1. Developing Recovery in Calderdale Stuart Honor, Recovery Facilitator

2. 30 Years and Four Ages of Drug Treatment
1.1970s/1980s: Health & Welfare of INDIVIDUAL Addicts
2.1980s/1990s: PUBLIC Health and Welfare and HIV prevention
3.1990s/2000s: Crime Reduction and Community Safety
4. NOW: The 3 R’s: -Recovery
-Reintegration
-Regeneration

3. Why Recovery? In Calderdale we have high quality treatment services.
The numbers retained in treatment are high
The unit costs are very competitive
The Key targets are all exceeded
However, how many get out drug free?
Have we oversold the benefits of a medical model to address what is a social problem?

4. What is Recovery?
The process of recovery is characterised by voluntarily sustained control over problematic substance use which maximises health and well-being and participation in the rights, roles and responsibilities of society.
UKDPC, Consensus Statement

5. What can Recovery achieve?
Parents are able to care for their children
Individuals start coming off benefits
Health inequalities are reduced
We prevent the Intergenerational transmission of addiction (and other social problems, e.g. teenage parenthood, welfare dependency)

6. We built a 6 lane treatment motorway
Built ¾ of the way to its destination

7. Where was the B Road going the rest of the way?

8. …im down to one drink a day now!”
We use abstinence as a basis for recovery as you have to turn the water off to mend the plumbing
…im down to one drink a day now!”

9. Question for all of us?
How can an individual get well in the area where they got sick? Anybody can get clean, but how can an individual sustain sobriety in the life of their community?

10. Key to Recovery
• “ … the key to successful recovery from addiction is the construction by the addict, of a new identity incorporating non-addict values and perspectives of a non-addict lifestyle.”
McIntosh & McKeganey (2002)
“To change their lives successfully, addicts must fashion new identities, perspectives and social world involvements wherein the addict identity is excluded or dramatically depreciated.” Biernacki (1986)

11. RESTORING A SPOILED IDENTITY
• How does an addict restore their spoiled identity?
• What factors and circumstances encourage, impede or sustain efforts to achieve this?
• The restoration of a spoiled identity cannot be achieved by the simple act of the addict declaring that he or she has stopped taking drugs; a renewed sense of self has to be built and constantly defended against a variety of often-powerful opposing forces.”

12. Establishing a Recovery Community
A critical aspect of the recovery process involves connecting recovering individuals and families to local recovery support groups and communities of recovery.
Common misconception is that NA/AA meetings are all ‘doom, gloom, ginger beer and jesus’. However, all the evidence suggests that 12 step recovery is the most successful route to continued abstinence for the recovering addict.

13. What do we do to build it?
Provide living role models that illustrate the diversity of the recovering community
Provide information and tools to help people find recovery
Create opportunities for people to come together to help each other and help the recovery agenda.

14. What happens when Recovery is Introduced?
Recovery Optimism replaces Treatment Pessimism.
Ambitions and Aspirations are raised.
Commissioners and Providers learn that substance use disorder is a condition that people recover from.
People still suffering with substance use disorders are exposed to the experience, strength and hope of those who have recovered or are recovering.
Treatment workers see people they have treated get well in the same communities that they got sick.

15. “A grateful addict/alcoholic”
“The Power of Recovery”
(Phillip Valentine, Executive Director, CCAR, Connecticut Community for Addiction Recovery)
“5 years+
In recovery”
“Recovering People”
“Long Term Recovery”
“Better than well”
“A grateful addict/alcoholic”
“Model citizens”
“Normal People”
Potential
“Early Recovery”
Time

16. Local Recovery Programmes
Pre-Recovery (4 weeks)
Attendence – Twice/week (min.)
Working towards abstinence/detox
Abstinence (12 weeks)
Attendence – Three times/week (min.)
Must be abstinent from all substances/alcohol

17. What’s Involved in Pre-Recovery?
Group Work:-
These sessions introduce themes such as unmanageability , cycle of change, goal setting, slippery places, detoxification, healthy lifestyles, managing risks and controlling the mind. In all, we work on preparing for a life of recovery and maintaining motivation.
All participants will also receive additional one-to-one sessions and the opportunity to build new relationships with recovering addicts.

18. Detoxification
The aim of our pre-recovery groups is to offer the choice of an abstinent lifestyle – they should not be viewed as a hoop to jump through for a detox.
Both the pre-recovery and abstinent programmes should be seen as a supportive therapy to achieving a successful detox.
All our programmes should be view as a stand-alone service.

19. Abstinent Groups
The sessions are a continuation from the pre-recovery groups work at a deeper level to address and inform the behavioural change that is required to maintain a drug/alcohol-free life.
Themes include fear, powerlessness, relationships, sprituality, carrying out a moral inventory and planning for a life in recovery.
One-to-one work continues and developing a new identity with new interests becomes a focus towards the end of the programme

20. …and the bridge takes you both ways to and from...
Recovery Services
bridge the gap…
Recovery Community
Treatment Community
…and the bridge takes you both ways to and from...

21. Who can benefit? People who are stable on prescribed medication
People who demonstrate the motivation for change
People who are already abstinent
People working on planned reductions

22. Message to Service Users and Providers
Take responsibility for your recovery
Treatment can work if you make it work for you
Recognise lapse and relapse will happen but don’t make that an excuse
Learn from your “lapses” and “relapses”
Stay in contact

23. What else has changed? Social Rehabilitation Service. Tier 4 group.
Personalisation through IRMF.
Recovery Champions.
Sober living housing.
Potential for segmentation of treatment population.

24. Though we hit the target lets not miss the point!
Recovery is the point!

25. Pathways to Recovery Script to Prison to Recovery
Script to DIP to Recovery
Drug use to Recovery
Drug use to Prison to Recovery
Drug use to DIP to Recovery
MMT Script to Detox to Recovery?
Long term MMT patients begin to leave treatment

26. THE POWER OF THE PERSON
Each patient carries his own doctor inside him. They come to us not knowing that truth. We are at our best when we give the doctor who resides within each patient a chance to go to work.’
Albert Schweitzer

27. Questions?

28. Resources www.nauk.com www.aauk.com www.thebasementproject.org.uk