Step by step

Viv EvansStep by step

DDN reports from the second Adfam/DDN national conference for families and carers, which highlighted that, despite the progress in bringing family support to the fore, there’s still a long way to go to convince commissioners.

‘We might be fed up of banging on about the same old thing – but many families haven’t heard it and it’s important that they do,’ Adfam’s chief executive Vivienne Evans told delegates at the second Adfam/DDN Families First conference. ‘We have to aim that people can speak out.’ Much of Adfam’s work was centred on promoting family support in its own right, tackling stigma, and developing forums and regional networks, she said.

Mark Gilman, national recovery strategy lead at Public Health England (PHE) believed in the essential value of support networks. ‘Social relationships are a matter of life and death,’ he said, adding that social isolation could be ‘a death sentence alongside the chemicals.’ This applied equally to families of loved ones, whose involvement with organisations such as Al-Anon showed better outcomes and support throughout the recovery process.

Nick Barton, chief executive of Action on Addiction tackled the difficult concept of ‘tough love’, commonly seen to mean not tolerating certain behaviours and often driven by helplessness.

‘When someone comes up with a simple formula like tough love seems to be, there’ll be plenty of takers,’ he said. ‘But the core question is, can you get someone to stop their addiction by the way you relate to them? My answer would be no. And can you improve your life by the way you relate to someone with addiction? The answer is yes.’

Setting boundaries was no bad thing between adults, but it had to be done for the right motives. Families needed to realise that it might have an effect, or it might not, he said.

‘Addicted people often offer invitations to treat them badly,’ he stated. ‘We don’t have to accept these – in fact they should be resisted. Don’t take the addicted behaviour personally – it’s not directed at you. It’s about their difficulty in being themselves. 

A nurturing attitude to helping was usually better than confrontation, he suggested. ‘There’s no evidence for tough love. It can be counterproductive and make problems worse.’ Participants in a ‘carers’ rights’ workshop were glad to hear this advice.

‘It was so reassuring to hear Nick Barton’s talk on tough love and that it doesn’t necessarily work,’ said a couple from Southampton. ‘We had been living with guilt as Speakerwe couldn’t do it.’ The couple’s son had been ‘cast adrift’ from a young people’s support service as soon as he’d reached 18, leaving them struggling, with nothing but the number of a local support group that had turned out to be a lifeline.

The couple explained that they had been to their family doctor who gave no more help than to say ‘I don’t know how you cope,’ leading to a discussion within the workshop about the need for GPs to be actively involved.

‘The biggest theme to come out of this is that GPs should signpost information and support,’ said Su Bartlett, drug and alcohol development worker at Carers in Hertfordshire, who led the workshop.

‘Caring is tough whatever the rules,’ she said. ‘It’s hard work and often a battle. The impact is on your physical and mental health – it’s a huge, huge issue.’ It was even difficult to get people to identify with the label of carer. ‘Some drug and alcohol carers feel that they shouldn’t be accessing services,’ she said.

A UK Drug Policy Commission (UKDPC) study suggested that around 1.5m adults in the UK were affected by a relative’s drug use, but other studies put this number closer to 8m, she said. Whatever the figure, there was no doubt of the significant negative impact on physical and mental health, emotional wellbeing, family relationships and finances, and the health and wellbeing of any children involved.

The workshop group brought family members and carers into discussion with practitioners, and the conversation frequently became impassioned as carers brought their day-to-day tensions to the group.

‘I don’t hate my son, but I hate what he does,’ said a mother. ‘It helps me to go to the support group. I hadn’t really thought of myself as a carer till today – I’m his mum. My group takes us away on days, such as spa days, and I think “why am I here? Because my son’s a drug addict.”’

‘My son was on drugs for nine years before I knew about support,’ said another mother, highlighting how far family support still needed to go.

‘So how can we encourage people to access support for themselves?’ asked Su Bartlett. The Adfam stigma campaign would help to show that carers had a right to get angry and give them the way forward to deal with a lot of internal processes, said Esther Harris, an independent practitioner.

‘A lot of parents believe it’s their fault, and this erodes the belief that they deserve something for themselves.’


Adfam’s Kate Peake addressed the issue of stigma at a plenary session later in the day and explained the charity’s ‘Speak Out’ campaign.

‘It’s about telling the world this can happen to anyone,’ she said. This isn’t an additional extra, it’s intrinsically related to the main agenda. It’s about regaininghumanity for family members.’ 

Family members were not comfortable talking about their issues, but could be encouraged to share, she said. Illustrating her point with an account of organising a flash mob with a carers’ network in Tyne and Wear, she said the important message to convey was that ‘things can and do get better’. This local initiative had enabled the participants to give out the message that ‘family members need support and here’s where you can get it’.

‘There’s still stigma, but there are huge changes and we need to learn from that,’ she said. ‘We have to take small steps.’

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