Building Recovery DIP Clinic Mark Gilman Strategic Recovery Lead National Treatment Agency

Contents Drugs Alcohol Addiction Crime Prison Recovery

2 very different types of drug and alcohol use A for Addict Pareto Principle The Addicts 20% use 80% + Responsible for 80% acquisitive crime A Group B The Recreational Users Bingers Public Disorder

Who gets caught in DIP nets? Drug and alcohol addicts offending driven by addiction Offenders who also use drugs and alcohol. Offending not driven by substance use

What do we do with them? Offenders who use Non-OCUs Addicts who offend OCUs Time limited, non medical intervention Retained in treatment

DIP, TREATMENT, CARAT Frequent Flyer & Recycling Programme DIP CARATs TREATMENT How many? Who are they? Dual Diagnosis? PPOs?

Me, Myself and I – in treatment and alone Social Isolation in Treatment ME MYSELF I

Why remodel treatment systems?

2010 drug strategy: Building Recovery (in Communities) Substitute prescribing continues to have a role to play in the treatment of heroin dependence... (But...) Its first step on the journey to recovery

2010 drug strategy: Building Recovery (in Communities)... supporting recovery from drug and alcohol dependence. puts more responsibility on individuals to seek help and overcome dependency holistic approach...employment and housing

Recovery Communities Community Treatment Finding Recovery? Where do I find this recovery stuff?

"The therapeutic value of one addict helping another 75 years on: more than 2 million members Wikipedia Rediscovering AA and Mutual Aid: 10/06/35; The Enlightenment (See Griffith Edwards On Lifelines FEAD) I cant but WE can

Issue date: July 2007 NICE clinical guideline 51 Developed by the National Collaborating Centre for Mental Health Drug misuse Psychosocial interventions NICE Guidelines Staff should routinely provide people who misuse drugs with information about self- help groups. These groups should normally be based on 12-step principles; for example, Narcotics Anonymous & Cocaine Anonymous.

Note All paths significant at p<.05. Goodness of Fit Index =.950. Mutual Aid Group Involvement Reduced Substance Use Active Coping General Friendship Quality Friends Support For Abstinence Psychological and Social changes via Mutual Aid Keith Humphreys Motivation to change

Summary of What We Know (ref: Keith Humphreys) 12-step group participation significantly reduces drug and alcohol use. 12-step group involvement reduces ongoing health care costs. Benefits of 12-step groups mediated both by psychological and social changes.

Identifying and changing social networksYou are who you spend time with

The Lifestyle of Active Addiction

The Lifestyle of Recovery

Recovery as Emigration & Immigration RECOVERY LAND RECOVERY COMMUNITY Farewell Treatment. Thank You

Big Ideas SANITATIONAsset Based Community Development

Deficit Based Approach Asset Based Approach WeaknessesStrengths Outside InInside Out Dependence on outside ProfessionalsDependence on each other Consumers of servicesPartners in provision of services Professionals non-judgemental training makes challenge difficult Challenge each other to do the right thing DisabilitiesAbilities, capacities, Assets ClientCitizen Passive victim of problemsActive participant in solutions

Treatment and Recovery: Content, Themes & Characteristics Treatment: Acute Short Term interventions I for Individual, Individualism Medical & Clinical Risk Averse Apathetic Talking therapies Aftercare Day Programmes (CBT) Residential Treatment Professionals as Experts Recovery: Long term process We as in Community, Mutualism Social & Communal Embraces Risk Ambitious Activities – WORKING! 12 Step Mutual Aid (NA, CA, AA) SMART Recovery (CBT) Recovery Housing & Employment Recoverees as Experts

Node = a person Line = a relationship between two people embedded: the degree to which a person is connected within a network more embedded = central less embedded = periphery CONNECTING & SOCIAL NETWORKS

CONNECTING & SOCIAL NETWORKS; Contagion, Connection, Homophily Contagion: what flows across ties (germs, money, violence, fashions, organs, happiness, obesity, etc.) Connection: who is connected to whom (ties to family, friends, co-workers, etc.) Homophily: the tendency to associate with people who resemble ourselves (love of being alike)

PPOs Carrying the Message BEFORE AFTER

Creating Recovery Communities Changing Social Networks Organising Recovery Communities The addition of just one abstinent person to a social network increased the probability of abstinence for the next year by 27% Litt et al – Changing network support for drinking (2009, (p230))

Relapse = Warrior Down!

5 ways to well being in Recovery 1.Connect… With people around you. Go to meetings (AA, NA, CA, SMART) 2.Be Active…do something, go for a walk, exercise, do anything, WORK 3.Give… Do something for someone else. Volunteer. Sponsor. 4.Keep Learning… Try something new. Become a student of recovery? 5. Take Notice… Be curious. Be present. The Power of Now.

Recovery Pioneers & Champions

We are family! Hard Wired to Attachment We may not need everybody but all of us need somebody