Slide 1 Onwards and Upwards Hayden Duncan Regional Manager West Midlands National Treatment Agency

Slide 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”

Slide 3 The Lifestyle of Active Addiction

Slide 4 The Lifestyle of Recovery

Slide 5 Good news about treatment It makes communities safer Reduced crime Promotes citizenshipd Troubled families stabilised It protects public health prevents drug-related deaths restricts blood-borne viruses (HIV, hepatitis C) reduces the burden on the NHS It helps drug users overcome addiction 255,000 treated for drug addiction in England since ,000 (28%) left free of addiction 84,000 (33%) still being treated It has public support 75% think drug treatment is a sensible use of public money 66% fear crime would increase without drug treatment 80% believe drug treatment makes society better and safer

Slide 8 The Impact of Drug Treatment Summary of key findings Individuals who are retained in treatment for the entire two-year period observed (4,677) show an average 47% reduction in convictions Those who completed treatment successfully after being retained in treatment for six months or more show virtually the same average reduction (48%) as those retained in treatment for the full two-year period 41% of all 19,570 individuals in the study show no convictions in the two-year period following initial assessment for treatment For all those who both completed treatment successfully and did not return during the period, the observed reduction in convictions is 61%.

Slide 9 Whether individuals are referred into treatment via the CJS, or present of their own accord or via any other route, appears to make little difference to reductions in convictions. The Impact of Re-offending (NTA March 2012)

Slide 10 Lest we forget “Royal Flush of Dependency” Heroin Benzodiazepines Crack Cocaine Alcohol Welfare Cheque Early Identification: Most likely to emerge in “multi-problem” families. There will be few surprises for GPs.

Slide 11 “A lot of shared care is just another place to pick up a script where very little patient intervention happens, often with patients who have been dumped there by CDTs.....often a Thursday morning ‘meth clinic’ with a surly, depressed drugs worker dishing out scripts.

Slide 12 GPs are ideally placed to deliver, for example, Hep C interventions and Hep C groups with practice nurses, NA meetings, evening groups, parent groups, CBT, alcohol interventions etc.. In other words all the benefits of a local health service which most of us can access

Slide 13 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. “

Slide 14 Rediscovering AA: Recovery 1935; “The Enlightenment” (See Griffith Edwards On Lifeline’s FEAD) "The therapeutic value of one addict helping another” “I cant but WE can” 75 years on: “more than 4 million members” Wikipedia WEIGHT WATCHERS

Slide 15 Dr Michael Taylor, Primary Care & ‘Recovery Republic’ Surgery York Street RECOVERY REPUBLIC York Street

Slide 16 5 ways to well being in Recovery A Prescription for a life 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. 3.Give… Do something for someone else. Volunteer. 4.Keep Learning… Try something new. Become a student of recovery? 5. Take Notice… Be curious. Be present. ‘The Power of Now’.

Slide 17 Recovery does slowly what drink, drugs & medications do fast......changes perception of reality. Learning how to fit in To live life on life’s terms Free from fear Free from addiction “Community as method” Recovery community a place where you learn how to live right, with other people...

18 Dialogue and engagement with authentic recovery providers Engagement with prescribers re: MAR Tier 4 provision review to include recovery Housing and Quasi-residential services Independence of entry to treatment system (LASARS) Multi-disciplinary reviews for all in treatment Recovery reviews of current caseload and treatment completion dates for all Links and coverage of mutual aid groups Co-production pilots Contingency management pilots Patient Opinion on-line Individual recovery care planning for all in treatment (with a recovery coach) Commissioned abstinence services – An inspirational recovery-oriented workforce Building on Recovery- good ideas Slide 4/12

“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) Questions 19