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Oliver’s blog got me thinking (again, for this is one of these recurrent themes for me) about how differently we treat addiction compared to other illnesses.
If you get something wrong with you healthwise, you would normally go to the doctor and the aim would be to get you better. If you have something serious, you are expecting to get a treatment that cures you or gets you to the best level of functioning you can have with the illness.
Shouldn’t it be the same with addiction?
Example. You get a little mole on your arm that grows larger. You go to the surgery and the doc sends you to the skin specialist. Then what?
Does she say. “Oh dear, it’s cancer. Such a shame”. We’d best get you onto a morphine drip and book your bed in a hospice”?
No she doesn’t. She says: “It’s not good news; you’ve got skin cancer. But the positive thing is we’ve got some great treatment options and a good chance of remission. If you do A + B + C, then the outlook is not bad at all”.
In addictions we do the opposite. It’s called palliation. It goes something like this:
“Oh dear, you’ve got addiction. That tends to kill you unless we put you on a whacking great big dose of methadone.
Yes, some people do get better from addiction, but we don’t really know much about who they are or how they do it, and to be honest, you don’t really look like one of them anyway, so just take the medicine and maybe when you grow up, we can look at recovery (whatever that is).”
It’s not good enough and I would challenge the whole “we’ve got to get you stable for a decade on methadone” thing. I suspect that once you’re on a script for a while it gets less likely that you will find recovery.
Let’s adopt a positive and expectant approach in treatment services and aim always for the best outcome possible rather than settling for the palliative approach.
I suspect that for many of those working in treatment, if their sons or daughters or partners or friends became addicted, they would want a different sort of recovery for them than their clients tend to get.
I know I would.
“I suspect that once you’re on a script for a while it gets less likely that you will find recovery.”
I think neil Mckeagneys and other research across the world has said there is a window of oppertunity during the first two years of prescribing after that ……………….
Anyway peapod thankgod i met the experts who said dunno if you got addiction why dont you hang about with people in recovery from it and they will help you identify whether you have it or not!!! what have you got to lose, if they dont help go to the docs and im sure you will get any number of pills and potions that might help.
I am so blessed i stayed away from the treatment system but actually i had witnessed family members being prescribed methadone and other drugs and from what resulted in their lifes after that,i knew i did not want it, I suppose i had the benefit of their experience one of the few times i actually learned from othhers experiences!
BTW the mole ananolgy is class nae quality man!
stabilisation in addiction spells contradiction to me, i could never stabilise as many others could’nt you see, supposedly the new government drive or backstep is recovery whether you like it or not approach, i believe when assessed an addicts needs and desires should be taken in to account, drug of choice to be prescribed and choices about recovery to be offered not forced upon the addict, from personal memories i always wanted rid of substance slavery even when i had a bucket full of drugs, i just needed some guidance on a way out.
TONY A
‘choices about recovery to be offered not forced upon the addict.’
With you all the way on that one. If you don’t buy into it it will never work for you.
Nice blog Peapod. For those seeking help, methadone should be one choice, one alternative thats provided ( with abstenance as the ultimate goal). Is it only me but does there not seem some merit in support groups, with possitive roll models, people who have made it out of the maze. Just helping each other within the group would help, knowng your not alone with these problems. I have not been on methadone. Perhaps someone who has can enlighten me.
I think choice is important, but informed choice is more important. Many of the clients I work with have never been offered alternatives and certainly have not met any other recovering addicts to their knowledge.
If they don’t know that drug free recovery is possible, how is it going to happen?
I wonder how many of us working in drug treatment have met lots of recovered/recovering addicts. Not that many I suspect.
How we change that is we show them the evidence and let the recovering people speak for themselves.
Another good comment Peapod. I also liked the one in your blog about ‘adopting a positive and expectant approach’. I get the feeling that is what one could expect from you.
Coming from the user side of course I get to see many in recovery that would act as positive roll models. I believe that its a part of service user involvement equaly as the providers. Its up to both paties to come together and work out how we get to peer based ercovery programmes.
Aren’t we rather assuming that all of those of us in active addiction have sound capacity to make healthy choices? When we are using and drinking choice becomes impaired. As does the ability to prioritise. We have trouble being consistent, sensible and logical.
Scans of addicts show that the law-abiding, decision-making, choice part of the brain is off line. It’s popped out for a pint of milk and a packet of fags and left a dumb bit the size of a pea in charge.
Result? Not dependably able to choose what’s best.
We need to address this. Laying out the choices in front of clients in the chaos of active addiction and expecting enlightened selections is like popping down a knitting pattern in front of a chimp and coming back an hour later expecting a lovely Aran sweater. (No offence to addicts or simians intended). It takes time for the brain to recover.
I believe we need help and support to make the choices that suit us best. That help needs to come from well informed, compassionate supporters who understand the nature of addiction and the nuts and bolts of recovery. Thank God, that’s what I found when I asked for help.
When we are using and drinking choice becomes impaired. !
this bog sums up the whole crooked wanting system for me, the quote above describes perfectly the insanity of what we are doing as treatment providers, if you ask a using addict what they want there is usually only one response, and that is more drugs!
Why do we as a profession collude with this insanity?
and I wonder what the chances are of services in the UK doing what they did in Philadelphia (described in the partnership paper) released by white & co this week where the whole cities services sat down and took a fearless and thorough moral inventory in order for them all to change which they did to tremendous benefit to the people of Philly.
I just read that paper too nattypunk and fired it round a variety of people to see if it might inspire. It’s a great example of what can be done where there is “big picture” and “joined up” thinking.
To an extent, it is happening in the North West as they introduce recovery oriented integrated systems.
John, like you, I see many people in recovery as I work in a service for those aiming to be abstinent, but many colleagues don’t see the evidence. I think we need to showcase it for them.
Choice is impaired in addiction, but that leaves us with a difficult ethical path which we tread with our clients. We need to steer them, but we can’t walk for them.
Steering them in a recovery direction is something we all ought to be doing.
