Demoralisation in a Treatment Service: Huseyin Djemil

June 16, 2023 by

Huseyin Djemil, Founder of Towards Recovery, has done a good deal of consultancy work over the years. Here’s an example of the sort of work he has done within the treatment system.

‘Huseyin provided a one-day training course on opiates for practitioners of a well-known treatment provider. He finished his presentation slides by lunchtime. He wondered what was he going to do for the rest of the day?

He discovered that there were no opiate groups for clients, despite the fact that 51% of them were opiate users. When he started to discuss this matter with practitioners in the afternoon, he was told that the clients didn’t want anything other than methadone. Huseyin explored with the practitioners in an innovative way whether this was actually the case. He came up with some interesting findings.’

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My Journey: 7. Early Reflections on Addiction Treatment

April 11, 2023 by

In the early 2000s, I saw how different addiction treatment services operated in Wales. Here, I outline the approach adopted by the government-led addiction treatment system, which was heavily influenced by the 1998 UK Drug Strategy, and describe some of its shortcomings. I discuss what I saw at West Glamorgan Council on Alcohol and Drug Abuse (WGCADA) in Swansea in relation to ideas related to self-healing and the therapeutic process. (2,962 words)

In the last six parts of My Journey I have described various community activities in which I was engaged, both at a local and national level, in the few years after I left the neuroscience field in the year 2000. In this chapter, I reflect on various aspects of these activities and on the environment in which I now worked.

1. Early Reflections on Addiction Treatment
‘Step by step that change is happening and Britain is becoming a better place to live in. But it could be so much better if we could break once and for all the vicious cycle of drugs and crime which wrecks lives and threatens communities.’ Prime Minister Tony Blair, 1998

What was happening in the addiction treatment field was heavily influenced by the UK government’s 1998 drugs strategy, Tackling Drugs to Build a Better Britain, which classed the drug problem as a criminal justice issue, rather than a health/social issue. The UK Government’s priority for drug treatment was to provide methadone, a long-lasting heroin substitute, to people who were addicted to heroin, believing that this would reduce the crime that they perceived was caused by heroin addicts. 

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Harm Reduction (Harm Minimisation)

March 14, 2023 by

Describes the rationale behind the harm reduction approach, as well as the different harm reduction interventions, e.g. needle and syringe exchanges and methadone maintenance. (922 words)

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Journeys, Part 2: Living With Heroin Addiction

March 14, 2023 by

Heroin addiction often leads to changes in a person’s relationships, lifestyle, physical and psychological health, values, and identity. Some heroin addicts engage in criminal activity to maintain their habit. Heroin addicts are stigmatised by wider society. (5,643 words) *

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Kevin and Kerry’s Recovery Story: ‘A Family’s Journey’, Part 1

January 31, 2023 by

Mother and son describe Kevin’s heroin and amphetamine addiction, and related activities, and how they impacted on Kevin and the family and as a whole. (7,376 words)

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Iain’s Recovery Story: ‘This is Me’

January 31, 2023 by

A treatment agency helped Iain detox from the methadone that was prescribed for his heroin addiction. College, employment, recreational activities and romance facilitated Iain’s recovery. (9,237 words)

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Sapphire’s Recovery Story: ‘It Should All Be About the Person’

January 31, 2023 by

Things went well when Sapphire was intimately involved in decisions about her methadone-based treatment, but poorly when professionals took sole control. (7,631 words)

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Is Medication Assisted Treatment like the Hotel California?: David McCartney

August 12, 2022 by

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.

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‘Addiction treatment mismatch: when what’s on offer isn’t always what’s wanted’ by David McCartney

July 13, 2022 by

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.

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A Conversation with… Mark Gilman (Part 2 of 2)

March 11, 2022 by

The second of a two-part conversation that Toby Seddon had with Mark Gilman. ‘In this part, we pick up the story in 1999, when Mark moved from Lifeline to the Home Office. The conversation ranges widely, covering treatment, recovery, social justice and crime, reflecting the unique breadth of Mark’s contributions to the field.’

In this conversation, Mark talks about the time he was a regional manager for the National Treatment Agency (NTA).

‘There was actually some public opinion research done in the NTA which reiterated the idea that the primary beneficiary of many of the interventions was not individual people with drug problems themselves, with substance use disorder themselves, but the wider community.

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‘A Personal Story’ by Wee Willie Winkie

November 11, 2021 by

Here’s a story we first ran on our online community Wired In To Recovery in September 2010. I then posted it on Recovery Stories in June 2013.

‘I’m 33 years old. I started taking drugs from ten years old and, apart from a three and a half year stint in the army, took them continuously right up to the age of 30. This included 11 years as a heroin addict.

During this time, I felt totally isolated and alone in the world, and completely worthless. After a few years I was desperate. I’d overdosed a couple of times and, at this point in my life, I’d have welcomed death with open arms. It never came, so I decided to help it along a bit.

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What Works in Treatment: Sapphire’s Story, Part 3

September 30, 2021 by

In my last two posts, we’ve been following Sapphire’s Story with a focus on the treatment she received, recognising that treatment can either facilitate or have a negative impact on the recovery process. We’ve seen Sapphire courageously overcome heroin addiction, crack addiction and most recently an addiction to benzodiazepines (benzos). There’s more to overcome.

‘Once I was off the benzos and feeling a little more like myself, I went back to work. I hadn’t worked since having the crack-induced event, so was really scared that I wouldn’t be able to cope with a job.

As I had come off the benzos, and now had the proper support of a partner and my family, I started thinking about reducing my methadone with a view to abstinence. I knew I had the willpower, as I’d managed eight nightmarish months of the benzo detox and I’d also kicked a crack addiction about two years earlier.

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What Works in Treatment: Sapphire’s Story, Part 2

September 29, 2021 by

In my last post, I looked at Sapphire’s Story, with the aim of showing the importance of person-centered treatment. Along Sapphire’s journey into and out of addiction, things went well when Sapphire was intimately involved in decisions about her treatment, but poorly when professionals took sole control.

We left Sapphire’s Story after the Community Drugs Treatment (CDT) had reduced her prescribed methadone dose against her will and she started to use street drugs again. She eventually became addicted to crack. This drug took over Sapphire’s life, until the day she ended up in hospital: ‘I’m not sure what actually happened one particular day. I know that I had been up for about five days smoking crack and I think I had a fit and was taken to hospital.’

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What Works in Treatment: Sapphire’s Story, Part 1

September 28, 2021 by

Sapphire’s Story shows the importance of person-centered treatment. Things went well when Sapphire was intimately involved in decisions about her treatment, but poorly when professionals took sole control. In this post, I start a short series focused on various stages of Sapphire’s treatment career.

Sapphire was being prescribed methadone for her heroin addiction, but as the dose was not high enough she was suffering withdrawal symptoms. To counter the discomfort of this withdrawal, she was purchasing methadone on the street and using benzodiazepines. Then a problem arose from her urine sample:

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Learning About Addiction Treatment, Part 5

May 13, 2021 by

I continue my series of blogs, starting here, about my journey into the addiction recovery field after I changed ‘career’ in 2000 from being a neuroscientist to working in the community. At the same time, I was still working as a Professor in the Department of Psychology, University of Wales Swansea (now Swansea University) in the UK.

In an earlier blog, I briefly described how I led the national team that evaluated all projects funded by the National Assembly of Wales’s Drug and Alcohol Treatment Fund (DATF) for two years from mid-2000. Here is what I wrote in my recently published book Our Recovery Stories: Journeys from Drug and Alcohol Addiction about the DATF evaluation and my views about the UK drug treatment system at the time.

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Factors Facilitating Recovery: Empowerment

May 5, 2021 by

Following on from my post about Hope, I include another section, this time on Empowerment, from the second last chapter, ‘Factors That Facilitate Recovery’, of my recently published eBook, Our Recovery Stories: Journeys from Drug and Alcohol Addiction.

‘As emphasised throughout this book, recovery is something done by the person with the substance use problem, not by a treatment practitioner or other person. The major sources of power driving the recovery process are the person’s own efforts, energies, strengths, interests and hope. Treatment practitioners, and others involved in the person’s recovery journey, can facilitate the recovery process by encouraging and supporting the person’s own hopes, strengths, interests, energies and efforts.

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Historical Perspectives: Opium, Morphine and Opiates (Part 3)

April 27, 2021 by

Concluding a brief history of the opiates by looking at the massive increase in heroin use that occurred in America and the UK during the later parts of the 20th century. (1,012 words)

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

April 11, 2014 by

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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What Works in Treatment?: Sapphire’s Story, Part 3

November 7, 2013 by

rsz_dscf2263We’ve been following Sapphire’s Story with a focus on the treatment she received, recognising that treatment can either facilitate or have a negative impact on the recovery process. We’ve seen Sapphire courageously overcome heroin addiction, crack addiction and most recently an addiction to benzos. There’s more to overcome.

‘Once I was off the benzos and feeling a little more like myself, I went back to work. I hadn’t worked since having the crack-induced event, so was really scared that I wouldn’t be able to cope with a job.

As I had come off the benzos, and now had the proper support of a partner and my family, I started thinking about reducing my methadone with a view to abstinence. I knew I had the willpower, as I’d managed eight nightmarish months of the benzo detox and I’d also kicked a crack addiction about two years earlier.

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What Works in Treatment?: Sapphire’s Story, Part 2

November 6, 2013 by

rsz_img_2115Last week, we looked at Sapphire’s Story, with the aim of showing the importance of person-centered treatment. Along Sapphire’s journey into and out of addiction, things went well when Sapphire was intimately involved in decisions about her treatment, but poorly when professionals took sole control.

We left Sapphire’s Story after the Community Drugs Treatment had reduced her prescribed methadone dose against her will and she started to use street drugs again. She eventually became addicted to crack. This drug took over Sapphire’s life, until the day she ended up in hospital: “I’m not sure what actually happened one particular day. I know that I had been up for about five days smoking crack and I think I had a fit and was taken to hospital.”

Sapphire was transferred to the drug and alcohol unit of the hospital and put on a high dose of methadone. When she left this unit, she did not go back to the controlling and abusive man she had been living with since she was 16 years old.  Her parents had found out about her drug-taking and became very supportive.

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