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I was just reading how well treatment is going in England today on the NTA website where thousands are being discharged from treatment ‘free of their drug of dependency and no longer in receipt of medication’. (Paul Hayes). Cozy and reassuring.
I would feel elated if I hadn’t worked for years in drug treatment and been through the system myself. There’s a dischordant sound in the melody here for me and it has a tone of ‘spin’ about it.
It was the last line that tickled me (with barbed wire mind you ):
“The NTA will continue to advocate a balanced treatment system, offering abstinence and maintenance options in residential and community settings, and based on clinical evidence rather than belief.”
“Continue to advocate a balanced system?” What’s the plan for introducing that?
Residential referrals are down. centres are closing and clinical evidence seems to mean prescribing options only. Rather than belief. What belief? Belief that addicts can recover?
Belief that people can recover tends to be a teeny bit low in treatment settings. Recovery is more than discharge free from drug of dependency.
Are we to swallow this stuff?
No, we must NOT swallow this!
I don’t like being negative on this site, but we do have to challenge this nonsense. Otherwise, the system and all the bad things in it may stay.
This is a simply a PR exercise by the NTA – and a dishonest one at that. But one that had the media crowing about the success of treatment.
‘Spin’ affects people’s lives.
The ROIS model (Recovery Oriented Integrated System) can be started by the introduction of an Independent Single Point of Assessment and Access to each of the 149 DAAT based treatment systems in England (not sure how rest of UK systems are organised). Once introduced this makes sure that service users are directed to the most appropriate treatment option. Blackpool was one of the first to do this in the North West and referrals to Detox and Rehab shot up. This can also act to counter the ‘drift’ (from months to years) that can occur when people do need a period of stabilisation on medication.
On the residential front,as far as I know, residential referrals to places like Park View and BAC O’Connor and ADAS/ACORN and THOMAS are doing OK.
Sorry to keep having these comment bursts – but – one very practical thing that wired in could do would be to alert us to those areas where there is clear evidence of a lack of choice and balance. For example, I have been told by a service provider of a situation outside the North West where a particular type of abstinence based treatment service is not getting referrals because the pathway to that service is routed through (and therefore gate kept) by a Tier 3 stabilisation medication service. Now that same service operates in the NW and gets lots of referrals. So, what is the difference between one area and another. I suspect the gatekeepers in the area where referrals are not coming through would say things like “our clients dont want detox and rehab”. Interestingly, many of our Tier 3 providers in the North West used to say the same thing (I’m sure I did way back when in Trafford CDT). I’m not sure about naming names and places but if people wanted to provide me (via my nta email) with any evidenced examples of this kind of thing I will try and get the information to the right place in the NTA.
This is an excellent idea Mark, people on Wired In providing alerts of areas where there is clear evidence of a lack of choice and balance. Could you possibly blog about this so lots of people see your thoughts? Or I could copy this comment on for you, but probably better that you frame what you want to say.
If people highlight the problems in a non-confrontational way then we may start to get somewhere in certain areas.
There are pockets of great practice up and down the country and surely one of the best examples is what’s happening in the North West. There is evidence of incremental positive development in other regions and we need to highlight and celebrate that (as we do here and elsewhere).
Nevertheless the truth remains that generally addicts and alcoholics only get so far in our system and get stuck. A recovery programme locally closed down recently for lack of referrals from the statutory services. Addiction Today has evidenced closures of resdidential services and empty beds. For the NTA lead to suggest that there is equitable access and balance cannot go without challenge. We have a long way to go.
I love your offer Mark of being willing to highlight areas where things could be better. It is incredibly generous and not without risk. I hope professionals feel free to take you up on that.
I have a very real example of where a DAT refused referral into a centre we run last week. Even though the client visited the centre and specifically requested to be referred here directly from prison via RAPT.
Furthermore this DAT manager visited us when we opened 4 years ago and told us we were not welcome and they would prefer if we set up elsewhere.
We even had the local probation service for the DAT area lobby their counterparts in the northwest to “watch out” for TTP when we set up there. Thankfully this was retracted when we threatened legal action with the head of probation. And thanks to Mark Gilmans leadership we found the North West to be fertile ground with commissioners looking for professionally run Recovery Communities.
But its fair to say we have been discriminated against from day 1 in this specific locality and it still continues.
Their original gripe was with our service not being regulated. They even lobbied the local newspaper to this effect and we had to suffer being dragged through the press. I was also personally verbally attacked on a radio interview by the local service manager. If I were from any other minority group they would have been hauled before the Equal Opportunities Commission by now. But I am an addict in Recovery. So who cares! I guess in their eyes service users shouldn’t have the temerity to set up their own business’ and open Recovery Community Centres (9 to date and counting!!!).
So what did we do?
We became the first “quasi residential” provider to become CQC (CSCi) registered. We sought and gained ISO 9001 accreditation and are months away from Investors in People (IIP) accreditation. This has cost us tens of thousans of pounds.
Has this made a difference in our treatment? Not a jot! They continue to overtly discriminate against our service and to block service user choice. I was naively under the impression that service users we not supposed to be directed to any specific service but to be offered a range of services from which to make a choice. If they made a reasonable request they would be facilitated.
I have tried diplomacy via the NTA. We have been very patient and polite in all interactions but everything we’ve done seems to have no effect. My feeling is we are going to resort to the legal process and see what the lawyers can do. I have to say its taken 4 years for us to get to this state but quite frankly now the “gloves are off”.
Sounds frustrating Tom. Is there not a legal case already being prepared by an advocacy group that is frustrated that so few alcoholics get the sort of treatment they need?
If I remember part of it is also around the issue of the continued practice of attempting controlled drinking in alcoholics. We know how successful that is. I think they’d got a favourable opinion from a QC.
What do you think the local probation service has against you, if they can no longer blame regulation (or lack of it)? Just not keen on addicts recovering?
I am aware of many organisations experiencing what tom has and despite having all the care commision standards and higher than most national quality standards, they still do not get refferals, this has to stop if our goverments genuinely want people to recover and the stigma and bias that is in obvious abundance has to be highlighted if not outed as is the case with the advocates who are involved in legal proceeding with the NHS.
