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I was very heartened to read the interview with Alliance founder Bill Nelles (DDN, September, p10). The story of setting up The Alliance is an inspiring one of genuine user activism, and of making a huge difference and saving lives. For the past few years we have had a good system in this country with medication available, and I think it can be sometimes forgotten that this was not always the case.
There is much talk of patient choice and the oft-heard discussion of ‘an individual recovery journey’. However in the current climate individuals on a script are often left feeling stigmatised and in constant fear of having their medication removed. The situation in the UK 30 years ago, and the current lack of methadone prescribing in parts of Canada, provide a stark reminder of how many lives have been lost by the blinkered pursuit of abstinence as the sole treatment option.
Despite this, Nelles states how open he is to abstinence and how he ‘wants people to get the treatment they want’ and sees his role to protect people’s choices. Coming from him, talk of ‘individual recovery journeys’ does not sound hollow at all.
Someone with a vast knowledge of the UK treatment system gained through professional and personal experience, coupled with his current situation as someone removed, have given Nelles a unique perspective. I look forward to hearing more from him.
Colin Reed, by email.
Medications in recovery
Professor Strang tells us that overcoming drug dependence is often difficult, and reports that not everyone who comes into treatment will succeed (DDN, August, p14).
As he indicates, research and experience demonstrate that opioid substitution therapy (OST) succeeds in helping bring heroin addicts to abstinence (but only in 3 per cent of cases).
We also know that 12-steps succeeds in 20 to 30 per cent of cases and that, while other recovery programmes have consistently brought 55 to 70 per cent of addicts on various substances to lasting abstinence, there are still 25 to 30 per cent who, for well-known reasons, are fundamentally incurable and for whom therefore OST or the prescribing of diamorphine appears a realistic management of their addiction.
That leaves 70-plus per cent who have not quit, who have tried hard to do so on numerous occasions (often daily), who have failed just as often, but who still want to escape their addiction – including wanting to quit their methadone dependency.
In other words, the essential difference between the ‘incurables’ and the 70 to 75 per cent who still want to escape their addiction is willingness, with the larger group unfortunately lacking in knowledge of how to get themselves back into the natural state of abstinence into which 99 per cent of them were born, and the smaller group utterly resistant to quitting.
So why for one moment consider putting the majority of heroin addicts on OST, when the majority are both able and willing to quit, and have not done so only because they have not been offered the opportunity to be trained in the effective addiction recovery techniques which are currently practised at 169 centres (including prison units) in 49 countries and which have been helping hundreds of thousands of addicts of all types to cure themselves since 1966.
Regrettably, it appears that effective self-help training in do-it-for-yourself addiction recovery techniques is ignored and/or defamed because it does not entail the daily usage at any stage of psycho-pharmaceutical medications.
Along with addiction prevention training, the government’s goal of reduced demand is achieved by recovering existing addicts to relaxed lasting abstinence, without prescribing any other addictive substances.
Kenneth Eckersley, CEO, Addiction Recovery Training Services (ARTS).