The speakers and workshops at Families First 2013 gave delegates an opportunity to hear personal stories, network and exchange vital expertise.
Kate McKenzie speaks of the seismic effect of her daughter’s addiction
Hannah’s struggle to overcome her drug addiction has been a very testing time – often heartbreaking, frequently frustrating and even at times surreal. It has had a great impact on all the family and changed us forever. My younger daughter dropped out of school, my marriage broke up, illness and money problems soon followed. Drug addiction doesn’t just affect the lives of the addict but also those close to them.
Hannah is 26 and this struggle has been going on for over half of her short life. It began at 13 with anorexia, bulimia, self-harming and alcohol; from there it was a short step into the world of drug addiction. The descent was rapid and devastating and by the time she was 18 she was addicted to heroin.
At the time, my knowledge of drugs, and heroin in particular, was extremely limited. I knew it was dangerous, and that we should teach our children to ‘just say no’ and that advocating an abstinence policy was the way forward. My assumption that those who used drugs chose their lifestyle and somehow deserved to be sitting begging on the streets or selling the Big Issue was typical of many people’s. I now know I knew nothing at all about drug addiction.
What I subsequently discovered is that many drug users are messy, damaged, chaotic individuals with very complex needs. Yet time and time again while trying to help my daughter I found the treatment available to her was piecemeal, complicated and punitive. Those who use drugs cannot be fitted into neat bureaucratic systems and there are no easy ‘one size fits all’ solutions.
After a period of almost two years of being clean, Hannah relapsed last summer. I was devastated as I could predict the vicious downward spiral of disease, degradation and crime she would inevitably be sucked into. I also knew the destructive impact this would have on her sister and me. Straightaway the trust between us was broken. We could no longer leave handbags lying around, I hid all my valuable jewellery, I changed the locks on my flat. I hated doing this, but I knew what would happen if I didn’t.
The lies started, the money ran out. Moneylenders circled and drew Hannah in. Finally when the source of funding ran dry, the crime and prostitution began, swiftly followed by illness and overdoses. It was all too depressingly familiar. The relationship between us reached an all-time low on Christmas Day when I refused to pay for another hit. I was damned if I helped her and damned if I didn’t.
Hannah’s appearance in court earlier this year was one of many, and highlighted how punishing those who use drugs is a pointless exercise. Hannah was already in debt to moneylenders to the tune of £10,000 – a further £1,000 fine for stealing goods worth £30 was not going to achieve any positive outcome. Fortunately, simply because I was there, I convinced the duty solicitor to argue her case. The judge was sympathetic and she was given a 12-month discharge. I know very well that this would not have been the case for many others in a similar situation.
I asked myself what would make a difference to Hannah’s predicament and also to the many others trapped, like her, in this all too familiar cycle of addiction and recovery. I came to two conclusions. Out of all her addictions – anorexia, bulimia, alcoholism to name a few – her drug addiction is the only one that is criminalised.
If Hannah had been able to be stabilised on prescribed heroin, then her need to find £20 for the next fix simply wouldn’t exist. Her benefit money would continue to be used for food, not heroin. She would still be able to pay her rent and not be made homeless. She would not have to shoplift and steal.
On a personal level, it would remove so much of the anxiety and worry that I felt as soon as she relapsed. The trust would remain between us and the arguments over money for the next fix would cease. Most importantly though, the control and provenance of her drugs would be in the hands of doctors, not dealers. All the harm caused by black market heroin would be reduced considerably.
I know that prescribing heroin is not the only solution to this problem, but used in conjunction with other holistic forms of treatment and rehabilitation it makes sense to me. To allow Hannah to be stabilised on the drug of her choice, administered in a safe environment, would enable her to have more control of her recovery.
The second conclusion I came to concerns changing the focus of the treatment onto the cause of her addiction and not the symptoms. Hannah had been diagnosed as bipolar from quite a young age, leading to bouts of mania and depression. Because she is on heroin, no NHS psychiatrist will go near her. Their response is to say that until she comes off heroin they cannot treat her, yet she uses the drug to cope with her mental illness and so is caught in a catch-22 situation.
Some years ago she had a manic episode and attacked my younger daughter with the kitchen knives. I managed to calm her down and not knowing where else to go, I took her to A&E. After many hours waiting, the young doctor appeared and apologetically explained there was nothing he could do. The duty psychiatrist refused to be called out because Hannah was on drugs, so he suggested I took her home and hid the knives.
By contrast, her current treatment within the French health system has been a revelation. In April, Hannah went to stay with my sister in France in an attempt to detox. While there, she became severely dehydrated and was taken to hospital. The next day she was transferred to a psychiatric unit and the consultant explained to me that her heroin addiction was just a symptom and not the cause of her problems. Until her bipolar illness was properly treated and controlled, she would continue to self-medicate on heroin.
This was a first! To have the focus shifted from the drugs to her bipolar totally changed how she viewed her situation. Instead of being labelled as ‘just another junkie’, she felt her illness was at last being taken seriously. Her whole demeanour changed and became more positive; she began to believe she could really get well again.
For me, it meant I no longer had to fight the system to get help – it was being offered willingly and without any conditions. I was able to leave her in France, knowing that she was getting joined-up care and support for her complex problems.
Seven months on, Hannah is still receiving excellent outpatient treatment and psychiatric support. She has just been over for a two-week visit and the progress in her recovery is encouraging. She no longer has cravings and is a lot calmer. Her ability to deal with normal everyday issues has improved dramatically and she is starting to look ahead and plan a future.
My journey alongside Hannah in the past ten years has motivated me to try to seek better understanding and treatment for those who use drugs. I want people to know and really understand the cause of drug addiction and not be misled by the sensationalist articles pedalled by the popular press.
It breaks my heart and also makes me angry to see my daughter being treated as a criminal. When she is in the grip of her addiction she can become a monster and do things that even I find hard to accept and condone. But underneath I know there is a vulnerable damaged woman who struggles to cope with life and uses the drugs to escape from her problems.
When clean, Hannah is a kind, thoughtful and vibrant daughter who deserves to have a happy and fulfilling life. One day I hope she will finally achieve that. Until she does, I will continue to shout as loudly as I can to tell people the truth about heroin addiction. Ultimately I hope we can change misguided assumptions and get a majority to understand that people like Hannah need help, not punishment.
Only then, when we have significant numbers of people behind us calling for a change in current drug laws and policies, will we persuade politicians to be brave enough to implement the changes needed and provide the joined-up care and treatment people like my daughter really need.
Jason Gough recalls realising the impact he was having on his family
While I was in active addiction I didn’t understand the full impact of it on my family. Dad used to say ‘if you want to see our front room, go to cash converters – it’s all in there.’
It was only later that I realised I’d made our home an unsafe place. My family became frightened of me. I was oblivious to this; I thought at the time that I was the one who was suffering. I imagined I was protecting them in some way. When I was relapsing I didn’t say anything. I didn’t want to spoil the joy of ‘Jason’s getting better’.
In the early days it was all about escaping and nothing about my family. One day I clicked on a YouTube clip of the effect of drugs on a family and realised the impact. Hearing what someone else said had a huge effect on me. I left Sheffield that day, went to my mum, and told her I was sorry, that I loved her. I began the process of looking at my parents as individuals with their own hopes and desires, not just people there to serve Jason.
I realised how my addiction had affected them – it felt like losing a limb. I could recover from it, but life would never be the same. It was extremely difficult, realising the effect on my family. Without their support I could never have got into recovery. Without their help I never would have made it.
My father and mum dealt with me differently. My mum could cut herself off, but my father was always there and visited me in prison. He passed away while I was in rehab and never saw me get a job.
So I say to families, please share your story. Tell as many people as possible. Commissioners have to put families first.
‘We need family members out there advocating naloxone,’ said drugs trainer Nigel Brunsdon, leading a workshop about this life-saving intervention. Who better to put pressure on commissioners than families, daughters, sons, mothers and fathers, he asked. ‘We should be demanding naloxone. It shows we care. We care if someone lives or dies.’
‘The more people that are trained, the more people can train,’ said Dr Judith Yates, a GP in Birmingham. ‘It should not be one and a half hour sessions, it should be normalised, part of life – not made an occasion.’
With an (award winning) video of his daughter demonstrating saving her teddy bear from an overdose (pictured), Brunsdon showed how administering naloxone correctly was ‘child’s play’.
‘As long as it is injected into the thigh muscle it’s fine – you cannot overdose from naloxone,’ he reassured participants concerned about lack of knowledge. It was important to get naloxone into families with drug-using children or parents, he stressed.
For more advice and the naloxone film, visit www.injectingadvice.com
Drinking affects every family differently
‘Alcohol often gets left behind when people talk about substance misuse,’ said Alcohol Concern’s workshop programme manager, Lauren Booker, in a session about alcohol and families.
While alcohol had always received less money for services, people who gave up class A drugs often turned to alcohol, using it as a replacement, Lauren Booker explained. Roughly 1m children lived in a household with one or more dependent drinkers and almost a fifth of the population were affected by the alcohol use of family members.
The most common question asked by relations and friends of people with alcohol problems was ‘What can I do to help?’ While the World Health Organization defined dependence as ‘when alcohol affects physical, emotional and social functions’, it also applied to the functions of those around someone who struggled with alcohol issues.
During the workshop, case studies were given to groups describing a family of five with two parents who drank the same amount of alcohol per week (over the recommended number of units) but in different social and economic situations. Groups were asked to give examples of the effect of alcohol on the families – depression, break-up of the family, abuse, bad influences on the children leading to trouble at school or with the police, problems with household budget and negative impact on careers.
It was agreed that drinking affected every family differently and that there was no ‘standard’ pattern of what would happen. The environment surrounding the family and alcohol users had a big impact – it was never cut and dried. Alcohol was a short-term coping method, but caused more problems in the long term. Participants discussed what could be done to help families who were experiencing alcohol misuse. The ideal was to catch it early before problems became serious. Failing that, what was necessary was early identification, assessment and referral pathways, coupled with better multi-agency working.
Effective approaches to helping family members included online forums, recovery communities, and workplace counselling and referrals. It was essential to know what different services were available and to recognise that treatment did not necessarily mean abstinence.
Alcohol was all around us, in our society, community and families, said Lauren Booker, and there was a lot we could do about alcohol-related harm. However, it would be a slow process, in the same way that society eventually began to realise that tobacco was harmful and the culture around it changed. ‘
We are at the start of a long-term mission to change the way the nation drinks,’ she said.