I was really excited and honoured recently to chair a side event on Recovery at this year’s Commission on Narcotic Drugs in Vienna. I’ve been learning a lot in the past few months through my involvement as a volunteer with Wired In. I’ve had opportunities to listen to the experiences and challenges of people who are recovering not only from addiction problems but from many difficult life experiences. They want and are planning to manage their recovery, not passive recipients of drug treatment, rather, mapping out positive life futures. Drug treatment and other social services and stronger communities can support this, they can’t deliver it. It seems fundamental but it is revolutionary and it’s about hope not hopelessness. It requires a systemic rethink, based on listening to and trusting communities and learning from people in recovery.
The Wired In website – www.wiredin.co.uk – supports an increasingly empowered community of people in recovery, supporting each other, exchanging ideas, challenging the traditional way drug and alcohol treatment services have been provided, emphasising that people with drug and alcohol problems are the experts who are best placed to map out and manage their recovery. Many people in recovery are talking about how drugs and alcohol had always been the focus of their lives and how that’s changing so that their focus is becoming not just about what treatment they get; rather, it’s about how they become integrated into their communities, how their communities change to support that and how they contribute as full members of their communities. And this movement is growing within communities and across countries.
When we think about the problems that people have with drugs and alcohol, we know that problematic drug and alcohol use almost always comes with a whole lot of accompaniments – family breakdowns, abuse, violence, housing difficulties, involvement with criminals and the criminal justice system, financial problems and poverty, social exclusion. We all need support in recovering from that. We all need to recover from the challenges we experience as we go through life. I was in Glasgow last week. I always visit this city with somewhat mixed emotions; I haven’t been there very often recently. I grew up there and have very fond memories of visits to the Kelvin Hall at Christmas and to the Citizens Theatre where I remember a memorable Hamlet set in a mental hospital. However, I also remember when I was very young being frightened of a very drunk man slavering up against our car window. I also remember the sectarianism, which sadly continues to this day – bombs to Celtic supporters! – so that it wouldn’t be unusual for me, even at the age of 48, to be asked which school I went to. (St. Patrick’s it was – no hiding one’s religion and cultural background with that one.) I can appreciate Glasgow’s incredible architecture and history and the great wit and culture of its people. However, we’re never just professionals or academics or just private individuals, nor are we ever only addicts; as individuals, we’re part of communities and as individuals and as communities we need to and can recover together from all the difficulties we encounter. I guess Glasgow makes me reflect and reframe; thus my ambivalence towards the place.
Following on from this, there seems to me to be a huge and continuing gap between how we frame the context within which drug and alcohol addictions and other social problems occur and the policy responses to it. The UK Employment Minister, Chris Grayling, was on the Today programme on Radio 4 this morning talking about the government’s plans to introduce a payment by results scheme for services delivered for people with drug and alcohol problems. Regardless of whether the government’s motivation is essentially ideological and about cost-cutting, it’s undoubtedly correct that there needs to be more emphasis on delivery of outcomes from treatment. However, recovery communities need to be trusted and supported to grow and they need to be engaged fully in a process to define what successful outcomes look like and to plan how people can be supported to achieve them. Within a new framework, clinicians need to be less arrogant and politicians less ideological and simplistic to recognise that addiction is a chronic long term health condition and that treatment can only ever contribute to delivering recovery, it can’t deliver it – individuals supported within and working as part of communities do that. Just as the law on its own can’t prevent drug problems – for example, drug use patterns in San Francisco and Amsterdam, with strikingly different legal arrangements, are remarkably similar, indicating perhaps the irrelevance of drug laws to people’s behaviours – neither can treatment on its own. And moreover, just as a treatment service which opts to work with complex drug or alcohol users rather than “cherry picking” more likely “successes”, should not be automatically deemed as failing, coming off drugs and alcohol on its own should not be deemed to be a success. Nor indeed should being employed. You can be employed and still be poor, unfulfilled, unloved and unappreciated, lonely and isolated.
I believe that there’s a very positive debate currently going on in the general public about how we re-build our communities and develop community solutions across all areas of our lives, rather than simply pathologising and blaming individuals for problems such as drug and alcohol misuse (or indeed unemployment) and penalising them. Wired In is one example of a network that is demonstrating the high aspirations of people in recovery, celebrating achievements and showing the way forward. But our politicians still have a long way to go to appreciate and embrace the full meaning of recovery, rather than just using the word as a rhetorical tool.