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’.