Moving Towards a Recovery-Oriented System

eATA and its members have had a long association with the recovery movement. I am therefore delighted as its Chief Executive to be a member of the Recovery Academy.

Across Great Britain, politicians, policy makers, service commissioners, providers and service users are, at long last, waking up to the fact that we should be raising our aspirations to demand that recovery become a reality in our communities. To this end the Scottish and English Governments have laid out compelling and credible visions for the future of their respective systems. The challenge for us all now is to make these visions come alive.

Central to this will be an acceptance by us all that there are many recovery pathways, all of which are equally valid as long as they work for the individual. Given that no two recovery journeys will be the same, it is imperative that local areas provide a range of services which can be tailored to meet user needs. At a minimum, these should include:

·         Harm reduction services that act as gateways to a wider recovery system;

·         Prescribing services that work with individuals to stabilise them in times of crisis, provide them with time to consider next steps and motivate them to make further progress;

·         A range of detox services;

·         A choice of residential treatment modalities and abstinence-oriented community services;

·         Truly recovery-oriented services for those opiate users for whom medically assisted recovery or long term planned maintenance would be most appropriate;

·         Community aftercare and recovery ‘check-ups’;

·         Integration with primary healthcare services, such as GPs and mental health;

·         Partnership work with reintegration services, such as education, employment and housing.

I would argue that any local system that does not offer the above cannot truly call itself recovery-oriented. Nor can a system that does not support and facilitate access to a variety of mutual aid pathways and other types of peer engagement and support. ‘I can’t but we can’ and ‘Nothing about us without us’ being very pertinent rallying calls in this regard.

A key paradigm shift will be to move from an acute care to a chronic disease model in the treatment of addiction. In particular viewing addiction as a condition which, for the vast majority of people, will require ongoing management and accepting that relapse, whilst not inevitable, does often happen and should be seen not as a failure of the individual or the system, but as an error or learning experience resulting from the acquisition of new unfamiliar behaviours.

It is also vital that we don’t kid ourselves that we can deliver the kind of change required overnight, as it is likely to take years. Nor should we be satisfied with rebranding everything previously referred to as treatment as recovery and bolt on a few extra bits and pieces – we should be aiming for long-term transformational change from the bottom-up.

As great endings almost always start from small beginnings I would urge each and every one of you, as a first step, to play your part and engage with commissioners, providers, service users and people in recovery in your local communities in a ‘big conversation’ about the nature of addiction and recovery and the implications for your local services. We do after all ‘make the path by walking it’.

Tackling the challenges affecting residential rehabilitation providers

It’s hard to believe as I write this, that it is little more than a month since I started working here at eATA. In this time my focus has been on getting out and about and meeting as many members as possible. In doing this I have been heartened and gratified by the warm welcome that I have received, and the positive ongoing commitment from members to what I promise will be a rejuvenated and re-energised eATA.

As a result of these meetings, a number of very clear front-runners are emerging as priority areas of work for us to focus on in the coming months, with my next challenge being to develop a programme of activity to take them forward. These are (in no particular order) providing a strong representative voice for the residential sector; payment by results; transition to public health; building links with commissioners; and exploring with other second tier organisations/representative bodies how we might come together collectively on behalf of the sector to give it a stronger and more unified voice.  

A significant chunk of our time has also been spent responding on behalf of members to the media coverage that has arisen from Mitch Winehouse highlighting difficulties that people can experience in accessing residential rehab. For the record, I am very clear in my own mind that, in any local system that seeks to badge itself as recovery oriented, residential treatment has a key role to play in serving the small but significant minority of clients whom it would benefit.

It is also apparent, based on feedback from members that, whilst some providers are fortunate enough to be operating at or near capacity, many others have seen a significant decline in referrals in recent years.

A trend that, if replicated on a continued basis across the sector, could present a near terminal threat to this important treatment modality unless arrested quickly. Conversations with service users have also indicated that availability and ease of access to such services is variable.

I am confident we will be able to work with DH officials on this pressing issue and I am therefore very hopeful that we will be able to build on this at the first meeting of a rehab working group on 29^th September and develop a constructive dialogue with government.

I am now on annual leave but my first engagement on my return will be, along with my family, to attend the 3^rd UK recovery walk in Cardiff on 9^th September. I hope to see as many of you and your clients (past and present) there as possible, and also at the UKRF conference the day before (where I will be speaking) to celebrate recovery in all its forms. “Gobaith ar gerdded!” or “Recovery Walks”, which is what I believe to be the appropriate English translation.

Welcome to eATA

I would like to start by saying how delighted I am to be taking up the post of Interim Chief Executive at eATA, and to thank the staff, board and members of the organisation for making me welcome. My vision for eATA is of an organisation that recognises and celebrates the fact that there are many recovery pathways. As a consequence I want to build a membership base that truly represents the breadth, richness and diversity of provision that exists in the drug and alcohol sector.

Historically, eATA existed to serve the needs of the residential sector. Subsequently its remit has expanded to include all treatment providers. It is therefore important that, whilst eATA will seek to represent the needs and views of the sector as a whole, it does not lose touch with its roots.

What I hope will make us distinct from other second tier organisations is an emphasis on supporting the building of capacity within the sector in the context of the Government’s new recovery agenda. Whilst we will of course keep abreast of politics and matters of policy, our primary focus will be on the practical issues facing our members in delivering services, and the development of pragmatic solutions to address these.

The Government’s shift towards localism means that, whilst there will be an ongoing dialogue with civil servants in Whitehall, we will increasingly be seeking to build links with local commissioners on behalf of our members. We will also be looking to play a full role in shaping the future direction of the drug sector partnership.

It is also important that we are visible to our membership and communicate effectively. I will be seeking to meet as many of our members as I can in the coming months, and we will be arranging a programme of regional and local events to provide an opportunity for members to network and discuss the issues of the day.

In closing, it has been an odd few weeks for the sector, with the tragic death of Amy Winehouse meaning that the papers have been full of addiction related coverage. Sadly, much of the debate, on social networking sites in particular, has indicated that we still have a long way to go in order to reduce stigma and raise understanding in relation to addiction in this country.

Whilst the cause of Amy’s death is as yet unknown, speculation in the papers was very much that she succumbed to her long and well documented battle with addiction, reinforcing a negative message that relapse is inevitable. This overlooks the fact that there are multitude of effective services in the UK delivering many thousands of people into recovery every year.

My condolences are extended not just to the Winehouse family, but to all those other families who have suffered the loss of a loved one as a result of drug or alcohol dependence, and whose deaths, whilst equally tragic, go unreported and unnoticed.