‘My drinking was out of control – but now I know I can recover’: Andrew

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.”

Read More ➔

People Need Choice & Opportunity: Dr. David McCartney

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.

Read More ➔

Helping Others: Dr. David McCartney

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.

Read More ➔

Recovery, Connection & Hope: Dr. David McCartney

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?

Read More ➔

Kevin and Kerry’s Recovery Story: ‘A Family’s Journey’, Part 2

Kevin’s hospitalisation with septicaemia acts as a turning point and a process of recovery begins for the family as a whole. (6,933 words)

Read More ➔

Adam’s Recovery Story: ‘A Moment of Clarity’

After spending years in Australia locked into an addiction to amphetamine, cannabis and alcohol, Adam’s recovery leads him to the UK where he marries. His life spirals out of control after traumatic experiences, before he continues on his recovery journey and moves back to the other side of the world. (11,648 words)

Read More ➔

Tim’s Story: ‘Doctor in Recovery’

As Tim found out, having a medical degree offers no protection against addiction, nor from the hard work that is required to change oneself as a key part of the recovery journey. (7,135 words)

Read More ➔

Paul’s Recovery Story: ‘Doctor Knows Best’

After years of taking opiates whilst working as a medical doctor, Paul has become a new person through residential treatment, the 12-step programme, and a good deal of work on himself. (11,760 words)

Read More ➔

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.

Read More ➔

‘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.

Read More ➔

‘Rehab works!’ by David McCartney

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.

Read More ➔

What Works in Treatment?: Tim’s Story

rsz_img_2891Here are Tim’s experiences of treatment. Well, actually two different forms of treatment, one which did not help and the other that helped Tim overcome his addiction to alcohol and opiates. Tim is a doctor and his Story is packed full of insights. Here, I’ll start with his moment of clarity.

‘The epiphany which did eventually provoke some help-seeking was relatively simple. I came down to the kitchen one morning feeling wretched and defeated. I opened the cupboard and reached up. With one hand I brought down the cornflakes and with the other the whisky bottle.

I flexed my elbows to bring the two closer to me and weighing them up in my hands I thought, “There’s something not right about this… there’s something very wrong with this picture.” The bit of me that wanted to drink finally began to yield to the bit that didn’t. Shortly after, I went so see my GP.

Read More ➔

‘Detoxification: the ‘nuts and the bolts’ by Peapod

“Expect the first few weeks to be rocky emotionally. Life can feel a bit ‘greyed out’ for a while and youʼll need to adopt a longer-term view. Getting to as many recovery meetings as you can manage during this period will help.”

“Expect the first few weeks to be rocky emotionally. Life can feel a bit ‘greyed out’ for a while and youʼll need to adopt a longer-term view. Getting to as many recovery meetings as you can manage during this period will help.”

Okay, youʼve got to the point where you are looking to detox but youʼre not sure what the nuts and bolts of it are. How do you go about it and how do you know you are ready? What can you do to boost success?

Here are my suggestions, which are based on guidance and my own experience of working with hundreds of people going through detox.

First things first: “detox plus”
The first thing to say is that any detox which is not connected to other things will almost certainly fail. You might get through the detox (or “stopped”) but remaining drug free (“staying stopped”) is very, very unlikely without other things added in. Not to mention that itʼs potentially dangerous too. Donʼt set yourself up to fail.

Itʼs best to see detox as a tiny part of the recovery process. Important, no doubt about it, but in the grand scheme of things not a giant cog in the machinery. Recovery is a longer-term process.

What is the “plus” part of “detox plus”: what needs to be added in?
1. Ask: am I ready? You will probably have a feel for this because youʼve been working towards this goal for a while and others have been supporting you. If youʼre using regularly on top of your script or have major stressful life events going on, you may want to wait a bit, or get referred for consideration of residential options where the support is highest.

2. Weigh up the pros and the cons. Everything involves some sort of risk. Talk to others whoʼve done it successfully. Make an informed choice.

3. My next suggestion is to get referred to an intensive community or residential rehabilitation programme. Some will offer detox as part of treatment. Your prescriber or support worker will be able to advise. Try to get onto a programme that is at least three months long and that prioritises connecting up their clients to peer-led recovery communities.

4. Get involved with local recovery community activities in any case. The most important of these is mutual aid. Groups like Narcotics Anonymous, Cocaine Anonymous (you donʼt need to have a problem with coke) and SMART recovery offer peer-based support.

The evidence suggests that engaging with these groups reduces relapse rates and adds much to quality of life too. You donʼt need to be drug-free to attend.

5. If youʼre not going to sign up to intensive treatment, then get started with meaningful activities daily. Find an educational course or volunteering opportunity and get stuck in. Structure your days and donʼt spend time in bed or stuck to the TV or computer screen.

6. Stay away from using friends and places you associate with scoring and using. These are powerful triggers to use when you are feeling vulnerable.

Detox basics

1. Donʼt do your own detox. Shutting yourself in a room with DFs and Valium might seem like a sensible idea, but it is not known for its success rates. Achieving your goals is much more likely if you have an expert in detoxification supporting you as you do it. Cold turkey is being unkind to yourself and has low success rates.

At the same time, this is your detox, so youʼll want to know you have some say in how it looks. It shouldnʼt be something that is done to you, but something you do with the support of the prescriber. Alcohol, GHB/GBL and Benzodiazepine detoxes are particularly dangerous if not medically supervised.

2. If you are coming off opiates, discuss whether you want to use methadone or Suboxone to detox. In some areas you might also have the option of lofexidine (Britlofex) too. Occasionally some doctors offer a dihydrocodeine (DF118) detox. Iʼm going to write a separate article on choosing between a methadone detox and a Suboxone detox.

3. Get as much support around you as you can. If you are in a structured day programme, residential treatment or a therapeutic community, the support ought to be built in.

If youʼve chosen to try this without that sort of intensive input, then tell your mutual aid group members what youʼre planning, get your prescriberʼs support and that of family members (non-drug using). Do some relapse prevention work and donʼt rely only on yourself. I canʼt stress this enough; most of us need help to do this.

4. If you are struggling, admit it. There are various medications that can be added in to help with any unpleasant symptoms like pain, insomnia, nausea, diarrhoea, cramps etc. Emotional support from positive people will boost your chances of success. If you know people whoʼve been through detox successfully, find out how they did it and get their help.

5. Expect the first few weeks to be rocky emotionally. Life can feel a bit “greyed out” for a while and youʼll need to adopt a longer-term view. Getting to as many recovery meetings as you can manage during this period will help.

6. Guard against relapse and if you do go back to using, remember loss of tolerance and the increased risk of overdose. Donʼt use as much, donʼt use alone, donʼt inject and donʼt mix heroin with other drugs (particularly alcohol or valium).

7. Remember a lapse is not the end of recovery. Itʼs common and not a cause for shame or giving up. Most of us need more than one go. Going back onto maintenance for a while is a viable option, as is getting referred to a more intensive treatment setting.

PDF document >

‘The user as expert’ by Peapod

IMG_2817Another blog on WITR from April 2009.

‘When I went to look for help for my addiction, I ended up in the care of an addiction specialist. He was good at his job. He knew all about addiction.

He was impressive in terms of assessment and he knew about methadone and antidepressants and other prescribing options. His team inspired confidence in terms of their knowlege of addiction.

Unfortunately, it turned out they didn’t know much about recovery. The specialist advised against mutual aid and dissuaded me from professional counselling.

Read More ➔