Swift and Certain Punishment: Gearing the criminal justice system to change behaviour

‘Policy Exchange is delighted to host Keith Humphreys, Professor of Psychiatry at Stanford University, for a lecture and discussion about how policymakers can better gear the criminal justice system to change behaviour and substantially cut reoffending.

Professor Humphreys, formerly senior drugs policy advisor to President Obama, is a prominent advocate of a new generation of community supervision systems in the United States that are dramatically cutting substance misuse, crime and imprisonment.

These programmes are based on a simple idea: punishment that is swift and certain but not severe will control the vast bulk of offending behaviour. These programmes, such as South Dakota’s 24/7 Sobriety Scheme, combine much greater offender accountability and monitoring with a system of quick, consistent and modest sanctions.

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‘Psychiatric drugs are doing us more harm than good’ by Peter Gøtzsche

'More than 53m prescriptions for antidepressants were issued in 2013 in England alone.'This excellent blog appeared in The Guardian recently. 

‘As with benzodiazepines in the 1980s, the UK is prescribing SSRI antidepressants at a staggering rate – and to no good effect

We appear to be in the midst of a psychiatric drug epidemic, just as we were when benzodiazepines (tranquilisers) were at their height in the late 1980s. The decline in their use after warnings about addiction led to a big increase in the use of the newer antidepressants, the SSRIs (selective serotonin re-uptake inhibitors).

Figures released by the Council for Evidence-based Psychiatry, which was set up to challenge many of the assumptions commonly made about modern psychiatry, show that more than 53m prescriptions for antidepressants were issued in 2013 in England alone. This is almost the equivalent of one for every man, woman and child and constitutes a 92% increase since 2003.

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‘I am 14 years sober today!’ by Veronica Valli

ID-100227306-300x300Congratulations, Veronica! And thank you for your great blog.

‘Today is my 14th sober birthday. When you get to my age, birthdays aren’t something you necessarily want to shout about.

But recovered addicts and alcoholics have a different attitude to their sober birthdays. Every year we have under our belts has been hard fought for. This did not come easy. It’s the hardest thing I’ve ever done, so hell yeah; I’m going to let everyone know how proud I am to have got this far. [Too right! DC]

So here are the 14 things I’ve learnt about sobriety along the way…

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Psychiatric drugs cause altered mental states

Another ‘Unrecognised Fact’ from the Council of Evidence-based Psychiatry

‘Just like other substances that affect brain chemistry (such as illicit drugs), psychiatric drugs produce altered mental states. They do not ‘cure’ diseases, and in many cases their mechanism of action is not properly understood.’

Check out the other two short videos and research evidence.

‘When we reject the single story we regain a kind of paradise: Why Jubilant Stories matter!’ by Cormac Russell

UnknownHere is a really excellent blog from Cormac Russell of Nurture Development.

‘This blog reflects on the dangers of becoming trapped in the single story. This is a ubiquitous risk. From getting trapped in our personal history, to the dangers inherent in how media shape messages for our consumption, we all need the inoculation that a multiplicity of diverse and contradictory stories bring.

“Show a people as only one thing, over and over again and they become that one thing.”

These are the words of Chimamanda Ngozi Adichie, a Nigerian novelist who has dedicated herself to writing about the many stories of her life; her country and her continent. Her newest book, The Thing Around Your Neck, is a brilliant collection of stories about Nigerians struggling to cope within a corrupted context in their home country, and about the Nigerian immigrant experience.

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‘4 Tips for Super Sobriety’ by Beth Burgess

beths-storyHere are some real words of wisdom from Beth Burgess

‘In the early days of recovery, hanging onto your sobriety is pretty much the main priority in your life. But  in order to be sober and happy, you have to make an effort to grow as a person. Here are 4 elements that you can work on to ensure you have super-sobriety. Doing the following things will help you grow stronger and happier in your recovery.

Learn To Let Go
Addiction is an disease of stuckness. We get stuck in the cycle of using drink or drugs, and we also get stuck with our moods, grievances and resentments.

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’12-Step Programmes Help Thousands, but Are Outdated and Sexist’ by Jessica Smith

Geological wonders: picture three‘Addiction is everywhere. The drug of choice may be alcohol, or it may be food, sex, romance, gambling or shopping, but the basic problem is the same; the inner void created by a culture that sells us the empty promise that reaching for external things will make us happy.

When all that striving for money and possessions, and for status through jobs and relationships, still leaves a gaping hole inside us, many of us reach for the bottle, the chocolates or the credit card – and the cycle is complete.

In an article in the Guardian on May 30, Damian Thompson argued against the disease model for addiction, as developed by Alcoholics Anonymous. The roots of addiction, he wrote, lie in environmental factors, in the fact that “contemporary capitalism is ruthlessly targeting our mental reward circuits.”

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‘Lost lessons from an earlier era’ by Bill White

Lessons from an Earlier EraMy 2009 monograph outlined in considerable detail the history, theory and status of peer recovery support services (PRSS) in the United States.  In the years since the monograph’s publication, voluntary and paid recovery support services have dramatically increased in the US and internationally. 

Such growth has recently prompted me to reflect on the pre-professional days of addiction counseling in the United States (1965-1975) when people in recovery constituted the core workforce within newly arising addiction treatment programs. 

The current expansion of PRSS raised the following question:  What experiential lessons from this earlier era could inform the present implementation of PRSS?  Here are my top 20 answers.

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‘Invisible Pain’ by Jonathan Keys

‘In my practice as a therapist I often work with people who have been seriously hurt by the practice of psychiatry, either directly or indirectly through family members. Many of them started taking psychiatric drugs for moderate depression, or for some anxiety, or for panic attacks. But as time went on, their doses went up. More meds were added. By the time they realized the drugs were making things worse, they were already stuck on a large cocktail of psychiatric drugs.

The side effects worsened and became intransigent. Increasing depression, lethargy, loss of libido, confusion, mental fog, weight gain, lowered immunity and poorer sleep became the norm. Drugs were added to combat the side effects, leading to more side effects. At some point the realization settles in that the psych meds are causing tremendous suffering, are causing iatrogenic illness.

The sad part about this common story is that when the person finally decides that the psych drugs have caused deep harm, and that they want to stop, the road towards coming off these drugs is long and arduous.

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‘Four Examples of Expensive Rehabs That Spread Stigma, Not Recovery’ by Tom Horvath

shaming‘Eliminating stigma against people in recovery appears to be a universally supported goal within the recovery community, and for good reason. Recovery is hard enough without this additional burden.

The unspoken assumption is that stigma is the fault of the “outside” world – not of other people in recovery. But the recovery community has failed to provide effective leadership on this issue. And one component of the community—treatment providers—frequently reinforces stigma. How can we expect the world at large to change when we don’t change?

I operate a treatment system with two residential facilities, a sober living home and outpatient services. Because relapse is common, we often see clients who have been to other facilities. Most are frustrated, and often furious, at how they have been treated elsewhere. They generally report that they were viewed by staff as entirely lacking good judgment or a capacity for self-management. Therefore their requests and perspectives were easy to dismiss, even ridicule. They often have not been treated with much hospitality, either.

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‘Family Recovery, Al-Anon & Altruism: in helping we are helped’ by DJ Mac

w600_c83da257562805a91d9b09b368a04f2ePeer support is of immense value in helping people find recovery from addiction and mental health problems. However, what is it about peer support that is so important? How does it work? Here, DJ Mac looks at a recent science paper focusing on this issue. 

‘“Giving implies to make the other person a giver also.” So said Eric Fromm whose quote starts this research paper which travels to the heart of mutual aid. The clear message? In helping other, we help ourselves. The recovery saying “We only keep what we have by giving it away” hits the mark in this respect.

The researchers in this Finnish study looked at communication and support in Al-Anon groups, a 12-step mutual aid network for family and friends of alcoholics. In Finland, 97% of Al-Anon members are female and three quarters are partners of alcoholics. They conducted the research through questionnaires (169) and 20 interviews. In the survey they focused on two questions:

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‘Shame & Empathy’ by Dr. Brené Brown

Here’s an early video (2007) from Brené Brown before her TEDx talks went viral. Shame plays a major role in keeping people locked into addiction. Developing shame resilience can play a major role in recovery. 

‘In an excerpt from her new psychoeducational shame-resilience curriculum, University of Houston researcher and educator Brené Brown discusses the destructive nature of shame and the healing power of empathy.’

’18 Ways to Live a Successful Life (That Have Nothing to Do With Money)’ By Alexa Cortese

Geographical wonders travel picture quizHere’s an interesting article from the Huffington Post. Picture is from The Guardian.

‘People are always talking about success. It’s a word we hear often and an idea that seems to be constantly dangling in front of our faces – just out of reach.

But what does it mean? How, exactly, does one measure “success?”

We read articles that promise to enlighten us on “How to Be Successful.” They always tell us to work hard, ask for that raise, be innovative, not to waste time being unproductive, not to surround ourselves with those loser friends who have no interest in climbing the proverbial ladder. Someday, these articles promise, enough hard work and the right amount of luck will make us successful. (In other words, very rich and very powerful).

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Myth of the chemical imbalance

Here is the second ‘Unrecognised Fact’ from the Council for Evidence-Based Psychiatry.

Psychiatric drugs have often been prescribed to patients on the basis that they cure a ‘chemical imbalance’. However, no chemical imbalances have been proven to exist in relation to any mental health disorder. There is also no method available to test for the presence or absence of these chemical imbalances.

‘Recovery is too hard and dangerous. Solution: methadone for life’ by DJ Mac

w600_817157f479b2b1cb43e6a6646b8f7efcWell worth checking out excellent new blog, Recovery Review, by DJ Mac. Here’s a sample:

‘Berlin, like many big cities has a heroin problem. People presenting for help are being prescribed opioid replacement therapy (ORT) in greater numbers. That’s a good thing isn’t it? Well it depends on what you think is the end goal of treatment.

At the start of this interesting recent German paper “Why do patients stay in opiod maintenance treatment?”, Dr Stefan Gutwinski and colleagues say that the scientific literature indicates the point of ORT is: “to increase survival and bring stabilization to patients, in order to enable them to reach abstinence of opioids.” The Scottish Government’s drugs policy and the UK policy agree.

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‘My Story of Benzo Withdrawal and Activism’ by Barry Haslam

Barry-SueLatest from Mad in America is the story of a remarkable activist.

‘My story starts in 1976. I had a nervous breakdown whilst studying for my Accountancy Technician examination (which i passed with distinction). Plus I was holding down 2 jobs and bringing up a young family. My daughters where then aged 5 and 7.

I was then prescribed a series of benzodiazepine/anti depressant drugs for 5 years. This information was gleaned from my medical records (from 1976 until 1986) at a later date, as I have COMPLETE MEMORY LOSS, no memory at all, for that time.

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Trailer for “OPEN DIALOGUE,” an alternative Finnish approach to healing psychosis

Check out this important film from Daniel Mackler.

‘In the far north of Finland, a stone’s throw from the Arctic Circle, a group of innovative family therapists converted the area’s traditional mental health system, which once boasted some of Europe’s poorest outcomes for schizophrenia, into one that now gets the best statistical results in the world for first-break psychosis. 

They call their approach Open Dialogue.

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Unrecognised Facts About Psychiatry

I really like the Council for Evidence-Based Psychiatry website, in particular their Unrecognised Facts About Psychiatry. They say:

‘Most people assume that psychiatry is just like any other branch of medicine, with objective tests for diagnoses and drug treatments that cure real diseases.  In reality, however, psychiatric diagnoses and treatments differ enormously from diagnoses and treatments for say cancer or diabetes, since, for mental disorders, there are no known biological ‘diseases’ for psychiatric drugs to ‘treat’.

Here we highlight various Unrecognised Facts about modern psychiatry which every patient, practitioner and policymaker ought to be aware of.’

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SURVEY – CEP needs your contribution for BMA review into prescribed drugs

UnknownI really like The Council for Evidence-based Psychiatry website and they have just asked for submissions for a potentially important study. Please participate if the study is relevant to you.

‘The Council for Evidence-based Psychiatry (cepuk.org) has been invited to contribute evidence to a project at the BMA (British Medical Association) which will review the issues associated with dependence upon prescribed drugs, including benzodiazepines, sleeping pills, pain relievers and antidepressants.

If you or a family member has experienced negative effects with one or more of these drugs, or has had difficulties withdrawing or following withdrawal, then you are invited to submit your experiences to CEP. We will then collate these and include a summary and/or individual responses in our submission to the BMA.

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‘Stop kicking people out of addiction treatment’ by Bill White

Kicking Image‘In 2005, my colleagues Christy Scott, Michael Dennis, Michael Boyle and I co-authored an article entitled It’s Time to Stop Kicking People out of Addiction Treatment. The latest (2002) data then available confirmed that 18% (288,000) of all persons admitted to specialized addiction treatment in the U.S. were administratively discharged (“kicked out”) prior to treatment completion.

Those persons whose treatment was terminated in this manner were often those with the most severe and complex addictions and the least natural recovery support resources – in short, those most in need of professional treatment.

The most frequent cause for administrative discharge (AD) over the past half century has been continued use of alcohol or other drugs during treatment in spite of threatened consequences, e.g., the central symptom of the disorder.

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