DISC News Spot - Updated 15/06/09

Comment on the recovery debate by Mark Weeding, Executive Director DISC

The recovery debate may mark a large scale change in policy and direction for drug treatment providers in the UK because it fills a void in what we do and why we do it.

It provides a much-needed sense of direction and a goal for drug treatment.

Defining recovery isn’t simple as it’s about how each individual transforms their lives. Each person’s journey is different, with some people achieving abstinence, and others accepting that drugs and alcohol will always be an issue in their lives.

Transformation should be the end goal and not methadone, which at the end of the day is a not very healthy substitute.

I became interested in drug treatment and policy in the mid 80’s when the first large scale wave of heroin use became established amongst young people. I was working in London in the youth justice arena and a whole cohort of my clients became users - seemingly overnight.

I moved to the NE only to have the experience repeated 3 or 4 years later. Drug treatment services had little to offer young people. Given that we were taking the strain anyway we decided to develop our own dedicated services for young people initiated into heroin use. We opened our first drug service called Orbit 20 in Spennymoor in 1998, with a methodology based on what would later be referred to as wraparound support.

We struggled for many years, working within a primarily medically focussed set of drug treatment regimes, and arguing for individually tailored interventions designed to support community inclusion. The ‘stack it high, flog it cheap’ approach to methadone broke over us like a wave over a novice surfer. It was much better than the reducing scripts everybody got in the 90’s, but we asked where was it all going.

As time passed we seemed to be marginalised, delivering services that were likely to destabilise the methadone maintenance regime by asking awkward questions about what else people wanted from their lives.

We persevered and gradually the value of our approach was recognised. In Leeds in 2008 we bid for the community drug treatment service with 2 other charities and a GP practice under the banner, ‘drug treatment is a stepping stone to community inclusion’. We took on the limited vision of a medical treatment model, and were awarded the contract.

What does ‘recovery’ have to do with all this you may ask?

For me the discovery that there is a recovery model with structured approaches to planning, case management and coaching has filled a void that we knew existed and had started to try and fill ourselves in Leeds.

We will be adopting a ‘recovery model’ in our work at DISC. In some ways it is easy as much of our practise drops in with little trouble and staff can see the development opportunities it offers.

The idea of a recovery journey is a powerful idea that can take on needle exchange, prescribing, PSI’s, aftercare and being drug free. They are all part of a complex long term journey that people will make, including the reverses and lapses that are so much a part of our service users lives. However I don’t believe that many providers have started to take on the idea of recovery communities, in which they support and work with local coalitions of individuals and groups.

Traditionally there has been a big divide between providers funded by the charity and public sectors, and mutual aid and self-help organisations. What we should do is enable people to find the intervention they need, be it through a faith group, Alcoholics Anonymous or a drug treatment service, support them to look at the bigger picture, and accept that there are lots of different routes ways of getting there. A clear vision, whether as customer, worker, volunteer or manager is crucial, as long as we don’t oversimplify or hijack it to meets our needs as providers of services.

Updated 15/06/09