Transcript Mark Gilman - National Treatment Agency for Substance Misuse

Building Recovery
DIP Clinic
Mark Gilman
Strategic Recovery Lead
National Treatment Agency
Contents
•Drugs
•Alcohol
•Addiction
•Crime
•Prison
•Recovery
2 very different types of
drug and alcohol use
A for “Addict”
A
Pareto Principle
The Addicts
20% use 80%
+ Responsible for 80%
acquisitive crime
Group B
The “Recreational” Users
•Bingers
•Public Disorder
Who gets caught in DIP nets?
Offenders who also use drugs
and alcohol. Offending not
driven by substance use
Drug and alcohol addicts
offending driven by addiction
What do we do with them?
Offenders who use
Addicts who offend
Non-OCUs
OCUs
Time limited, non medical
intervention
Retained in treatment
DIP, TREATMENT, CARAT
Frequent Flyer & Recycling Programme
How many?
Who are they?
Dual Diagnosis?
PPOs?
CARATs
DIP
TREATMENT
Social Isolation in Treatment
ME
MYSELF
I
Me, Myself and I – in treatment and alone
Why remodel treatment systems?
2010 drug strategy:
Building Recovery (in Communities)
“Substitute prescribing continues to
have a role to play in the treatment of
heroin dependence...
(But...)
Its first step on the journey to recovery”
2010 drug strategy:
Building Recovery (in Communities)
 ... supporting recovery from drug
and alcohol dependence.
 puts more responsibility on
individuals to seek help and
overcome dependency
 holistic approach...employment and
housing
Finding Recovery?
“Where do I find
this recovery
stuff?”
Recovery
Communities
Community
Treatment
Rediscovering AA and Mutual Aid:
10/06/35; “The Enlightenment”
"The therapeutic value of
one addict helping
another”
(See Griffith Edwards
On Lifeline’s FEAD)
75 years on:
“more than 2
million members”
Wikipedia
“I cant but WE can”
NICE Guidelines
Issue date: July 2007
Drug misuse
“Staff should routinely
provide people who
misuse drugs with
information about selfhelp groups.
Psychosocial interventions
These groups should
normally be based on
12-step principles; for
example, Narcotics
Anonymous & Cocaine
Anonymous. “
NICE clinical guideline 51
Developed by the National Collaborating Centre for Mental Health
Psychological and Social changes via Mutual Aid
Keith Humphreys
Active Coping
Mutual Aid Group
Involvement
Motivation to
change
General
Friendship Quality
Friends’ Support
For Abstinence
Note
All paths significant at p<.05. Goodness of Fit Index = .950.
Reduced
Substance
Use
Summary of What We Know (ref: Keith Humphreys)
 12-step group participation significantly reduces drug and alcohol
use.
 12-step group involvement reduces ongoing health care costs.
 Benefits of 12-step groups mediated both by psychological and
social changes.
Identifying and changing social networks
“You are who you spend time with”
The Lifestyle of Active Addiction
The Lifestyle of Recovery
Recovery as Emigration & Immigration
“Farewell Treatment.
Thank You”
RECOVERY LAND
RECOVERY
COMMUNITY
Big Ideas
SANITATION
Asset Based Community
Development
Deficit Based Approach
Asset Based Approach
Weaknesses
Strengths
Outside In
Inside Out
Dependence on outside Professionals
Dependence on each other
Consumers of services
Partners in provision of services
Professionals non-judgemental
training makes challenge difficult
Challenge each other to “do the right
thing”
Disabilities
Abilities, capacities, Assets
Client
Citizen
Passive victim of problems
Active participant in solutions
Treatment and Recovery: Content, Themes & Characteristics
Treatment:
Recovery:
Acute Short Term interventions
Long term process
“I” for Individual, Individualism
“We” as in Community, Mutualism
Medical & Clinical
Social & Communal
Risk Averse
Embraces Risk
Apathetic
Ambitious
Talking therapies
Activities – WORKING!
•Aftercare
•Day Programmes (CBT)
•12 Step Mutual Aid (NA, CA, AA)
•SMART Recovery (CBT)
Residential Treatment
Recovery Housing & Employment
Professionals as Experts
“Recoverees” as Experts
CONNECTING & SOCIAL NETWORKS
Line = a relationship between two people
more embedded = central
less embedded = periphery
Node = a person
“embedded”: the degree to which a person is connected within a network
CONNECTING & SOCIAL NETWORKS; Contagion, Connection, Homophily
•
Contagion:
what flows across ties
(germs, money, violence, fashions,
organs, happiness, obesity, etc.)
• Connection:
who is connected to whom
(ties to family, friends, co-workers, etc.)
• Homophily:
the tendency to associate
with people who resemble ourselves
(“love of being alike”)
PPOs Carrying the Message
AFTER
BEFORE
•Creating Recovery Communities
•Changing Social Networks
•Organising Recovery Communities
“The addition of just one abstinent person to a social network increased the
probability of abstinence for the next year by
27%
Litt et al – “Changing network support for drinking” (2009, (p230))
Relapse = “Warrior Down!”
http://www.whitebison.org
5 ways to well being in Recovery
1. Connect… With people around you. Go to meetings (AA, NA, CA, SMART)
2. Be Active…do something, go for a walk, exercise, do anything, WORK
3. Give… Do something for someone else. Volunteer. Sponsor.
4. Keep Learning… Try something new. Become a student of recovery?
5. Take Notice… Be curious. Be present. ‘The Power of Now’.
Recovery Pioneers & Champions
“We are family!”
Hard Wired to Attachment
“We may not need everybody but all of us need somebody”