Dr. David McCartney of Lothians and Edinburgh Abstinence Programme (LEAP) talks to David Clark about the development of his drinking problem whilst working as a GP in an inner-city practice in Scotland. He describes an unsuccessful attempt at sobriety, which involved a medical approach focused on prescribing. In crisis, he later called the Sick Doctors Trust Helpline and was told a doctor’s personal recovery story. That telephone call gave him hope and the opportunity to take his own journey to recovery. David talks about setting up LEAP and about facilitating recovery in the community. [15 films, 76 mins 11 secs]
‘My drinking was out of control – but now I know I can recover’: Andrew
July 3, 2023
Here is an excellent article about recovery from addiction by Chris Clements, social affairs correspondent for BBC Scotland.
Andrew is in recovery after a decade of alcoholism.
Ten years ago, he suffered a mental breakdown and his drinking spiralled.
It led to the loss of a career in finance and the breakdown of family relationships.
But the 62-year-old told BBC Scotland that his darkest point came last year.
“In June, my partner died and my drinking just got totally out of control,” he said. “I couldn’t function as a human being. I had to be cared for.”
People Need Choice & Opportunity: Dr. David McCartney
June 28, 2023
Another film clip from my stimulating and moving interview with Dr. David McCartney, Founder of Lothian and Edinburgh Abstinence Programme (LEAP).
David experienced a sudden and profound change in the quality of his life, and he felt an immense gratitude for ‘having another shot of life’. At one stage, he couldn’t have cared if he had gone to sleep and not woken up. He then suddenly had his enthusiasm and spirit back—things fired him up and he was looking forward to so much.
At the same time, he felt he needed to atone, make amends, for his past behaviour. He also felt concerned that he had not gotten the help that really mattered in facilitating recovery during his ‘first time around’. He felt strongly that people needed to be aware of all the options that were available so they could make an informed choice.
Overwhelmed by Shame: Dr. David McCartney
June 20, 2023
Shame plays a significant role in addiction. It is also a barrier to recovery. One can alleviate the feelings of shame by taking the drug and/or drink that led to the development of shame in the first place. Here’s a film of David McCartney, Founder of LEAP (Lothian and Edinburgh Abstinence Programme), talking about his drinking problem and his personal experiences of shame.
As David’s drinking increased, his interests and hobbies started to disappear. Eventually, he was only interested in activities that involved alcohol in some way. More and more the people he interacted with were either drinkers, or people he knew would not criticise his drinking.
His personal honesty eroded as he lied as to why he could not go into work. A mountain of shame grew, and his self-esteem diminished greatly, as he was living against all his personal values. He was a man who desperately needed to ask for, and access, help. Instead, he hid behind the thin veneer of being a doctor.
Anxiety, Craving & Insomnia: Dr. David McCartney
June 9, 2023
I am so grateful to David for sharing the story of his addiction and recovery journey with me for the Recovery Voices Initiative. This film includes the time when David first accessed help for his drinking problem.
‘David eventually asked his GP to sign him off work through stress, as he thought he could tackle his problematic drinking when avoiding work. Instead, he started drinking in the mornings, as there was no reason not to!
David confessed his problem to his GP who told him he ‘wasn’t a drinker’—he had been drinking problematically for a decade by now!! He visited a psychiatrist who diagnosed his problematic drinking and referred him to an addictions psychiatrist who in turn arranged a community detox, involving librium and various other drugs. At one stage, David was taking between 20 and 30 pills a day.
Helping Others: Dr. David McCartney
June 1, 2023
David Clark asks David McCartney whether he found himself helping others, in the way he was being helped by others, when he was in the rehab. David stated that when he found himself functioning more healthily as a human being, and felt that he had some useful things to share, he did start contributing in a way that could help others.
However, he had to first dismantle the veneer of a doctor identity he was using as a mask and shield. This was difficult at first, as a lot of his self-esteem was tied up with this veneer, even though it was holding him back. He had to stop being a doctor and be a member of the rehab community, and then gain the identity of being a recovering person.
Being Held Back… by a GP Identity: Dr. David McCartney
May 24, 2023
Another film clip from the second of our Recovery Voices, Dr. David McCartney, the Founder of Lothians and Edinburgh Abstinence Programme (LEAP) in Scotland. David is someone who has inspired me greatly over the years.
When he finished medical school, David wanted to make a difference and work where the greatest problems were evident. He joined an inner-city GP practice. The job was extremely stressing as the need (medical and social) was so overwhelming.
In retrospect, David felt he was naive and had not learnt to create distinct boundaries. He started to go to work earlier and earlier to be able to deal with all that needed doing in the practice. With the benefit of hindsight, he can now see he was not equipped to deal with all the tragedy he saw.
Dr. David McCartney’s Recovery Voice
May 10, 2023
Dr. David McCartney of Lothians and Edinburgh Abstinence Programme (LEAP) is the second of our Recovery Voices, a project I developed with Wulf Livingston of North Wales which involves filming interviews of recovering people and their allies.
In the first of 15 film clips edited from an interview I had on Zoom with David in late March 2023, he introduces himself as a person in recovery and as an addictions doctor. He spent the first half of his career in an inner-city GP practice in Glasgow, and the second half working exclusively in the addiction treatment field. He also does work for the Scottish Government supporting the development of residential rehabs in Scotland.
In the interview, I point out that we have known each other since 2007, when I first started visiting LEAP (Lothians and Edinburgh Abstinence Programme), which David had set up earlier. I had always enjoyed my visits and had continually been inspired by David and his work colleagues and patients.
Recovery, Connection & Hope: Dr. David McCartney
April 17, 2023
I’ve deliberately broken my ‘blog break’ to announce the second of our Recovery Voices, Dr. David McCartney of LEAP (Lothians & Edinburgh Abstinence Programme). I’ve known David since 2007 when I first started to drop in at LEAP when visiting my daughter Annalie, who was a medical student in Edinburgh. David and his team and patients always inspired me. I loved my visits, the last of which was in September last year.
In my Zoom interview with him, David talked about the development of his drinking problem whilst working as a GP in an inner-city practice in Scotland. He described an unsuccessful attempt at sobriety, which involved a medical approach focused on prescribing. In crisis, he later called the Sick Doctors Trust Helpline and was told a doctor’s personal recovery story. That telephone call gave him hope and the opportunity to take his own journey to recovery. David talked about setting up LEAP and about facilitating recovery in the community.
I am thrilled to have this collaboration with David. I’ve always hoped that one day we would be able to do some serious recovery advocacy together. I hope there will be more! I have edited our discussion into 15 short films, totalling just over 76 minutes. Above is one of my favourites from that collection. Please check out the other films. And why not subscribe to our YouTube channel?
‘Lessons from Rehab’: David McCartney
March 30, 2023
Here’s another excellent blog post by Dr. David McCartney on the Recovery Review blog.
In 2005, concerned at the lack of choice in addiction treatment in Scotland and hearing frustrations from patients and families around lack of access to residential treatment, I sought support and funding to set up a drug and alcohol rehab service based on the therapeutic community (TC) model. This would be unique in Scotland as, based in the NHS, it would be free at the point of delivery, eliminating difficult funding pathways.
I proposed the service should serve a local population to keep people close to their families and allow them to develop local recovery supports and access intensive aftercare. It should develop close working relationships with other treatment and support options – this should be an ‘as-well-as’ service rather than an ‘instead-of’ service. There should be direct family support and detox offered as part of the deal. We would actively connect people to recovery resources in the community, offer them peer support and open avenues into education, training and employability.
Outcomes from rehab in Scotland (and even the UK) at the time were hard to find – but so were any treatment outcomes from services already in operation, so I built in that we should commission a robust evaluation. If this wasn’t going to work, we needed to know that – and if it helped people achieve their goals we wanted to get that message (and any other learning) out there.
Dr David McCartney’s Blog
March 16, 2023
One of my favourite bloggers is Dr David McCartney, Clinical Lead at the Lothians & Edinburgh Abstinence Programme (LEAP). I’ve known David for over 15 years and I love visiting LEAP when I am in Edinburgh. Here are links to 11 of David’s posts on our website that first appeared on the Recovery Review blog.
Is Rehab Effective? The Results Are In: Dr. David McCartney
February 21, 2023
Here is another great blog post from Dr. David McCartney of Lothians & Edinburgh Abstinence Programme (LEAP) on the Recovery Review blog.
‘Recovery journeys are dynamic, take time and for those who receive treatment, may need several episodes. For some, residential rehab is part of the journey, just as harm reduction interventions can also be part of the journey. However, residential rehabilitation is a complex intervention and complex interventions are difficult to study.
In Scotland, the government is making rehab easier to access and growing the number of beds. This development is not without its critics. Some feel the resource needs to ‘follow the evidence’ – in other words into harm reduction and MAT interventions. This all-the-eggs-in-one-basket position would reinforce the rigid barriers that make rehab the domain of the wealthy or the lucky.
‘Follow the evidence’ in this context is a refrain that implies that there is no evidence that rehab works to help people achieve their goals and improve their quality of life. That is simply not true. Last month saw the publication of a literature review on residential rehab by Scottish Government researchers. It’s a thorough piece of work. This summary of the research evidence provides verification that “that residential rehabilitation is associated with improvements across a variety of outcomes relating to substance use, health and quality of life”.
A Genesis of Hope: Dr. David McCartney
January 26, 2023
I hold Dr. David McCartney in my highest regard. He not only overcame his serious alcohol problem, but also set up Lothians and Edinburgh Abstinence Programme (LEAP), a programme that offers structured treatment based in the community using a blend of evidence-based interventions. The patient group in treatment operates as a therapeutic community. I used to love visiting LEAP in my Wired In days, interacting with staff and patients as described in my last blog post.
David is very knowledgeable about addiction and recovery, and posts content to the Recovery Review blog, as part of a community of recovery-oriented experts who write about recovery and related matters. In April 2021, he appeared in a podcast about his addiction and recovery.
‘Switching from doctor to patient was not an easy transition for me. My first attempt at recovery was medically assisted, but only got me so far. What I needed was something more profound: hope, healing and connection to other recovering people. In this podcast for the National Wellbeing Hub, Dr Claire Fyvie interviews me about my own experience of addiction and recovery – warts, wonder and all.’
Visiting UK Recovery Friends: Part 10 (Dr. David McCartney & LEAP)
January 25, 2023
After visiting Ian and Irene MacDonald, I headed back to my usual base when I am visiting the UK, the Beech House Hotel in Reading. It’s a wonderful family-run hotel that I have been staying in for over a decade whilst I visit my three youngest children. The next morning, I delivered my hire car back to the main office, and then headed to Heathrow airport to catch a flight to Edinburgh.
I was soon on my way to my favourite UK city where I would be meeting some of my favourite people, the staff and patients at Lothians and Edinburgh Abstinence Programme (LEAP), led by my close friend Dr David McCartney. I first visited LEAP in 2007, at a time when my eldest daughter Annalie was a medical student at the university. For some years, even after I moved to Australia, I would spend the day talking with staff and patients. My discussions with David and his Clinical Lead Eddy Conroy were enjoyable, thought-provoking, and inspiring.
‘Why the empty seats at the free public health lunch?’ by Dr. David McCartney
January 9, 2023
When I worked in the addiction field in the UK in the first decade of this millennium, I was surprised how few treatment practitioners encouraged their ‘clients’ to access Alcoholics Anonymous (AA), Narcotics Anonymous (NA) and other mutual aid groups. This fact was all the more puzzling in that the treatment services that were having the most success in helping people overcome substance use problems always strongly encouraged the people who were seeking help to access mutual aid groups.
Here’s an excellent blog post on Recovery Review from one of my favourite bloggers, Dr David McCartney of Lothians and Edinburgh Abstinence Programme LEAP), about this issue:
‘A few years back in my first few months of working full time in addictions, I attended a seminar on mutual aid. Facilitated by an addiction psychiatrist, the meeting was packed with a variety of addiction treatment professionals.
The facilitator laid out the evidence base for mutual aid as it was at the time and discussed how assertively referring to mutual aid organisations could result in high take-up rates with benefits to patients. This was in the days when most groups were 12-step – SMART and other groups were still to be launched locally.
‘Peer recovery support: a bridge to hope and healing’ by Dr. David McCartney
November 29, 2022
I’ve just been reading another excellent post from Dr. David McCartney on the Recovery Review blog.
Good human relationships and social connections are potent protections against both physical and mental ill health. In an analysis [1] involving hundreds of thousands of people researchers looked to see to what extent social relationships influenced the risk of death. They found that those who had stronger relationships were 50% less likely to die early. Loneliness and social isolation have significant negative impacts. You want to live a long and healthy life? Get loads of friends.
In the same way, being connected to pro-recovery social networks improve outcomes in addiction treatment. For a variety of reasons, not least because of stigma, those suffering from substance use disorders are often relatively socially isolated. Guidelines consistently recommend connections to peer groups like mutual aid and LEROs [Lived Experience Recovery Organisations], though this has historically not been a priority for some services. For recovery from alcohol use disorders, being part of mutual aid has an impact at least as great as evidenced psychological therapies like cognitive behavioural therapy. [2]
Is Medication Assisted Treatment like the Hotel California?: David McCartney
August 12, 2022
When I worked in the addiction recovery field in the UK running Wired In, I was a strong advocate of harm reduction services, including medication-assisted treatment. However, I spoke out against a treatment system that locked people into a methadone maintenance programme that provided no other therapeutic options, and no opportunity for abstinence-based treatment if people wanted to move on from daily use of methadone. Many people on methadone maintenance programmes were not even made aware of other treatment options.
Here is an excellent recent post on Recovery Review which discusses this highly pertinent issue by one of my favourite bloggers, Dr David McCartney from Edinburgh.
‘The tragedy of Scotland’s drug-related death figures has been in my mind this last week or so. The media may have largely moved on, but those of us who work in the field of addiction, those of us who know individuals who have died and those of us with lived experience of addiction will not be able to do the same.
‘Addiction treatment mismatch: when what’s on offer isn’t always what’s wanted’ by David McCartney
July 13, 2022
Another really except blog post on Recovery Review by Dr. David McCartney, this one focused on what people want from addiction treatment.
“I never knew that rehab was available to guys like me”, he said to me just before he completed his rehab programme. He’d been in and out of `treatment for many years before he got to rehab. “Why did nobody tell me?” I was left struggling for an answer.
This is one of the things that still upsets me in my work with patients. It is still happening – even in my area where there are clearly established pathways to rehab with no funding barriers to navigate.
‘Rehab works!’ by David McCartney
March 15, 2022
Here’s another excellent post from Scotland’s Dr David McCartney on the Recovery Review blog.
‘When it comes to trying to improve access to residential rehabilitation in Scotland, one thing I’ve heard too often from doubters is: ‘there’s no evidence that rehab works’. Ten years ago I was hearing the same thing about mutual aid, which was recently (at least in terms of Alcoholics Anonymous) found to be as effective, if not more effective, than commonly delivered psychological interventions.
There are a some problems with the ‘there’s no evidence that it works’ line. The first is that even if we accept the faulty premise that there is a poor evidence base, this is often taken as evidence that rehab doesn’t work, which is illogical. The second problem is that while there is evidence, some people don’t know about it or, for a variety of reasons, choose to dismiss it. What we can say is that the evidence base is weighted towards some areas (e.g., medical interventions) at the expense of others. The third issue for me is that while we need to find ways to balance the evidence base, we will not find more evidence if we’re not looking for it.
