Sarah Vaile Recovery Cymru

 Lots of talk about recovery  Collaboration is the key!  Crossed-wires?  Where are we at as a sector?  Different approaches to recovery focused treatment in Wales, England, Scotland…

Recovery = Abstinence

Recovery is just a new buzz word – it’s what we were doing all along!

Recovery is the opposite of harm reduction

The Recovery approach is not suitable for everyone

 Recovery for the individual  The Recovery Model for Treatment  Community-led recovery support

 A journey, process, experience  Self-defined  About quality of life  Reduction in problems  Different for each individual

 Waiting lists  Service User feedback – disempowerment, communication, treatment is ‘done to’ someone, lack of options for people seeking abstinence  ‘The methadone issue’ / ‘Script & nothing else’  Perceived lack of psycho-social interventions  Treatment exits  The revolving door – aftercare / sustaining change

 Recovery is a process that occurs in the community with others  Treatment may be one part of this process  Client ownership of the treatment process  Greater emphasis on long term goals and aspirations vs. symptom management  Valuing the contribution of professional expertise and the expertise of lived experience

 Recovery Oriented Integrated Systems - services are not isolated pockets of care but should form a ‘greater whole’  A range of treatment options and client choice  Planning for exit  Early re-intervention and re-linkage to treatment and recovery supports  Recovery communities

 Treatment – Aftercare – Community is not linear  The grass-roots peer-led recovery movement  Supports individuals on all stages of their journey, including throughout treatment  Independent life in the community

 Differences in the English, Scottish and Welsh approach  What does recovery mean for methadone prescribing, non-abstinence based recovery, client choice and treatment options  Perceived differences between alcohol and drug recovery  Perceived differences in options needed depending on the severity of problem  Philosophical differences re: abstinence

 Are not separate or opposing paradigms!  Focus on individual journeys  You need to be alive to recover!  A recovery oriented treatment system needs a range of options for people on all stages of their journey and to support all client choices.

 Focus on engagement in treatment and treatment retention… then what?  Disempowering prescribing practices  Long term prescribing with little / no choice to attempt reduction  Lack of psycho-social options available

 Don’t throw the baby out with the bathwater  Medication can be a powerful tool  Options and choice  People’s needs and choices may change over time  We need to validate all recovery pathways: the recovery community is a big tent

 Medication Assisted Recovery Support Project  Collaboration between the National Alliance of Methadone Advocates (NAMA) and the Albert Einstein College of Medicine  Opiate addiction has both medical and behavioural components.  Walter Ginter, Director  M-A-R advocate

 “Methadone is not Recovery, Recovery is Recovery. Methadone is a pathway, a road, a tool. Recovery is a life and a particular way of living your life”  The methadone debates de-values the individual’s process of change and achievements  We should be focusing on a person’s life functioning.

 A partnership prescribing plan  Psycho-social-spiritual options alongside prescribing  Focus on recovery capital and quality of life  Choice and encouragement: to attempt reduction (abstinence is not a dirty word!)  Validation of medication assisted recovery: challenging stigma

 Harm reduction is a necessary and critical part of a recovery oriented treatment system  The recovery community and harm reduction should work together  Recovery is about an individual’s quality of life, not about treatment philosophies  Policy, commissioning and system design need to support all elements of a recovery oriented treatment system and all recovery pathways!

Definition of Recovery for the individual:  “Recovery from alcohol and drug problems is a process of change over time that facilitates an individual to make positive choices and improve the quality of his or her life.” (2012)  Still a work in progress!

The definition will be used to support the development of:  A definition of a Welsh Recovery Oriented Treatment System  An audit criteria to measure recovery- focused practice

A shameless plug! “Embracing Recovery Training” In partnership with