Recovery Plus

How to help addicts into long-term enriched recovery SSaveave ttime,ime, ssaveave liveslives

RECOVERY FROM ADDICTION IS POSSIBLE: Experience, research and hope, by the experts MUTUAL AID: RESEARCH ON EFFECTIVENESS by Professor John Kelly HOW TO MEASURE RECOVERY: by Professor Joanne Neale WHAT IS ADDICTION? 15 MANIFESTATIONS and 12 core characteristics, by Mandy Saligari HELP THE CHILDREN OF ALCOHOLICS Politician Liam Byrne’s campaign THE COMPLEX PATIENT: Integrated treatment, by Dr Michael Genovese WOMEN’S ISSUES, MEN’S ISSUES: Similarities and diff erences, by Paul Hokemeyer ADOLESCENTS: PREVENTION & TREATMENT by Dr Andrea Grubb-Barthwell, Mary Brett REDUCING STIGMA EASES PATH TO CARE: Recovery Brands’ £7,000/$10,000 prize to help FAMILY MATTERS: SUPPORT & BE SUPPORTED by Don Lavender ADVANCES IN DRUG AND ALCOHOL TESTING: Innovation, technology – and integrity SPOT THE 7 SIGNS OF RELAPSE ... use them to help change, by David Brown STRUCTURED FAMILY INTERVENTIONS History and overview by Rebecca Flood PLUS: Where to fi nd rehabs and self-help groups... alphamusic... Laura Loves, Laura Loathes... and 12-page Recovery Plus pullout programme.

your library’s essential reference February Feb 2016 2016 1 Recovery Plus Recovery Plus

SSaveave ttime,ime, ssaveave liveslives

Welcome to Recovery Plus, will do the same. That’s the our fi rst annual publication philosophy of the experts in this dedicated to the professional publication and the publishers. knowledge of how to recover People are what matter in this from addictive behaviours. world – not money nor fame nor Worldclass experts have written buildings nor organisations nor articles on their specialist topics to institutions. Only people, values give you a comprehensive overview and ethics. Achievement comes to or ‘crash course’ on addiction and people who can do great things for recovery. We hold them in such high themselves. Success comes when they regard that they were invited them to lead followers to do great things for speak at our conferences – and they generously them. But a legacy is created only when leaders off er you their PowerPoint presentations, too. All enable their people to do great things without you need do is access our accompanying online them – hard as that might sound to you initially. Recovery Plus journal, then click on the “Click for presentation” icon embedded in their articles. This applies not only to staff and colleagues: it is Professor John Kelly’s article, for instance, stands also the most eff ective way to give healthy life alone but also links to 70 pages of select research. choices to people with dependencies. And so Download them from www.dbrecoveryresources.com. we hope to help you to help others. We hope to help you... Gain confi dence in handling clients What should be the legacy of a successful leader? with complex needs… Prevent relapse... Break And how is that relevant to this publication? destructive intergenerational patterns... Know 20 years from now, all that will matter is the when to refer and who you can safely refer to… people you connected with in such a way that Discover new colleagues... and fi nd sources of you added value and meaning to their lives. The help from our Directories of mutual-aid groups fi nal test of a leader is that s/he leaves behind in and treatment centres towards the back of this others the conviction and will to carry on. That publication. Click on the photos in our online requires imparting expertise as well as passion, journal to be brought directly to their websites. and helping people to connect with others. The greatest legacy a leader can leave is having In the course of your work, as you increasingly helped to develop other leaders. Develop them encounter people/colleagues with alcohol or as widely and as deeply as you can, supported by drug problems or addictive behaviours, you can the knowledge and contacts in Recovery Plus. grow confi dent that you are doing the best for them – and yourself, following best practice. If If you want to leave a legacy, invest in people, you need more support, do join the next intense and encourage those you develop to pass on fully-rounded ‘crash course’ in how to recover everything they learn from you to others who from addiction, on 20 May: see page 35.

2 Feb 2016 your library’s essential reference Feb 2016 3 Recovery Plus Recovery Plus

In our online ‘sister’ Recovery Plus journal, you can click on the orange button beside each article to be automatically brought to it. Contents

FOR YOUR DIARY: DRUG AND ALCOHOL POLICY IN 2016 3 WELCOME TO THE FIRST RECOVERY PLUS ESSENTIAL REFERENCE 47 Recovery Plus What should be the legacy of a successful leader? Creating more leaders – like you. Will there be an open consultation? What will policy include? Laura Graham investigates. conference NEWS FAMILY MATTERS: THROWING A LIFELINE 7 48 20 May 2016 Catch up on the addiction field: latest legislation, rehab closures – and hope, psychoactive Don Lavender explains the importance of family behaviours when addicts return after rehab. Interventions Plus substances, dependency on prescribed medicines, legalisation lobbying and more... HELP PARENTS TO HELP THE NEXT GENERATION, part 1 tutorials, training 50 MEASURING RECOVERY: MOVING TO AGREEMENT The later a person starts to use substances, the better their life chances, urges Dr Andrea Barthwell. 12 21 May 2016 To optimise treatment and recovery, service providers’ and users’ definitions of addiction Waldorf Hilton, recovery must converge more – Dr Joanne Neale and colleagues start the research. 52 PREVENTION: SUFFER THE CHILDREN, part 2 London. How cannabis affects children is often misinterpreted and denied; Mary Brett lists the facts. SCIENTIFICALLY-INFORMED RECOVERY: WHAT’S NEW? 16 Harvard’s first professor of addiction medicine, John Kelly, summarises rigorous studies by 56 THE SEVEN WARNING SIGNS OF RELAPSE IC&RC CEUs and the scientific community on the clinical utility and cost offsets of mutual-help groups. Relapse back into addiction is not an overnight event – it is weeks or months in the making. CIPs awarded. David Brown identifies seven warning signs so that disaster can be prevented. MEN AND WOMEN IN TREATMENT: THE ISSUES 20 For men and women in active addiction, or accessing treatment, or in recovery, what are the INTERVENTIONS: THE HISTORICAL PERSPECTIVE 62 similarities and differences? Paul Hokemeyer did the research for you and gives his findings. Over 90% of structured interventions can be successful in persuading a reluctant addict into treatment - they also create a shield for troubled family members. Rebecca Flood explains. ADDICTION COMES IN PEOPLE, NOT PACKAGES 26 “It is not only possible to get completely well from addiction – I would also claim that it is BRAINWAVES, MUSIC, ADDICTION, TRAUMA possible to prevent it,” says Mandy Saligari, who has ‘manualised’ how to achieve this. 66 How can music actively assist in the treatment of addiction and trauma? John Levine explains. INTEGRATE TREATMENT FOR COMPLEX PATIENTS STIGMA AS BARRIER TO RECOVERY – PLUS £7,000/$10,000 COMPETITION 28 70 Integrative treatment includes all viable modalities. While we cannot cure dual diagnosis, Recovery Brands is campaigning to reduce the stigma of addiction treatment and recovery. IM can help to heal, maintaining hope and positive growth. Dr Michael Genovese explains. 72 HOW TO FIND: SELF HELP GROUPS LATEST ADVANCES IN DRUG AND ALCOHOL TESTING How to contact the mutual-aid groups recommended by WHO and NICE. 30 George Powell explains how innovation and technology have impacted the rehab sector. 76 LAURA LOVES, LAURA LOATHES HELP THE CHILDREN OF ALCOHOLICS: A POLITICIAN’S CAMPAIGN Despite a “dismal year for recovery” in 2015, Laura Graham fi nds reasons to be optimistic. 34 MP Liam Byrne recently opened up publicly about his experience as the child of an alcoholic – and is proposing legislation for all local authoriites to recognise and support them. 78 HOW TO FIND: PROFESSIONAL CARE If you or a loved one want the best of treatment for an addiction problem, fi nd it here. FREE 12-PAGE PULLOUT PROGRAMME: RECOVERY PLUS CONFERENCE WHAT IS... A CIP? EXPLAINING CERTIFIED INTERVENTION PROFESSIONALS 35 82 Join our team and a host of professionals and trainees in London on 20 and 21 May! Credentialling gives you an ‘edge’ over lesser-qualifi ed counterparts.

4 Feb 2016 your library’s essential reference Feb 2016 5 Recovery Plus Recovery Plus

Celebrate recovery: News: stories symbolising trends to watch This year’s challenges Catch up with the addiction fi eld! Each of the news invest in recovery items below crystallises a major nuance in the drug and alcohol prevention and treatment fi eld: challenges we will be facing in 2016 and for years to come. PRESCRIBED DRUGS associated with dependence and withdrawal – building a consensus for action... was published by the British Medical Association last October. Read CEP summary and link to the 44-page report at http://cepuk.org/2015/10/13/cep-welcomes-report- This year celebrates the millions of people who have recovered from addiction bma-prescribed-drug-dependence. Campaigners have been – and the work of the caring professionals who reach out daily to help the many, fi ghting for recognition for over 30 years. 5-year drug strategy many millions of vulnerable people and suff ering families who still need to E-CIGARETTES... with opinion still sharply divided as comes out in March experience enriched recovery. to whether e-cigarettes help stop tobacco smoking or We celebrate, encourage and advance that by introducing Recovery Plus as the instead cause harm, the NHS spends taxpayer money “With deaths from illegal drugs in England and Wales at the highest rate ever recorded, we might imagine UK’s major print-and-posted journal on how to recover from addiction, as well prescribing them: see overview at www.telegraph.co.uk/ that the Home Offi ce would be desperate for a as being available fully interactive online (with over 2million views in 2015). Recovery Plus online news/science/science-news/12037518/E-cigarettes-contain- fl avouring-chemical-linked-to-deadly-popcorn-lung.html. robust and eff ective strategy,” writes BBC Home journal has interactive bonuses – eg, click on the seminal article by Professor John Kelly of Harvard Aff airs editor Mark Easton. “So it comes as a surprise FUNDING CUTS... Turn to page 76 of this issue. and you will access 70 slides of research chosen by him! Each reference publication is posted to over to discover that ministers have quietly abandoned 5,000 people selected for their infl uence in this fi eld, and each accompanying e-mag is guaranteed GIGANTISM... The latest merger/takeover is US Acadia the idea of a formal consultation process in advance to continue achieving 2million views annually. Recovery Plus WARriors – Recovery Plus In The paying £1.28billion in cash for the UK Priory group, of a new drugs strategy this March. Traditionally, Workplace – and Interventions Plus will soon follow, and the 2nd issue of Recovery Plus later this including £925million of debt (www.reuters.com/article/us- these fi ve-year plans are put together after weeks year. They are all free to our growing community of recovery advocates. priorygroup-m-a-acadia-health-idUSKBN0UI16B20160104). of discussions and submissions from experts and the Also, the ‘Big 8’ alcohol/drug agencies, which turnover Join the Recovery Plus community, and you join passionate professionals who devote themselves to general public. In 2010, for example, there were 1,850 £380million of taxpayer funds between them annually, responses to the drug strategy consultation, including the prevention, intervention, treatment and recovery management of addictions for the benefi t of united to form Collective Voice to lobby for more. from health professionals, charities, lobby groups, individuals, society and countries. Deirdre Boyd, editor, publisher ADDICTED BABIES, NAS & FASD... More pregnant local authorities, government advisors, police and women who drink alcohol or use drugs are giving birth service providers as well as interested individuals. Not I have been involved with the recovery community for the past 20 years and have met some amazing to babies who “suff er more at the beginning of their this time. You won’t fi nd any details on the Home people and heard many inspirational stories of people who have overcome tremendous adversity lives than many people do in an entire lifetime” – the Offi ce website.” Others posit the reason is merely not much change: www.bbc.co.uk/news/uk-politics-35696804. in their lives. In 2015, Summit Diagnostics sent a team to represent our company at the Recovery Cradle Act in the US aims to ameliorate this. Plus conference in London. We were so impressed with the quality of the show, organisation, networking opportunities and quality of speakers – that we knew we had to be involved. We asked its organiser, Deirdre Boyd, if Summit Diagnostics could take up sponsorship for 2016. We felt/feel that this conference and the Parliamentary moves online Recovery Plus publications are a fantastic way to keep up with the events PSYCHOACTIVE SUBSTANCES ACT – Designed to tackle ‘legal highs’, this bill that shape this industry and to contribute to the recovery eff ort of the many courted more amendments than any other bill we monitored, but will come into professionals in the UK and US. I was so impressed with the quality of articles and coverage, that I force on 6 April 2016. DrugWatch off ers a simple(ish) guide at: often forwarded the online publication on to my colleagues, business associates and friends. Indeed, www.drugwise.org.uk/wp-content/uploads/Psychoactive-SubstancesAct.pdf. I became such a fan that I decided to invest! CHILDREN OF ALCOHOLICS – Liam Byrne MP, who recently became patron of the National Association for Children of Alcoholics, has spoken publicly this year about I am taking on the role of co-publisher with one of the most dedicated and knowledgeable experts his own experiences and has submitted an Early Day Motion for these children to in the business, Deirdre Boyd. We bring you, free of charge, the Recovery Plus journal in print, as be safeguarded; read details on page 34 of this issue of Recovery Plus. requested by so many readers of the online version. It is our goal to provide professionals in our WELFARE REFORM AND WORK BILL – covering, among other things, welfare industry with the ability to keep abreast of up-to-date information that infl uences the worldwide payments to people diagnosed as alcohol or drug dependent, you can catch up at epidemic of addiction and the eff orts of addiction medical professionals treating this disorder. We www.parliament.uk/business/news/2015/november/lords-debates-welfare-reform-and-work-bill. want to give our readers a chance to network with each other and to share experiences that help BENZOS – Massachusetts is passing Bill HD.4554 189th, relative to benzodiazepines shape the future of treatment. Join our exciting adventure! George Powell, publisher and non-benzodiazepine hypnotics: https://malegislature.gov/Bills/189/House/HD4554.

6 Feb 2016 your library’s essential reference Feb 2016 7 Recovery Plus Recovery Plus

Substance Misuse Personnel Permanent • Temporary • Consultancy

Supplying experienced, trained staff: • Commissioning • Project Management • Service Reviews • Group & 1-1 drug workers • DIP Management • Prison & Community drug workers • DAT Co-ordination • Nurses (detox, therapeutic, managers) stories symbolising trends to watch • Needs Assessments • many more roles... News: Call today: 020 8987 6061 Solutions Action SA Register online: Management www.SamRecruitment.org.uk Still No.1 for Recruitment and Consultancy M Neuroscience of addiction & recovery Addiction changes brain biology in three stages, according to Dr Nora Volkow, director of the National Institute on Drug Abuse, and co-authors Thomas SAM Supplying the best for the best McLellan and George Koob, director of the National Elite Institute on Alcohol Abuse and Alcoholism. They use neuroscience to break down addiction into: binge For Senior Managers, and intoxication, withdrawal and negative aff ect, and Directors and CEO’s preoccupation and anticipation. within the The authors conclude that neuroscience supports Substance Misuse field. the brain disease model of addiction. They clarify the Over half of UK rehabs link between addiction and brain function, including: desensitisation of reward circuits, addiction’s Register today: www.SamRecruitment.org.uk have disappeared... contribution to increasing strength of conditioned Or call: 020 8987 6061 SA Addiction-treatment clinics start 2016 in perhaps responses and the brain’s reaction to stress, and weakening of brain regions involved in executive SAM Elite Management & Consultancy Services M their greatest test of survival. Over 24 closed in the 24 months leading up to the 2010 general election then, functions. You can read more at www.drugabuse.gov/ after a year’s respite, another 18 and more were forced news-events/news-releases/2016/01/review-article-reinforces- to shut their doors. Another 200-250 ‘rehab beds’ support-brain-disease-model-addiction. were lost when TTP closed down, albeit not for the usual funding reasons. This is a cut in rehab capacity of over 50% since 2008, even taking into account a few new ones. Sadly, World Benzo Day reduced capacity does not mean that the remaining The inaugural World Benzo Day will be 11 July 2016 – on rehabs are full: far from it. As Recovery Plus speaks the birthday of Professor C Heather Ashton, DM FRCP, to rehab CEOs around the country, they consistently who wrote the withdrawal ‘bible’ for people who want report cuts of 30% in local authority funding. It has to quit benzodiazepines safely. For more details or been clear for some years that treatment providers to participate, go to www.oldham-chronicle.co.uk/news- will need to diversify: more mixed funding and adding features/8/news-headlines/96339/barry-takes-centre-stage-for- We believe that anyone can recover from alcohol or drug dependency given the right support day programmes are options. world-benzo-day-launch. ... So help addicts to access treatment Two developments could help more vulnerable people to access eff ective treatment for addictive behaviours. The fi rst is the Montgomery v Lanarkshire Health Board case. Seven Supreme Court judges ruled last May that a doctor is under a duty to take “reasonable care to ensure that his patient is aware of any material risks involved in any recommended treatment” and “the doctor’s role involves dialogue”, including that “the patient understands the seriousness of her condition, and the anticipated benefi ts and risks of the proposed treatment and any reasonable alternatives”. Patients can now require explanation from doctors of the harms which can - ResidenƟal & Day Recovery Programmes for Single bedrooms accompany opioid substitution and off ering of drug-free options. Read more at www.jordanpublishing.co.uk/practice- areas/pi-and-civil-litigation/news_and_comment/the-rippling-eff ect-of-montgomery-v-lanarkshire-health-board. with en - suite people with an Alcohol or Drug Dependency Second is Patients’ Rights in Cross-border Healthcare, an EU directive which came into force across the faciliƟes. - ResidenƟal DetoxificaƟon European Union in 2013. An EU or EEA citizen can now claim the cost of healthcare treatment in any other Wi-Fi, TV, Radio. European state, if they can’t get it promptly in their own country, with reimbursement coming from their home - ARBD Services : Assessment & CogniƟve Gym, IT Suite, state’s statutory health funder (NHS in the UK). Details of how it can help patients are at www.castlecraig.co.uk/ admissions/admissions-europe/cross-border-qa. RehabilitaƟon Programme Extensive Gardens.

A creative modern rehab with fresh thinking Brynawel RehabilitaƟon Centre, Llanharry Road, Llanharan CF729RN Registered Charity Number 1113952 BACP Membership Number : 122941 CSSIW Registered www.brynawel.org

8 Feb 2016 your library’s essential reference Feb 2016 9 Recovery Plus Recovery Plus

News: stories symbolising trends to watch Silkworth Charity Group provides help to those who are affected by drug and/or alcohol addiction together with their families and signifi cant others and is the only residential rehabilitation treatment centre in the Channel Islands. All US presidential Alcohol and drug dependency is particularly prevalent in Jersey where alcohol consumption is twice that of the UK and the second highest in Europe. Excessive use of alcohol and drugs places families and relationships under great stress, so the actual candidates talk drugs number of people affected through this addiction is multiplied by at least 4 or 5, when you take into account the impact on With only months until November’s presidential election to the White House and as the US addiction families and signifi cant others. epidemic receives growing attention from both public This is a no-blame illness as nobody sets out to become an alcoholic or drug addict and it is not a problem of morals, social and policymakers, MAP’s 2015 Recovery Network National Addiction and Recovery Survey found standing, upbringing or will power. It is a very powerful and confusing illness which destroys a person from the core and also that 73% of US voters favour a presidential candidate those closest to them. Here at Silkworth Charity Group, we recognise and understand the illness and thus provide a complete willing to expand access to addiction treatment and pathway of treatment to allow long term recovery. recovery services (https://thisismap.com/wp-content/ about his friend from law school who was addicted uploads/2015/11/2015_National_Addiction_and_Recovery_ to opiates. Author Anna David gives a good summary We help our clients rebuild relationships, regain their self esteem, and most of all we give them the tools they need Survey_by_MAP_Recovery_Network.pdf). and links to Christie, Carson et al at www.huffi ngtonpost. to manage their illness and allow long-term recovery. All the presidential candidates foresaw the trend. com/anna-david/do-we-only-have-one-presidential-candidate- Last August, when Hillary Rodham Clinton, Jeb Bush who-understands-addiction_b_8526032.html. and Carly Fiorina made inaugural visits as presidential But how well will the politicians’ words serve We provide a suite of services to support those that are affected by substance misuse:- candidates, the fi rst question they were asked was their electorate? How much do they understand  Residential Treatment Programme about New Hampshire’s opioid epidemic. about how recovery is achieved? Will they play into Last October, ex-congressman Patrick Kennedy, pharmaceutical interests? With Clinton’s biggest  Secondary Care through our half way house and individual fl ats Policy Exchange chairman David Frum and Kevin campaign donor, George Soros, pushing marijuana  Home Detox in collaboration with the Drug and Alcohol Service Sabet, cofounders of Smart Approaches to legalisation, will she open the gateway to Big Pot?  Community Day Programme Marijuana, ranked 18 candidates on their support for (http://blog.sfgate.com/smellthetruth/2016/02/16/hillary-  Family Programme a comprehensive, evidence-based marijuana policy. clintons-biggest-campaign-donor-supports-marijuana-legalization). They identifi ed Marco Rubio, Chris Christie and Ben Judge for yourself – presidential candidates’  Aftercare Programme. Carson as the best runners, with Bernie Sanders comments on drugs and mental health are available at All of the above services are vital in helping individuals and Rand Paul as the worst (https://learnaboutsam.org/ www.refi nery29.com/2016/02/102841/2016-presidential- together with their families aim towards a goal of being clean and sober. wp-content/uploads/2015/10/29Oct2015-SAM-presidential- candidates-statements-drugs-mental-health#slide. We like scorecard-updated-for-distribution.pdf). the last three of these best, including Carson’s With over 25 years’ local experience in the fi eld, Amid the political mishigas came Chris Christie’s “Regular exposure to marijuana in the developing we have touched thousand of people’s lives now well-known speech which rocketed him up the brain has been demonstrated defi nitively to result in from the alcoholic /addict to their families and signifi cant others. rankings – he talked about the lack of stigma against a decreased IQ. And the last thing we need is a bunch his mother’s addiction to smoking vs the judgment of people running around with decreased IQ”. Referrals into any of our services can be made direct by the person or family member themselves or through the local Health & Social Agencies and General Practitioners. Drugs legalisation: the fallout We have spent many years developing and tailoring our services Anyone debating the heated issue of legalisation of marijuana and other drugs to the needs of our service users, which has resulted in Jersey having should fi rst read local facts from the Pulitzer Prize-winning Gazette. Separating fact a nationally respected suite of services delivered with the client at the centre of everything we do. from fi ction, it covers regulation, crime, youthful addiction and medical marijuana. “The ugly truth is that Colorado was suckered. It was promised regulation and has If anyone wishes to know anything more about the charity group, then please access our website been met by an industry that fi ghts tooth and nail any restrictions that limit its www.silkworthlodge.co.uk for further information or contact us on 01534 729060. profi tability” is a conclusion (http://gazette.com/clearingthehaze). Rocky Mountain High also reveals post-legalisation pot use fi gures ( www.dbrecoveryresources.com/wp-content/ uploads/2016/01/FINAL-NSDUH-Results-Jan-2016-Release.pdf). Smart Approaches to Marijuana published the fact-based Big Marijuana Claims Vs The Science (https://learnaboutsam.org/the-issues/big-marijuana-claims-vs-the-science). Finally, in the UK, a rigorous 10-year followup of the Lambeth depenalisation of cannabis revealed increased crime and hospitalisations: a warning to be heeded (www.dbrecoveryresources.com/2014/04/crime-and-the-depenalisation-of-pot).

10 Feb 2016 your library’s essential reference Feb 2016 11 Recovery Plus Recovery Plus

To optimise treatment and recovery, service Measuring recovery: providers’ and users’ definitions of addiction recovery must converge more – Dr Joanne moving to agreement Neale and colleagues start the research.

The researchers: ‘‘You’re all going to hate the word ‘recovery’ have experienced drug or alcohol problems can Infl uenced by the medical model of addiction In this article, we disclose how and why service by the end of this’’: Service users’ views of highlight important weaknesses in dominant and a pervasive culture of monitoring and users disagreed with service providers. This is Joanne Neale1,2, Charlotte measuring addiction recovery is a research recovery discourses. performance targets, there has been a tendency relevant both to the development of our PROM 3 4 Tompkins , Carly Wheeler , paper by myself and colleagues (see left) to focus on very basic quantitative indicators, for addiction recovery, and for drug and alcohol 1,5 1 Emily Finch , John Marsden, published in Drugs Education Prevention Policy This work forms part of a broader study in weighted particularly towards reduced drug policy, practice and research more generally. Luke Mitcheson1,6, Diana Rose7, (2015; 22(1): 26-34 ). The quote was given by ‘Sean’ which we are seeking to develop a novel consumption and off ending. The extent to which Til Wykes8, John Strang1 half way through an ex-user focus group. recovery outcome measure that will prioritise measures of recovery used in the addictions fi eld The initial exercise revealed that almost all 1Addictions Department, King’s the goals of people who are, or who have refl ects the goals and aspirations of people who service users agreed that recovery was a very College London & Institute With the other participants, he was debating been, addicted to alcohol or drugs and experience problems with drugs and/or alcohol important concept, with only two people from of Psychiatry, Psychology & the importance of good physical health. His used treatment services. I plan to share those About the author has, meanwhile, received little attention. the ex-user group questioning its utility and Neuroscience, London throwaway line sits in notable contrast to one preliminary fi ndings at Recovery Plus in May. arguing that it was a meaningless word that had 2University of New South Dr Joanne Neale BA(Hons), of the fi nal remarks made in the same group. Patients’ views of their own health and been hijacked by politicians. Furthermore, there Wales, Australia MA, CQSW, DPhil is Reader 3Leeds Community Healthcare On being told that the session was formally In recent years, ‘recovery’ has become a core in Qualitative and Mixed treatment are now proactively sought in many was a high level of consensus that recovery NHS Trust, Leeds over and everyone was free to leave, group principle in the drug and alcohol sector, resulting Methods Research based in the areas of medicine, and this has resulted in constituted a unique personal journey but one 4Department of Psychology, members responded: ‘‘We don’t want to go! in a signifi cant move towards ‘recovery-oriented’ National Addiction Centre and the development of myriad questionnaires, that would last a lifetime, as the risk of relapse Social Work and Public Health, We don’t want to go!’’. Therein, perhaps, lies a drug treatment nationally and internationally working across the Biomedical rating scales and assessment forms – known as was ever-present. Service users in all groups Oxford Brookes University further valuable insight into service users’ views (Duke, Herring, Thickett, & Thom, 2013). But Research Centre at the Institute patient reported outcome measures, or PROMs emphasised that recovery was not only about 5Blackfriars Road Community of measuring recovery. It is simultaneously a recovery defi nitions range from vague and of Psychiatry, Psychology (Dawson, 2009; Epstein, 1990; Garratt, Schmidt, their substance taking; rather, it involved them Drug and Alcohol Team, South frustrating but compelling activity and one that nebulous (‘recovery is what each individual wants & Neuroscience. She is also Mackintosh, & Fitzpatrick, 2002). PROMs focus making changes in their lifestyles, behaviours, London and Maudsley NHS can be enjoyable. it to mean’) to the highly prescriptive (‘recovery an Adjunct Professor in the on the quality rather than just the quantity of relationships, physical and mental health, Foundation Trust (SLAM) means abstinence from all substance use’). Centre for Social Research in patients’ lives and give priority to the patient’s – and social circumstances. Whether someone 6 Health at the University of Lambeth Drug and Alcohol The research came about because we wanted to Latterly, there has been emergent stakeholder rather than the clinician’s – perspective. could be in recovery while receiving opioid Service, SLAM New South Wales, Australia. Jo explore how service users’ views of measuring agreement that recovery can be achieved with substitution treatment was a more divisive issue 7Service User Research originally qualifi ed as a social Enterprise, Department of addiction recovery diff er from those of service appropriately prescribed medications (Recovery worker and has held positions We are committed to ensuring that the opinions with no consensus in any group. Health Services and Population providers. Service users have detailed knowledge Orientated Drug Treatment Expert Group, 2012) at the University of Glasgow, of those who have experienced drug or alcohol Research, KCL & IoP London and understanding of their own health status, and is more than just a reduction in substance the University of York, and dependence and have been users of addiction Our analyses found nine main types of problem 8Department of Psychology, psychosocial problems, personal resources, use (ACMD, 2013; HM Government, 2010; more recently Oxford Brookes services are central to our work. To this end, we with service providers’ views of recovery, as below. KCL & IoP, London support needs and aspirations. Such information Scottish Government, 2008). Instead, it involves University, where she was are working closely with a newly formed service 1. Expecting the impossible of service users can be crucial to researchers, service providers, people achieving benefi ts in a wide range of Professor of Public Health. user research group that is advising us as we 2. The dangers of progress service commissioners and policymakers life areas, including their relationships, housing, Jo is the senior qualitative progress. We are also using Service users’ views 3. The hidden benefi ts of negative outcomes who might not have fi rst-hand experience of health, employment, self-care, use of time, editor for Addiction journal; a of measuring addiction recovery documenting 4. Outcomes that negate the agency in addiction and related problems. Involving service community participation and wellbeing (ACMD, member of the editorial board service users’ reactions to 76 recovery measures recovery of The International Journal users in designing measures of recovery can 2013; Burns & MacKeith, 2012; Neale, Pickering, & suggested by 25 senior service providers – the 5. Contradictory measures of Drug Policy; a trustee of lessen the likelihood that researchers develop Nettleton, 2012). the Society for the Study list is over the page – in a preliminary stage 6. Failure to recognise individual diff erences assessment tools that use inappropriate, of Addiction; and a member of the research. Measures on which service 7. Entrenched vulnerabilities contradictory or objectionable outcomes, and Defi nitional ambiguity renders measuring of the expert committee of providers and service users largely agreed will be 8. The misattribution of feelings and behaviours ambiguous and unclear language. People who recovery outcomes particularly complex. Action on Addiction. included in the next stage of the PROM. 9. Inappropriate language.

12 Feb 2016 your library’s essential reference Feb 2016 13 Recovery Plus Recovery Plus

The online issue of Expecting the impossible of service users. incompatible. For example, reduced and Recovery Plus will Many service provider-suggested measures of safer drug use were diffi cult to reconcile with Measures of recovery, by service providers also link you to the recovery expect service users to behave better abstinence, and accessing treatment and 1. Reduced drug use 29. Eating healthily 54. Having good relationships with author’s presentation and achieve more than ‘normal’ people – who support (particularly residential) was considered 2. Using drugs safely 30. Dealing with toothache peers in recovery can also break the law, get into debt, have bad somewhat inconsistent with being independent. at Recovery Plus 2015 3. Achieving abstinence 31. Appetite returning 55. Having good relationships with relationships, become dependent on other 4. Practising relapse prevention* 32. Not feeling tired non-using friends* – just click the logo people, lack self-awareness. Everyone feels Failure to recognise individual diff erences. 5. Reduced cravings 33. Going to the toilet regularly/ 56. Having social support* shown below when you anxiety, depression, loneliness, shame and guilt Participants reported frustration that many 6. Accessing treatment* not being constipated 57. Being independent access us online: at some point – these are natural emotions, and service providers’ measures did not allow for 7. Accessing peer support/self-help 34. Periods coming back (for women) 58. Not having negative relationships feeling them can be progress. Also, measures individual diff erences and personal preferences. 8. Engaging in private therapy 35. Sex drive coming back 59. Having honest relationships* such as good physical or mental health, can be Whether or not somebody wanted or needed res 9. Having good mental health 36. Putting on weight 60. Supporting others or p ent f at impossible for some people with health problems. formal treatment or peer support, liked having k i 10. Being confi dent 37. Feeling energetic 61. Having a role in society ic o l n C lots of people round them, could cope with 11. Coping* 38. Sleeping well* 62. Participating in society The dangers of perceived progress. a full-time job, would be suited to voluntary 12. Feeling in control 39. Having a daily routine* 63. Not causing problems to society Suggested outcomes such as having confi dence/ work, or needed more education would depend Click 13. Having self-belief 40. Going to appointments* 64. Having a good quality of life* feeling in control/experiencing self-belief were on that individual. Furthermore, those diff ering 14. Having self-worth 41. Having hobbies 65. Not off ending important to a point, but beyond that could wants and needs might relate to stage of 15. Being able to trust people 42. Using time meaningfully 66. Not being in contact with the result in people being complacent and relapsing. recovery, gender and other demographic factors. 16. Having emotional balance 43. Not being bored criminal justice system 17. Achieving self-acceptance 44. Participating in education/training 67. Behaving morally The hidden benefi ts of negative outcomes. Outcomes that negate the agency in recovery. 18. Having no anxiety 45. Doing voluntary work 68. Not feeling shame or guilt If people in recovery did not experience Some provider-desired outcomes were simply 19. Dealing with past trauma* 46. Having a paid job 69. Feeling positive tiredness or feel anxious, shame or guilt, they physiological and ‘automatic’, occurring over 20. Accepting responsibility* 47. Having a stable income 70. Not feeling stigmatized were probably not ‘working at their recovery’ time and, while markers of progress, should 21. Being able to manage feelings* 48. Not having debts 71. Being self-aware and ‘did not care’. Tiredness, some participants not be priorities. These include appetite and 22. Not feeling depressed 49. Being able to manage money* 72. Having a non-addict identity emphasised, can feel satisfying at the end of a menstrual cycle returning. 23. Not being lonely 50. Having stable housing* 73. Having purpose* productive day, anxiety might signal new and 24. Feeling safe* 51. Living independently 74. Having realistic plans and goals* interesting challenges, remorse for previous Entrenched vulnerabilities. 25. Having good physical health 52. Keeping the house clean and tidy 75. Having hope misdemeanors can be progress, contact with The extent of some service users’ vulnerabilities 26. Being physically active 53. Having good relationships 76. Being spiritual the criminal-justice system could mean legal – and thus the height of the bar set by some 27. Taking care of your appearance with family (including partner * Service users had few problems with help and protection – and the police, probation recovery measures – became apparent when 28. Taking care of yourself * and children) these measures. service and courts can fast track those with drink issues such as ‘being able to trust people’, ‘not or drug problems into treatment. being lonely’ and ‘having good relationships with The misattribution of feelings and behaviours. and did not aspire to be part of mainstream family’ were discussed. Service users from all Some service users never lost their appetite society and its ‘dubious values’. Contradictory measures. groups emphasised that some people ‘cannot during their drinking or drug use, needed to Focus group service users seemed increasingly and should not be trusted’ and loneliness is lose weight rather than increase it, felt energetic Inappropriate language. bemused that some service providers’ measures preferable to friends who ‘become enemies’ and using drugs and tired in abstinence – and many Participants noted that measures were designed appeared to contradict each other or were family members who let them down. were proud to identify as an addict in recovery, by people who had ‘no idea of their experiences’.

14 Feb 2016 your library’s essential reference Feb 2016 15 Recovery Plus Recovery Plus

Harvard’s first professor of addiction medicine, Scientifically-informed John Kelly, summarises rigorous studies by the scientific community on the clinical utility and recovery: what’s new? cost offsets of mutual-help groups.

Six lessons from the Over the past 80 years, Alcoholics Anonymous multipronged, including prohibiting certain Studying AA empirically is not without its help group participation alone is an eff ective past 15-20 years: has grown from two members to over 2million substances; attempts to reduce consumption challenges, particularly in terms of the gold intervention for substance-use disorder. members. AA and similar organisations such through price controls, taxation and licensing standard of treatment research: the randomised 1) Substance use and related as Narcotics Anonymous are among the most- of sales outlets (in the case of alcohol); federal, controlled trial. The tightly controlled and highly Questions can arise as to whether AA is less disorders are a massive health, sought sources of help for substance-related state and community prevention initiatives; insulated context of an RCT runs counter to the suitable for certain groups of people, social and economic burden problems. But it is only relatively recently that and professional treatment. In addition to way real-world AA groups are conducted. particularly dually diagnosed people, those 2) Mutual-help organisations the scientifi c community conducted rigorous these considerable formal eff orts, peer-led AA is attended anonymously, usually voluntarily. taking psychotropic or anti-relapse medications, help off set this burden and studies on the clinical utility and healthcare mutual-help organisations have fl ourished in No records are kept about who attends and atheists or agnostics, women and youth. But can be studied empirically cost-off set potential of mutual-help groups, and most communities in the past 80 years, perhaps what is said. Groups vary widely in their size and the available empirical evidence suggests 3) Mutual-help groups confer developed and tested professional treatments stemming from recognition at the grassroots About the author content. Because AA is freely accessible in the that, for the most part, such people benefi t clinically-meaningful benefi ts to facilitate their use. level of the need for more fl exible, rapidly community, it can seem unethical to randomly from participation in regular AA meetings. for many diff erent types of John Kelly BS Psychology (Summa accessible and ongoing support that can mitigate Cum Laude) PhD is Harvard assign some RCT participants to attend and One exception might be people with severe people over and above formal Professionally delivered interventions designed relapse risk at little to no cost. University’s fi rst professor in prohibit the attendance of others. These issues impairments in psychosocial functioning and treatment to facilitate the use of AA and NA – Twelve-Step addiction medicine, president have led researchers to examine AA through reality testing – such as SUD with schizophrenia 4) Mutual-help groups work Facilitation – are now “empirically supported Mutual-help organisations help off set this of the American Psychological other methods, such as through naturalistic, – who might benefi t more from dual-diagnosis through mechanisms similar treatments” as defi ned by US federal agencies burden and can be studied empirically. Association Society of Addiction prospective, eff ectiveness studies which use mutual-help groups such as Double Trouble to those in formal treatment and the American Psychological Association. The By far the largest and most researched of these Psychology and associate editor sophisticated methods to account for self- in Recovery. Similarly, although young people 5) Mutual-help groups can World Health Organisation and the UK’s NHS- peer-led mutual-help organisations is AA. for the journals Addiction and selection biases (eg, statistical controls, propensity can benefi t from attendance at AA and NA reduce healthcare costs by the Journal of Substance Abuse guidance body NICE recommend their use. So Sophisticated scientifi c evidence supports the Treatment. He is also founder scores, instrumental variable analyses). meetings, benefi ts can be enhanced at meetings reducing patients’ reliance on let’s look at six lessons learned during the past role of AA and similar groups in helping people and director of the Recovery with at least some same-aged peers. professional services without 15-20 years on how mutual-help organisations to achieve abstinence and maintain recovery. Research Institute at Massachusetts Researchers have also examined the effi cacy of detriment to, and might can help individuals suff ering from substance use We now have a strong evidence base in support General Hospital, programme professionally delivered TSF treatments, which Mutual-help groups work through mechanisms enhance, outcomes disorders (SUDs) while cutting healthcare costs. of professionally delivered interventions (TSF) director of the Addiction Recovery systematically encourage and facilitate 12-step similar to those in formal treatment. 6) Empirically-supported to eff ectively engage individuals with these Management Service and associate meeting attendance, relative to other treatments Over 20 years ago, the Institute of Medicine clinical interventions increase Substance use and related disorders confer a community resources. director of the Center for that neither encourage nor forbid attendance. called for more research on how AA works. Addiction Medicine at MGH. patient participation in massive health, social and economic burden. Together, these types of research show the A recent review of the research on the mutual-help groups and He has served as a consultant to Globally, alcohol kills 3.3 million people annually. AA purports that the primary mechanism US federal agencies such as the benefi ts of AA attendance in a way that has both mechanisms of change in AA revealed that AA enhance treatment outcomes. It is the leading risk factor for death among through which recovery from alcohol addiction White House Offi ce of National scientifi c integrity and real-world relevance. helps people to attain and maintain recovery males aged 15-59 and it is the third leading risk is achieved is through a “spiritual awakening” Drug Control Policy, the Substance through multiple mechanisms, many of which factor for disease burden around the world. In which is realised by following a sequential Abuse and Mental Health Services Meaningful benefi ts for many diff erent types of are also activated by formal treatment. Most the US, alcohol use is the third-leading cause of 12-step programme. Such spiritual processes Administration (SAMHSA) and the people, over and above formal treatment. consistently and strongly, AA appears to work preventable death and the fi nancial impact of might seem antithetical to empirical study. National Institutes of Health (NIH); There have been hundreds of empirical studies through mobilising adaptive changes in the social SUD is estimated to approach $600billion per But research over the past 20 years has shown to non-profi ts such as the Hazelden on AA, summarised in several meta-analyses and networks of attendees – for instance, decreasing Betty Ford Foundation; and to year, stemming mostly from lost productivity, that there are many aspects of AA and its foreign governments. one Cochrane review. These reviews indicate pro-drinking social ties and increasing pro- criminal justice and healthcare costs. In most mechanisms of action which are amenable Dr Kelly has published over 100 that AA is associated with a moderate eff ect on abstinence social ties – and enhancing coping developed nations, the societal response to to empirical study, including spirituality and peer-reviewed articles, reviews, and alcohol and other drug use that is on par with skills and self effi cacy for abstinence in high-risk these endemic public health problems has been spiritual practices. chapters in the fi eld of addiction. professional treatment. For some people, mutual- social situations.

16 Feb 2016 your library’s essential reference Feb 2016 17 Recovery Plus Recovery Plus

The online issue of Among more severely alcohol-impaired people, substance-dependent males found that those that patients will become and stay involved using various forms Recovery Plus will AA also appears to work by enhancing spiritual/ in professional 12-step treatment participated in these organisations. One early study of TSF. These studies religious practices, reducing depression and in community-based AA and NA meetings foundf that, when therapists actively linked consistently show that also link you to the increasing peoples’ confi dence in their ability much more after treatment than those from patientsp with current 12-step group members TSF interventions produce author’s presentation to cope with negative aff ect. Thus, AA appears professional cognitive behavioural therapy by having them speak over the phone during outcomes superior to control at Recovery Plus 2015 to work through diverse mechanisms and might treatment programmes, who relied more heavily a ssessioness and make arrangements to attend a conditions. As a result of – just click the logo work diff erently for diff erent people. on professional services. This translated into a meeting, every patient attended at least one this growing empirical shown below when you two-year saving of over $7,000 per patient, again meeting in the month after referral. In contrast, support, TSF was recently access us online: Mutual-help group participation can reduce without compromising abstinence rates. In fact, when patients were simply given information recognised as a “well supported treatment” healthcare costs and could enhance outcomes. patients treated in the 12-step programmes had and encouraged to attend, not one person did. by the Division of Clinical Psychology of the Substance dependence is recognised as a one-third higher rates of abstinence than those American Psychological Association and added res r p ent fo a chronic, relapsing condition which typically treated in the CBT programmes at two-year In Project Match, participants in TSF treatment to SAMHSA’s National Registry of Evidence- k ti ic o l n C requires multiple episodes of care over long follow-up (demographic and clinical severity attended AA at a signifi cantly higher rate than Based Practices and Programmes in 2008. periods of time. Sadly, individuals’ access to indicators were equivalent at baseline). those in the CBT and motivational enhancement professional healthcare resources is often limited therapy conditions in treatment and during the Where the research is now. Click to short periods of time by insuffi cient funds. Clinical interventions can grow participation in fi rst three months of follow-up. Another RCT The often-passionate debate about the pros In the US and UK, government policies have an mutual-help groups and enhance outcomes. compared standard 12-step referral, in which and cons of mutual-help organisations seldom ever-increasing impetus to reduce healthcare Since AA and related organisations appear to be patients were given a schedule of meetings references the accumulating body of scientifi c costs and create a more cost-eff ective system. eff ective and cost-eff ective recovery resources, and encouraged to attend, to intensive referral, literature amassed over the past 25 years. This Mutual-help groups are a crucial adjunct to the question arises as to how clinicians can which included directly linking the patient “empirical awakening” and related science base professional treatment, as they can be attended best facilitate their patients’ engagement with with a current AA/NA member and addressing supports the eff ectiveness of 12-step mutual- for as long as necessary at no cost except for them. Many SUD counsellors report that they patient concerns about attendance. At six- help organisations and the effi cacy of TSF voluntary contributions. refer their patients to 12-step meetings, but month follow-up, those in the intensive referral interventions for reducing substance-related the degree to which they provide facilitation condition became more involved in several problems. Other non-12-step mutual-help groups Not only are 12-step organisations self-supporting eff orts beyond a simple referral is unclear. aspects of the 12-step programme. For example, such as Smart might provide similar benefi ts, but and inexpensive to attend, but research shows Growing research on TSF interventions suggests they were more likely to have a sponsor. await more extensive empirical study. The chief that involvement in 12-step organisations can that taking a more intensive and proactively strength of community mutual-help organisations reduce the need for more costly professional encouraging approach to facilitating attendance Importantly, studies have shown that TSF has a might lie in their ability to provide eff ective, treatments – while improving outcomes. can be benefi cial for patients. Clinicians monitor positive impact on patients’ substance use easily accessible, free, long-term recovery support and discuss patients’ reactions to meetings and outcomes. In Project Match, for example, TSF which is responsive to undulating relapse risk. One study found that people who attended explore reasons for nonattendance. was as eff ective as more empirically supported As we move to improve quality and healthcare only AA had overall treatment costs substantially CBT and MET at reducing alcohol use post- effi ciency and eff ectiveness, awareness of the lower than people in outpatient treatment, at TSF can be delivered in many formats, including treatment and at one-year follow-up – and more important role mutual-help organisations and no detriment to their substance use outcomes as a standalone treatment, brief intervention or eff ective at the three-year follow-up. Moreover, related professional interventions can play in a and despite experiencing more drinking- part of another treatment. Studies show that TSF was superior to CBT and MET at increasing recovery-oriented system of care will enhance related consequences at the start of the study. clinicians using these more intensive facilitation rates of continuous abstinence. Similar fi ndings the profi ciency of our overall response to the Similarly, a large prospective study of over 1,700 eff orts can substantially increase the likelihood have been demonstrated in several other RCTs burden imposed by substance-related harms.

18 Feb 2016 your library’s essential reference Feb 2016 19 Recovery Plus Recovery Plus

For men and women in active addiction, or Men and women in accessing treatment, or in recovery, what are the similarities and differences? Paul Hokemeyer treatment: the issues did the research for you and gives his findings.

The online issue of Providing culturally and clinically competent Their intrapersonal relationship. Everyone has an Younger women and older men develop to a woman’s use and abuse of alcohol and Recovery Plus will mental-health and addiction services requires internal dialogue and self-concept. Men tend to more medical consequences of addiction drugs than a man’s. Women – and, in particular, also link you to the clinicians to meet their patients in the reality value themselves for “what can I get” while, in than men. This is a function of key enzymes – mothers – are subjected to shame and ridicule. author’s presentation of the patient’s life with compassion and contrast, women tend to defi ne their value by dehydrogenase and aldehyde dehydrogenase As a result, their use tends to be more “hidden” empathy for the patient’s unique needs. “what can I give”. – and body composition. These two enzymes than it is among men. at Recovery Plus 2015 Central to these needs are an understanding of break down alcohol in the stomach and liver. – just click the logo and sensitivity to gender diff erences and the In addition, eff ective and competent treatment Younger women and older men have less of Women suff er from higher rates of mood and shown below when you power dynamics inherent in them. Historically, requires clinicians to understand and incorporate these enzymes in their system. As a result, anxiety disorders than men. Lifetime rates of access us online: treatment programmes have failed to properly the following evidentiary fi ndings relating to younger women (<50) and older men (>70) mood and anxiety disorders are signifi cantly address identity constructs which deviate from addiction and gender diff erences into their About the author absorb alcohol into the bloodstream more higher among women than men, with and a normative standard based on a middle-aged, treatment plans. quickly and intensely5. In addition, compared to without substance-use disorders6. The most res r p ent 1 Paul Hokemeyer JD, PhD is fo a white male demographic . True cultural and a man’s, a woman’s body contains less water and common mood disorder among women was k ti ic o an internationally recognised l n C clinical competency, however, demands diff erent Men are more likely than women to become expert on cultural competency more fatty tissue. Alcohol-related problems such reported as major depressive disorder (15.4%) 2 treatment interventions for diff erent gender addicts . In 2008, the US National Survey on in the treatment of mental as brain atrophy and liver damage occur more and the most common anxiety disorder was expressions. These bespoke interventions must Drug Use and Health found that 11.5% of males health and addictive disorders. rapidly in women than in men. specifi c phobia (15.6%)7. Click address the systemic realities of the patient’s life aged 12 and older had a substance abuse or He is senior clinical adviser to and consideration of the following. dependence problem, compared with 6.4% Caron Ocean Drive, a licensed Women develop more social consequences from When provided with the proper social and of females. Women, however, face tougher marriage and family therapist, addiction than men. There is much therapeutic supports, women are The sociocultural framework in which patients challenges to getting treatment. It is important former attorney, judicial law greater stigma attached just as likely to recover as men. live. This includes the dominant cultural view to note this gap is narrowing. clerk and law review editor. He of gender and the zeitgeist surrounding gender holds a BA in economics, MA in clinical psychology, PhD in expression and gender roles. This analysis Women suff er from a phenomenon know as psychology and a doctorate must include the impact of patriarchy and an telescoping. Women progress more quickly from in law (JD). Lambert Academic understanding of feminist theory. using an addictive substance to dependence, Press, Addiction Professional addiction and treatment then men. Women and Family Therapy Magazine Their family of origin. In addition to obtaining who enter treatment do so with a more severe have published his research. a thorough medical and psychological history, clinical profi le than men despite having used less Dr Hokemeyer is part of the clinicians must get a sense of how gender roles of the substance or having used the substance Dr Oz Show panel of experts manifested in the patient’s family of origin. for a shorter time compared with men3. This and is a Fox News analyst. means they present with more severe medical, He contributes regularly on The interpersonal relationships. Gender roles behavioural, psychological and social problems. psychology to Good Morning historically come with prescribed power America, The Today Show, CNN’s Prime News and has structures. It is critically important that clinicians Hormonal diff erences impact substance been q uoted in The New understand the pathological power dynamics responsiveness. Oestrogen, progesterone, York Times, Wall Street that are supporting the patient’s illness in order metabolites of progesterone and negative allosteric Journal, Time, Johns Hopkins to fashion appropriate interventions and support modulators of the GABA-A receptor, such as DHEA, Newsletter, The Washington the patient’s long-term recovery. can infl uence the behavioural eff ects of drugs4. Post, and more.

20 Feb 2016 Recovery Plus essential referenceyour library’s for youressential addiction-recovery reference library From DBrecoveryresources.com June 2015 Feb - 2016May 2016 21 Recovery Plus Recovery Plus

Women’s relapse rates are more likely to increase if they are in a relationship with a partner who abuses substances – but the same phenomenon does not occur in men.

A comprehensive review in the American Journal References. of Drug and Alcohol Abuse of the literature 1. Greenfi eld SF, Grella CE. Alcohol & drug concluded that, although women with alcohol abuse: what is “women-focused” treatment for problems were less likely to enter treatment, substance use disorders? Psychiatric Services once they began treatment they were just as 2009;60:880–2 likely as men to recover. But this review also 2. US Substance Abuse and Mental Health concluded that programmes which provided Services Administration Offi ce of Applied perinatal care, childcare and other family Studies. Results from the 2008 National Survey services would better facilitate women to enter on Drug Use and Health: National Findings 8 treatment . (Department of Health and Human Services, 2008). Gender specifi c programs are generally no 3. Hernandez-Avila CA, Rounsaville BJ, Kranzler more eff ective than mixed-gender programmes HR. Opioid-, cannabis-, and alcohol-dependent for alcohol dependence. However, there is Is addiction destroying women show more rapid progression to greater effi cacy for subgroups of women with a substance abuse treatment. Drug Alcohol your life?

Every stepoftheway. – just click the logo Gender diff erences between female and male 6. Conway KP, Compton W, Stinson FS, et al. substance-abuse patients are impacted by shown below when you Lifetime comorbidity of DSM-IV mood and a host of biological, emotional, cultural and access us online: anxiety disorders and specifi c drug use disorders: socioeconomic factors. Central to a patient’s 0330 024 0705 results from the National Epidemiologic Survey www.themanorclinic.com r presen success in recovery is their ability to establish a fo ta on Alcohol and Related Conditions. Journal of k ti ic o reparative psychotherapeutic relationship with l n Clinical Psychiatry. 2006;67:247–57. C his or her clinical team. Eff ective treatment demands that clinicians understand their 7. Goldstein RB. Comorbidity of substance use Click patients’ unique needs and meet them with with independent mood and anxiety disorders in based in Southampton cultural and clinical sensitivity. women: results from the National Epidemiologic

22 Feb 2016 your library’s essential reference Feb 2016 23 Recovery Plus Recovery Plus

Central to a patient’s success in recovery is their ability to establish a reparative psychotherapeutic relationship with his or her clinical team: resources and references.

Survey on Alcohol and Related Conditions. In: and female alcoholics’ attributions regarding To read our online ‘sister’ Recovery Plus journal Brady KT, Back SE, Greenfi eld SF, editors. Women the onset and termination of relapses and the – with all its interactive hyperlinks to more information and addiction: a comprehensive handbook. maintenance of abstinence. Journal of Substance Guilford Press; New York: 2009. pp. 173–92. Abuse. 1998;10:27–42. and to selfhelp and treatment contacts – 8. Ashley OS, et al. “Eff ectiveness of Substance Abuse Treatment Programming for Women: A Additional resources. simply go to www.DBrecoveryresources.com. Review,” American Journal of Drug and Alcohol  http://pubs.niaaa.nih.gov/publications/ Any queries, email [email protected] Abuse (Jan-Feb 2003): Vol. 29, No. 1, pp. 19–53. brochurewomen/women.htm 9. Greenfi eld SF, et al. “Substance Abuse  www.doctoroz.com/blog/paul-hokemeyer- Treatment Entry, Retention, and Outcome in phd-jd/women-and-alcohol-riskier-combination Women: A Review of the Literature,” Drug and  www.caronoceandrive.org/affl uent-women- Alcohol Dependence (January 5, 2007): Vol 86, in-treatment-a-survey/ We are a charitable organisation No 1, pp. 1-21.  www.webmd.com/mental-health/addiction/ The best possible whose sole aim is to help those 10. Annis HM, Graham JM. Profi le types on the suffering from addictive disorders to news/20110915/drinking-is-on-the-rise-among-us- find abstinence based recovery. Inventory of Drinking Situations: implications women treatment at a We have a wealth of experience for relapse prevention counseling. Psychology of  www.foxbusiness.com/personal- providing treatment to over 50 LA’s Addictive Behaviour. 1995;9:176–82. fi nance/2013/05/16/focus-on-perfection-turns- for the past 25 years. Our service is 11. Connors GJ, Maisto SA, Zywiak WH. Male some-moms-to-addiction. reasonable cost CQC registered and fully compliant.

‘StreetScene is an organisation that aims for We offer high quality treatment delivered by a qualified the highest standards in the delivery of care and and dedicated team of professionals. The methods we use treatment. I have rarely met such passionate include: * Individual care plans * Focal counsellor * Detox * Group therapy * One to one’s * Cognitive Behavioural staff and managers who are prepared to go the Therapy * Motivational Enhancement Therapy * Evidence extra mile for the people they serve.” based relapse prevention * Anger management * 12 step David Finney Associates – social care consultancy facilitation * Mindfulness / stress management * Learning about the nature of addiction * Addictive behaviour ‘I’ve put my money where my mouth is because workshops * Healthy relationship workshops * Managing thoughts and feelings * Impulse control * Assertiveness I believe great results at good prices is the future training * Communication skills * Life planning and of addiction treatment - that’s StreetScene.’ structuring * Dealing with underlying issues . Simon Woodroffe OBE – founder of YO! Sushi and YOTEL and original BBC Dragon www.streetscene.org.uk

24 Feb 2016 your library’s essential reference Feb 2016 25 Recovery Plus Recovery Plus

“It is not only possible to get completely well Addiction comes in from addiction – I would also claim that it is possible to prevent it,” says Mandy Saligari, people, not packages who has ‘manualised’ how to achieve this.

I never wanted to be a therapist or the anti-fun That prevention starts at home. For too long we those around them from the opportunities of squad talking in schools about the dangers of have invested time, resources and energy into early intervention. This needs challenging by drugs and alcohol. No: I was destined for wider the fi re-fi ghting end of this condition alone, being able to spot it – and treat – it in its early horizons, I was destined for the stage. I was prioritising the decriminalisation debate. But stages. This is where the Core CharacteristicsTM probably good enough to have a proper shot. what about prevention: teaching the tools of comes in. But as I dreamed of stardom, the days turned recovery to children such as education, self- Don’t miss Mandy into months then years and the sad reality was regulation, personal responsibility and emotional My approach is aimed at recognising addiction Saligari’s TV series that I was falling deeper and deeper into the intelligence. early enough, often before it begins to parade on Violent children, self-destructive behaviour that I now understand as drug and alcohol abuse. This approach seeks About the author desperate parents: to be addiction. It didn’t look like addiction You do not ‘air drop’ into chronic addiction, you to assess high risk factors, and identify certain at the start, it looked like brilliance, potential, travel there through what often appears to be behaviours which might appear explicable and www.channel5.com/ Mandy Saligari MSc, Fdap and devil-may-care. And as that brilliance turned normal, if stressed or avoidant, behaviours until ‘normal’ but can provide early warning signs of show/violent-child- NCAC (accred) is founder and sour, I was ‘the one’ who threw it all away. suddenly you ‘fi nd yourself’ behaving in ways executive/clinical director of addiction that warrant more serious attention. I am mum to three wonderful children who bring desperate-parents. you never imagined you would. Thus, hidden Charter Harley Street. She also The approach is based on the belief that meaning to my life, and have been faithfully Despite having ‘so much going for me’, I am lucky in plain view, addiction can pollute individual trained in Arizona under Pia addiction is about how a person feels about married for 20 years to my beloved James who You can also use our to be alive. And now I live each day to tell the perspective, destroy families and run rampant Mellody in the Post Induction and therefore behaves towards themselves and is a nightmare to live with, and he feels the same onine journal to link story and work with others who suff er as I did through the very fabric of our society before it Therapy model: a trauma towards others. It’s about relationship. about me – that much we have in common! reduction-based methodology to her presentation at and who want to get well. appears as one of the manifestations. There are high risk factors in any individual, too, that are working with the inner child Of course you can become addicted to an In truth I have been very lucky: in 1990, rehab Recovery Plus 2015: Personal experience tells me that addiction is well known in the addiction-treatment industry and unhealthy feelings carried addictive substance, but that is the tip of the did not hold the same cachet as it can today misunderstood by society in subtle but vital but which don’t yet seem to have reached into adulthood. Mandy iceberg. Addiction comes in people not in but somehow I found myself there when I was entered treatment herself in r presen ways. When I say I work in the fi eld, people’s the wider medical community where early packages. To treat it, we need to focus in the only 23 years old. Cocaine had almost killed me, fo ta 1990 and is now a relationship k ti ic o thoughts turn immediately to drugs and alcohol intervention is most often possible. right place. and my love addiction had broken me so that l n and parenting expert and a C – to what I consider to be two manifestations of straight-talking speaker, both I no longer wanted to live. The next 10 years addiction rather than the condition itself. Too often in assessment for treatment, I discover knowledgeable and hugely Part of my expertise is in my striving as an adult or so were a constant battle between strict Click a long history of mental illness – sometimes entertaining – she recently to establish a solid foundation of recovery adherence to the programme of abstinence and Because of this attentional bias, the goal often spanning decades – of an anxiety disorder, appeared on This Morning TV. in long-term respectful relationships with rebellion as I instinctively felt that my obsession becomes sobriety, to my mind a shallow and depression, repeated disturbed behaviour, that She is developing a creative others. I am now an addiction therapist with for abstinence was the same ‘sickness’ as my stressful goal compared to seizing and living the within a matter of months, or possibly a year, and innovative model of a Masters degree in addiction psychology and obsession to use. I now know that throughout day. Further, I have long wondered if addiction is has been successfully, and sustainably, treated care related to treating and counselling and experience in clinical practice this time I was carving the basis for a successful indeed a ‘chronic relapsing condition’ or whether by an addiction programme. I feel frustrated preventing addiction, currently spanning over 20 years around addiction and treatment and prevention programme for the our focus on sobriety as the goal enables this. by the system that serves this patient with cul- undergoing IP. Charter comes relationships. Certifi ed by the Law Society to social malignance that is addiction as well as from a psychodynamic Perhaps we as treatment professionals should de-sac answers that too often leave a person provide Continuing Professional Development a strong foundation for the life that I cherish perspective and uses the re-examine our treatment focus and methods, dependent on medication. 12-step method modifi ed to (CPDs), and with well-established links to the today. A life of recovery where I no longer as in my experience it is not only possible to get incorporate CBT, psychodrama, independent schools sector where I present to experience loneliness nor despair, where I am completely well from addiction, I would also The denial round this condition crucially blinds Gestalt, Focussing, MI and pupils, parents and provide teacher training, I am respectfully myself, where I am free. The day I claim that it is possible to prevent it. those suff ering from the onset of addiction and mindfulness. dedicated to education and early intervention. entered recovery, my life changed forever.

26 Feb 2016 your library’s essential reference Feb 2016 27 Recovery Plus Recovery Plus

Integrative treatment includes all viable Integrate treatment modalities. While we cannot cure dual diagnosis, IM can help to heal, maintaining hope and for complex patients positive growth. Dr Michael Genovese explains.

By the end of this Until recently, mental illness triggered little public A signifi cant number of patients are “dually the art and science of medicine. Modalities rather, as the name implies, it includes all viable presentation at discussion. It was often kept quiet and regarded as diagnosed”, meaning they suff er from both supported by hard data are preferred to those modalities. The complex, chronic diseases Recovery Plus 2016, “a private family matter”. Despite a growing body addiction and psychiatric illness such as accepted anecdotally. We rely on the diligent of addiction and mood disorders present a delegates will be able to: of scientifi c evidence, many failed to recognise depression or anxiety. Similar to a patient physician’s ability to supplement evidence-based challenge to healthcare providers in search of the disease states of depression or addiction as with cardiovascular disease and comorbid treatment with those backed by the experiences a cure. Cure implies a single event – success illnesses. Now people are talking. Why? diabetes, patients with co-occurring disorders of patients and practitioners but comprehensive, or failure, usually in terms of one criterion or 1) cite statistics to assess pose complex challenges, all of which must quality care also demands the rigour of peer- treatment modality – and our medical culture prevalence of mental-health According to the National Institute of Mental be addressed if the individual is to achieve reviewed science whenever available. is all too often invested in success at all costs. disorders and accompanying Health, depression is the leading cause of optimal mental health. An integrative model 4. The treatment team is open to all relevant Healing, on the other hand, takes the onus off substance-use problems disability in the US. About 20% percent of of treatment aff ords the comprehensive care About the author disciplines and approaches: no single practitioner outcomes and places it on relationships: fi rst, 2) list and discuss the 5 americans suff er with diagnosable mental illness necessary for success. can be an expert in every fi eld. It is incumbent the patient’s with himself or herself, then the pillars on which integrative Before joining Sierra Tucson as each year and 17.5% of adults with psychiatric on the care provider to cast a broad net and patient’s with his or her practitioner. medicine rests medical director, Dr Michael V illness have co-occurring chemical dependency. What is integrative medicine? accept help from all disciplines capable of 3) apply an integrative Genovese MD, JD co-founded In the UK, anxiety and depression are the most The answer varies according to the responder. In healing the patient. For example, a complex, approach to their practice Long Island Mind and Body, common mental disorder, and about 25% of my professional opinion, integrative medicine, dually diagnosed patient could benefi t from 4) more eff ectively establish an integrative practice in New the population will experience a mental-health much like psychiatric illness, has garnered little the expertise of a primary care physician, a reparative relationship to York which focuses on mood problem each year. Co-existing mental health public interest – but thankfully that is changing and anxiety disorders, insomnia, addictionologist, psychiatrist, psychotherapist, meet complex patients’ needs. and substance use problems – ‘dual diagnosis’ also. The American Board of Integrative Holistic addiction, and medico-legal acupuncturist, dietitian, naturopathic physician, – is estimated to aff ect 30-70% of patients in Medicine describes fi ve basic pillars on which issues. He serves as a Diplomat physical therapist and other practitioners, health and social care settings integrative medicine rests, as below. of the American Board of depending on the patient’s condition. Moreover, 1. The relationship between the practitioner Psychiatry and Neurology communication between the providers is and The American Board of r presen The statistics are clear; clinicians should not and patient is paramount. The practitioner and necessary to provide a continuum of care. fo ta Integrative Holistic Medicine. k ti ic o ignore suff ering and its detrimental impact. patient work as partners, in tandem to foster 5. All aspects of the patient’s experience l n He was a Fellow in the C The conversation is on. It is imperative to the patient’s health. As a team, the patient and department of Child and – physical, emotional, and spiritual – are discuss mental illness and deliver mental health provider continue to address acute illness, but Adolescent Psychiatry at North considered. Failure to consider every dimension Click in order to circumvent the occurrence of make prevention of disease the relationship’s Shore University Hospital, New of the patient’s experience, including any tragedy aff ecting us privately in small numbers primary goal. Bilateral education is a key York. Prior to attending medical cultural infl uences, limits our understanding of while causing detriment to the safety of our component: the patient gives information about school, Dr.Genovese earned a the ways in which a patient will respond to a communities and of our world as a whole. lifestyle, health and goals, while the healthcare law degree and is a member of given intervention. Treatment issues surrounding practitioner informs the patient about the the New York Bar Association. pregnancy, end-of-life decisions, sexual health Society has made some advances in disease and treatment options. A popular lecturer on topics and parenting highlight the import of this view. Healing then can be conceived of as a continued understanding depression as a “brain disease” 2. Integrative medicine addresses the whole such as psychopharmacology, eff ort to improve wellbeing in the midst of pharmacogenomics, and but misconceptions of addiction as a weakness, person. This view moves us away from the “Cartesian Why should I consider an integrative approach? changing conditions and circumstances. The neuromodulation, Dr Genovese moral failing, or personal shortcoming persist. split” of mind-body duality and the reductive view taught resident physicians and The complexity of co-occurring illness requires integrative model reminds us that, when we are As the scientifi c study of addiction advances, so of patients being a bundle of pathologies. medical students at Winthrop a comprehensive, multifaceted treatment unable to cure, we are still able to heal. And if too, one hopes, will public understanding and 3. Treatment is informed by evidence. In every University Hospital. model to facilitate optimal healing. Integrative we are able to heal, we can maintain hope and support for patients. discipline, physicians seek a balance between medicine does not exclude treatment paradigms; positive growth.

28 Feb 2016 your library’s essential reference Feb 2016 29 Recovery Plus Recovery Plus

How have innovation and technology impacted Advances in drug drug testing and the rehab sector over the past decade? How important is testing to integrity of and alcohol testing addiction services?George Powell has answers.

By the end of this Drug and alcohol testing has been a part of We only put numbers out. We don’t look at presentation at addiction and recovery for as long as I can who it came from, where it came from or the Recovery Plus 2016, remember. I started working in the business type of test it is. We just develop data for the copresented with in the mid-1990s, for employers. Testing was counsellors and doctors to better treat patients. essential, in that industries needed to ensure Stephen Valle, they had alcohol- and drug-free workplaces. At What is Routine Medication Monitoring? delegates will be able to: the start of this millennium, I started getting We look at working with ethical organisations involved in the addiction and recovery industry. round the world to help build programmes 1) list trends in drug Substance testing is an important tool in to educate medical professionals that and alcohol testing monitoring compliance and adherence to a treat addiction and do so in an economical About the author The best analogy for immunoassay results is issues. An even bigger problem was diversion over the past decade programme, without which you’re just going to and eff ective way. We don’t even call our telling a friend you’re going to Wembley Stadium – when somebody obtains a medication, but 2) explain why testing George Powell is CEO and be making guesses. programmes drug testing – we coined the term founder of Summit Diagnostics, but could not say where you sit. For example, doesn’t necessarily take it but instead sells it on is necessary for clients, Routine Medication Monitoring. It is important with over 30 years’ experience you could have a positive opiate but not know if the street. It’s a huge problem because these doctors and services A lot of people say to me that they’re not really that we look at medical necessity to treat the in the clinical testing business, it was heroin or poppy seeds from a bagel! drugs were prescribed to resolve a problem like a 3) list the latest testing interested in looking at drug testing or that patient for what they might be addicted to. in both products and services. pain issue or depression. techniques they have a pre-disposition about it because it Testing helps medical professionals determine George serves on the boards Confi rmation is a much deeper science and Medications sell at a premium on the streets 4) identify use of violates privacy and fosters a negative approach the problem, then prepares a way to treat it. of a number of laboratories helps to distinguish what actual drug is present. and are a gateway to more illicit drug use. This is benzodiazepines and to treatment. They’ll say they’ve been in the and has expertise in lab start Going back to the analogy above, using lab where the drug-testing industry started having other prescribed drugs business for a long time and can tell when With most diseases, your doctor would perform up, compliance, production confi rmation technology you could tell your an important place in the market. “Doctor in the workplace, as somebody is using. Although professionals a battery of tests to determine if you have the and partnering with labs friend that you were in Wembley, what section, shopping” was popular and diversion rampant. well as illicit drugs. treating patients in recovery can have a keener disease and extent of the disease, then develop to assure compliance and row and seat – and probably what you ate. This cost containment. He is sense in spotting drug and alcohol use, there is a treatment plan. Addiction needs the same is important for medical professionals to help Then there are pregnant women who use an avid supporter of the no way to confi rm that for external authorities consideration when diagnosing. Patients then recovery eff ort locally and them determine what medications their patients marijuana, which is stronger than ever. Statistics without hard clinical evidence and data. realise that they’re going to get the best possible internationally – so much are on and taking correctly and which they might show that marijuana is more of a gateway drug outcomes while maintaining their dignity. We’re so that in 2016 be became be taking without consent. than previously believed – and it is only one of What main diff erence have you noticed between trying to help people – with an overall goal of a copublisher of Recovery Plus many drugs that pregnant women can use. There US and UK treatment centres? consistent treatment protocol internationally. journal. In many cases it’s innocent but adverse drug will be adverse eff ects on the baby. In the US, drug monitoring is well accepted, with reactions are a big problem. Multiple physicians most people in recovery realising that they will How have innovation & technology impacted drug/ can prescribe medications, not knowing what We’re trying to get a reasonable testing protocol have to be tested. It’s a bit more mature than alcohol testing and rehabs in the past decade? each is prescribing. Self-medicating is a problem based on medical necessity for each patient in the UK, where there is a pervading issue of It has changed tremendously. When I started, as well. These tests help distinguish what’s that takes into account many variables. These people feeling their privacy is being invaded. there was basically only one way to do a test: present and what might not work well together. variables include type of testing, how to test, But laboratories are not trying to invade privacy with an immunoassay. This was a screening when to test and frequency of testing. In the or publish anything about patients that would device, like an instant test cup or a tabletop What other trends have you seen over the past past that’s been the biggest problem: labs have aff ect their everyday life. Labs simply produce analyser that would analyse a specimen and decade or more? had protocols that say you should test for every data to help plan treatment. That’s what the determine if a drug was present or not, but it In the US, when pain care medicine became drug that’s out there, three or more times per industry is about – it’s a data driven industry. wouldn’t specify what drug or type of drug. prevalent in 2004-2005, we started seeing big week. That is unnecessary: there are ways to

30 Feb 2016 your library’s essential reference Feb 2016 31 Recovery Plus Recovery Plus

Tel: 0118 940 4413 Fax: 0870 167 1999 Email: [email protected] “We want to get together with the thought www.yeldall.org.uk leaders in london – about what they need, what they want, and what they’re going to get from a more personalised laboratory.” t
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3-6 month 3FIBCJMJUBUJPO counselling and individual programme (includes one to one support plans with key worker) counselling, group work, work Recovery Plus WARriors experiences, literacy, numeracy t
One year of "GUFSDBSF included and IT training, and recreation) free of charge. (work, addiction, recovery) Residents experience acceptance and an opportunity to turn their lives around without fear of judgement. A client can make mistakes The online issue of moderate and cost contain while still obtaining Conference without feeling like anyone will turn their back on him. Recovery Plus will valuable treatment data. 2 December 2016 also link you to the Waldorf Hilton, London author’s presentation What does the future hold for drug/alcohol testing? It’s unfortunately an endless market. As long www.recoveryplusdb.com at Recovery Plus 2015 as the supply and the demand are there, we Yeldall is a – just click the logo will have addiction problems. Simultaneously, t

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"GUFSDBSF $PNNVOJUZ access us online: compassion while preserving dignity. We need to put our minds together and bring treatment testing together, with a set protocol that will res r p ent fo a work and enable the job to get done. Medical and talk to them about what they need, what k ti ic o l n C professionals on both sides of the Atlantic need they want and what they’re going to get out of to look at this and fi nd a way to put together a a more personalised laboratory. Let’s see if we cohesive policy to treating that disease. Routine can implement it together. Our goal is to put Click Medication Monitoring is an essential tool in together a great policy to help people get well. developing data and ultimately a care plan for people suff ering from this disease. We spend a lot of time in the recovery business. We see a lot of people who have been on the On a broader scale, there needs to be a real really bad side of things and have still been able dialogue between leaders of the US, the UK and to get them completely back. I saw somebody the rest of Europe about this ongoing problem who had been a life-long drug addict for 55 or of drug abuse. It’s at epidemic proportions in 56 years make a complete recovery, so there is almost every country. Even in my small town in hope. It doesn’t matter what age people are, we New Hampshire, we’re seeing unexpected, dirty don’t give up on anybody. There is always hope drugs coming over from Eastern Europe. There and that’s what we do. We work with people is a worldwide connection to the drug problem. who want to get clean and help them to do so. Internationally, we need to be consistent – and attack the problem with children at a young age More information is available at: through education to cut the demand.  www.today.com/health/new-help-babies- withdrawal-moms-battling-addiction-t60191 What are your own plans for the future?  www.ncsl.org/research/human-services/drug- We’re very interested in the European market. testing-and-public-assistance.aspx We’ve looked at some sites in London, for our  https://www.advisory.com/daily- fi rst laboratory there. We’re very excited about briefi ng/2013/07/24/more-doctors-require- the potential of doing that. We want to get patients-to-take-drug-tests-for-pain-pills together with the thought leaders in London  http://summitdiagnostics.com.

32 Feb 2016 your library’s essential reference Feb 2016 33 Recovery Plus

Break the silence FREE 12-PAGE PULLOUTHow to help addicts into long-term enriched recovery The chair of the All-Party Parliamentary Group PROGRAMME: JOIN US! on Children of Alcoholics, Liam Byrne MP, breaks his silence to break the cycle – write to SSaveave ttime,ime, ssaveave liveslives your MP to support his children’s Bill.

At the National Association for Children of The text of Liam Byrne’s Ten Minute Rule Bill: THE CONFERENCE AND TRAINING OF 2016 Alcoholics’ annual David Staff ord lecture in “Children with Alcoholic Parents (Support) Bill; on how to deal eff ectively and confi dently with That leave be given to bring in a Bill to make February, its patron, Liam Byrne of the All-Party people who have drug and alcohol problems Parliamentary Group on Children of Alcoholics, provision about the care and support of children with one or more alcoholic parents; to provide for launched his parliamentary campaign calling on ORGANISED BY PEOPLE IN RECOVERY the government to change the law to ensure the allocation of a duty to coordinate specified health and social services to a specific Minister; to help others achieve and enjoy drug-free lives that every part of the UK has a plan to support to establish a national strategy and a system the UK’s 2.5million children of alcoholics. of annual reporting of performance by local SAVE THE DATES: authorities against relevant objectives and targets Friday 20 May and Saturday 21 May 2016 The APPG on Children of Alcoholics published within such a strategy; to oblige local authorities ground-breaking research which showed that: to provide specified other data on children with GET EARLY-BIRD DISCOUNTS!  No council has a specifi c strategy to support one or more alcoholic parents in their area; and Book by 31 March and you can save over £100 children of alcoholics for connected purposes.”  Almost no Local Authority is increasing its – on already-subsidised tickets drug and substance abuse treatment budgets, What you can do: despite the increases in alcohol related hospital Write to your MP (www.theyworkfor you.com) HONOUR YOUR CAREERS AND WORK admissions – over a third cut treatment budgets and ask them to sign Early Day Motion (EDM) 750: People working with addicts deserve the best for  Referrals for alcohol treatment vary widely “That this House notes that alcohol harm costs their high calling but are too rarely recognised – from 0.4% of a local authority’s estimated the UK £21 billion a year; further notes that we do, including off ering London’s prestigeous number of hazardous drinkers, to 11%. alcohol misuse is now Britain’s third biggest health problem after smoking and obesity, costing the 5* Waldorf Hilton as your workplace for 2 days At a meeting in parliament’s Portcullis House, NHS alone £3.5 billion a year; recognises that just one in 20 dependent drinkers receives treatment; HIGHLY-QUALIFIED, FRIENDLY PRESENTERS: Byrne recently published a proposal for a believes that all too often the 2.6 million children of Browse our speakers’ bios in this 12-page pullout new law, the Children with Alcoholic Parents hazardous drinkers are forgotten; notes that children (Support) Bill, which would: of hazardous drinkers suff er a range of mental health COMPREHENSIVE, VITAL TOPICS – & CEU/CPDs  Appoint a minister with national responsibility issues, are more likely to consider suicide, are more We cover all the bases you could need, from for policy to support children of alcoholics, with prone to eating disorders and are far more likely than the neuroscience of addiction to measurements the power to coordinate specifi ed health and most to become alcoholics themselves; and calls on social services the Government to bring in a strategy to help children of recovery, issues unique to men and women  Require an annual national strategy to support of alcoholics, specifying concrete steps by which and to young and old, as well as LGBTQii – not children of alcoholics public agencies should identify children of alcoholics forgetting family supports, dual diagnoses, drug in order to connect them with sources of support and  Require councils and the NHS, in every part of testing, types of treatment, contacts and more... the country, to set out the scale of the challenge to undertake a public information campaign aimed at parents who are hazardous drinkers, warning with hazardous drinking parents in their area, to them of the risks to their children’s health and to set out a coordinated plan to support children of DON’T MISS OUT – BOOK NOW ensure that the right provision is in place in every Get information, savings and guaranteed seats at alcoholics, and to publish budgets for treatment part of Britain that will provide treatment to parents and support, organised in a national league table. seeking help with alcohol dependence.” www.recoveryplusdb.com, or post form on p46.

34 Feb 2016 R+ programme preview - updatesyour library’s at recoveryplusdb.com essential reference wwww

WWhere:here: WWaldorfaldorf HHiltonilton Welcome! Join us for Recovery Plus & Interventions Plus: cost-effective, enjoyable ‘crash course’ training in how to save and enhance lives – while also discovering supportive, helpful colleagues.

In response to demand, the 3rd ConferencesCon are what you make Recovery Plus conference on of them. Conversations can how to help people recover beb more valuable than the from addictive substances and sessions,s no matter how behaviours is dedicated to excellent.e So, to nurture both experts (hello again!) and networkingn and help you those who increasingly often in forgefo contacts useful for your the course of their work come work,wo we are limiting Recovery face to face with people who havee PlusPlus to one stream of trainer alcohol and drug problems, but whowho presentations,present so that delegates are are not specifi cally trained to handlehandle seatedseated withwith each other for most of the them. It is hugely rewarding to witness experts daydd and naturally ll share their experiences.

Ballroom: presentation room Exhibitor floor plan: and those thirsting for knowledge meet up with Palm Court each other and forge long-term professional As well as meeting potential colleagues and old Images, by row: relationships which are mutually supportive and friends, take a social wander round the exhibitor 5 help vulnerable people in our care. stands at Recovery Plus. These off er opportunities 4 • Entrance to R+ 5* venue – steps 13 14 to chat with the companies involved as well as 1122 115 browse our online version for a 3 5 16 ‘google streetview’ tour. For families, for therapists seeking a second with fellow attendees interested in what they 11 Refreshments career, for rehab admissions staff who feel off er. Lunch prepared by Hilton chefs will also • Recovery Plus 5* venue - turn 2 1100 2200 2211 2222 2233 1177 6 right on entering. helpless when they receive desperate calls for be in the iconic Palm Court, which off ers more Refreshments help, and for interventionists who want to prove opportunities to meet people. 9 2277 2266 2255 2244 1188 • Presentation room. 7 their credentials, family intervention workshops • Lunch, refreshments and Registration will take place on 21 May. If you fi nd that one of the topics is of particular 1 8 exhibitors will be in the iconic interest and wish to learn more, we will source steps steps Palm Court, fi lmed as the EEntrance,ntrance, ggroundround ffloorloor ballroom in the original Titanic In the course of your work, do you increasingly or organise dedicated workshops. We will also fi lm. Attend presentations via encounter patients/clients with alcohol or drug publish a journal on the Recovery Plus conference the glass doors. problems or addictive behaviours? Are you that you can use as a handy reference in your • Exhibitor fl oor plan. confi dent that you are doing the best for them – professional library. So... Gain ‘gold standard’ and yourself, that you are following best practice? internationally-recognised CEUs & attendance • Nearby Tube stations. Buses If your answers are “yes”, “no” and “no”, then this certifi cates… Be confi dent in handling clients to Aldwych and Strand include RV1, X68 1, 4, 6, 9, 11, 13, 15, 23, 59, intense fully-rounded ‘crash course’ in how to with complex needs… Prevent relapse... Know 68, 98, 171, 172, 176, 243, 341. recover from addiction is for you. You will meet when to refer and who you can safely refer to… more people and learn more at Recovery Plus Create a support network… Meet new colleagues • The Carole King and Mamma Mia musicals fl ank the R+ than you could from months of research. Truly, and old friends! venue. you can save time, save lives... The day is packed, to make the most of your time. We will also give For more details, to book onlline or organise • Or relax after the conference at other nearby theatres. you documentation to refer back to. accommodation, go to www.recoveryplusdb.com.

R+ programme preview: due to life, changes might occur – updates at recoveryplusdb.com WWhen:hen: 2020 MayMay WWhen:hen: 2121 MayMay

8.00am MINDFULNESS MEDITATION – relax with Mary Somerville 8.00am OOptional:ptional: ‘‘OPEN’OPEN’ 112-STEP2-STEP GGROUPROUP – chaired by well-known personality 8.15-9.00am ‘OPEN’ 12-STEP GROUP – chaired by a well-known personality For people in recovery and professionals who want to witness how it works. For people in recovery and professionals who want to witness how it works. 9.15am WWELCOMEELCOME – Deirdre Boyd 9.15am RECOVERY FROM ADDICTION IS POSSIBLE – Deirdre Boyd Experience, strength, hope gather us all here together Accreditation, interventionist movement, benefi ts of the day 9.20am HELP THE CHILDREN OF ALCOHOLICS – Liam Byrne MP (tbc) 9.25am HHISTORYISTORY OFOF INTERVENTIONSINTERVENTIONS – Bill Stevens Learn their unique characteristics, and how to prevent later life problems. How today’s models came about, and their philosophies and approaches – 9.50am WHAT’S LIFE IN RECOVERY LIKE? LATEST RESEARCH – Professor David Best as a taster, see article on pages 62-65. Latest updates from the fi rst national UK Life in Recovery survey. 10.15am HHOWOW YOUYOU CANCAN CONVERTCONVERT DESPERATEDESPERATE CCALLSALLS IINTONTO IINTERVENEDNTERVENED PATIENTSPATIENTS 10.20am WHAT IS ADDICTION? BEHAVIOURS, NEUROSCIENCE – Prof Oscar D’Agnone Paul Spanjar shares how admissions staff and others can facilitate access. Understand the neurochemical and molecular aspects of addiction. 11.00am CCOFFEE/TEAOFFEE/TEA BBREAKREAK 10.50am WHAT IS ADDICTION? WHAT DOCTORS SEE – Dr Steven Hood Why doctors lead the way in calling for alcohol prevention and treatment. 11.20am EETHICSTHICS FORFOR ACCREDITEDACCREDITED INTERVENTIONISTSINTERVENTIONISTS – Robin Lefever 11.20am BREAK – have a coff ee/tea, visit exhibitors, enter your card for a prize. Client clinical care and fi nancial transparency are top considerations. 11.45am HOW TO BEST TREAT COMPLEX PATIENTS – Dr Michael Genovese 11.50am HHOWOW TTOO SSTOPTOP TTHEHE FAMILYFAMILY FROMFROM EENABLINGNABLING AADDICTIONDDICTION Integrate interventions to heal patients’ mind, body, spirit – for a lifetime. Identify and address unhelpful behaviours, to start and sustain recovery 12.15pm ADDICTION AND THE YOUNG – Mandy Saligari The presenter of Channel 5’s popular programme shares her techniques. 1.05pm LLUNCHUNCH & A CCONVERSATION:ONVERSATION: WWHEREHERE DODO WEWE GOGO FROMFROM HHERE?ERE? Lunch will be provided, so you have time to network and catch-up. 12.45pm ADDICTION AND THE ELDERLY – Professor Tony Rao, Professor Ilana Crome How to identify motivations to change which are unique to this population. 2.00pm PPREPARINGREPARING FORFOR ANAN INTERVENTION:INTERVENTION: USINGUSING REAL-LIFEREAL-LIFE SCENARIOSSCENARIOS 1.15pm LUNCH – by Hilton chef, in the iconic Palm Court Briefi ng family members, writing letters to be read to addict, and more. 2.10pm SUPPORTING PARTNERS OF PROBLEM DRINKERS – Dr John McMahon ‘Normal’ is not taking drugs; what we can do to help children resist. 3.00pm TTHEHE INTERVENTIONINTERVENTION ROLEROLE PLAYPLAY ITSELFITSELF ((1)1) – supervised This is followed by a debriefi ng: what went right and what could be better. 2.40pm DEVELOPMENTS IN DRUG TESTING, INCLUDING BENZOS – Steve Valle Copresenting with George Powell, learn how services can be tailored to you. 4.00pm CCOFFEE/TEAOFFEE/TEA BBREAKREAK 3.10pm WARNING SIGNS OF RELAPSE: NIP THEM IN THE BUD 4.15pm TTHEHE INTERVENTIONINTERVENTION ROLEROLE PLAYPLAY ITSELFITSELF (2) – supervised Relapses don’t just happen on the day of use: they are months in the making. This is also followed by a debriefi ng, so any emotional buildup is 3.40pm BREAK – have a coff ee/tea, visit exhibitors, see if you are a prize winner. discharged, and to build confi dence and reassurance for future scenarios. 4.05pm WOMEN’S ISSUES, MEN’S ISSUES Similarities and diff erences in accessing treatment, maintaining recovery. 5.00pm TTHEHE NEWERNEWER COMPONENTSCOMPONENTS OOFF IINTERVENTIONNTERVENTION 4.35pm LESBIAN, GAY, BISEXUAL, TRANSGENDER LIVES What happens after the intervention? We explain case management, Addiction occurs at higher rates in the LGBT community than generally. monitoring family and continued involvement, for long-term outcomes. 5.05-5.35pm BME ISSUES IN RECOVERY: MYTHS & FACTS WWRAPRAP UP,UP, GIVINGGIVING ATTENDANCEATTENDANCE CERTIFICATESCERTIFICATES In life and death therapy, clinicians must distinguish critical issues vs excuses. Throughout the day HEAD & SHOULDER MASSAGES – Karrim Rahman AAWARDINGWARDING 7 CCIPIP HOURSHOURS – Rebecca Flood, Deirdre Boyd

R+ programme preview: due to life, changes might occur – updates at recoveryplusdb.com Liam Byrne (tbc) is Member of Parliament for Birmingham, Hodge Hill, chair of the All-Party Parliamentary Group on Inclusive Growth, co-founder of Red Shift and proud patron of the National Association for Children of Alcoholics – he is campaigning that all local authorities identify and help WWho:ho: thethe trainerstrainers this vulnerable group. He joined the Labour party aged 15, came top of his class at Manchester University, winning the Robert Mackenzie prize for political science, then won a Fulbright scholarship to Harvard Business School where he took his MBA with honours. When he came home he started a fast-growing software company. In 2004, he won the hard-fought Hodge Hill by-election; he doubled his majority two General Elections, in 2010 and 2015. Liam was promoted to Gordon Brown’s Cabinet Professor David Best BA Hons (1st Class) in Psychology (Strathclyde University), MSc with Distinction in after four years in Parliament. In Westminster, Liam has been asked to do some of the hardest jobs in Criminology (London School of Economics), PhD in the Social Psychology of Addictions (Strathclyde government – in the Home Offi ce, Downing Street and HM Treasury. In Opposition, Liam has chaired University) is a leading fi gure in the international research and policy movement around recovery from Labour’s policy review, led the Shadow DWP team and served as the Shadow Minister for alcohol and drug problems, with his primary research interests being round recovery and social justice, Universities, Science and Skills. Liam is the author of over 20 books and pamphlets about the UK’s including issues of stigma and inclusion for off enders and substance users.. He has published about future. He is also the author of the Road to Full Employment, Reinventing Government Again and 150 peer-reviewed papers, over 50 policy and research reports and authored 3 books on addiction Local Government Transformed. He is governor of the Institute of Government. recovery. He is professor of criminology at Sheffi eld Hallam University and has studied and researched at a range of academic institutions – Strathclyde University, London School of Economics, the Institute Ilana Crome is EIlana Crome is Emeritus Professor of Addiction Psychiatry at Keele University, of Psychiatry, Kings College London, Birmingham University, Griffi th University (Queensland, Australia), honorary consultant psychiatrist at South Staff ordshire and Shropshire Healthcare NHS Foundation University of the West of Scotland, Monash University (Victoria, Austrailia) and Sheffi eld Hallam Trust, honorary professor at Queen Mary University of London and senior research fellow at Imperial University. He has also led Policy Research Teams at the Police Complaints Authority and the National College, London. Her specialist areas at Keele University are Clinical practice and service Treatment Agency. And he worked with the Prime Ministers Delivery Unit, the Scottish Government development for drug alcohol and nicotine dependent patients; older substance misusers; and the Victorian Government. David is also a director of the US Recovery Research Institute, co-chair psychiatric comorbidity and substance misuse; epidemiology; psychosocial risks; implementation of Sheffi eld Addiction Recovery Research Group, founder and co-chair of Recovery Academy Australia. and evaluation of multidisciplinary training and education; the development of novel instruments to measure craving and withdrawal in substance misusers; decision making in addicted patients; Professor Stephen Bevan is director of the Centre for Workforce Eff ectiveness at The Work Foundation evidence based policy responses to substance misuse problems; the development of innovative and an honorary professor at Lancaster University. He has researched high-performance work practices, multidisciplinary multiagency services for young substance misusers; outcome research in young employee reward strategy, staff engagement and retention. He has a special interest in workforce people. With Dr Tony Rao, she co-authored Substance use and older people. health and wellbeing, leading national and international projects focusing on workforce health and the impact of chronic illness on productivity and social inclusion. Stephen is an adviser to UK government Professor Oscar D’Agnone MD, MRCPsych, is honorary professor of the Faculty of Medical and departments and has advised employers and policymakers in Europe, Asia-Pacifi c, Australasia and North Human Sciences, Institute of Brain Behaviour and Mental Health, at University of Manchester, Oscar America. In 2014 he was named the 6th most infl uential HR thinker in the UK. Stephen is a reviewer for D’Agnone is a member of the Royal College of Psychiatrists with over 30 years’ international several academic journals, including The Lancet, a regular columnist for HR Magazine, a judge at the experience in mental health and addictions. He authored Cocaine Addiction and Treatment and Global Healthy Workplace Awards and is a member of Public Health England’s Health & Work Advisory Prevention of Addictions and is published widely in the professional medical press. He has authored Board and the Health and Work Group of the Public Health Responsibility Deal. Stephen is Chair of the standard text books and guidelines on addiction, advises governments, whilst also maintaining a high UK Fit for Work Coalition and Director of The Work Foundation’s Health at Work Policy Unit. level of clinical interactivity with his patients. He chairs or is clinical lead for many of the most important medical and academic addiction conferences in the UK and abroad, and advises NICE and For two decades, Deirdre Boyd has been a leader in the fi eld of recovery from addiction, with an the Home Offi ce on patient-centred clinical guidelines. He provides comprehensive assessments and international reputation. Based in the UK, she heads up DB Recovery Resources which supplies a treatment and specialises in high risk as well as ‘dual diagnosis’ patients. He supervised over 2,500 daily news service to the international alcohol/drug-treatment fi eld on addiction recovery, publishes Recovery Plus e-mag and print journal, and organises Recovery Plus which last year became the detoxifi cations per year whilst working for clinical and rehab units including CRI (responsible for over UK’s most successful symposium on how to recover from addiction She has spoken at the All 30,500 patients, 46 doctors and 227 nurses), Promis Clinics and Withersdane Hall. Party Parliamentary Drugs Misuse Group, been quoted in House of Commons and House of Lords debates on alcohol and drugs, and contributed to the Drug Policy 2010 and Select Committees. She Dr Michael Genovese is board certifi ed by the American Board of Psychiatry and Neurology and authored ‘Addiction & Recovery: self-help for friends, families and addicts’, which was translated into by the American Board of Integrative Holistic Medicine. Before joining Sierra Tucson addiction- 7 languages. Deirdre serves on the board of the National Association for Children of Alcoholics (UK), treatment centre as medical director, he cofounded Long Island Mind and Body, an integrative sits on the Centre for Policy Studies’ Addictions committee, served on IC&RC’s Advisory Council, practice in New York that focuses on mood and anxiety disorders, insomnia, addiction, and medico- and is collaborating with the Work Foundation to create a briefi ng paper for the UK government on legal issues. He serves as a Diplomate of the American Board of Psychiatry and Neurology and the addiction and recovery in the workplace. She was voted by the public to receive the Directory of American Board of Integrative Holistic Medicine. Dr Genovese was a Fellow in the department of Social Change Infl uencer Of The Year Award 2012. The International Council on Alcohol & Addictions Child and Adolescent Psychiatry at North Shore University Hospital in New York. He completed presented her with the ‘Dr Vincent Bakeman Memorial Award for Outstanding Community Services’. his adult psychiatry residency training at the University of Connecticut. Prior to attending medical Formerly and for over 20 years, she worked as CEO of the Addiction Recovery Foundation and was school, he earned a law degree at the University of Pittsburgh School of Law. With this unique editor of Addiction Today journal. Earlier, Deirdre facilitated women’s groups at the Drug & Alcohol background, Dr Genovese is a respected consultant on mental health and behavioral health topics foundation after training in integrative psychotherapy. She was on the Employee Assistance Programme by multiple organisations, school districts, and for private industry and he is a member of the Association steering group. Before entering the substance-misuse fi eld in 1993, Deirdre worked in the PR Professional Committee on Alternative Dispute Resolution for the Nassau County Bar Association. departments of charities such as the Sick Children’s Trust and was development offi cer for Mensa. Dr Genovese taught resident physicians and medical students at Winthrop University Hospital.

R+ programme preview: due to life, changes might occur – updates at recoveryplusdb.com Dr Tony Rao is an honorary lecturer at King’s College London and a consultant psychiatrist at South London and Maudsley Foundation Trust on the elderly and alcohol. Over the past 13 years, he has published widely on the subject of alcohol misuse in older people. He was visiting Professor of WWho:ho: thethe trainerstrainers Addiction in Older People at London South Bank University from 2010-2012 and is a Visiting Researcher at the Institute of Psychiatry. He was also co-author of The Royal College of Psychiatrists Report Our Invisible Addicts in 2011. He has acted as a specialist advisor to the All Party Parliamentary Group on Alcohol Misuse, the Institute of Alcohol Studies and Alcohol Concern. He received a Clinical Governance award from his Trust in 2007 for work on service development for dual diagnosis (alcohol Daniel Gerrard left his job in the City in 2009 at the same time as a close family member admitted to misuse accompanying other mental disorders) and helped to set up the fi rst dual diagnosis working being an alcoholic. He accompanied her to meetings, and found her a psychotherapist specialising in group for older people there. He is chair of the Substance Misuse in Older People Working Group at addiction and supported the family. He is now a board registered certifi ed Interventionist with the the Royal College of Psychiatrists and co-author for a book on older people and substance misuse. relevant qualifi cations from the Pennsylvanian Certifi cation Board www.pacertboard.org and a member of Association of Intervention Specialists www.associationofi nterventionspecialists.org He Mandy Saligari MSc, Fdap and NCAC (accred) is founder and executive/clinical director of Charter is also an accredited member of the Federation of Drug and Alcohol Professionals. He set up Harley Street. She came into treatment in 1990 after working as a TV producer. Earning her stripes in Addiction Helper as a source of information and support for friends and family of those in the grips group work and interventions, and showing a particular fl air for family work, Mandy began to lecture of addiction. Daniel continues to actively work the 12 step programme for himself. as part of the PSHE provision in independent schools on addiction, emotional coping mechanisms and self-esteem. Around the same time, she took on clients wanting to get well from addiction, Robin Lefever has a BSc in Psychology from the University of Kent and is the managing director of earning a reputation for clinical excellence, delivering thorough recovery outcomes. 20 years on, and Promis Clinics. A leading researcher in the fi eld of addiction, Robin has studied addiction treatment specialising in individuals and families aff ected by broad-spectrum addiction and addictive for over 20 years, publishing numerous articles and papers in international scientifi c journals. Robin is processes, Mandy is a relationship and parenting expert, a straight-talking speaker – and presenter of also a skilled therapist and his clinical interests include a wide range of therapies including EMDR, Channel 5’s TV series Violent Children, Desperate Parents (see pages 26-27 of accompanying journal). NLP, EAP, Psychodrama, CBT, DBT, Sand Play, Ropes Course, Family Therapy and Intervention. Paul Spanjar has been CEO of Providence Projects since 2013, after working there in a comprehensive range of roles since 2002. The Providence Projects, established in 1996, is a residential detox and rehab centre based in Bournemouth. It off ers all aspects of the journey from detox through to aftercare and reintegration with bespoke and tailored packages available to suit the individual. Dr John McMahon has been involved in the alcohol and drug fi eld for 40 years. His current occupation Importantly, Providence Projects has been treating intervened-patients for some years so is familiar is using the internet to reach people who want/need help with their own or other people’s drinking. with their specifi c needs and requirements, and the procedures which rehabs need to put in place For 12 years, he was senior lecturer in alcohol and drugs at the Centre for Alcohol and Drug Studies, to admit these patients. It has also identifi ed what interventionists need to know about what University of the West of Scotland and Research fellow at the University of Glasgow before that. He diff erentiates their clients from others after being admitted to treatment, so that their intervened- set up and wrote the MSc in Alcohol and Drug Studies as the UK’s largest distance learning course; he patients’ have improved outcomes for long-term recovery. taught GPs, psychologists, social workers and alcohol and drug counsellors at MSc and PhD level. He was chair of the National Alcohol Counsellor Training scheme for Scotland and consulted for Health Bill Stevens is a Certifi ed Intervention Professional and the cofounder of RedChair, an addiction Boards, Local Authorities and more. Johnmonths. He has been clean and sober since 1984. intervention company which operates across the UK and Europe. He is a full member of the Association Of Intervention Professionals, and is its UK liaison. Bill has 16 years’ experience as a George Powell is president and CEO of Summit Diagnostics/Summit DNA which provides drug safety psychotherapist, working with behavioural and substance addictions; for over 10 years he was programmes designed to protect patients, prevent diversion and abuse of prescription drugs through employed at The Priory Group as an addictions counsellor. He often appears on TV and radio. detailed drug testing, limit liability, and eliminate unnecessary treatmsents and their related expenses. His expertise includes urine drug testing, oral fluid testing, drug metabolism testing, mental health testing and customised programmes based on your needs. He can also call on expert legal staff . Steve Valle is president of AdCare CJ Services, and a recognised leader and international expert in the addiction, criminal justice and mental-health fi elds. In 1993, He was nominated by Senator Harold Hughes to serve as director of the Federal Substance Abuse and Mental Health Services Administration Karrim Rahman BA(HONS) DTC, CRW, LCSP(PHYS), APBMD, CRZ will be (SAMHSA) in the Clinton Administration. In 2009, he was invited to address the UK Parliament regarding giving head and shoulder massages throughout the day at Recovery Plus. prison reform and addiction issues. Steve is founder of Accountability Training®, a behaviour change He has been practising remedial massage for over 20 years, using massage model for off enders with addiction, author of over a dozen journal articles and the text, Alcoholism and manipulation, therapeutic massage, reflexology, Tui Na, counselling Counseling: Issues for an Emerging Profession, and editor of Drunk Driving in America: Strategies and and relaxation techniques, including for sports/joint injuries. He qualified Approaches to Treatment. He has served as associate editor of Alcoholism Treatment Quarterly. fi rst in law and his early career was in local government, then social work and finally therapeutic work. Remedial massage involves deep-tissue techniques to assist the client’s body to return to normal functioning. More panellists will be added to this list from across the UK and Europe including Richard du Plessis, Deep-seated tension can be released, deposits and scar tissue broken down, Santiago Rotaeche, Philip Fisher... The list will be regularly updated over the coming months at and nerves freed, clearing pain and enhancing blood/lymphatic circulation. www.recoveryplusdb.com.

R+ programme preview: due to life, changes might occur – updates at recoveryplusdb.com JJoin:oin: thethe exhibitorsexhibitors GGain:ain: CEUs,CEUs, CPDsCPDs

BBallroom:allroom: ppresentationresentation roomroom 1 Internationally-recognised, gold standard Continuing Education Units from IC&RC, the International Certifi cation & Reciprocity Consortium, which has over 45,000 members worldwide. These are earned via UKPCBADC, the UK Certifi cation Board of Alcohol & Drug Practitioners. 2 CIP – Chartered Intervention Professional – credits; turn to page 82 of accompanying journal for details. 3 CME – Continuing Medical Education – credits have been applied for. 3 CPD – Continuing Professional Development – credits are being applied for from BACP.

5 4 CCare:are: fforor yyourselfourself FFreeree eextrasxtras steps 13 14 Start this one-day conference with breakfast Simply write the code on each exhibitor table onto a form 1122 115 3 5 pastries and coff ee or tea. we give you, and we will enter it into a draw Why not relax with meditation at 8am followed for the following prizes. 16 by a mutual-aid support group? 11 Refreshments Network and join presentations at 9.15am. Lunch prepared by Hilton chef. 2 1100 2200 2211 2222 2233 1177 6 (Free) head-and-shoulder massages throughout the day. Generous 5.12ct 9K yellow gold 3/4 ct red diamond

Refreshments Only UK conference to be approved to off er Ouro Verde quartz ring with three fi re & white diamond 9 2277 2266 2255 2244 1188 internationally-recognised IC&RC CEUs. ring in 9K gold, opals, 0.72ct, 9K gold ring, size S, value £481. value £203. size R, value £705. Meet the team behind DB Recovery News, and 7 explore how they can raise your profi le. Burberry orange/ Discover what exhibitors can do for you. tan leather key Registration 1199 chain, value £195. 1 8

steps steps The following sponsor organisations, with a mission of raising the standard and quality of care for people with addictive behaviours, and for their families and those close to them, are subsidising all EEntrance,ntrance, groundground floorfloor delegates’ places - to the extent that they are even below cost. Take advantage!

To meet up with our delegates, sponsors and fellow exhibitors for a buzzing and informative day, simply book at www.recoveryplusdb.com or www.recoveryplusdb.com/events/recovery-plus/#registration_hook. If you have any queries, email [email protected] with your top 3 site options. The early-bird rate each day for delegates is £85, or £150 for 2 days, if you book by 31 March 2016 (standard rate is £139 per day). A 9’ exhibitor site includes entry for 2 delegates for both days and is only £349 total if you book by 31 March 2016. An exhibitor 6’ table includes entry for 1 person, early bird rate is £249. Each is a saving of £100.

R+ programme preview: due to life, changes might occur – updates at recoveryplusdb.com FREE 12-PAGE PULLOUT Recovery Plus PROGRAMME: JOIN US! Recovery Plus

EXHIBITOR BOOKING FORM: R+ 2016 DELEGATE BOOKING FORM: R+

Throughout the symposium, there will be displays by treatment centres and 3rd international Recovery Plus symposium related disciplines such as specialist booksellers and drug testing providers. 5* Waldorf Hilton Hotel, Aldwych, London WC2B 4DD. Delegates can stroll around the exhibition room, familiarising themselves with Tel: +44 (0) 20 7836 2400 20, 21 May 2016. the offerings on display, and interacting with exhibitors. Free-to-enter raffles will be held to encourage visits; winners will be announced in the exhibition Policy points: 2016 room. Lunch and refreshments will also be served in this room. EARLY BIRD DISCOUNTS: To help professionals on a budget, DB Recovery Resources, Recovery Plus and sponsors subsidise rates The (early-bird; pay by 31 March) cost covers 2 full days of display facilities: – benefit from even more subsidies by booking in March, as below. Size: 6' table + chair + cloth + 1 delegate £249 (no extra Vat) Where is alcohol and drug policy going this Size: 9' site + table, chairs, cloth + 2 delegates £349 (no extra Vat) Subsidised rate for all participants: Add £100 if paying after 31 March 2016. • if paid before 31 March 2016 £85/day or £150 for 2 days Includes entry for one delegate/representative of exhibitor’s organisation • if paid after 31 March 2016 £139/day or £220 for 2 days year? Will consultation be publicly transparent with 6’ table and two delegates for those booking a 9’ table. To join in the event of the year, please use the reply slip below to inform Please confirm reservation of places for the full two-day training or limited to a select few? Laura Graham us of your requirements. If you want to know more about the arrangements for exhibitors, email [email protected]. at £150/£220 per place (delete as appropriate) TOTAL: £ Please confirm reservation of places for one/two days only at explains why she asks the questions. 3rd INTERNATIONAL RECOVERY PLUS SYMPOSIUM £85/£139 per day (delete as appropriate). TOTAL: £ Organisation Name: PAYMENT Following the trend for renenants, Paul Hayes, must include a defi nition of recovery. Ideally, formerly of the abolished National Treatment this defi nition would come from a consensus of Contact Name: Please debit my Visa/Mastercard/Maestro account £ Agency, re-surfaced in 2015. This time, he is the people in long-term recovery rather than from Address: Expiry date Issue no (Switch only) 3-digit CCV ‘lead’ of the Collective Voice project, which is the service providers who are funded to deliver A/C: sponsored and overseen by a group made up their version of recovery which could well be of the UK’s biggest statutory-funded providers distorted to protect a vested fi nancial interest. I enclose a cheque payable to Deirdre Boyd for £ – they receive a combined annual turnover of £380million in taxpayer money. One of the If we are to have a truly recovery-focused Postcode: Name: project’s stated aims is to engage eff ectively strategy, it must recognise and include alcohol Telephone: Job Title: with the Conservative government... and it as a drug. We know of service providers which seems that Hayes kicked this off by announcing support people to come off illegal drugs but Email: publicly in December that the government do nothing to support the same people with Please tick: 2 days or 20 May 14 May intended to start consulting on a new drug their alcohol addiction. This could be down to Organisation: REQUIREMENTS, AT EARLY-BIRD RATES (please tick): strategy in January with implementation funding – or a lack of training and knowledge. Size: 6' table INCLUDES entry for 1 person £249 (no Vat) Address: expected in March 2016. Who knew? There was no offi cial announcement We also need greater transparency in who is Size: 9’ site+table INCLUDES entry for 2 delegates £349 (no Vat) at time of going to press.* advising government on drugs and how they are doing it so that we can all understand how I enclose a cheque for the total amount of £ and accept that the organisers can not be held responsible for any loss, injury or damage I have seen a few tenders, all working to policy and funding decisions are made. We which might occur to an exhibitor, his/her representative or equipment prior Postcode: the current strategy with implementation due know that ACMD business is largely done in a to, during or subsequent to the symposium. in April 2016. While none of the tenders public forum but there are others who are less Telephone (including codes): appeared unfair, they would be unfair if transparent. The Care Quality Commission took Signed: Email: only a few providers, with ‘insider’ information a much-needed step in fi lming and broadcasting Print Name: of potential strategy contents, applied that its Board meetings online in recent years to Signed: knowledge to current tenders. Is Hayes having a ensure that we could judge how Date: Print name: moment of hireath or is he privy to information honestly it conducted business. ahead of other stakeholders?* Could government follow this GET A DEAL ON ACCOMMODATION: Date: You can book discounted accommodation at the Waldorf Hilton, London WC2, route to at least attempt to restore at www.hilton.com/en/hi/groups/personalized/L/LONWAHI-ADBT-20160519/index.jhtml. Notes to organisers: If a new drug strategy is to be published soon, some faith, generate genuine unity The Strand Palace Hotel, only 4 minutes’ stroll away, was £160/night at time of what would we hope to see included? and inclusion, and develop a broader going to press: http://secure.strandpalacehotel.co.uk/hbs/room_availability_list.html. debate in the fragmented, largely The current strategy is claimed to be recovery voiceless and despondent climate CONTINUING EDUCATION CREDITS: INTERNATIONALLY RECOGNISED focused. However, without any stated defi nition that the fi eld is currently experiencing? 'GOLD STANDARD' QUALIFICATIONS CANCELLATION POLICY FOR EXHIBITORS AND DELEGATES: Bookings cancelled before 9 April 2016: 50% of fee payable. of ‘recovery,’ it is unclear what the strategy A certificate of attendance will be provided for those desiring to apply Bookings cancelled after 9 April 2016: full fee payable; no refunds. expects to achieve, and it is impossible to * Hot off the press: BBC Home Aff airs editor for Continuing Education Credits. The symposium is accredited by measure how well the strategy is implemented. Mark Easton gave an update as Recovery Plus was UKPCBADC, the UK Professional Certification Board of Alcohol/Drug Please return all exhibitor/delegate booking forms to Deirdre Boyd: Any new strategy, in order to be meaningful, going to press – see page 7. Counsellors, a member board of the IC&RC ADC International Certification DB Recovery Resources, 22 Sternhold Avnue, London SW2 4PJ. & Reciprocity Consortium of Alcohol & Drug Counsellors. These credits Tel: +44 (0)20-8123 2334 Enquiries: [email protected] are internationally recognised in over 69 countries, including most of the US, Canada and Europe. R+ has also applied for BACP and other CEUs. PHOTOCOPIES ARE ACCEPTABLE

46 Feb 2016 your library’s essential reference Feb 2016 47 Recovery Plus Recovery Plus

Addicts, on returning home from treatment, can Family matters: fall into a sea of family anger and rigidity, with no place for their newfound self and behaviour throwing a lifeline – then relapse. Don Lavender explains.

The online issue of The World Health Organisation defi ned alcoholism the family does not realise is that the whole scene for everyone to take up the same place By the end of this presentation at Recovery Plus, Recovery Plus will (addiction) as a family disease in 1956. It took the system’s way of coping has become toxic. After and the same roles just where they left off . No delegates were able to: 1955 American Medical Association defi nition coping with a long-term chronic situation of change will be evident and all will be the same; also link you to the 1) Take away information which will give your of alcoholism being a disease, one step further. stress, families need something to relieve them as horrible and painful as before. Sound familiar? author’s presentation residential clients a 65% higher probability of “Family disease” is not arbitrary terminology. of the unhealthy alliances and the dysfunctional It’s called addiction, but whose addiction drives getting well and staying well at Recovery Plus 2015 coping which they have used as a defence from these rigid patterns? 2) Off er information to families so they can – just click the logo This statement could not be clearer. With this the illness and pain caused by everyone feeling understand their own family-of-origin issues clarity in mind, how many treatment centres in abandoned, lost and wounded. Failing to attend a family workshop process shown below when you which unwittingly enable the ‘designated the world have a family workshop component supports the common complaint that “we’ve access us online: patient’ to remain active in their addictions in their residential clinical care programme? Next... the suggestion for family therapy is made. About the author wasted our time and money again”. Family work 3) List what helps families best overcome How many treatment centres collude with the Most often, the fi rst response from the family is off ers healing to families who need and deserve res r p ent Don Lavender BA, MDiv, communication blocks as well as blocks to their fo a unhealthy system of fault fi nding and blaming the resistance, or denial. “Why should WE get help?” new tools to get back to normalcy. Eff ective k ti ic o CADAC, CSAC has worked in own recovery process l n C scapegoat/addict by ignoring the family in pain? “They’re the problem” and “How much does it family work turns the time and resources spent intervention and counselling 4) Discuss what makes an addict, the ‘designated cost?” In reality, everyone in moments of despair on treatment into a wise investment. with individuals and family patient’ in a family system and how to combat Having conducted family work since the mid knows that they need help but are afraid of systems since 1980 and now that dysfunctional family culture of blame Click 1980s, it is easy to see that codependent family being exposed, revisiting the pain and potential When giving focus to family workshop runs Camino Recovery. He is 5) Guide family members through resistance to members are often at their wits’ end as they confrontations. Family members are especially a certifi ed alcohol and drug programmes, I do not mean family therapy per change and, hopefully, gain insight to their own struggle to understand why they cannot ‘control’ afraid of what will happen if they relinquish their addictions counselor and se, although the process is specifi cally designed familial issues with multiple families present or ‘cure’ their addict/alcoholic while they defences and allow themselves to love and be certifi ed substance abuse to be therapeutic. I do not mean a weekend visit 6) Enable prevention of perpetuation in future subconsciously believe they are often the ‘cause’ vulnerable again. What if the family´s resistance counselor. He is passionate at the rehabilitation centre. It is also not a group generations as well as repeated experiences. of the designated patient´s problems. to get help is too strong? What if they resist about ‘family work’, regularly session slotted into the programme schedule holding Healing the Family a family workshop which is one of the most for family members to let staff know how bad- workshops. Families struggle with dysfunction, disease, eff ective adjunct therapies connected to the He has been a consultant to and-wrong the addict has been and how much addiction and everyone fi nds themselves addict’s treatment process? Next Health (Sierra Tucson) they have suff ered. What is most eff ective is a plunged into crisis. Feelings of hurt and anger and the California Physician’s full-fl edged family workshop designed to open emerge while those who feel unloved attempt If the family does not enter the therapy process diversion programme, Priory lines of communication that have been closed or to make things right for everyone. Instead of – with or without the designated patient – they Hospitals and Lifeworks, damaged due to a septic environment of crisis normal coping that occurs when problems arise, will stay in the unconscious rigid patterns of Ireland’s Resurrection Rehab, coping mechanisms. unhealthy alliances form. This drives family feelings and behaviours. Anger, shame and Israel’s Biet Orin, Beirut and members further apart. Family members know disappointment will persist and the addict, on Saudi Arabia’s Nour Al-Shorouk. Families do not need to be told how they have something is wrong and it must be fi xed, due to returning home/reconnecting, will walk into He also ran Harmony, a 26-bed got it wrong. Families need information so that love being replaced with contempt. that wall of anger and rigidity and they fi nd no extended care facility in Devon they can see the dysfunction as well as their part where he was the fi rst to bring place for their newfound self and behaviour. of the dance. Families need education regarding equine assisted psychotherapy The next order of things is an intervention to Since people’s communication is often of to England (see pages xx-xx). the tools they can use to make healthier choices deliver the designated patient into the hands a circular nature, old ways of thinking, old (www.caminorecovery.com for themselves thus no longer enabling the of professionals (rehab). The family has tried attitudes and old patterns of communicating www.donlavender.com). addict to stay stuck in a negative pattern of self- everything and nothing seems to work. What will be immediately present and will set the defeating behaviours.

48 Feb 2016 your library’s essential reference Feb 2016 49 Recovery Plus Recovery Plus

The later a person starts to use substances, the Help parents to help better their chances in life – and parents are essential in preventing life-long consequences. the next generation Dr Andrea Grubb Barthwell explains.

Parents are a wonderfully powerful infl uence of adolescents. Adolescent rebellion is an Prescription drugs. In the US, 17.8% of students in their teenager’s lives. The National Council essential part of separation and individuation; had taken prescription drugs – such as on Alcoholism and Drug Dependence (NCADD) parental guidance of how rebellion is expressed Oxycontin, Percocet, Vicodin, codeine, Adderall, found that teens who learn about the risks of saves pain and suff ering across the lifetime. Ritalin or Xanax – without a doctor’s prescription alcohol and drugs from their parents are up to In fact, global rebellion is a healthier sign of one or more times during their life (www.cdc. 50% less likely to use illicit substances – however, development than rebellion narrowly focused on gov/mmwr/pdf/ss/ss6304.pdf?utm_source=rss&utm_ only about three in 10 teenagers report learning a single issue, such as marijuana policy. medium=rss&utm_campaign=youth-risk-behavior- about the dangers of substance abuse from their surveillance-united-states-2013-pdf). In the UK, about parents. What is the scale of this issue? Let’s look at some 1.3million people are estimated to be dependent statistics on a range of substances that teenagers About the author on prescription drugs (www.publications.parliament. A serious and consistent fi nding in the NCADD can be tempted by. uk/pa/cm201314/cmselect/cmhaff /819/819.pdf); no Andrea Grubb Barthwell MD, and similar studies is that drug and alcohol FASAM, is the founder and CEO separate fi gures for adolescents are available. initiation during adolescence is linked with E-cigarettes. In 2014 in the US, more teens used of Two Dreams and the CEO of greater problems across the user’s lifetime: e-cigarettes in the past 30 days than any other Encounter Medical Group. Illicit drugs. In 2013 in the US, an estimated the earlier the initiation, the more severe and tobacco product, and e-cigarettes have the President George W Bush 2.8million people aged 12 or older used an pervasive will be the adult defi cits of failure lowest perceived risk for regular use than any nominated and the US Senate illicit drug for the fi rst time; this averages to to grow and develop. In the US, the tendency other drug surveyed, including alcohol. In the confi rmed her as deputy about 7,800 new users per day. Over half of to early initiation is trending and persistent. UK, it is thought that 20% of children have director for demand reduction initiates were younger than 18 when they fi rst This suggests a potential accumulation of bought or used e-cigarettes (www.biomedcentral. in the White House Offi ce of used, and 70.3% of users reported the drug as As mentioned earlier, adolescence is a period consequences in the years to come. com/1471-2458/15/244). A major concern in the National Drug Control Policy marijuana (www.samhsa.gov/data/sites/default/fi les/ of great change, which should be marked by from January 2002-July 2004. public-health community is that e-cigarettes NSDUHresultsPDFWHTML2013/Web/NSDUHresults2013. development and acquisition of competencies Dr Barthwell was a principal r presen As some of us know all too acutely, adolescence could serve as a point of entry into the use pdf). In 2013 in the UK, 16% of pupils had ever essential to fully function as an adult, self fo ta adviser in the Executive Offi ce k ti ic o is a transitional period of time in the life cycle, of nicotine (http://monitoringthefuture.org/pubs/ taken drugs, with cannabis the most widely used suffi cient and independent of parents. Perhaps l n of the President on policies C visibly marking the change from childhood to monographs/mtf-overview2014.pdf). They have been aimed at reducing the demand (www.hscic.gov.uk/catalogue/PUB15943/drug-misu-eng- paradoxically, parental supervision and guidance adulthood. Separation and individuation from called the “alcopops of the nicotine world”. for illicit drugs. 2014-rep.pdf). is vital to the growth and development of Click the family is facilitated and marked by the move She received a Bachelor of adolescents along lines that support healthy from parental direction to peer association – and Tobacco. In the US, 17% of young adults aged 18- Arts degree in psychology Alcohol. 18.6% of US students drank alcohol individuation and separation. potential peer pressure. 24 years currently smoke cigarettes, and almost from Wesleyan University, and (other than a few sips) for the fi rst time before all adults who become daily smokers fi rst started a Doctor of Medicine from age 13 (www.cdc.gov/mmwr/pdf/ss/ss6304.pdf). Alcohol Adolescents live and learn in environments This transitional period does not eliminate the using cigarettes by 26 years of age. Tobacco use the University of Michigan is the most commonly used and abused drug where their peers are increasing in importance need for a parent. The parent is still essential – remains the single largest preventable cause Medical School. Dr Barthwell among US youth – more than tobacco and illicit and expressing earlier onset of substance is a past president of the just not as central as s/he once was when every of death and disease in the US (www.childstats. drugs. Alcohol is responsible for over 4,300 initiation. Parents have an essential role to play American Society of Addiction need was met by the ‘perfect’ parent. gov/americaschildren/beh4.asp). In the UK, it is annual deaths among underage youth (www.cdc. Medicine. In 2003, she received in whether adolescents are to be protected from gov/alcohol/fact-sheets/underage-drinking.htm estimated that each year about 207,000 children the Betty Ford Award, given ). In 2012 pressure that promotes, rather than suppresses, The diff erence in perception by the adolescent start smoking, and two-thirds of adult smokers by the Association for Medical in the UK, 43% of school pupils (aged 11-15) said initiation. Delaying their age of initiation is and the parent of parental salience is responsible started before the age of 18 (http://ash.org.uk/fi les/ Education and Research in that they had drunk alcohol at least once (www. important to the prevention of harmful life-long for missed opportunities to infl uence behaviours documents/ASH_108.pdf). Substance Abuse. hscic.gov.uk/catalogue/PUB14184). consequences.

50 Feb 2016 your library’s essential reference Feb 2016 51 Recovery Plus Recovery Plus

The greatest concern about cannabis is perhaps Prevention: look after that its dangers are too-often downplayed. Research findings are ignored, misinterpreted the next generation and denied. Mary Brett lists the facts.

Article 33 of the Convention on the Rights of How does cannabis aff ect children’s bodies? ‘skunk’ averaged 16.2% up to 46%. 80% of the taking cannabis, the receptor sites are empty. the Child says that “States Parties shall take The fi rst thing is to look at the brain cells. cannabis seized, mostly grown here in “factories” They have to be fi lled otherwise withdrawal sets all appropriate measures, including legislative, Cannabis receptor sites (C1) are in many areas and “farms” was skunk. The rest was hash (resin), in – irritability, sleeplessness, anxiety, depression, administrative, social and educational measures, of the brain and (C2) in other cells of the with about 4-6% THC. The Dutch are considering sometimes even violence. It takes time for the to protect children from the illicit use of body. So its eff ects are many, widespread and banning the sale of skunk with a THC content of anandamide to resume production. Withdrawal narcotic drugs and psychotropic substances as varied. Messages pass along nerve fi bres as 15% or more. They equate it with the UK’s class A from cannabis is not as dramatic as drugs like defi ned in the relevant international treaties”. tiny electrical impulses and cross the gap – the drugs, cocaine and heroin. heroin since THC persists in cells for a long time. synapse – between nerve cells as chemicals I was a biology teacher in a school for boys for called neurotransmitters. These are the brain’s “Old-fashioned” herbal cannabis had about Of everyone who tries cannabis, 10% will over 30 years and introduced health education. natural drugs and there are dozens of them. Each About the author equal amounts of THC and an anti-psychotic become addicted. In teens this rises to 1 in 6. Children always want and need explanations for neurotransmitter molecule has a specifi c shape substance CBD (cannabidiol). CBD used to A record number of children are being treated Mary Brett is a trustee of the everything, so I decided to show them exactly that fi ts into its own receptor site on the next Cannabis Skunk Sense charity counteract some of the psychotic eff ects of for cannabis addiction. 13,581 youngsters under how drugs can aff ect the body, particularly cell, as a key fi ts a lock. (www.cannabisskunksense. THC, but it is almost absent (0.1%) from skunk. 18 were treated in 2013/4 – a 50% rise in 7 years brain cells, using simple scientifi c diagrams co.uk) and author of Drugs: including 200 aged 12 or under. Treatment and reasoning. My talks would be factual, non- Mind-altering drugs operate at these synapses. It’s just not worth it. She Addiction, substance dependence. averaged 150 days and involved counselling and patronising and regularly updated. Watching the They can mimic the neurotransmitters by shape, provides the secretariat for the Most drugs that can be abused – heroin, cocaine, support. Rehab specialists told us that cannabis faces of children change as understanding slowly increase the rate at which they are released, All-party Parliamentary Group alcohol, nicotine and cannabis – increase the addiction is the most challenging to treat. dawns as to how drugs work is very rewarding. block them or prevent them being recycled. on Cannabis and Children and amount of dopamine, the “pleasure” neuro- has been invited over the years transmitter in the brain. It’s also increased by What does this mean for children’s health? My greatest concern was then, and is now, The substance that gives the “high”, THC – to give evidence on prevention eating, listening to music, exercise etc. But two Cannabis can cause psychosis. We have seen this cannabis. It’s the most commonly used illegal tetrahydrocannabinol – mimics anandamide to various Home Affairs other substances are produced. One reduces the from long-term studies from birth, and the fact Select Committees on Drugs, drug – 2-3million users in the UK, 3.6million daily (Sanscrit for ‘bliss’), a neurotransmitter. Receptor brain’s natural production of dopamine so more that cannabis increases dopamine. The brains particularly that on Breaking users in the US – and its dangers are constantly sites for anandamide, and so THC, are in many the cycle. She is a former is needed to get the same eff ect; this creates of people with schizophrenia and psychosis downplayed. Up-to-date research fi ndings are areas of the brain and other cells of the body. biology teacher (30 years at tolerance to a drug. The other creates new have excess dopamine. The fi rst paper linking ignored, disputed and challenged by people, Unlike most other common drugs, THC is fat- a grammar school for boys), connections and receptor sites, making the brain cannabis and psychosis was published in 1845. some of whom are users. Most don’t read all soluble so persists in the fatty membranes of a member of the Prisons and more open to the drug. These cravings persist It’s simply a matter of how users they take at a or even any of the literature. Some cherry-pick brain cells: 50% will be there after a week and Addictions working party at the for a long time and come back even years after time – too much and they can suff er a psychotic the occasional paper to suit their purpose, 10% a month later. Traces are found in hair and Centre for Policy Studies and a a person has stopped. I tell children that they episode. Skunk users are almost 7 times more constantly quote it and argue that it proves their urine for weeks after that. This “clogging up” of former vice president of Eurad, can increase the release of dopamine naturally likely than hash users to suff er. This was work point despite many others that fi nd otherwise. the cells by THC interferes with the transmission Europe Against Drugs. She has with the brain in control, for example by jogging, done by Professor Sir Robin Murray and his team of other neurotransmitters so functioning of the been interviewed as a cannabis rather than stuffi ng it with random amounts of at London’s Institute of Psychiatry in 2009. He The normalisation of drug use is indefensible. whole brain is impaired. expert on national and local chemicals which then take charge with unknown was also involved in the work on CBD. television, radio and press. Only about 3% of the adult population in the UK and sometimes tragic outcomes. regularly use drugs so about 97 % do not; in the Potency has increased since the 19602/1970s. Some people have a genetic vulnerability to US, 1.1% of the population are daily users. Drug In the 1960s/1970s, the average THC content of Physical dependence happens when cannabis schizophrenia. In general, cannabis users are at use is clearly not the norm and this must be herbal cannabis was about 1-2%. In the UK’s last replaces anandamide. Production of anandamide least 2-3 times more likely to develop this life- constantly emphasised. potency report in 2008, the THC content of drops; it’s not needed. If a person then stops long condition than non-users.

52 Feb 2016 your library’s essential reference Feb 2016 53 Recovery Plus Recovery Plus

Scans of users’ brains show a decrease in volume, neurotransmitter, is reduced. Children’s brains Cannabis smoke contains more carcinogens than Exposure to second-hand cannabis smoke causes which might be permanent, in parts of the brain’s are undeveloped. They will not be fully mature tobacco. The smoke is inhaled deeper, held in mild intoxication, minor problems with memory grey matter (cell bodies), hippocampus (learning), till their 20s. The younger a person starts using the lungs for longer, and smoked down to the and coordination and, in some cases, positive thalamus (receives and passes on messages) and cannabis, the worse the damage. butt. About 3-4 times as much tar is deposited tests for the drug in urinalysis. Some participants amygdala (emotions). A decrease in white matter in the airways of the lungs. One joint in cancer did not pass the equivalent of a workplace drug has been seen in the cerebellum. School grades fall, As and Bs become Cs and terms equals 4-5 cigarettes. Rare head and neck test. Note the implications for driving. Ds. An average grade D student is 4 times more cancers occur in young people, previously seen Violence and aggression are usually linked with likely to have used cannabis than an average only in much older tobacco users. Collapsed Apart from driving, the combination of cannabis alcohol, with cannabis perceived as a ‘peaceful’ grade A and some miss out on university places. lungs, lungs riddled by holes and even young and alcohol is all too dangerous and common. drug. But a New Zealand study found young A teenage user continuing to smoke will lose people needing transplants are documented. If a person drinks too much, they can overdose male users almost 4 times more likely to be an average of 8 IQ points. The IQ of non-users Bronchitis and emphysema can result. and die. But often they are sick and get rid of violent than non-users – the risk for alcohol rises. A cannabis personality develops, users some. If they use cannabis as well, the vomiting was about 3. Violence is thought to be linked have fi xed opinions and fi xed answers. They fi nd The DNA in any new cells being formed in a refl ex is inhibited. Tobacco, alcohol and cannabis with psychosis or withdrawal. A Swedish study it hard to fi nd words, can’t take criticism, and body will be damaged by THC. THC speeds up can all lead to the taking of other drugs. If a found more suicides among cannabis users can’t plan their day. Trying to talk to them is the programmed cell death (apoptosis) of white person starts to smoke cigarettes, the technique than those who used amphetamines, alcohol futile. They and their families suff er from their blood cells, our defence cells. Fewer are made, of smoking is learned. A MORI poll found that or heroin – and the manner of death was more violent mood swings, houses get trashed, family some are abnormal – and protection against 50% of smokers had tried an illegal drug but only violent. Cannabis smokers are almost 20 times members get injured. At the same time, they are infection weakens. People are more vulnerable 2% of non-smokers. more likely to commit suicide by jumping than a lonely, miserable and feel misunderstood. They to disease, their illness worse and longer. non-user. Some high-profi le homicides have also are twice as likely to drop out of education. A Christchurch study from birth concluded been linked to cannabis use. An Australian report commented that, while THC shortens the life span of sperm cells, too. that the greatest single factor in progressing to alcohol and cannabis both carry health risks, the The online issue of Young men suff er infertility, even impotence. other drugs is the use of cannabis. And research Less dramatic but harming more young people overwhelming evidence is that cannabis is the Recovery Plus will on almost 30,000 French adolescents found are the eff ects on personality and academic drug for life’s future losers. also link you to the The birth weight of babies born to cannabis- occasional users 21 times more likely to proceed performance. Because THC persists in brain cells, author’s presentation using mothers is lower and they can have to other drugs, daily users 124 times! it interferes with other neurotransmitters. New “You have one real chance at education,” I problems with behaviour, brain function connections are made in learning and memory tell pupils. “Few children using cannabis, even at Recovery Plus 2015 (particularly problem-solving, learning, memory Because cannabis stays in the body for weeks, processes. During adolescence, this is particularly occasionally, will achieve their full potential.” – just click the logo and planning) as they grow. They are more likely tests will be positive even if a joint was taken important as there is normally a growth spurt of shown below when you to develop one of the commonest childhood a month ago. More employers test future these new nerve branches but their formation is As with alcohol, cannabis users shouldn’t drive. access us online: cancers, neuroblastoma, or one form of employees and their workers. Visas for countries impaired. Just one joint a week or even a month Over 24 hours after taking THC, airline pilots leukaemia, and to use cannabis at adolescence. like the US will not be issued to anyone with a will ensure the permanent presence of the drug. trying to “land” on fl ight simulators made errors r presen Babies often have mild withdrawal symptoms. cannabis conviction. fo ta k ti butthought they were fi ne. An average joint ic o l n Cannabis users can become anxious or apathetic. (20mg) is thought to have the same eff ect as C There is a rise in blood pressure and heart rate. I’ve surveyed the international evidence base The risk of deep depression is doubled even in being just over the drink-drive limit. Combining Heart attacks and strokes have been recorded, for the effi cacy of drug education. To learn what weekly users and can lead to suicides. In 2009, it alcohol and cannabis is 16 times more dangerous Click with paralysis. Boys who smoke cannabis before truly works – and it’s not harm ‘minimisation’ – was found that serotonin, the natural ‘happiness’ than either drug alone. puberty can stunt their growth by over 4 inches. click here in online issue for more information.

54 Feb 2016 your library’s essential reference Feb 2016 55 Recovery Plus Recovery Plus

Relapse back into addiction is not an overnight The seven warning event – it is weeks or months in the making. David Brown lists seven warning signs so that signs of relapse disaster can be prevented.

In the recovery movement, there is an adage: So as clinicians if we are not able to notice these “Relapse may be part of my story, but it doesn’t subtle shifts in attitude in our client we will need to be part of my recovery”. It sounds great: miss the subtle changes which left unchallenged there are many men and women who get clean will nearly always result in relapse. Let me tell and sober and stay so without ever suff ering you about a very recent case where I missed a relapse. I do not believe for a moment that the telltale signs completely. I had been lulled relapse needs to be part of the disease! into a false sense of confi dence. The person was a former male intervention client who Relapse is a process. What we examine here had done very well in four years of recovery. are the warning signs that become apparent as I had worked with other family members and About the author this process develops. This article cannot be he was the motivator in recovery coming to David Brown is a professional written without mention of the work of Terry other family members. He attended his 12-step interventionist, mentor, coach, Gorski, a pioneer known for his research and fellowship meetings assiduously, worked with public speaker and educator. contributions to this topic. a sponsor and sponsored other young men. So He is english, educated in to all appearances, the man was thriving. But he Cumbria, and has travelled the In my own case as a man in long-term recovery, I relapsed. What could have gone wrong? world extensively. am happy to report that I have never succumbed He is a licensed addictions to a return to substances. Having said that, The man was nursing a potential for untreated counsellor and a board one could imagine that life has been a breeze. sex addiction which was always bubbling registered interventionist. The reality is diff erent. I am reminded of the beneath the surface. Over spring break, with He is also a CSAT (c) as he Alcoholics Anonymous adage that we have all his family away and by turning his back on believes that increasing his knowledge in the sex addiction been given a daily reprieve contingent on the his 12-step support system, he smoked a little fi eld will help him with the that we can easily convince ourselves that it’s no a process, deterioration, a return to stinking maintenance of our spiritual condition. What marijuana which he had confi scated from his interventions he does. has that meant to me over the years? It means son some time earlier. We might ask why he David and his wife own big deal. We look the other way and start doing thinking. There are usually signifi cant behaviours that, subtly, “stinking thinking” reappears as I had not thrown it away. Soon he was using Avenues to Recovery in the other things. All of a sudden a huge domino falls which signal that the recovering person is at become disconnected. Stinking thinking means other substances again. In hindsight, this was Kansas City area. Avenues on us from behind, crushing us to fl oor, causing high risk for relapse. It is critical for anyone in that I revert to my old ways of thinking. I revert a classic stinking thinking act... the client was provides substance-abuse serious pain and injury in the process. We need recovery to understand these warning signs. So to a state of introspection and ego protection. secretly keeping the weed for a rainy day, it was treatment, intervention and to make the pain go away and we reach for old let’s look at these, with the help of Gorski. The people closest to me notice that something his secret and he was not going to share this recovery mentoring services. reliable – the magical substances that usually is changing, that something is going on and yet information with anyone. The good news is that David’s personal recovery dates helped us be without pain in the past. We’ve The following are seven warning signs that you when challenged all they get back from me is the he has responded well and is back on track. from 1 August 1982. now started drinking and drugging.” might be heading toward a relapse. fact that “I am fi ne”. I learned over the years that, when this state is entered and not addressed, How would Gorski describe what happened? We now understand the sad truth which is that 1. You stop doing what you need to do to stay it becomes a matter of time before a return to “So here we are, moving along in recovery. We many people who try to recover from addiction abstinent. use is guaranteed. If this were to happen, I would tip over one small domino. No big deal. But that to alcohol or drugs do not stay non-stop in The recovering person stops doing the things have been guilty of thinking my way out of domino hits the next, then the next. A chain recovery. Although relapse may be common, that were doing to stay clean and sober. They recovery and back into active addiction. reaction starts. The fi rst dominoes are so small rarely does it occur without warning. There is don’t have time. Their priorities change. They

56 Feb 2016 your library’s essential reference Feb 2016 57 Recovery Plus Recovery Plus

“Sometimes we act like we did when drinking or drugging – even without the drink or drug. A Co-Occurring Disorders Treatment Program on 35 beautiful acreacress This is a warning sign. Treat it as a red flag Adult Program and review what is happening in your life.” • Group & Individual Therapy • EMDR • Psycho-Education Groups • Nutritional Consulting • DBT • Relapse Prevention • Biofeedback (Heartmath) • Intense Family Therapy • Somatic Experiencing • Fitness Consulting/Yoga/Tai Chi

Medical Services/Assessments Issues we address include... • Onsite Detox Facility • Trauma The online issue of make excuses. People who are successful in 4. You start thinking that maybe just one drink • Psychiatric Evaluation • Substance Use Disorders recovery stay connected so that they hear about or one pill wouldn’t hurt. Recovery Plus will (Minimum once per week follow-up) people who give up on the discipline – and the It you fi nd you are talking yourself into “just • Depression also link you to the COTTONWOOD • Comprehensive Medical Examination • Anxiety author’s presentation dire consequences, which they do not want to one”, this is one of the most obvious signs of an emulate. We might stop cutting back on our impending relapse. Again from a personal point tucson (Minimum once per week follow-up) • Eating Disorders at Recovery Plus 2015 therapy sessions or meetings and no longer of view, this is always a lie. I never ever took only • Neuropsychological Testing • Grief and Loss – just click the logo follow helpful suggestions. one drink or just one hit, pill, line, pint, bottle • Psychological Assessment • Family Conflict shown below when you etc. So why think now would be diff erent? The 1-800-877-4520 • Psychopharmacologic Assessment • Low Self-Esteem access us online: 2. You start romanticising the days when you rule of thumb is that those who relapse pick up www.cottonwoodtucson.com • 24-hour Nursing Coverage were abusing substances. right where they left off . It might take a few days Most addicts had a time during which they had or weeks, but you will rapidly be in the same res r p ent fo a few consequences for substance abuse. They place you were when you last quit drinking or k ti ic o l n C might even have had fun. However, those times using drugs. And it will accelerate. were long gone by the time you got clean. This is where euphoric recall can kick in. This happens 5. You begin seeking out old friends from your Click when the brain chooses only to bring to mind substance abusing days. the fun times or highlights of past drug use. I can see my old using friend. I will just drink The user will not remember the pain, sickness, lemonade. I will white knuckle it through the destruction, disappointment or trapped feelings get-together. You might excuse this as just trying of addiction – only the good times. If we begin to fi nd out how old friends are doing, but if you to miss the good times, we are heading down start seeking out old drinking buddies or people regory the wrong path. we used to drug with, we are heading into G onsulting dangerous territory. A familiar metaphor is that, C 3. You start acting the way you did when using: if we spend enough time in the barber shop, we shine your light self-centred and a legend in your own mind. will eventually get a haircut. Sometimes this is called a “dry drunk”. We act like we did when drinking or drugging, even 6. You slowly but surely remove all those COACHING & MARKETING without the drink or drug. I have described what elements from your life that keep you anchored happens to me in a paragraph above. I have and balanced. FOR learned by my own example that addicts have Maybe we stop keeping your journal and stop a tendency to personalise things and overreact. calling healthy friends. We remove things that MENTAL HEALTH SERVICES We sometimes get frustrated by the smallest of keep us calm and centred. We might say we are things and we want what we want when we want getting lazy. We might also notice we are slipping it – which is always fi ve minutes ago. If you have back into old deceptive patterns; we start lying Katie Gregory, MA, CIP. been working on this behaviour then start to see to loved ones to keep them from challenging [email protected] it reappear, this is a warning sign. Treat it as a red us. We are not taking care of our emotional, fl ag and review what is happening in your life. spiritual and physical health. We are beginning (+1) 310 699 6885

58 Feb 2016 your library’s essential reference Feb 2016 59 Recovery Plus Recovery Plus

“We tip over one small domino – a drink, a drug, dŚĞEĂƟŽŶĂůƐƐŽĐŝĂƟŽŶ an acting out – no big deal. But that domino ĨŽƌŚŝůĚƌĞŶŽĨůĐŽŚŽůŝĐƐ hits the next, then the next. A chain reaction pushing us into relapse has been started.”

to go through the motions, to just hang on. If screams at me as it always has a better idea for we are not moving forward in recovery we are me. I need to remind myself that my addiction perpetually going backwards. wants me dead.

7. You are extremely defensive when anyone So instead of wishing everybody would leave brings up the changes in your behaviour and me alone, I realise that I am actually being attitude. encouraged to get back to work, to get back into My fi rst clue that something is amiss comes the middle of my recovery instead of sitting on from either my wife Lucy or one of my children. the edges. Once again, I change direction and It starts with one of those seemingly-nothing move towards the sunlight of true recovery. throw-away comments that they make. Is everything OK? Are you feeling alright? Do you Many a time those in recovery have heard stories have a lot on your mind? No, I am not feeling where someone says “I don’t understand; I just any of those things. I don’t actually know what I suddenly heard myself ordering a drink”. In truth, am feeling. I wish you would just leave me alone. if that person looked back over the past few weeks and months, they would see this was the What I now understand is that my addiction is natural result of a progression toward relapse. I still there. It resides at my core. It is always there. don’t want to be one of those people. Maybe, The voice is always there. Sometimes it is silent, by writing this article, we can help someone else sometimes it whispers and in times like this it from going down that path.

Affected by a parent’s drinking? #youarenotalone FREE Helpline 0800 358 3456 [email protected] @NacoaUK

Registered charity: 1009143 nacoa.org.uk

60 Feb 2016 your library’s essential reference Feb 2016 61 Recovery Plus RecoveryRecovery PPluslus

Over 90% of structured interventions can be Interventions: the successful in persuading a reluctant addict into treatment - they also create a shield for troubled historical perspective family members. Rebecca Flood explains.

The online issue of In the 1900s, there were high mortality rates not blame or anger. Families can highlight to the Recovery Plus will from what was then called alcoholism. In the addict that they love them but they hate their also link you to the 1930s, psychiatry defi ned uncontrolled drinking disease. author’s presentation as an emotional/psychological problem. Then in 4. All information presented should be tied to 1956, the American Medical Association for the the alcoholism, not other problems or concerns at Recovery Plus 2015 fi rst time recognissed alcoholism as a permanent that might be occurring. – just click the logo and fatal disease with defi ned symptoms. In the 5. Statements should be backed up by evidence, shown below when you 1960s, Dr Vernon Johnson studied 200 recovered statistics, relating stories (in a factual manner) – access us online: alcoholics with an attempt to fi gure out why and that evidence should be specifi c. they chose to quit. 6. The team has to agree that the goal of the intervention was to lead the alcoholic into a res r p ent fo a He found that most of these alcoholics quit residential setting of treatment. The goal is not k ti ic o l n C when there were multiple disruptions or a presented as a punishment, but as an off er of variety of negative consequences in one or more assistance. of their major life areas, such as work, family 7. The team can off er this help with their Click and so forth, rather than a defi ning moment presentations to the alcoholic in an offi ce at a such as a car accident or visit to the emergency meeting that everybody was openly invited to room. As a result, he developed and birthed the attend. Johnson model of intervention. From Johnson’s day to this, there has been an Dr Johnson was an Episcopal priest who devoted ongoing evolution of the intervention process. r presen his life to the study of then alcoholism (known A variety of models and perspectives continue fo ta k ti ic o to us today as substance-use disorders). He to assist in getting thousands of individuals help l n C is best known for developing the original for substance-use disorders over the last six intervention model, but also for the landmark decades. This is not new, even if it feels like it. Click book that still sells today, I’ll Quit Tomorrow, which began distribution in 1973. Jeff and Debra Jay are the co-authors of Love First, a Family Guide to Intervention. Together, The Johnson model had seven components... they developed what they call the Love First 1. An intervention specialist heads up the team Intervention Process, which is probably the to help the addict. The team is made up of most well known continued take-off from the family members, friends and co-workers. Johnson Model. Ed Storti, the author of Heart to 2. In a planning session held with the Heart, created the Storti model of motivational interventionist and team, they plan out how to intervention. Wayne Rader and Ed Speer lovingly share exactly what they would like to developed the Family Systemic Invitational say to the alcoholic. model of intervention, which was seen as the 3. All information focuses on concern and care, fi rst invitational model. This approach involves

62 Feb 2016 your library’s essential reference Feb 2016 63 Recovery Plus Recovery Plus

“Intervention is not a coercive process. It is not shame-based. It is not an ambush or uncaring attack... The goal is healthy productive living for the individual and the family members.”

changing of the relationships that surround planned interaction between an individual and variety of services could also be off ered, such information about the nature and dynamics the addicted person, which leaves them no a group whose sole purpose it is to modify the as educational consultation, being an author, of substance use disorder, being the one to longer supported by old enabling behaviours, individual’s dependence on a harmful substance developing marketing strategies, and off ering describe the principles and specifi c techniques thereby forcing change in the addict’s action or or practice. It is a process of invitation, other clinical services such as individual and about the intervention model being utilised, behaviour. education and preparing family and friends who outpatient services. Interventions can also be in selecting and equipping the family members make the commitment to initiate change in the context of a larger organisation that deliver with information about each of these roles It diff ers from the Johnson model, because it their, or a loved one’s, life. an array of addiction services such as detox, within the intervention process, listing the is invitational and educational. The invitation is residential, and/or outpatient. various alternatives in a continuum of care for to all loved ones (including the one that suff ers The goal is to return to healthy productive living all of those involved in the process, and coaching from a substance use disorder) to attend a for the individual suff ering, and for each of the About the author As the evolution of addiction treatment and modelling throughout the process. family workshop. It is educational because the individual family members. services have evolved, we have found that these Rebecca Flood MHS, LCADC, interactive family workshop is held so that all NCACII, BRI II is immediate techniques can be used to help all individuals You will start to become familiar with these at participants can learn about the disease, their The truth is that intervention is a process past president of AIS, the with substance-use disorders, family members Interventions Plus on 23 May in London (after family system, their family of origin and the founded on love and honesty. I have always Association of Intervention that suff er from codependency, people with Recovery Plus on 22 May). I hope that this impact that the historical family system has defi ned family intervention, regardless of the Specialists and sits on the eating disorders, gambling addictions, mental- overview has provided you a snapshot of the on them and their current relationships with model being used, as a process in which you board of NAATP, the National health issues, and other process/behavioural roots and origins of intervention, as well as the everyone else in the family. present an individual suff ering from substance- Association of Addiction addictions and compulsive behaviours. evolution. My favourite saying has everything to use disorder and their signifi cant others with Treatment Providers. She is do with interventions: you can lead a horse to Another well known model is the Arise model, objective information in a caring way with the CEO of New Directions for The role of the interventionist remains water, but you can’t make him drink – however, known as a relational intervention and a goal of motivating each of them to accept Women, headquartered in consistent through all of the models: providing you can make him thirsty. sequence of engagement, and developed by Dr appropriate help and/or treatment. It is always Los Angeles and working internationally. Judith Landau. This model integrates traditional wise to remember that someone who suff ers In her nearly four decades of family therapy, Johnson Intervention techniques, from substance-use disorders and their loved experience in the health care and DiClemente and Prochaska’s research ones are blind to their disease (as it is a disease industry, she has demonstrated dealing with motivational stages of change. of denial). They need to be motivated in a way expertise in programme This model is also known as a collaborative that will allow each of them to seek immediate development, implementation process; from the initial invitation, the process help. and evaluation, starting when conveys respect and establishes the ground she was with Seabrook House rules for openness. In addition, it acknowledges The overarching fi ve ethical principles that each in New Jersey for over 25 years, that mistrust will be a major issue if things are of these models hold true are: to do no harm, becoming its vice president of created in secret, and assures the individual make things better, respect others, be fair and treatment services. suff ering from a substance-use disorder that be compassionate. She is a Licensed Alcohol and they can trust family and friends. Drug Counselor (LCADC), a Historically, the arenas in which one can practice Nationally Certifi ed Drug & Alcohol Counselor (NCAC II) It is important to note that intervention is intervention work have been: private practice or and is certifi ed as a Drug & not a coercive process. It is not shame-based. a larger organisation. In a private practice setting, Alcohol Counselor (CADC II). It is not an ambush or uncaring attack. It is a delivering intervention as a single service, a

64 Feb 2016 your library’s essential reference Feb 2016 65 Recovery Plus Recovery Plus

How can music actively assist in the treatment Brainwaves: music, of addiction and trauma? John Levine links music to brainwaves, while a therapist reports addiction, trauma how this helped his patients to recover.

How can music actively assist in the treatment as I read that it could help to lessen and/or My fi rst experiment, Silence of Peace, was tested states that “Often we cause ourselves suff ering of addiction and trauma? You might already have manage negative thoughts. During the on a patient using an EEG machine. It was shown when we ache for something that lies out of witnessed how a particular piece of music can be introduction in the fi rst lesson, we were shown that the brainwaves of that patient moved to our grasp or cling in vain to something that has used to sensitively remind a client of particular how brainwaves slow down as we get into a the alpha state within minutes. already passed away. Sometimes, the wanting memories – when introduced skillfully into the deeper state. Feeling lifted, as if a heavy load had mind involves tightly holding on to something therapeutic process, music can allow that client been taken from my shoulders, was the eff ect Subsequently, a test was conducted by researchers negative: an unwholesome belief about how to have the ability to experience a degree of of my fi rst meditation lesson. I experienced a at the University of Cambridge. In a class of things ought to be or should have been, or an catharsis round that memory. signifi cant, positive change in my mental and disruptive teenager boys, which the teacher unwholesome emotion such as anger, sadness, emotional state. I wanted to share this with my called “my class from hell”, the results of playing or jealousy”. It is exactly these states of mind About the author Or you might have played soothing classical or father, who was by now in his last months of life, Silence of Peace during lessons were a drop of that alphamusic is being found to alleviate. other music in the background during sessions, in intensive care. 87% in talking and a 108% increase in academic John Levine has been creating original music and playing to create an atmosphere of calm, conducive to results. And so began the infl ux of evidence A Cambridge-based drug addict in recovery piano since he was six. He allowing the client to feel safe and supported. The frustration of my father not understanding, that the music slowed down the brainwaves noticed that alphamusic greatly assisted in graduated as a composer from nor being receptive to what I had to share with to the calmer alpha-state, allowing listeners to dissipating the fears that usually would drive her Sydney University, Australia But the placing of specifi c music usually requires him about the benefi ts of meditation, and experience a variety of benefi ts. to relapse. and spent several successful you to know a certain amount about the client the fact that this information came 20 years Amanda Gordon, years in commercial music, and their circumstances. While calming music too late to help him, drove me to question In an article published in Psychology a past working with bands like can create a feeling of safety, it can also be a meditation itself. There must be a way, I Today (16 April 2010) entitled president INXS and Midnight Oil and distraction to the great well of emotions in thought, to allow a person to experience the Mindfulness, meditation of the writing jingles for Saatchi and turmoil beneath the surface, which are often the benefi ts of meditation without that person and addiction, Dr Australian Saatchi and the Coca-Cola very thing we want to support the client in being having to learn or understand meditation, Ronald Alexander Psychological Company. Trained originally as able to safely access and heal. nor perform any particular exercise. Even if it an electronic engineer then as a classical composer, John was too late to help my father, I was driven to has also studied psychology Many years ago, my father was found to be continue this enquiry in the belief and hope and the physiology of hearing. suff ering from a myriad of physical illnesses, all that I could be able to help prevent others His alphamusic helps those of which the medical experts confi rmed were from befalling a similar fate. battling to balance sensory and related to and/or caused by stress and anxiety. emotional overload. He was not an addict per se but he was addicted Having a degree in classical music composition, to anxiety and tension, and this eventually music was my medium, so I decided to create a caused him to suff er from diverticulitis, diabetes, composition which would induce the brainwaves heart disease and a stroke, eventually passing to slow down from the beta stressed state to away when he was 58 years old. the calmer alpha state, and then even below, to theta and delta. My aim was to create a When I saw my father suff ering in this way, I was special type of music which would induce the determined to learn as much as I could about meditation eff ect of slowing the brainwaves how the brain could keep you relaxed and stress down, in the belief that similar benefi ts would free. This journey took me to learn meditation, then be forthcoming for the listener.

66 Feb 2016 your library’s essential reference Feb 2016 67 Recovery Plus Recovery Plus

Example of exhibitor Society, noticed that while using alphamusic calm atmosphere at appropriate stages of the at Recovery Plus: during therapy sessions her clients reported group as there is a strong psycho-education feeling more relaxed and “in the moment”. component in learning about the body’s John will be ‘meeting She stated that “clients remained focused and reaction to stress and teaching mindfulness or and greeting’ and calmer, even when talking of quite traumatic self soothing strategies. I replaced Brian Eno’s showing samples of his events”, and while not being re-traumatised. ambient music with an alphamusic recording work at Recovery Plus during one session and found a profound change in the Hilton, London In 2012, I met Richard Scanlan, a senior specialist in the patients’ response. I was intrigued. on 20 May. therapist at Castle Craig Hospital who had To publicise your services For practitioners been using alphamusic to great eff ect with his “A US soldier described it as ‘the education wishing to learn more clients, in particular when used in conjunction made more sense... I felt calmer… [and] was directly into the hands of our 5-6,000 readers about the application with EMDR, eye movement desensitisation and able to visualise a more positive future’. Other and into Inboxes with a guaranteed 2million views a year, of alphamusic to help reprocessing. Afterwards, he decided to utilise members reported similar fi ndings. alleviate stress and alphamusic in a group therapy setting, to see email [email protected] related health issues, what further eff ect it might have in complement “I had been working with this patient individually visit his website to his treatment of addiction and trauma clients. and was aware of his deep complex trauma and www.silenceofmusic. diagnosis of post-traumatic stress disorder. He com or email info@ THE THERAPIST’S CASE HISTORY. had received EMDR and it was not unheard-of Kingsley Napley LLP is an internationally silenceofmusic.com Below, Richard Scanlan describes the eff ects of for patients to have such moments of clarity. He alphamusic on patients in a trauma group... stated that the music had a direct infl uence on recognised law fi rm based in central London him. I continued to use alphamusic and heard protecting the interests of its clients in a “For fi ve years, I had facilitated a trauma group this consistently reiterated by other members. wide range of aspects of their private and at Castle Craig Hospital. The group addresses the professional lives. We are renowned for our complex issues of treating traumatic stress and “I tried ambient music with the same group integrity and expertise in supporting clients at often critical and highly sensitive times of their lives. We are trusted by our addiction simultaneously in a 12-step rehab. Our and they reported calmness but not the same clients, our peers and intermediaries to know what’s at stake and what it takes to get the best outcome. We understand that lives members included combat veterans, survivors of profound sense they got from the alphamusic. can be dramatically affected by addiction and we support individuals or family members when it leads to issues such as: sexual assault and physical violence. So this is now integrated into the group work. • allegations of a crime We need more scientifi cally validated studies on • problems in the work place and a professional career might be at risk “The aim of the group was to learn skills to cope the music...” • public and personal reputation is at stake with the ‘here and now’ and problems associated • relationship and family breakdown with traumatic experience. Individual members • protecting their assets and wealth. receive cognitive behavioural therapy and EMDR Personal relationships and individuals in crisis require 360° support. We cooperate closely with other professionals who are outside the group setting. The group is seen able to support our clients and the work that we do with them. The results we achieve for our clients must be measurable in as a sanctuary or a safe place to tolerate the terms of both their fi nancial and emotional security and it is important to us that we help them get back on track. eff ects of the past, not revisit them. Soon after setting up the group I discovered alphamusic. I Kingsley Napley LLP: Knights Quarter, 14 St John’s Lane, London EC1M 4AJ Telephone: +44 (0)20 7814 1200 had previously used ambient music to create a Authorised and regulated by the Solicitors Regulation Authority www.kingsleynapley.co.uk

68 Feb 2016 your library’s essential reference Feb 2016 69 Recovery Plus Recovery Plus

Because of the data which Recovery Brands What stops people collected on the stigma of recovery (see below), it launched the Lives video challenge – and a from seeking care? chance for 2 people to win $5,000/£3,500 each.

According to the Substance Abuse and Mental Lives Challenge participants will receive a Pura THE WINNING FORMULA: Health Services Administration, addiction aff ects Vida bracelet, designed by Recovery Brands, as a 1 Register at https://herox.com/ about 23.5million americans every year, and reminder to spread the word and reduce stigma sign-up?next=/EndTheStigma. about 11% receive treatment. While there are (part of the purchase price goes to charity). 2 Shoot your video: you have many factors that contribute to this addiction- until 23 May 2016 to create a treatment gap, stigma is one of the largest: Two awards will be granted at the close of the 1-3 minute video. Recovery Brands’ research found that stigma is Lives Challenge: The Judge’s Choice Award and 3 Upload your video to cited as the second-largest barrier for people The People’s Choice Award. Each is paired with a YouTube or Vimeo. considering treatment, surpassed only by cost. prize of $5,000. 4 Copy the YouTube or Vimeo The company’s fi ndings also unveiled that URL from step 3 and paste it in 82.2% of people struggling with addiction have To determine the Judge’s Choice Award, your HeroX campaign profi le. felt stigmatised, and 73.9% of them felt most submissions will be vetted on creativity, impact, stigmatised by family members. clarity and quality by a panel of third-party judges. The panel includes Chris Henderson, “Despite eff orts of the addiction treatment lead guitar player of Three Doors Down; Justin industry to make treatment more readily Luke Riley, president and CEO of Young People accessible, research and personal experience in Recovery; David Sheff , author of New York show us that stigma remains one of the largest Times best-seller Clean; and Anne Fletcher barriers to seeking help,” said Melanie Haber, MS RD, an award-winning health and medical vice president of brand development. “Until writer, New York Times best-selling author, we change the conversation and perception speaker, consultant, and author of Inside Rehab. surrounding addiction and behavioural health Each panelist has intensive personal and/or disorders, lives will continue to be lost too soon. professional experience with addiction and its We’re committed to eliminating that barrier by associated stigma. bringing a new, empowering message through the Lives Challenge.” The video that receives the most public votes in a set period of time will be presented with The The Lives – Leveraging Impactful Videos to End People’s Choice Award. Stigma – Challenge is a three-month public video contest, run by Recovery Brands until 23 Early supporters of the Lives Challenge include May 2016. It is seeking video submissions that Young People in Recovery, Kula for Karma, Pura will reduce the stigma surrounding the disease Vida, National Eating Disorders Association, and encourage people struggling with addiction ATTCK, A New Path, Moms United to End the to seek treatment. Participants have a chance War on Drugs and HealMyPTSD.com. Join them! at winning $10,000 (£7,000) as well as a featured video placement on the company’s fl agship For more information on the competition, you website, Rehabs.com. can visit http://recoverybrands.com/lives.

70 Feb 2016 your library’s essential reference Feb 2016 71 Recovery Plus Recovery Plus

Self-help groups Contact details for mutual-aid groups, endorsed by the World Health Organisation and NICE.

UK contacts. Addictions Anonymous Coda - Co-Dependents Anonymous UK contacts. Emotions Anonymous Marijuana Anonymous US contacts 020-7584 7383 for people working to end patterns of US contacts www.emotionsanonymous.org for those who wish to stop using marijuana Adult Children of Alcoholics dysfunctional relationships and develop World meeting list: www.allone.com/12/ea www.marijuana-anonymous.co.uk PO Box 1576, London SW3 1AZ functional and healthy relationships Families Anonymous www.marijuana-anonymous.org Resources in other www.adultchildren.org www.codependents.org Resources in other for relatives & friends of people with drug Muslim Youth Helpline* countries will be http://coda.org countries will be problems confi dential counselling service for young added. Al-Anon... added. for families and friends of problem drinkers – Computer Gaming Addicts Anonymous www.famanon.org.uk muslims in need; many languages spoken including after they quit cgaa.info www.familiesanonymous.org www.myh.org.uk ...and Alateen Cosa (was Codependents of Sex Addicts) Food Addicts Anonymous Nacoa* for people aged 12-20 aff ected by someone for recovery from sexual codependency www.foodaddictsanonymous.org (National Association for Children of Alcoholics) else’s drinking. www.cosa-recovery.org Food Addicts In Recovery Anonymous www.nacoa.org.uk www.al-anonuk.org.uk Cruse Bereavement Care* help with food obsession, bulimia, overeating or www.nacoa.org www.al-anon.org www.cruse.org.uk undereating. Narcotics Anonymous Alcoholics Anonymous Crystal Meth Anonymous www.foodaddicts.org for drug problems www.alcoholics-anonymous.org.uk www.crystalmeth.org Gamblers Anonymous www.ukna.org www.aa.org World meeting list: www.crystalmeth.org/cma- for gambling problems www.na.org Addicts Anonymous meeting/cma-meeting-directory.html Gam-Anon Net* www.alladdictsanonymous.org Debtors Anonymous for relatives of those with gambling problems internet addiction in all forms Bullying* for problem debting, compulsive spending, For information on both: www.netaddiction.com & National Bullying helpline: under-earning & other money/work issues 020-7384 3040 Nicotine Anonymous www.bullyonline.org www.debtorsanonymous.org www.gamblersanonymous.co.uk www.nicotine-anonymous.org www.gamblersanonymous.org CITA* - Council for Information on Tranquillisers Depression Alliance* Obsessive Eaters Anonymous & Antidepressants Self-help groups, workshops & conferences. Heroin Anonymous www.obsessiveeatersanonymous.org www.citawithdrawal.org.uk www.depressionalliance.org http://heroinanonymous.org/HAUK.html www.heroin-anonymous.org OCD action* Christians In Recovery Depressives Anonymous* information & support for people with obsessive www.christians-in-recovery.org 0870-7744 320 Heroin Helpline* compulsive disorder 020-7749 4053 (offi ce hours) Co-Anon DrinkLine* www.ocd-uk.org for families and friends of cocaine addicts 0800-917 8282 HIV Anonymous Online Gamers Anonymous www.hivanonymous.org www.co-anon.org.uk Drug Addicts Anonymous www.olganon.org/home www.co-anon.org www.drugaddictsanonymous.org.uk Internet & Tech Addiction Anonymous Overeaters Anonymous Cocaine Anonymous www.daausa.org www.netaddictionanon.org for problems with food, including anorexia for cocaine/crack and other substances Eating Disorders Association* Love Addicts Anonymous www.oagb.org.uk www.cauk.org.uk www.edauk.com www.loveaddicts.org www.ca.org

72 Feb 2016 your library’s essential reference Feb 2016 73 Recovery Plus Recovery Plus

Self-help groups Contact details for mutual-aid groups, endorsed by the World Health Organisation and NICE.

US contacts Pan fellowship Spear* UK contacts. any dependency/codependency with emphasis Supporting people who self-harm New Directions for Women (NDFW) in California’s Costa Mesa, near Newport Beach’s Back Bay and on steps 4&10 www.projectspear.com Nature Preserve, was founded in 1977. We help women of all ages, pregnant women in any trimester, and Resources in other 7pm Fridays - Methodist Hall, Fulham Broadway, Survivors of Incest Anonymous women with their children up to the age of thirteen. We have expanded in the last four decades to become countries will be London www.siawso.org added. an internationally respected, clinically effective and award-winning 42-bed residential rehab which is State Pills Anonymous Talking About Cannabis* licensed and certified. Commission on Accreditation of Rehabilitation Facilities (CARF) accreditation dem- www.pillsanonymous.org Supports families of cannabis users onstrates our core value of putting patients at the centre of care, and we have high recovery rates for those World meeting list: www.pillsanonymous.org/ www.talkingaboutcannabis.org meetings/fi nd-a-meeting who complete its personalised recovery plans. We accept most major insurances such as Aetna, any and all UK self-help* PPO’s, and insurances in networks of: MHN, United Health Care, and Value Options. In addition, we offer Samaritans* website containing hundreds of listings for anyone feeling low, depressed or suicidal www.ukselfhelp.info partial scholarship opportunities for those needing financial help. Contact our caring intake coordinators www.samaritans.org for more information any time of day, and to arrange the finances for your loved ones by going to our web- Underearners Anonymous S-Anon www.underearnersanonymous.org site and submitting an inquiry at www.newdirectionsforwomen.com for people aff ected by someone else’s sexual behaviour Violence Initiative* www.sanon.org off ering violent people a chance to change cardiff [email protected] – meetings, one-to-one sessions, confl ict resolution training Sex Addicts Anonymous www.tviccv.org www.sauk.org https://saa-recovery.org Workaholics Anonymous Celia 01993-878220 Sexaholics Anonymous or George 020-7498 5927 for those who want to stop their self-destructive www.workaholics-anonymous.org sexual thinking and behaviour 020-8946 2436 * Resources other than 12-step groups – www.sa.org check if free of charge. Sex & Love Addicts Anonymous (The Augustine Fellowship) www.slaa.uk.org www.slaafws.org Sexual Compulsives Anonymous www.sca-recovery.org/ Shopping Overshopping* www.overshopping.com

74 Feb 2016 your library’s essential reference Feb 2016 75 Recovery Plus Recovery Plus

Researcher Laura Graham finds optimism even Laura loves, among losses of lives from drugs and closures of rehabs. “As a sector, we need to become Laura loathes... more united,” she urges.

2015 was a dismal year for recovery. Figures & Houses which operates as a Community One such event was hosting a meeting with released in 2015 showed a dramatic rise and an Interest Company, with the mission to “support, the Recovered Users Network chair, Boro Goic unprecedented number of drug-related deaths empower and employ people” furthest away (see photo below right), on his fact-fi nding trip in Scotland and England for the previous year. from the housing and job market including those over to England from Sarajevo last October. Figures released by the Samaritans in 2015 show aff ected by addiction. Goic, through his work at RUN, is a member of that, even with a caveat of under-reporting, the the Civil Society Task Force working towards suicide rate for men has never been higher. Founded by police Sergeant Steve Hodgkins, the United Nations General Assembly Special (currently on secondment from Lancashire Session on Drugs in New York in April 2016. This Alongside these tragic loses, some of the most Constabulary), Jobs, Friends and Houses works will be the most signifi cant opportunity to hold established treatment providers in the UK closed to renovate derelict properties using trades About the author a global-level and in-depth discussion on drugs their doors for the fi nal time. This included people they have trained in a broad range of in the past 20 years and for the fi rst time will Laura Graham is an Bournemouth- based Quinton House in August construction skills and qualifi cations. Many of independent consultant discuss addiction recovery at great length. after 30 years of providing treatment and the properties, when renovated, are off ered undertaking research, strategy helping thousands of people to regain their lives up to the rental market and can provide and policy development, and It is vital that this important meeting captures after active addiction. safe accommodation for people in recovery writing in the areas of addiction as many recovery voices as possible and Goic is with access to a supportive network via the recovery, mental health and keen to hear from you! To get involved simply Without question, harsh cuts in funding across organisation. Such a simple idea is delivered off ender management. She join RUN (at no cost) at [email protected]. the fi eld are a major factor. Indeed, the HM superbly by the team involved. is the founder of Cure the Inspectorate of Prisons, in his annual report NHS – Lambeth which works to 2016 has to be a better year. We are in danger of considered reduced staffi ng levels (as the result 2015 also saw the opening of the Cascade Coff ee improve NHS provision locally losing more of the smaller services which, despite of reduced funding) to have led to increasingly Shop in Brighton which has quickly established ([email protected]). proven track records of success in helping people restricted regimes across the prison estate and itself as central to the strengthening of a to initiate and sustain recovery, are currently gasping for breath waiting to have seriously undermined prison safety and recovery community in the area. It was born for the crumbs of funding to fall off the table in their direction. With a any opportunity for a “rehabilitation revolution”. from the idea of a small but determined team of shrinking range of treatments available, there will be fewer options for Slashed budgets in areas closely linked to the local people who together organised a national people to access when they need help to get well. fi eld, in areas vital to recovery such as aff ordable recovery walk in 2012 – after which they knew housing, the mental health “system”, and access there was a need for a meeting place in the area Additionally, with less money being to purposeful activity have impacted greatly where recovery could be visible and accessible. made available, the more competitive on the most vulnerable. As we go into 2016, I providers will become at a time when, as a fear that we can only expect more funding cuts In February 2015, after a great deal of hard work, sector, we really need to become aff ecting most deeply the vulnerable people founder and manager Pete Davies offi cially more united. The time whom our fi eld seeks to serve. opened the doors of Cascade Coff ee Shop. The to do so is now and café off ers more than coff ee and cake. There’s I choose to remain As we refl ect on last year, there were some a space for mutual aid groups, an out of hours optimistic. glimmers of hope at grassroots level that have safe space, entertainment nights, a choir, theatre thrived despite diffi cult times. This includes the groups and all manner of other events to draw Turn to page 47 for award winning Blackpool- based Jobs, Friends the community in and keep them coming back. Laura’s loathes

76 Feb 2016 your library’s essential reference Feb 2016 77 Recovery Plus Recovery Plus

Treatment centres Need help for yourself, a loved one, an employee or client? Start with this list of resources.

The addiction- treatment and recovery centres on these pages are based in the UK.

When you visit our sister online journal, Ark House Broadreach Bosence Farm Kenward The Manor Clinic Mount Carmel you can click on photographs of each rehab to go direct to Admissions Team: 01723 371869 Admissions Team: 01752 797102 Admissions Team: 01736 850006 Admissions Team: 01622 814187 Admissions: 0330 024 0705 Admissions: 020 8769 7674 its website. email form on website admissions@ [email protected] [email protected] email form on website [email protected] Ark off ers 1st-stage and 2nd- broadreach-house.org.uk Bosence off ers rehabilitation Off ers drug and alcohol Treats alcohol, drugs including Off ers residential, day and If you have specifi c stage care and aftercare, using Group consists of Broadreach, using the 12 step model, detox services, mental health and prescription drugs, gambling quasi-residential programmes requirements, such psychodynamic therapies, REBT, Closereach, Longreach and and stabilisation to anyone resettlement of off enders and co-occurring disorders – and counselling; detox can be as gambling or eating CBT, 12 steps, Gestalt, etc – Ocean Quay – details at aged 18 or over – details at in residential and supported details at organised – details at disorders, a search www.arkhouserehab.co.uk www.broadreach-house.org.uk www.bosencefarm.co.uk housing – details at www.themanorclinic.com www.mountcarmel.org.uk facility will soon be 15 Valley Rd, Scarborough, 465 Tavistock Road 69 Bosence Rd, Townshend, www.bosencefarm.co.uk Mansbridge Rd, Southampton 12 Aldrington Rd, available. North Yorkshire YO11 2LY. Plymouth, Devon PL6 7HE. Hayle TR27 6AN. Kenward Rd, Yalding, ME18 6AH. SO18 3HW. London SW16 1TH.

To add your facility to these pages, email TheTeam@ DBrecoveryresources.com

Castle Craig Charter Harley Street Hebron Trust StreetScene Withersdane Hall Brynawel House

Admissions Team: 0808 231 8168 Admissions Team: 020 7323 4970 Admissions Team: 01603 439905 Admissions Team: 01202 467 661 Admissions: 0845 053 1785 Admissions: 01443 226 864 International: +44 1721 788 006 email form on website [email protected] [email protected] [email protected] email form on website [email protected] Counselling and psychotherapy Looks at the multiple and Group includes Allington Part of Promis which off ers 24- Only residential rehabilitation Treats alcohol and drug for addictions, eating complex problems which lie House, Cornerways, Francis hour medical supervision, service in Wales with cognitive addictions, complex illnesses, disorders, trauma and family behind dependency, including House and Unity House – 1st-stage, 2nd-stage and behaviour therapy at its core – gambling, trauma, PTSD & more relationshipsy – details at past trauma – details at www.streetscene.org.uk extended care plus aftercare www.brynawel.org – details at www.castlecraig.co.uk www.charterharleystreet.com www.hebrontrust.co.uk Allington House, and ongoing support – details Llanharry Road, Llanharan, Blyth Bridge, West Linton, 162 New Cavendish Street 10-12 Stanley Avenue, Norwich, 46 Dean Park Road, http://withersdanehall.co.uk Pontyclun, Mid Glamorgan Peeblesshire, Scotland EH46 7DH. London W1W 6YS. Norfolk NR7 0BE. Bournemouth, Dorset BH1 1QA. Withersdane, Wye, Kent. Wales CF72 9RN.

78 Feb 2016 your library’s essential reference Feb 2016 79 Recovery Plus Recovery Plus

Treatment centres Need help for yourself, a loved one, an employee or client? Start with this list of resources.

The addiction- The addiction- treatment and recovery treatment and recovery centres on this page centres on this page are based in Europe are based in the US. (and one in Australia). When you visit our When you visit our Nova Vida, Portugal Camino, Spain Paracelsus, Switzerland sister online journal, Alina Lodge Hazelden Betty Ford BHoPB sister online journal, you can click on you can click on photographs of each photographs of each Admissions: +351 919357186 Admissions: +34 952 78 29 36 Admissions: +41 52 624 6333 rehab to go direct to Admissions: +1 908-362-6114 Admissions: +1 866-831-5700 Admissions: +1 561 296-8121 rehab to go direct to email form on website admissions@ [email protected] its website. email form on website [email protected] [email protected] its website. English speaking, individualised broadreach-house.org.uk Bespoke addiction treatment: Long term treatment for email form also on website Behavioral Health of the Palm If you have specifi c 12-step recovery treatment Residential and outpatient one client at a time, with those who have attended a A vast range of services from Beaches has 5 rehabs: for men, requirements, such from professionals trained at care, family interventions and biochemical restoration of the residential treatment in the what is probably the world’s for women, executives, mental as gambling or eating the Priory – details at training – details at brain and body over 4-8 weeks past – good reputation for most famous rehab – details at health, and one added luxury – disorders, a search www.novavidarecovery.com www.caminorecovery.com of treatment – details at handling very diffi cult cases – www.hazeldenbettyford.org https://www.bhpalmbeach.com facility will soon be Located 25 minutes’ drive from La Alberdina, 377, 29680 www.paracelsus-recovery.com www.alinalodge.org 39000 Bob Hope Drive, 631 US Hwy 1, Suite 304 available. the main airport at Faro. Estepona, Málaga, Spain. Zurich, Switzerland. 61 Ward Rd, Hardwick, NJ 07825. Rancho Mirage, CA 92270 North Palm Beach, FL 33408. To add your facility to these pages, email TheTeam@ DBrecoveryresources.com

Sanctuary Byron Bay Aiseiri, Ireland Smarmore Castle New Directions for Women Sierra Tucson The Ranch

Admissions: +61266398888 Admissions: +353 52 744 1166 Admissions: +353 41 986 5080 Admissions: +1 800.939.6636 Admissions: 1 877.959.8896 Admissions: +1-562-521-0608 [email protected] [email protected] [email protected] email form on website email form on website email form on website All treatments are on a one- Off ers residential, outpatient Treats alcoholism and drug 1st-, 2nd- and 3rd-stage Programmes cover addiction Looks at the complex issues to-one basis, with daily work and aftercare, detox, family and gambling addiction with abstinent-based addiction & co-occurring disorders, that contribute to addictive including psychotherapy, support, adolescent care and evidence-based 12-step care. treatment for women, including complex pain, trauma & PTSD, and self-defeating patterns – somatic bodywork, nutrition gambling treatment – details at www.smarmorecastle.ie pregnant women and those mood & anxiety and eating https://www.elementsbehavioral and fi tness and meditation. http://aiseiri.ie Smarmore Castle Private Clinic bringing children with them. disorders – details at health.com/treatment-centers/ www.sanctuarybb.com Townspark, Cahir, Co Tipperary, Smarmore, near Ardee, www.newdirectionsforwomen.org www.sierratucson.com the-ranch Byron Bay, Australia. Ireland. County Louth, Ireland A92 YY22. Orange County, California. Sierra Tucson, Arizona. Long Beach, CA 90815.

80 Feb 2016 your library’s essential reference Feb 2016 81 Recovery Plus Recovery Plus

What is... a CIP? A CIP is a chartered intervention professional – earning this accreditation attests to people seeking someone to intervene on a family member that you are competent and ethical.

Provided by PCB, the CIP credential is Credentialling also provides globally recognised and available employers, clients and to intervention specialists their families with the regardless of the country assurance that you or US state in which you live have met internationally or work. The Association of recognised standards of Intervention Specialists worked professionalism and ethics. It with PCB to develop this gives you an ‘edge’ over lesser- CIP certifi cation, introduced last year. qualifi ed counterparts. They are also recognised by IC&RC, the International Credentialling & Reciprocity Interventions Plus (see the pullout Consortium which is the global leader in programme with this journal) has applied ‘gold standard’ credentialling of prevention, to again award CIP hours, your continuing addiction treatment and recovery professionals education credits to become a Certifi ed and which has 45,000 addiction-specialist Intervention Professional. Candidates need 14 members across the world. CIP hours to start joining AIS. Interventions Plus off ers you half of this – a great head start. Accredited interventionists used to append the You can fi nd certifi cation forms at https://www. letters “BRI-I” or “BRI-II” to their names (acronym pacertboard.org/certifi cations/cip and check more for board registered interventionist) but CIP details at www.associationofi nterventionspecialists.org. replaces these. Before the CIP release, Credentialling off ers Over 90% of the Pennsylvania needed standardisation Certifi cation Board and to the ever-evolving structured interventions many intervention addiction treatment specialists throughout and prevention the US, Canada and profession. Being result in the addict Europe had worked credentialled displays together for two years competency, by going into treatment on the development having professional of this specialty expertise and qualifi cations verifi ed by an certifi cation. Several of them are members of independent evaluator. It recognises the holder’s AIS as well as NII, the Network of Independent achievement of professional education as well Interventionists, who played a major role in as the experience necessary to provide quality creating the new credential. All wanted to help addiction services to employers and families you become an integral part of the recovery striving to get a reluctant addict into treatment. process for people struggling with addiction.

82 Feb 2016 your library’s essential reference Feb 2016 83 Recovery Plus

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