Drug Rehab and Alcohol Rehab

When someone we love has a drug or alcohol problem it is natural to want to help them, but expecting yourself to become an addiction expert over night is unrealistic and can be very damaging to the person and the family unit. 

Sometimes, because we are so emotionally invested in a loved one,  our well meaning efforts actually empower the addict to continue using - often this is because our reactions to the alcoholic or drug addict allow them to carry on with the same patterns and actions, but they avoid the consequences of their behaviour.  This is enabling.

Of course you care about the person and you don’t want to see them encounter social, financial or legal problems, but by allowing the person to continue with no consequences, effectively giving permission to continue on the same path, is not the best way to help the one you love. 

In the same way that physical problems are treated by a medical professional, addiction problems require the support of a addiction specialist to help the addict address what is motivating their substance abuse.  We wouldn’t expect ourselves to be able to match our GP in their clinical knowledge so we shouldn’t expect ourselves to be able to match the skill of a addiction clinician.  What we can do is get some help - both for the ones we love and for ourselves, to gain an understanding of the complex nature of an addiction and ultimately help our loved ones to regain control and live free from the constraints that their substance abuse has put on them.

Enabling is a complex relational issue and one that most people may not realise they are doing, but there is help available.

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http://news.bbc.co.uk/local/suffolk/hi/people_and_places/newsid_8611000/8611987.stm

Chris Hibble is a 37 year old man in recovery from alcohol and drug addiction, after receiving professional support on a rehabilitation programme Chris is now gearing up to run the London Marathon.

“It was a lot harder to battle with drugs than it is to run a marathon,” said Chris, who’s training for the big event in the capital on 25 April.

“Chris’s addiction story started when he was 11 years old and had his first drink. By the age of 16 he’d tried his first drugs.   He took them socially as part of the rave scene and tried everything, including ecstasy and heroin, although he says alcohol was the drug that eventually got him.

“It spiralled out of control. I enjoyed drinking and taking drugs when I first started and before long I didn’t have the ability to stop by myself.   I was forever losing jobs, being in A&E and in trouble with the police.  It caused devastation and misery and pain to everyone that I was really close to - my family and friends.”

He’s now self-employed as a painter and decorator and has a wife and two children.

“It came to a point where I could no longer function with or without them, contemplated taking my life and decided to get some help.”

In 2006 Chris did just that and turned his life around to live free from the constraints of his addiction and choose the direction he wants his life to go in….

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http://news.bbc.co.uk/1/hi/health/8599878.stm

The above link is to a BBC news story written in regard to hospital staff providing sensible drinking advice to patients coming back for follow up appointments after treatment for an alcohol related injury.  The Royal College of Surgeons of England suggest that outpatient clinic visits offer an opportunity for nurses to motivate people to drink sensibly and to offer advice about alcohol services should their patients require additional support.

“Janet Davies, from the Royal College of Nursing, said that it had recently accredited a training course to help nurses intervene at the right moment.   She said: “The time nurses spend with patients during follow-up appointments provides a valuable window of opportunity to encourage people to think about whether they might be drinking too much and to signpost them to further information and advice.”

Do you think that this step will help reduce the number of alcohol related A&E hospital admissions?

http://www.hse.gov.uk/alcoholdrugs/drugs.htm
Above is a link to the Directgov website, specifically the ‘Health and Safety Executive’. Below is an extract from the site discussing employment substance misuse policies and drug testing:

“Drug and other substance (e.g. solvent) misuse is everyone’s concern. In the context of work, not only does it damage the misuser’s health, but it can cost employers through absenteeism and reduced productivity. It may also increase the risk of accidents. Employers should adopt a substance misuse policy, in consultation with their staff. This policy should aim to support affected employees rather than punish them, though your policy must say that possession or dealing in drugs at work will be reported immediately to the Police. If an employee admits to being a drug user, your policy should seek to help them rather than lead simply to dismissing them.

The advice clearly states that any drugs policy or screening programme should be implemented with the intention of helping employees that are experiencing drug problems. In reality is this how substance misuse policies are interpreted by employees and do they feel that a positive drug test result will mean they get help or get the sack?

http://news.bbc.co.uk/1/hi/uk/8255418.stm

The link above refers to the news story published by the BBC this morning regarding three clinics who have been trialling a new approach to address heroin addiction. Over the past 6 months these clinics have been supplying heroin for over 100 heroin addicts – the scheme involves clients attending a clinic twice a day for supervised injecting – unlike previous treatment plans, these clinics are not just using methadone, but also heroin.

The findings that have been reported this morning include a reduction in personal use of street drugs, meaning less money being spent on the illegal drug market and a reduction in crime. However, at £15,000 per person per year the NTA is considering the financial implications of the scheme. Aside from finances (treatment is reported to be three times as expensive as alternative treatment, but roughly three times cheaper than a year long prison sentence), this trial has raised many points…Some about the individual and some about crime and money….
For example, whilst the news report this morning suggested the scheme is designed to stabilise heroin addicts, it said nothing about the end goal – I.e. how long do individuals attend the scheme, what does completing the programme result in – safer using or recovery? Additionally, whilst the report advised that the 127 participants involved in the scheme had failed at other kinds of treatment, they have not reported any details. There is a proportion of addicts who do not successfully complete treatment the first time – this can be due many reasons, not least because the individual has gone into a unsuitable clinic and has been unable to engage. The point is, would £15,000 be better spent on 6 months of rehab where addicts learn to live drug free in a supervised and supportive environment, or do you think this new scheme will path the way to a healthily population and a serious reduction in drug related crime?

If you want to stop smoking there is a host of government funded initiatives to support you - groups, one 2 ones, telephone buddies, patches, chewing gum, inhalers, giving up plans and tools to help you break your own individual smoking cycle….There is even a section dedicated to helping pregnant mothers to stop smoking (also how father’s smoking can impact on unborn children). However, there seems to be a significant lack of readily available information regarding how illegal drug use during pregnancy can affect your unborn child.

It is common knowledge that using any substance when pregnant has the potential to cause negative consequences for developing babies, but it is interesting that you can watch numerous videos of a foetus’ reactions to cigarette smoke, but getting the medical facts on how illegal drugs affect your unborn child is not nearly as accessible. Could this be a reflection of our countries determination to ignore wide spread drug use and addiction or is it that the facts, as it were, are still relatively unknown?

Should there me more information on how illicit drugs affect pregnant woman and their developing children even if the facts are still unclear?

http://www.guardian.co.uk/theguardian/2009/jul/25/gary-reinbach-alcoholic-madeline-hanshaw

Above is a link to an article published in The Guardian over the weekend that writes about Gary Reinbach, a 22 year old who died from liver failure last week. The article discusses his mothers experience of her son’s drinking and ultimately his death as well as more general issues, such as should an alcoholic be given a liver transplant if there is a chance they may start to drink again? Surely there is always a chance that an addict will return to drinking or using, but they deserve the opportunity to get into recovery and that requires specialist help.

As Gary’s mother discusses and reject, the population have attributed a far proportion of blame to her for Gary’s death, but it is also clear that if Gary was eligible for a transplant he may well still be alive, so who should decide if someone should or should not be given a second chance? A key point is that if more alcoholics were treated in suitable rehab clinics then there would not be so much demand for livers or indeed so many alcohol related deaths.

What is most shocking about this tragic story is that a man aged 22 years old could die from a condition that is widely associated with older people who have 40 years old alcohol abuse under their belts. Indeed, even Dr Nick Sheron, a liver specialist has been shocked by the number of liver failure cases he has seen in young people.

“What Luke and his mates have discovered the hard way is what liver specialists like Dr Nick Sheron, of Southampton General hospital, have been saying for some time: that young people who abuse alcohol heavily will suffer the same consequences that older people who’ve been abusing it for many years do; in other words, their livers will fail.

The lost of this young man’s life not only highlights the severity of alcohol abuse, but also emphasises the need for people who are experiencing problems with alcohol to seek help no matter how old they are.

http://www.guardian.co.uk/society/2009/jun/15/health-drugs

The above links refers to an article published in The Guardian that discusses the potential closure of Middlegate – Britain’s only specialist residential drug and alcohol unit for young people. Whilst the article makes points about the development of new and alternative services to units like Middlegate, it remains a travesty to our society that our only facility geared up solely to deal with severe substance abuse problems in our young population is facing closure – and why? It seems to come down to finances. Treatment is not inexpensive, but it is life saving and whilst intense residential treatment is not needed by everyone, we are kidding ourselves if we think that losing a specialist facility like Middlegate is anything but a crying shame. We need to wake up and stop ignoring the fact that children as young as 11 and 12 are using hard drugs – having a place for young people to get the help they really need, and not just a few counselling sessions a month, is vital for the recovery of many young people; what we need is more places like Middlegate, not to rid our country of the only unit of it’s kind.

This week sees Radio 1 launch Drug Week – offering an accessible and informative debate about drug use in the UK. The link below refers to a Newsbeat page discussing the shift in young people’s drug habits. Whilst the article advises that there has been a drop in the use of hard drugs (i.e. heroin and crack) and that more young people than ever are getting addiction treatment, it also emphasises that party drugs (i.e. cocaine, ecstasy and cannabis) are getting stronger and taking them is increasing risky, especially when mixing multiple drugs together. This implies that whilst one problem is decreasing a bigger one is increasing.

 “Alcohol is cheaper and more available, cannabis is far stronger, cocaine is half the price it used to be and you can get half a dozen ecstasy tablets for £10,” according to Howard Parker, Professor Emeritus at Manchester University, who coined the term ‘ACCE’ last year.

Not to mention the fact that alcohol abuse is at record levels across the population and that the statistics publish recently quite possibly do not include thousands of young people who abuse legal prescription drugs, albeit attained by illegal means.

The facts are that drug use in this county, whether legal or illegal, is a big problem and we need a new approach to support our young people – ‘just saying no’ is no longer a valid preventative measure. It seems that taking drugs is part of the teenage culture and we need more understanding if we are going to nurture our young people to make more informed decisions about what drugs they use and how they use them.

http://news.bbc.co.uk/newsbeat/hi/the_p_word/newsid_8084000/8084968.stm

http://www.addictiontoday.org/addictiontoday/2008/09/defining-recove.html

The link above relates to an article addressing the way we define recovery.  The key question, as highlighted by Addiction Today, is  “if today’s search for outcome statistics is to lead to clinical effectiveness and clinical cost-effectiveness, what definition will help us to measure outcomes, for both comparative purposes and to feedback into programme improvements? “.

How is recovery characterised, what impact does this have on treatment and will one definition ever be all encompassing?