I used to visit West Glamorgan Council on Alcohol and Drug Abuse (WGCADA) in Swansea in order to learn about addiction, recovery and treatment from treatment practitioners, and from people who have accessed the treatment service for help with their substance use problem. (1,306 words)
Dave Watkins (left), Community Support Worker at WGCADA.
Last week, I posted the first part of a serialisation of My Journey, my wide-ranging career in the field of addiction, mental health and trauma. This first part focused on my career in neuroscience, which lasted almost 20 years. In 2000, I closed my laboratory, as I did not think that neuroscience research was helping people overcome addiction.
Given that I did not feel that a biomedical approach and the use of drugs were the answer to helping people overcome drug addiction, what were the answers? And what methods were used in treatment services that were successful in helping people overcome substance use problems?
Clearly, I needed to find and listen to people who were in recovery from addiction, as well as people working in a treatment service that was obtaining good outcomes in helping people recover. I also wanted to learn how the treatment system worked, at a local and a national level.
In 2000, I was fortunate enough to win the tender to evaluate all projects supported by the Drug and Alcohol Treatment Fund (DATF) in Wales, a new source of funding for addiction treatment services in the country. Conducting this evaluation helped me to enhance my understanding of the multi-faceted nature of addiction treatment, as well as the way that the government-run treatment system worked. I will describe this evaluation in a future chapter.
In these early years, I also spent a good deal of time in a local treatment agency, WGCADA (West Glamorgan Council on Alcohol and Drug Abuse), where I had made some good friends.
I was inspired by the passion and knowledge of the staff, in particular Keith Morgan, Dave Watkins (left in top photo), Lawrence Mylan (R.I.P.), Fred Tuohy (R.I.P.), Esther Mead, Angie Welch, and Chief Executive Norman Preddy. A number of these people talked freely about their own recovery from addiction.
I also talked with some of the people who were attending WGCADA’s treatment programmes, which I enjoyed greatly. I soon realised that I was in the right environment to gain an insight into what factors contributed to successful treatment.
1. WGCADA
Keith Morgan, who ran DOMINO and set up the WGCADA Warblers band.
WGCADA was initially founded and established, as the ‘Alcohol Advice Centre’, in 1979 in Swansea. It was staffed by the Director and Founder Alan Douglas and a part-time secretary, Margaret Morris. Despite struggling to obtain funding initially, the Centre slowly developed over time due to the dedication and determination of the people concerned. Eventually, the Centre was renamed ‘West Glamorgan Council on Alcohol and Drug Abuse’ and started to receive a level of funding that facilitated its growth.
At the time I became involved with WGCADA in around 2000, it had grown considerably and had offices in Swansea, Neath, Port Talbot, Bridgend, and HM Prison in Swansea. It operated as a charity and limited company run by a Board of Directors/Trustees. The Chief Executive was Norman Preddy, who first started at WGCADA in the 1980s as a volunteer.
In the early days, WGCADA only worked with an abstinence-oriented approach based on Alcoholics Anonymous (AA), the Twelve-Step Movement, and the Minnesota Model. As the Centre expanded over the years, it developed a range of approaches to help people deal with substance use and related problems.
When I was spending time at WGCADA, these approaches included harm reduction services, a family programme, a young person’s service, DOMINO (Development in Motivation In New Outlooks; cf. Section 8), and a range of criminal justice programmes. Specialist workers operated for various matters, including domestic violence, home detox, tenancy support, and the elderly/disabled.
Lawrence Mylan, who ran the Pre-Treatment Programme at WGCADA.
People who engaged in the treatment programmes at WGCADA did so on an outpatient basis. The agency did not offer accommodation for their clients, but it did refer some clients to residential treatment centres (rehabs) in other parts of the UK. Clients only attended WGCADA for a small number of hours per week.
The discussions I had with staff and clients helped me realise that many people requesting help from WGCADA presented with a myriad of problems, in addition to their substance use problem. They could be homeless, jobless, experiencing problems with personal relationships, have a history of criminal activity, have a physical and/or mental health problem, and/or have experienced traumatic early life experiences. They could present with most, if not all of these problems!
These additional problems often contributed to, or exacerbated, the person’s excessive drinking and/or use of drugs. They often contributed to the development of the substance use problem in the first place. For example, the person may have been physically, psychologically or sexually abused as a child. Heroin is a great painkiller, not just for physical pain, but also for psychological pain. For many people, drugs or alcohol were being used as a coping mechanism to help them deal with the myriad of problems in their life.
Norman Preddy, CEO of WGCADA, in 2004.
As a result of these additional problems, WGCADA had to address the needs of their clients in a holistic manner. This, in turn, meant that the agency had to offer a range of services, and form collaborations with a variety of other organisations and individuals (e.g. social services, housing, GPs)—who could help clients in one way or other—in the communities where it operated. In my desire to understand the nature of addiction treatment, I was embarking on a journey that would take me over time to various parts of the community.
I soon learnt that the model for helping people recover from substance use problems was very different to the medical model.
In the medical model of treatment, the doctor or other practitioner is an expert on the nature of the client’s problems and how to alleviate these problems. He or she forms a diagnosis and then prescribes treatment, which consists of applying interventions (e.g. prescribing a drug, or referral to a surgeon for surgery) appropriate to that diagnosis. These interventions hopefully cause change in the client, thereby alleviating the symptoms and underlying problem.
My discussions with staff and clients at WGCADA, and extensive reading, helped me realise that it is the person with the problem who does the work in recovering from addiction. They make the decision to stop using or drinking, and do the (often considerable) personal work that is required before long-term abstinence occurs.
Practitioners don’t make people with substance use problems better; they don’t fix people. Recovery from addiction (and mental health problems) is actually a self-healing process, which can be facilitated by practitioners. Recovery can also be facilitated by non-professionals, such as other recovering people, family members and friends. I’ll talk more about the self-healing process in due course.
So, if treatment practitioners don’t do the recovery, or fix people, what is it that they do to facilitate the recovery process? Why is treatment important for some people? I gained insights into these issues as I learnt more about the different services offered by WGCADA, and later other treatment agencies, and how they facilitated recovery.
Before reading about what I learnt about the services offered by WGCADA in next week’s post, you might want to read two articles I have written about the core underlying approaches that were used by the agency to provide treatment and support in the community. The first article looks at the primary approach underlying WGCADA’s abstinence-based service, and the second focuses on the foundation of the agency’s harm reduction service.
> 3. Learning About Addiction Treatment – My WGCADA Experience, Part 2
