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)
Journeys, Part 2: Living With Heroin Addiction
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) *
Is Medication Assisted Treatment like the Hotel California?: David McCartney
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
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.
A Conversation with… Mark Gilman (Part 2 of 2)
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.
‘A Personal Story’ by Wee Willie Winkie
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.
What Works in Treatment: Sapphire’s Story, Part 3
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.
What Works in Treatment: Sapphire’s Story, Part 2
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.’
What Works in Treatment: Sapphire’s Story, Part 1
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:
Learning About Addiction Treatment, Part 5
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.
Historical Perspectives: Opium, Morphine and Opiates (Part 3)
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)
‘Recovery is too hard and dangerous. Solution: methadone for life’ by DJ Mac
Well 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.
What Works in Treatment?: Sapphire’s Story, Part 3
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 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.
What Works in Treatment?: Sapphire’s Story, Part 2
Last 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.
What Works in Treatment?: Sapphire’s Story, Part 1
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. We’ll look at 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:
‘When I was 25, my urine screening revealed that I was taking benzos and the CDT sent me to a shared care GP who was to prescribe my methadone and benzos. At my first appointment, I decided to be honest and tell the GP about the methadone I was buying, and how bad my benzo use had become.
Most visited content: Nos 10 – 6
And the drum rolls as we enter the top ten most viewed content on recovery Stories.
10. Journeys into and out of heroin addiction, Part 2, is an article I wrote that focuses on living with addiction and covers such topics as relationships, changes in personality and lifestyle, hustling, crime and prison, impact on health, and treatment .
9. Opiate detox: methadone or suboxone by Peapod is the third part of Peapod’s Recovery Guide. Peapod was the most visited blogger on Wired In To Recovery.