unit.

Equinox Drug Treatment service Logo

 

 

 

Equinox Aspinden Wood Centre

www.equinoxcare.org.uk • London • Supported Housing

Equinox Aspinden Wood is a CQC registered service that provides long-term 24 hour care and support to men and women with a history of alcohol dependence, mental ill health and homelessness.

The centre supports people who have been drinking for many years and while service users can continue to drink when they live at Aspinden Wood we work with them to find ways to reduce the harm caused by their drinking.

We offer service users many options for them to improve their quality of life and wellbeing, and work with them to give them back their dignity and self confidence.

Equinox Drug Treatment service Logo

 

 

 

Equinox Brook Drive

www.equinoxcare.org.uk • London • Detox Centre

Brook Drive is a CQC registered, residential community drug and alcohol detoxification unit, providing medically supervised alcohol and drug detoxification programmes for people aged 18 and above.

Many of our service users also have other needs including diagnosed mental ill health, pre-existing physical health needs and challenging life circumstances.

Brook Drive is a big and busy service with an NHS supported complex care pathway and a full time GP service integrated on site.

There is a multidisciplinary staff team of 20, including nurses, recovery substance misuse/mental health workers, complementary therapy workers and group workers.

Equinox Drug Treatment service Logo

 

 

 

Equinox Churchfield and Cherington

www.equinoxcare.org.uk • London • Eclectic

Churchfield Road is a 12 bed recovery focussed accommodation for individuals in active addiction whose homelessness is a barrier to accessing and
or committing to treatment packages and goals. Staff work with service users to access and maintain treatment and reduce negative impact on themselves and the wider community.

Cherington Road is a 5 bed abstinence based accommodation for individuals that have completed first stage treatment but have ongoing housing and treatment needs.

Both services offer an in-house community programme, one to one key working and signposting to other services such as ETE advisers, Hepatitis screening, fellowship meetings.

Eshworks Drug Treatment service Logo

 

 

 

ESH Community

www.eshcommunity.org • Warwickshire • Therapeutic Community

Fully Residential drug and alcohol treatment including medically assisted detox. CQC assessed and rated. Supported 24/7. Single rooms. Regular one-to-one counselling with experienced addiction counsellors. Ongoing comprehensive aftercare. Family support. Maximum of eleven residents to ensure we provide the best possible support with the right amount of personal dedicated time from our experienced professional staff.

Set in the heart of the Warwickshire countryside away from everyday distractions providing a safe and supportive setting to address life and addiction issues.Competitive prices for local authorities and service providers.

Freedom Recovery Centre www.Freedomrecoverycentre.co.uk

Gilead Foundation Addiction Treatment

 

 

Gilead Foundations

www.gilead.org.uk • Okehampton • Supported Housing

Gilead Foundations Charity provides accommodation for people who require support to overcome their compulsive behaviours through learning Christian principles and basic work ethics. Gilead is based on a working dairy & egg production farm which gives opportunity for a variety of agricultural work experience to equip them with work ethics.

 

 

Gloucester House

www.gloucesterhouse.org.uk • Swindon • 12-Step

Gloucester House is a CQC outstanding treatment centre that recognises the damaging effects caused to individuals, families and communities through substance misuse.

Our holistic, integrated 12-Step programme is designed to empower and support every individual to attain a life free from dependency, to look beyond their issues and to explore ways of changing their lives for the better. We pride ourselves on delivering a programme that is structured, supportive and personalised, and we take clients from anywhere in the country. We also welcome referrals from veteran services and self-funded clients.

Gloucester House offers both first stage, second stage and resettlement.

Hebron Trust Addiction treatment

 

 

Hebron Trust

www.hebrontrust.org.uk • Norfolk • 12-Step

Hebron House has been changing lives for 30 years. We are situated in Norwich, Norfolk in two beautiful houses.

We offer a 12-step programme including: a tailored care plan; therapeutic key worker; two, one to one counselling sessions per week; group therapy; CBT; sport, leisure and gardening activities; assistance to address financial/debt problems; move on house.

Help Me Stop addiction Treatment

 

 

 

Help Me Stop Dayhab –Rehab in the real world

www.helpmestop.org.uk • London • Eclectic

Help Me Stop offers the first US-style Dayhab treatment for alcohol and drug problems in the UK. Our unique non-residential treatment programme fits around daily life, meaning work, study or family responsibilities don’t have to be put on hold. And because our costs are low, we put recovery within reach of most people.

Affordable: From £2,500 – Intensive: 160 hours – Effective: Proven success rates

Accessible: non-residential

FIND OUT HOW HELP ME STOP CAN HELP YOU TODAY

Holgate house addiction treatment

 

 

Holgate House

www.holgatehousebarrowford.co.uk • Lancashire • 12-Step

Holgate House residential unit is staffed twenty-four hours a day. It offers a structured programme, i.e. looking at dealing with unresolved, here and now issues that would be too painful to deal with. It is warm, friendly, safe and a healthy environment to live in, and as a professional team we can offer support, structure and discipline in a caring nurturing way.

We offer move on accommodation for those that do not want to return to the area they came from and are supported in the community.

HOPE worldwide – ODAAT www.hopeworldwide.org.uk

Humankind addiction treatment service

 

 

 

 

Humankind

www.humankindcharity.org.uk • Sheffield, Sefton, Barnsley and Durham Supported Housing

We provide housing related support to individuals
to develop the skills required to manage homes, live confidently, remain in recovery and ultimately achieve independent living.

We also deliver group-based activities to support clients to promote health and wellbeing, employability and active-citizenship.

The services are open to both men and women and provides single, self-contained accommodation.
The services focus on housing-related support and developing the skills required to sustain a tenancy, recognising this as a key factor in maintaining recovery.

 

 

IFDAS – River Garden Auchincruive

www.ifdas.net • Scotland • Therapeutic Community

Access to a place at River Garden Auchincruive is free if you are motivated to turn your life around. In return for your residential place, you are asked to contribute to the life of the community through voluntary work.

Kairos www.kairoscommunity.org.uk

Kenward Trust addiction treatment service

 

 

Kenward Trust (Part of the Choices group)

www.kenwardtrust.org.uk • Kent • Therapeutic Community

Kenward Trust is a residential Therapeutic Community working with men, and women offering expertise

in dealing with Drug and Alcohol Addiction through recovery, resettlement and reintegration programmes. Retaining aspects of the Recovery Model of treatment delivery, alongside a wide range of activities with both therapeutic and skills based training in our Social Enterprise, which will allow people to take evidence of recognised training skills with them into the work place.

TRANSFORMING LIVES, CREATING NEW FUTURES

Ley community Addiction Treatment service

 

 

 

Ley Community

www.leycommunity.co.uk • Oxfordshire • Therapeutic Community

The Ley Community makes recovery real by providing the ideal therapeutic environment for lasting change.

Everyone leaves us with everything they need to succeed first time; employment, accommodation, extended aftercare, and well established peer networks. We don’t just point them in the right direction, we ensure they reach their destination

Linwood House www.linwoodhouse.co.uk

Littledale Hall Addiction treatment

 

 

Littledale Hall

www.littledaleaddictionservices.co.uk • Lancaster • 12-Step

Littledale was established in 2006 and has been consistently recognised by CQC and commissioning authorities as a provider that delivers a high standard of innovative and evidence-based care to people recovering from addiction. The model at Littledale has evolved through 25 years’ experience and addresses all the

key elements associated to an individual’s addiction. Littledale offers each resident an opportunity to develop a greater understanding and insight into the complexities of their addiction and we believe all residents can be empowered to make positive life choices.

For more information contact our Admissions Team on admissions@littledaleaddictionservices.co.uk

Livingstone house addiction treatment

 

 

Livingstone House

www.livingstonehouseuk.org • Birmingham • 12-Step

Livingstone House provides a family environment where Service Users can access help for their addiction, using a 12 Step Programme, in conjunction with any alternative therapies that support recovery. This will include providing detoxification for addictive substances in a controlled and medically supervised environment via

an agreed clinically indicated detoxification protocol all facilitated within the 12 Step Programme.

Following treatment, Service Users who have completed the programme benefit from after care for up to three months and beyond if required. Livingstone House offer an open door policy.

Mount armel drug and alcohol rehab

 

 

 

 

Mount Carmel

www.mountcarmel.org.uk • London • 12-Step

Mount Carmel is a centre of excellence for alcohol treatment. We deliver safe, supportive, and non- judgemental help through both residential and day programmes.

Although our focus is alcohol, we also address the many other addictions of our clients, including drugs, food, gambling and exercise.

Our prices are very affordable, and over 35 years we have helped more than a thousand clients to get well and to change their lives.

N Notaro Homes Ltd www.arbdcare.co.uk

Narconon United Kingdom www.narcononuk.org

Nehemiah addiction treatment

 

 

Nehemiah Project (The)

www.tnp.org.uk • London • Therapeutic Community

Are you Serious about your recovery?

Nehemiah might be for you. We will help you take that next step into the community.

The Nehemiah Project is an abstinence-based charity which helps men recover their lives from a cycle of addiction, offending and/or homelessness. You can break this cycle with our professional support and move on to recover and rebuild your life. We have 4 houses in London – 14 first stage spaces and 9 move-on spaces.

Nelston Trust Drug and alcohol treatment service

 

 

 

The Nelson Trust

www.nelsontrust.com • Gloucestershire • Eclectic

Providing both a mixed sex house and a women’s only service The Nelson Trust offers abstinence based treatment utilising a holistic package incorporating the development of recovery capital alongside relapse prevention with a trauma informed, gender responsive individualised package of care.

notaro homes arbd specialists

 

 

N Notaro Homes Ltd

www.arbdcare.co.uk • North Somerset • Supported Housing

Notaro ARBD Care comprises 3 residential homes situated in the South West of England. Our unique, successful provision is open to accepting referrals from across the UK. We provide effective residential support for individuals living with long term effects of misuse, such as Korsakoff’s syndrome.

Our unique 3-step enablement programme focuses on regaining independence through tailored activities and monthly assessments. It’s essential that clients have gone through detox before admission. We focus on supporting their recovery by developing structure and routine and working closely with their individualised goals. For some their diagnosis is permanent, in this instance, we can provide a home for life.

New Leaf Recovery Services Ltd www.newleafrecovery.co.uk

Perry Clayman Project (PCP) www.rehabtoday.com

Phoenix Futures drug and alcohol treatment

 

 

 

Phoenix Futures – Grace House

www.phoenix-futures.org.uk/services-directory • London • Eclectic

Grace House is a specialist female-only residential service in a quiet area in North London. The service provides trauma informed treatment for women with substance misuse problems and complex needs, including domestic violence, offending behaviour, sexual exploitation, homelessness and eating disorders.

Treatment: Biopsychosocial model • Full substance misuse group work programme • Specialist group programme including domestic and sexual violence • Cognitive Behavioural Therapy • Complementary therapies • Recovery through nature

Phoenix Futures drug and alcohol treatment

 

 

 

Phoenix Futures – Scottish Residential Service

www.phoenix-futures.org.uk/services-directory • Glasgow • Therapeutic Community

Phoenix Futures Scottish Residential Service offers abstinence based treatment for males or females over 18. The service is in a purpose built centre on the outskirts of Glasgow and benefits from strong links with the local recovery community. Treatment: Therapeutic Community model • Behavioural role play therapy • Life story work • Full group work programme • Complementary therapies • Recovery through nature

Phoenix Futures drug and alcohol treatment

 

 

 

Phoenix Futures – Sheffield

www.phoenix-futures.org.uk/services-directory • Sheffield • Therapeutic Community

Phoenix Futures Sheffield Residential Service offers abstinence based treatment for males or females over 18. The service is based in a large Victorian house in tranquil and beautiful grounds in a leafy, suburban area of Sheffield. Therapeutic community model • Behavioural role play therapy • Life story work • Full group work programme • Complementary therapies • Recovery through nature

Phoenix Futures drug and alcohol treatment

 

 

 

Phoenix Futures – National Specialist Family Service

www.phoenix-futures.org.uk/services-directory • Sheffield • Therapeutic Community

Phoenix Futures National Specialist Family Service is a unique service offering residential treatment for mums and dads to address their drug and alcohol issues whilst remaining the primary carers for their children. Positive parenting programme

  • Life story work • Full group work programme • Complementary therapies • Ofsted registered crèche • Family focused interventions

Phoenix Futures drug and alcohol treatment

 

 

 

Phoenix Futures – Wirral

www.phoenix-futures.org.uk/services-directory • Wirral • Therapeutic Community

Phoenix Futures Wirral Residential Service offers abstinence based treatment for males or females over 18. The service is a haven for animal lovers with chickens, rabbits, guinea pigs and cats. Uniquely residents are also able to bring their dogs (provided they are neutered), to live in the on-site kennels.

Therapeutic community model • Behavioural role play therapy • Life story work • Full group work programme • Complementary therapies • Recovery through nature

Priory Group www.priorygroup.com

Promis drug and alcohol treatment

 

 

 

PROMIS Clinics – Hay Farm

www.promis.co.uk • Kent • Eclectic

PROMIS Hay Farm is set in 12 acres of farmland, surrounded by nature reserves and the woodlands

of the famous North Downs of Kent. We believe that the surroundings have an impact on the quality of a patient’s wellbeing during treatment, and Hay Farm offers an exclusive 12-bed facility featuring comfortable and stylish rooms with en-suite bathrooms.

We integrate a wide range of cutting-edge treatment and experimental treatment like equine assisted psychotherapy, alongside intensive traditional one-to- one therapies in a programme individually tailored to the client.

Promis drug and alcohol treatment

 

 

 

PROMIS Clinics – London

www.promis.co.uk • London • Eclectic

Located in the Royal Borough of Kensington and Chelsea, PROMIS London offers a three mews house, six-bed exclusive mental health, alcohol and drug rehab facility featuring luxury rooms with en-suite bathrooms.

The programme embodies the holistic care philosophy of PROMIS and addresses the mind, body and spirit through an intensive programme tailored to the client’s needs.

Providence Project Drug Treatment

 

 

Providence Project

www.providenceproject.org • Bournemouth • 12-Step

The Providence Projects, established in 1996 and based just a few hundred yards from the beach

in Bournemouth, is one of the leading addiction treatment facilities in the UK. The Providence Projects offer affordable programmes and a range of comprehensive options including detox, primary treatment, secondary treatment and aftercare.

Quantum Sobriety Drug Treatment

 

 

 

 

Quantum Sobriety

www.quantumsobriety.com • Suffolk • Eclectic

Quantum Sobriety®️ is changing the conversation around addiction. Created by Jo De Rosa, the award- winning programme is based upon her own journey; from hopeless alcohol and drug addict to total freedom. This revolutionary approach is underpinned by meditation and the rewiring of the brain, giving participants permission to fully take their power back. Via specific meditations to first UN-learn the beliefs/trauma that has kept the addict trapped,

The programme supports the RE-learning of who the individual authentically is.

Quantum Sobriety®️ can be experienced via a residential retreat, one-day workshop, global online programme and community, and the book of the same name.

Recovery Hub Ispwich www.recoveryhubipswich.com

Recovery Lodge (The) www.therecoverylodge.co.uk

Seasons Rehabilitation Centre Limited www.seasons.rehab

Sefton Park addiction treatment service

 

 

Sefton Park

www.seftonparkrehab.co.uk • Somerset • Therapeutic Community

Located in a Grade II listed building close to the beach, Sefton Park is a specialist private rehab and one of the leading addiction treatment centres in the UK.

Our treatment approach is person-centred and personalised to meet the specific needs of each client.

Offering affordable programmes including detox, primary and secondary treatment and comprehensive aftercare packages, we support all our clients in getting the most out of their treatment experience.

Shardale www.shardalerehab.co.uk

Somewhere House www.somewherehouse.com

St Anne’s Alcohol Services www.st-annes.org.uk

Start2stop Ltd www.start2stop.co.uk

StepbyStep recovery www.stepbysteprecovery.co.uk

Steps Together Rehab

 

 

Steps Together

www.stepstogether.rehab • Nottinghamshire • Eclectic

Steps Together Rehab is an exclusive private residential clinic, set in a beautiful tranquil location in Nottinghamshire. It is the perfect place for detox, alcohol and drug addiction rehabilitation and aftercare. Our team consists of some of the UK’s most experienced and qualified practitioners.

Interventions available.

Streetscene addiction recovery ltd www.streetscene.org.uk

Thoams drug and alcohol treatment

 

 

 

THOMAS Witton Bank (Charity)

www.thomasonline.org.uk • Lancashire • Eclectic

THOMAS delivers a range of holistic recovery focused services, which take people from within prison or hospital, through detox and residential rehabilitation into community based provision. We offer drop in facilities, assertive outreach, recovery programmes incorporating cognitive, social and interpersonal approaches, and support with wider issues associated with addiction.

We provide residential provision, support for those living in their own homes and community-based programmes. We currently operate in Blackburn with Darwen and Salford and take the majority of our referrals from across the North West. For our residential rehabilitation unit in Blackburn, we accept referrals from across the country.

tom Harrison house specialist addiction treatment for ex military

 

 

 

Tom Harrison House

www.tomharrisonhouse.org.uk • Merseyside • Eclectic

Tom Harrison House is a specialist facility providing an addiction recovery programme exclusively to military veterans, reservists, serving personnel, and their families.

The primary programme runs over a 12-week period, and includes a diverse range of recovery-focused activities and therapeutic groups, as well as individual sessions and family work. We provide supported accommodation in a dedicated recovery house. A second stage is available, providing a stepping stone between primary care and a return to independent living.

Working in close partnership with Mersey Care NHS Trust and The Royal British Legion, we also support clients through pre-admission detoxification and post-programme reintegration.

trevi House addiction treatment for women with children

 

 

 

Trevi House (Charity)

www.trevihouse.org • Plymouth • Eclectic

Trevi House is a truly unique mother and child rehab. We have 25 years experience of helping families to recover from drug addiction. Based in Plymouth, we can accommodate mothers with their children from babies through to school age. We are also able to support pregnant women. Our new extensive free aftercare service is able to offer support with relocation.

Secure site, CCTV monitored • High quality accommodation • 24-hour staff cover • Maternal detox • Therapeutic groupwork programme • Input from clinical psychologist • Specialist on site nursery with sensory room (Ofsted registered) • Comprehensive progress reports • Individually tailored packages of care.

Rated Good by CQC 2019 with Outstanding for caring and Outstanding for responsive.

Turning Point addiction treatment

 

 

 

 

 

Turning Point

www.wellbeing.turning-point.co.uk/residential/ • Manchester • Detox Centre

Smithfield Detox Service is a purpose built 22 bed specialist in-patient detoxification unit, located in Man- chester City Centre, for adults of 18 years and over who wish to address their substance misuse and recovery within a specialist safe and supportive environment.

UKAT www.ukat.co.uk

WDP drug treatment

 

 

 

WDP Passmores House

www.privatedetoxandrehab.org.uk • Essex • Recovery Community

Passmores House is a recovery community for people aged 18+ who are dependent on drugs or alcohol. Combining idyllic surroundings, expert clinical care, and social, physical and psychological therapies, we offer a safe and supportive environment for our residents.

Our comprehensive care package includes inpatient stabilisation, detoxification (including the capacity to undertake extremely complex cases), and a residential rehab programme that runs for either 12 or 24 weeks. Longer reintegration programmes are also available.

Rated ‘Good’ by the Care Quality Commission (CQC), our residential rehabilitation retention rate is one
of the highest in the UK (85%) and our inpatient detoxification completion rates are 90%.

Western Counselling Drug and alcohol treatment

 

 

Western Counselling

www.westerncounselling.com • Weston-Super-Mare • 12-Step

Western Counselling offers a structured, abstinence- based, 12-step residential treatment programme. Our professional services include alcohol detox, drug detox, and a programme of rehabilitation and aftercare, to give you the best possible chance of achieving and sustaining long-term recovery from addiction.

If you are seeking addiction treatment yourself or for a family member, Western Counselling Bristol provides a safe, secure, supportive environment to start the recovery journey.

Yeldall manor christian addiction treatment centre

 

 

 

Yeldall Manor

www.yeldall.org.uk • Reading • Eclectic

For 40 years Yeldall Manor has helped men overcome their drug and alcohol addictions. We facilitate constructive change in a supportive residential environment through structured therapeutic programmes led by highly trained staff.

Yeldall offers: Detoxification • Rehabilitation • Resettlement • Work & training • Move-on housing • Aftercare

 

OVERSEAS LISTINGS

Cabin Changmai www.thecabinchiangmai.com

Camino recovery Spanish based addiction treatment

 

 

 

Camino Recovery

www.caminorecovery.com • Spain • 12-Step

Nestled below the stunning Sierra de Tejeda mountains, Camino Recovery is a tranquil residential retreat on Southern Spain’s Andalucian coast that deals with the treatment of Addiction, trauma and depression.

The intimacy of the family run centre means that a high degree of personal attention is a given in a compassion- ate and caring environment often lost in larger facilities. The luxurious surroundings include 7 en suite private bedrooms, Walled garden and pool and extensive secluded grounds.

Our bespoke program draws on over 80 years of com- bined therapeutic expertise and our masters qualified team will help you get your life back on track in sunny and peaceful surroundings.

Clinic Les Alpes www.cliniclesalpes.com

River Rehab (The) www.TheRiverRehab.com

Triora www.triora.uk

 

Hats off to Livingstone House

By
DDN
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[icon name=”home” class=”fa-2x”] DDN Rehab Guide [icon name=”address-book-o” class=”fa-2x”] Read the guide Spotlights Editorials Rehab News Directory

LIVINGSTONE HOUSE WAS FOUNDED BACK IN 2001 by the now much loved and highly respected Sally Livingstone from Birmingham.

Its purpose was to help those suffering with addiction to drugs and alcohol, and their families, and to help them address their addictive behaviours.

Sally is the Founder, Director and Chairperson of the board of Livingstone House drug treatment service
Sally is the Founder, Director and Chairperson of the board of Livingstone House.

Sally had come to realise, through her personal experiences of addiction, that there is far more to address in working with those affected than just detoxing them.

So now Livingstone House specialises in treating addictive behaviours – changing the thinking, which changes the behaviour and addresses the obsessive-compulsive disorders that lead to active and habit-forming addictions. The dedicated team worked tirelessly to give vulnerable people hope, encouragement and support – in short, to show them it’s possible to achieve anything if we only have the willingness!

That work started 18 years ago and continues to this day, right in the heart of the country. From its very humble beginnings, Livingstone House has been based in Birmingham. It’s a CQC- registered residential drug and alcohol treatment centre that provides a comprehensive and holistic programme for adult males aged between 18 and 64.

The residential units comprise detox, primary care, secondary care and re-entry into society phase, through a 12-step approach to the management and treatment of addictive behaviour. They are abstinence based and offer recovery from active addiction. The aim is to provide residents with a full range of life skills and knowledge to arrest their addictions and embrace their new way of living drug and alcohol free.

Livingstone House residential drug Treatment offers the therapeutic benefits of the countryside living.
Livingstone House offers the therapeutic benefits of the countryside living.

By the end of the programme, through group and one-to-one work with the highly trained and experienced multi-disciplined team, residents will have a greater awareness and understanding of the nature of their addictions. Regular attendance at AA and NA meetings helps strengthen their recovery foundations and highly important family support services also play a key part in each individual service user’s programme of recovery. There is also plenty to do and enjoy as a resident at Livingstone House, from weekly gym sessions, football, and other sports activities, to relaxing at the cinema, going bowling and for meals out, as well as the therapeutic benefits of the countryside and coastal walking days. You can also take part in group relaxation, mindfulness and meditation sessions, art and music classes and gardening and building projects.

Each person is treated as an individual at Livingstone House. You can self-refer or ask your doctor or social care/health professional to call for you. Local authority, NHS, local and national service provider contracts are all undertaken.

If you have a drug and/or alcohol problem, need detox and/or rehabilitation, are struggling with a family member trapped in addiction, or are in need of some supportive friendly advice, just give their team of specialists a call on 0121 753 4448 (24 hours).

Email: info@livingstonehouseuk.org Web: www.livingstonehouseuk.org

Scots record highest ever drug-related hospital admissions

By
DDN
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Scotland has seen a fourfold increase in drug-related hospital stays in the last 20 years, according to the latest figures from the Scottish NHS. Rates have increased from 51 to 199 stays per 100,000 population, with a ‘sharper increase’ seen in recent years.

In 2017-18, there were more than 10,500 drug-related general acute hospital stays in Scotland, the highest figure since records began. This related to nearly 8,000 patients, more than half of whom were ‘new’. Nearly 60 per cent of drug-related general acute hospital stays were the result of opioid use, while more than half of drug-related psychiatric hospital stays were associated with ‘multiple/other drugs’, including solvents, stimulants and hallucinogens. The 35-44 age group was the most represented in both types of admissions, with drug-related general acute stays for this group increasing more than tenfold since the mid-1990s.

However, admission rates for 15-24 year olds are also increasing, with the 2017-18 rate the highest in more than a decade. Around half of all patients with a drug-related general acute or psychiatric hospital stay lived in the country’s most deprived areas.

David Liddell: These figures highlight the need for greater, targeted interventions.

‘These figures are of great concern,’ said Scottish Drugs Forum (SDF) CEO David Liddell. ‘It highlights very clearly the need for greater and targeted interventions with this population both within the hospital setting and in the community, which can reduce unplanned hospital admissions. This will save the NHS resources and deliver a better service to people with a drug problem.’

There were examples of good practice however, he said, such as drug and alcohol nurse liaison posts situated in hospitals. ‘These posts aim to assist people in getting appropriate care while in hospital and help link people up with appropriate community based services.’ The trend in increasing admission rates for younger patients was also ‘worrying’, he added, and mainly linked to cocaine and cannabinoid use.

Meanwhile, a report from Audit Scotland shows a 71 per cent increase in drug-related deaths in Scotland since 2009, with 76 per cent of fatalities now in the over-35 age group. The 2017 figure was the highest ever recorded, at 934 (DDN, July/August 2018, page 4), with the 2018 total – due to be published this summer – expected to be higher still.

Drug-related hospital statistics Scotland 2017/18 at www.isdscotland.org

Drug and alcohol services: an update at www.audit-scotland.gov.uk

 

Less pain, more gain

By
DDN
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Pain management image of woman holding her head
Read the full article in DDN Magazine

Opiate medications don’t work for chronic pain – in fact they often make it worse.

In a recent pilot scheme in Hastings run jointly by Change Grow Live’s East Sussex drug and alcohol recovery service (STAR) with local GP surgeries, 235 patients were assessed and supported to manage their pain and wean them from opiate medications. Sixty were fully weaned and a further 57 reduced to a safe and sustainable level.

The results were startling. Patients who weaned from opiates reported an average 19 per cent improvement in their quality of life, significant reductions in anxiety levels, improved sleep, less constipation – and no increase in pain. Early indications also suggest a further reduction in GP appointments following weaning of as much as 20 per cent – a huge cost saving, especially when added to the £31,000 per annum saved in medications.

In addition a group work programme was developed that supported patients with a range of self-management techniques for pain. The isolation caused by chronic pain leads to a wide range of problems, and the group found it useful to spend time together connecting with others who truly understood their issues. In fact, the core of the group has continued to meet and, with support from Change Grow Live (CGL), is setting up a community-based peer support group for chronic pain sufferers.

Moderate to severe chronic pain – that is, pain that continues for more than 12 weeks – is thought to affect around 18 per cent of the UK population. GPs have traditionally prescribed opiate medications such as morphine, fentanyl, buprenorphine and oxycodone, as it was thought that – provided they did not over-sedate, cause overdose or other severe reactions – it was safe and there was little else that could be done for these patients.

A broad definition of dependence-forming medications encompasses GABAergic medicines, benzodiazepines and Z-drugs such as zopiclone, and the prescribing of these has been increasing (with the exception of benzodiazepines). In 2000, 6 per cent of the UK population were prescribed at least one of these types of medicines, but by 2015 this had risen to 9 per cent.

Hastings and Rother CCG looked at GP surgeries locally and were able to identify those with the highest rates of opiate prescribing. CGL were then contracted to provide a pilot scheme alongside The Station Practice in Hastings for one year from February 2018.

The pilot worked in two phases, with the first half of the year a multi-disciplinary team (MDT) approach, and the second half CGL-led with limited GP support and expansion into a second practice. The MDT approach showed the greatest results, but also used the most resource. The CGL worker engaged patients with an above 120mg morphine daily equivalent, as well as patients prescribed polypharmacy opiates or other DFMs.

Engagement was key – someone listening to patients’ stories was an incredibly powerful experience for them, as most clinical staff are usually unable to take the time to do this. Motivational interviewing was used to support movement towards change, both with lifestyle and medication, and mindfulness, TENS machines, sleep hygiene, and referral to other agencies were also key in fully engaging patients.

Once a week for half a day a dedicated GP was available and MDT practice appointments were run alongside the CGL worker – these were 20-minute slots that allowed time for holistic interventions for a wide range of health issues. Patients were provided with a ‘Hastings pain toolkit’ to assist with self-management of pain and lifestyle, which included links to other useful resources. A surgery pharmacist was also involved to provide follow-up support and discuss medication with patients by telephone. The MDT team has been nominated for this year’s BMJ awards in general practice, and has reached the final five.

During the second half of the year the CGL worker was spread across two GP surgeries, carrying out the same interventions without the MDT clinic. This approach was less resource intensive, yet still wielded some promising results.

Future plans – provided appropriate funding can be secured – centre around whole-surgery approaches, with all GPs supporting the programme, referring to a DFM worker for assessment, and most psychosocial and self-management of pain support taking place in a group setting. A similar trial is due to begin soon in Worthing, supported by CGL.

This is an often-neglected cohort of patients, who suffer daily and are often left ‘parked’ on large doses of opiates that have devastating long-term effects on their life, affecting their memory and digestion, accelerating osteoporosis, and potentially damaging their immune systems or causing fatal overdose.

Long-term prescription of opiates can also lead to a faulty pain system, with the medications starting to ‘drive’ the pain. But these effects can be reduced or negated through a combination of psychosocial support, a change in pain management techniques and judicious use of pain relief medications. After all, who wouldn’t want an 18-20 per cent improvement in their overall quality of life?

 

 

Robert Ralph is dependence forming medications lead at Change Grow Live (CGL)

 

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