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I was watching an interview with Stuart Honor by Inexcess TV last week that is well worth watching.
Stuart has carried out an amazing amount of ethnographic research over the years – he’s interviewed more people than NTORS – and he set up The Basement Recovery Project in Halifax. I have a lot of time for Stuart and always look forward to getting together.
Stuart mentioned a few things during his interview that we need to think about.
Firstly, he pointed out that he has some problems with use of the term recovery, since it assumes that people have a natural state to recover to. As he points out, that natural state does not exist in a lot of cases. Many people never had anything to recover to.
Stuart is more inclined to use the term ‘discovery’ rather than recovery.
George Williams of Inexcess TV asked Stuart what the North West – which has a thriving recovery agenda – is getting that other areas are not getting.
Stuart emphasised that a lot comes down to leadership. The North West has a very active NTA regional adviser who is really passionate and understands the issues. Mark Gilman has an abundance of charisma.
I don’t want to embarrass Mark here, but I have to say that I agree with Stuart. Mark is special. However, we need many other people like (and not like) Mark who push the recovery agenda across the country. We need more people with real passion, drive and charisma. That could be YOU.
That is one major reason why we set up this community, in order to get YOU on board.
Stuart also emphasised that people with problems need to know that recovery is an option. The vast majority of such people don’t know that recovery is an option because they have never seen it.
Stuart struggles with the idea that addiction is thought of by many as being an illness. He emphasises that there is a road into addiction, in particular opiate addiction, with many people having been in care, thrown out of school, etc.
I agree with Stuart, we really need to realise that heroin (and other drug use) is often a response to a person’s social situation. Then, once they have become a regular user and a ‘member’ of a drug ‘culture’ or ‘culture of addiction’, it is very easy to develop further problematic behaviours.
To just call this problem a disease and think only in medical terms is naïve.
Stuart refered to what someone had said to him some time ago, ‘We’re moping up the water, no one has looked at what turned the tap on.‘ He’s right there. We cannot just be looking at how to deal with the problems, we need to be working to prevent the problems. This has got to be happening at a community level.
Where to start?
Stuart believes that there is too much ‘us’ and ‘them’ in society. He points out that we must make the ‘them’, the ‘us’. We need to empower people to help them to be able to deal with their own problems . And we need to make them stakeholders in the future. This must be built at a grassroots level – at a community level, on the street.
Well-spoken, Stuart.
Look forward to seeing you and the family again. Take care.
Empowerment, grassroots construction and growth, looking to aetiological factors: all absolutely fundamental and wise approaches to the issue of addiction. I also like the idea of debating what it is that people are to ‘recover’ to. A clear concept of the elements of recovery is likely to help us all as we endeavour to help people become all they can be.
However, I do think that health is part of recovery. The World Health Organisation defines health as being “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”. I think that’s the goal for recovery from addiction.
If there are those around who think of addiction only in medical terms and put it in a box marked ‘disease only’ I would also call them naive. I don’t believe there are too many folk like that around.
However addiction does have many of the characteristics of other diseases; a genetic predisposition interacting with environment, physiological changes in the body (principally the brain), recognisable ‘signs and symptoms’, a tendency to have a chronic course with remission and relapse and it is a condition for which there is treatment available.
It is so entwined with other things we have no problem with calling diseases (mental health pathology, blood borne viruses, liver disease, cognitive impairment etc) that we cannot safely take medical assessment out of its management. In my job, I am regularly diagnosing unmet health needs in my patients.
While many people seeking help for addiction do have challenging social histories, many do not. Doctors for instance have the same estimated risk of addiction as the general public. Poverty and social exclusion may increase the risk but they are not necessary factors for addiction to develop.
Scientists can create laboratory models of addiction in rats and mice and primates. They behave pretty much like human addicts, yet mice are not known for having poor parents, truanting and social deviancy.
The truth is that addiction is a complex condition with many facets and angles. I believe that it behaves as a disease enough to satisfy a medical definition, but that’s not all there is in this picture. It can be a disease and other things. It’s a case of ‘both and’ rather than ‘either or’.
Let’s remember that those of us who suffer from this ‘condition’ are truly suffering. Getting recovery from that suffering back to full health is an important goal.
Really enjoyed this comment David. Please don’t think that I am being critical of a health view. Not at all. I just don’t want people to think about the social factors that lead a person into their problem, keep them stuck there, and sometimes need to be addressed to help them move on.
As we both agree, this is a social, psychological, biological problem (in no particular order)!
Hope you are well!
I am personally rather resistant to medicalisation of addiction, for a variety of reasons, in particular that for SOME individuals (by no means everyone) and their families it may encourage the culture of helplessness and acceptance of less than the person deserves and can achieve.
I would also like to comment on the following from David McCartney: “Scientists can create laboratory models of addiction in rats and mice and primates. They behave pretty much like human addicts, yet mice are not known for having poor parents, truanting and social deviancy.” What about the experiments with rats, where those in enriched environments have shown significantly lower rates of addiction to cocaine (same for amphetamines, I think)? I’ve just googled it and there are many hundreds of articles on the topic.
Our environment and our reality (the one we are born into, as well as the one we are co-creating for ourselves moment by moment) undisputedly have the most profound effect on our health, our physiology, our susceptibility to chemical and biological agents, our vulnerability to mental distress. There are some things we are stuck with (our genotype), but I believe that we are so much more than that!
The mental health recovery movement is now moving slowly towards the concept of “beyond recovery”, towards THRIVING – and I love the concept of “discovery” – this is what it is all about, discovering more about ourselves, other people, the world, being constantly curious about the wonders of being human.
How strange that no one has yet mentioned the spiritual aspect. I think it was Dubey who pointed out that there are more theories about why people use drugs than there are drugs, but the underlying reason people use them is to change the way they feel; an effortless altered state of consciousness, then continue to use them because they can’t stand the way they feel without them.
In view of that i would suggest that the use of drugs may well result in medical and psychological problems, but to address those, without addressing the spiritual cause of use strikes me as selling the client short.
MAYBE WE SHOULD HAVE A STARFISH APPROACH NOT THE SPIDERS
SPIDERS HAVE CONTROL ISSUSE’S ? MONEY VOTES.. PR ….ON AND ON IS THERE A REHAB FOR THEM ?
http://www.youtube.com/watch?v=WIUFArjt0Jw
LET THE PEOPLE HAVE A CHOICE?
The Starfish and the Spider
This is a excellent book that makes a very compelling case for decentralization in organizations and businesses. The authors contrast the Spider which represents top-down management, with the Starfish which is essentially headless … all its “legs” go in any direction it wants to … but the starfish still moves and is effective.
Whilst the first few chapters of the book present a couple of case studies and examples that serve to illustrate the main themes of the book. It’s really from chapter four onwards that the book picks up pace as the authors discuss operational principles behind decentralised organisations – the need for pre-existing networks as a substrate, the role of catalysts and champions to activate leaderless organisation, “circles” as their chief co-ordination mechanism, and “ideology” as the glue holding everything more or less together.
After reading the book I’m left feeling that the notion of leaderless organisations is unquestionably superior both morally and aesthetically – to centralised organisations. Partly because of their structural simplicity and elegance, but also, and more profoundly from my point of view, because they rely so openly on trust and the belief that man is fundamentally good and ultimately because they are capable of drawing the best from people and providing them with truthfulness, meaning and purpose in their life.
It’s interesting to also reflect on the fact that not only do organisations like Alcoholics Anonymous operate as a decentralised organisation, but also organisations like Al Qaeda, and it’s the very nature of that de-centralisation that makes them so difficult to contain.
As an interesting follow up to reading the book here’s a talk Rod Beckstrom gave at Next Web in 2007, that touches on the main themes in the book:
THE TALK ON UTUBE
http://www.youtube.com/watch?v=fumQ0s7DCEY
Dave, I think the reason that the North West has a very pro-active recovery movement is due to the fact that those involved work collaboratively together.
From Mark G (NTA) to service user groups, the barriers aren’t there and this encourages people to get involved!
Another point to mention is that the North West and Manchester in particular will embrace new recovery models and encourage its members to take the lead.
There are lots of us here in sunny Manchester that are promoting the new recovery movement via wiredin and inexcess.
Hoever, exposure is one thing, getting out there and ‘shoutin from the rooftops’ so others will hear is another.
We are certainly doing both.
We find ourselves in a better place than we’ve ever been regards recovery options (SMART, Intuitive Recovery, N/A & A/A)today and this cannot become some sort of flash in the pan – new kid on the block, if you like, it needs continual support, investment from its members and positive momentum.
Without a shadow of a doubt, all those that are passionately involved will continue to do this!
