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In this week’s DDN (Drink and Drugs News) the cover story focusses on the anthrax outbreak in Scotland. Since the story broke, I’ve been surprised by the lack of coverage and urgency given to it in the media, a point made by Claire Brown in her editorial.
Like her, I wondered if this had been a general population problem if it would have grabbed more attention. Stigma again.
The story makes the point that waiting times in Scotland are in general longer than in England, but curiously fails to mention the laudable steps the Government there have been making to change this through the introduction of minimum waiting times (through a HEAT target).
McGrail says “harm reduction and recovery are not mutually exclusive. They can and do exist side by side”. I agree though harm reduction and prescribing services grossly outweigh provision of abstinence focussed treatment in all parts of the UK and there is no reason why a recovery orientation could not be introduced in every harm reduction service.
I like some of the points made and although the article is not overtly critical of recovery there are a couple of things that trouble me.
The first is the quote by the unknown “Scottish commentator”, who suggests that the slow response to the anthrax outbreak is due to the focus on recovery and abstinence by the government. “I wonder if this terrible chapter could be the Banquo’s ghost of recovery? There is an increased recovery discourse that is being shaped by story telling, and soft-focussed recovery narratives. This discourse does not sit well next to impersonal epidemiological modelling…health protection and drug policy people seem to operate on different levels”.
I think the insinuation of a link between the anthrax deaths and the recovery policy is incredibly unhelpful. (Actually it produced a feeling of outrage in me). The withering dismissal of our recovery narratives (think on the powerful effect these have on those seeking recovery; they are the life blood of Wired In) is troubling.
The final words of the article also got me wondering. With the themes placed out of context, they too felt quite belittling to the recovery movement.
“No amount of recovery coaching, marching or witnessing will deal with an issue like anthrax. For that we need harm reduction…”
Who amongst us would ever have argued that marches or coaching would serve as an adequate response to an important public health issue? To introduce them here feels like contempt and increases the risk of further polarisation.
PeaPod – like you my first reaction was shock and then a large dollop of outrage.
And then a stange thing happened – a chuckle, followed by a titter and the a full blow belly laugh.
Although deeply shocking to imply linkages between recovery and anthrax, suggest we have no concept of public health and belittle our stories (and our lives perhaps?) – I am left with the feeling that if this is the best ‘they’ can do, ‘they’ are sadly mistaken.
Authenticity and dignity are cornerstones of the recovery movement and, while I feel a response is called for – perhaps from the Wired In community ? – it should reflect the fact that we do not need to resort to such techniques.
An opportunity in disguse perhaps? Let me know what you all think?
New to site Peapod, am not interestd in articles as I have to keep my recovery simple.
I have my own views and thoughts on things yet am on site to support and share my own recovery.
Hope you are not offened yet let the 20% do the fighting over these issues out of the 80%, a blog earlier put in. maybe you are the part of the 20% who can?
I’m with Michaela Peapod, I share your outrage but think it’s an opportunity. The more discussion and debate on recovery (or attacks) the more scope there is to re-frame the debate. It’s not an either/or scenario and I can’t help but feel that extravagant attempts to polarise things are either an illustration of a lack of understanding of what ‘recovery’ means (quite likely given the levels of discussion/reflection in a field that feels itself pretty much constantly under threat – and not just from new approaches) or fear in the face of a pretty intense paradigm shift.
We need to get our stuff out there in a more coordinated way.
I also think we need to situate the recovery movement within a wider agenda of social exclusion and link back to community initiatives that go back 40 odd years in this country. It would give us a more solid foundation and some natural allies outside the drug and alcohol world.
Whatever the deal, I believe the times they are a changing (as someone once said) and we are on the move.
I Like your approach to your recovery Martin. Many paths.
Take care.
Thanks PeaPod for blogging about the tragic anthrax outbreak. I have been considering doing a blog that would highlight some of what you wrote, but did not feel confident enough. As for some using the anthrax tragedies to further the redundant and no longer acceptable debate about recovery versus harm reduction is quite simply disgusting. And it shows a complete lack of understanding about what recovery actually means.
While I understand that for some who work in the field the process of change re: building recovery orientation into service and harm reduction being part of that continuum is difficult to come to terms with, I do not understand the contempt and ferociousness of the obvious straw man arguments being used to justify their reluctance to make the shift. Unfortunately my and many others vision of uniting the field seems a long way off.
I would have like to have seen any reporting or blogging on this tragic set of circumstance as an opportunity to educate the public about the disease of opioid addiction and opiate antagonist pharmacotherapy. Help reduce the stigma and discrimination associated with patients having addiction disorders and ultimately serve as a conduit connecting patients in need of treatment to qualified treatment providers.
I believe with the new recovery focus we have a historical window of opportunity to destigmatise what Bill White calls medication-assisted treatment and recovery.
This window of opportunity can be maximized by redirecting public attention from those patients who have yet to achieve stability and who receive the most media attention, and shining a light on those methadone maintenance patients who have achieved optimal dose stabilization and quality of life. I know Wired In has tried to collect some of these stories several times but there have been a low number of personal stories put forward by those in medically assisted recovery so far.
I know the aim here was to cast light on current and former methadone maintenance patients in sustained recovery, and to celebrate their successes, as this would surely change how our field and our culture perceive medication-assisted recovery. Such stories would l help us transcend the dichotomous and increasingly stagnant “harm reduction versus abstinence” debates.
I don’t think this will happen through the efforts of Wired In or any one organisation. As it is with those who choose abstinence, it is time a vanguard of people in long-term medication assisted recovery, who are personally called, whose life circumstances allow, and who are prepared and supported for this role, to stand collectively and tell their recovery stories to this country as well.
Our job as recovery advocates is to help create a cultural climate in which those stories can be safely told and to help with that preparation and support process. That day will not come without the support and unification of our field. It is time we connect the field’s pharmacological treatments to the larger and more enduring process of addiction recovery.
Also that day will not come if we are defending a idealistic view of what we would like to see in current methadone services, as you all know I have enormous respect for Bill and I welcome the diplomatic language as a bridge we desperately need to build and I feel myself am a regularly walker on, but it’s just not been my experience in Scotland.
It is unarguable that for a lot of people trying to even access medically assisted recovery the waiting lists etc and lack of therapeutic help once accessed is still a major issue. See David Best’s work in the UK that concludes that even if you are accessing weekly psychosocial support along side your script this totals about 3 hours therapeutic help per year i.e. what our patients are actually getting is to a dosing clinic, getting no real counselling, no real hope or aspiration towards even seeking recovery and little if any help at all when asking to be detoxed. And certainly very little if any aftercare support to pursue drug-free recovery.
These are the kinds of stories I hear without exception. I recognise that my contact might be limited to a non-representative sample, but I’ve never even heard someone say something like, “Other people were doing well on it, but it wasn’t for me.” or “The people there really cared and treated me well, but I decided I needed something else.”
It is the same recurring problems I see all over the UK with rare exceptions. But in particular, within the field, the problem I see (that serves no one but see most frequently) is the pessimism about the capacity of opiate addicts to recover.
This is horrendous as if there are all sorts of great methadone recovery stories and stigma is preventing them from being heard, it is only feeding the lie that we don’t recovery. Bill White has a history of doing a great job of delivering difficult messages to drug-free treatment providers.
Methadone providers need to be challenged in the same manner.
If drug-assisted treatment is ever to have a place in a recovery-oriented system of care, it seems to me that the providers in the UK need a dramatic culture change, and whilst straw men arguments are forwarded to try and stall a paradigm shift, those who still suffer will continue to die whilst we argue over philosophy and belief systems, instead of serving them !
Saddened, disgusted, and ashamed of my profession to all those who have lost a loved one to addiction.
Am
Hi Peapod,
The first cynical comment I will make is that it hard to get the “moral majority” to panic over the thoughts of dying Heroin addicts.
I think the Daily Mail could even go so far as to celebrate a story such as this.
Putting away my cynical stetson, and now donning my evaluative deerstalker, I’m not sure whether the quote in the last paragraph is misinformed, irrelevant or just plain bizarre
Firstly, there is no safe way to consume anthrax infected Heroin. So what use is harm reduction? Maintenance perhaps? Perhaps a higher dose of methadone would prevent people from using, I’m not so sure.
That deals with misinformed. Now for irrelevant, recovery marches and recovery coaches have absolutely nothing to do with antrax infected heroin, and it is very flawed logic to suggest that this has any impact on their effectiveness.
Just plain bizarre, well I’ve saved that one for the argument as a whole.
Matt
Michaela, I love the idea of harrumphing laughter at the insinuations in the piece. What a powerful way to dissolve the irritation and feeling of injustice!
Martin, I buzz between my many hats on this site so fast at times I forget which one I have on. Sometimes its recovering addict, sometimes its professional and sometimes it’s recovery advocate. In terms of “fighting” it’s really knowing what battles to choose. I let my passions and spirit be my guide.
Matt: your take: misinformed, irrelevant and bizarre. Succinct and hits the mark.
Annemarie, there is so much to agree with. I think the power of our stories does alarm some. Recovery cannot be contained by science or treatment though these things may aid it.
Alistair, I like your framing recovery as a social exclusion issue. It’s a civil rights issue. I thought earlier of the gay rights movement. In the early days there was a persistent attempt by some to link it with paedophilia, even in the face of clear evidence against this. It did not stick for it was clear that there was no truth in it and the human rights issue held forth.
Thanks for highlighting this Peapod and getting the discussion rolling. Everyone has given great comments – don’t think I can add anything right now but this has given me a lot of food for thought.
