Did Lockdown Cancel This Year's Dry January?

Drink and Drugs News February 2021 ISSN 1755-6236

ALL OR NOTHING? The controversial history of ‘controlled drinking’ A SHOT IN THE DARK Could online dealers help spread harm reduction messages?

ALCOHOL AND ISOLATION DID LOCKDOWN CANCEL THIS YEAR’S DRY JANUARY?

UPFRONT

IN THIS ISSUE Drink and Drugs News is published by CJ Wellings Ltd, INSIDE Romney House, School Road, 4 NEWS Cash boost for services north Ashford, Kent TN27 0LT t: 0845 299 3429 and south; Scotland’s new minister for 6 drug policy Editor: Claire Brown e: [email protected] 10 LETTERS Steps for behaviour change; Advertising manager: Ian Ralph your views needed for psychology e: [email protected] survey on recovery Reporter: David Gilliver e: [email protected] 16 PARLIAMENT A public health approach Designer: Jez Tucker to older people’s drinking e: [email protected] Subscriptions: 19 A GREATER CONNECTION Forward e: [email protected] Trust share ideas for digital support website: 21 I AM A... This month’s career story is www.drinkanddrugsnews.com ON THE COVER: Alcohol and us from an isolation support worker Website support by wiredupwales.com Printed on environmentally friendly paper by the Manson Was 2021 How have dark web What impact has Group Ltd the best Dry drug sales been affected COVID-19 had on mutual Cover by: Ian Shaw / Alamy 8 January so far? by the pandemic? aid groups like AA? CJ Wellings Ltd does not accept responsibility for the accuracy of statements made by contributors or advertisers. The contents of this magazine 12 14 are the copyright of CJ Wellings Ltd, but do not necessarily represent its views, or those of its partner organisations.

PLEASE GIVE US YOUR FEEDBACK! Every small change can ‘Some great articles and some signal success depressing statistics highlighting the The Dry January campaign reports significant success this year, need for change... I gain a lot of insight striking a loud chord in lockdown (p8). A characteristic of this from the magazine.’ success is its immediacy – website, Facebook page, app – as well as We love reading your feedback and the capacity for global reach, and its direction as a healthy lifestyle initiative rather than a competition with an expiry date chimes suggestions – please fill in our readers’ with everyone’s interest in cultivating a stronger immune system. survey at www.drinkanddrugsnews. What’s made it feel accessible to many is the celebration of com/ddn-readers-survey-2020/ behaviour change, however gradual; the fact that a totally ‘dry’ month is not the only indicator of success. The question in Mike DDN is a self-funded independent publication. Our bespoke partnership packages provide Ashton’s piece (p6) is can we ever contemplate gradual change – an opportunity to work closely with the magazine. Please get in touch to find out more. ‘controlled drinking’ – for dependent drinkers? For most of us, digital service options (and there are good ideas from Forward, p19) have given us innovative ways of reaching clients during and beyond COVID. But an equally important part of the narrative must include those who do not naturally live online. A survey of older adults receiving alcohol treatment found that many were struggling with the move to online or phone-based models (news, p5). The Drink Wise, Age Well programme (p16) also highlighted that loneliness and depression can loom large for those whose only buzz comes from reaching for the bottle. Claire Brown, editor Keep in touch at www.drinkanddrugsnews.com and @DDNmagazine

WWW.DRINKANDDRUGSNEWS.COM FEBRUARY 2021 • DRINK AND DRUGS NEWS • 3 NEWS ROUND-UP

Cash boost for services north and south of the border

ubstantial cash ends up losing their life as a result reduction in treatment funding injections have been of drug addiction is not just failed since 2013. announced for drug at the time of their death – in most As well as helping offenders services in both Scotland cases, they will have been failed to access treatment on release, and England. The repeatedly throughout their whole the funding package will also SScottish Government has pledged life,’ said Sturgeon. ‘It is a reasonable enhance the RECONNECT service £250m to tackling its record rates of criticism to say that this government to support people with complex drug-related deaths, with £50m to should have done more earlier, and needs to engage with mental be allocated annually over the next I accept that. But I am determined health, substance and other services five years. Meanwhile £80m will be that we will provide this national for up to a year after leaving invested in drug treatment across mission with the leadership, focus, prison. A further £28m will go England as part of a larger overall and resources that it needs.’ towards Project ADDER (Addiction, package of £148m to cut drug- The announcement was a Diversion, Disruption, Enforcement related crime. ‘clear statement that the Scottish and Recovery), a pilot programme A ‘national mission’ was needed Government is serious about We hope this combining ‘enhanced’ treatment to address drug deaths in Scotland reducing drug-related deaths,’ and recovery services with ‘targeted to end ‘what is currently a national said We Are With You’s director in is ‘the start of and tougher’ policing which is disgrace’, said first minister Nicola Scotland, Andrew Horne. ‘This level scheduled to run for three years Sturgeon, adding that £5m had of investment will make a huge a longer-term in five areas with significant drug already been allocated for the impact and help more people access problems – Blackpool, Hastings, remainder of this financial year. The the support and treatment they commitment Middlesbrough, Norwich and funding will be spread between need. The fact that this funding is to increased Swansea Bay. Another £40m will go drug and alcohol partnerships, third stretched over the next five years towards tackling county lines gangs, sector and grass roots bodies to shows that there is a long-term funding’. bringing the total invested in this ‘improve work in communities’ and vision in place.’ since late 2019 to £65m. ‘substantially increase’ the number The £80m for England, NIC ADAMSON While the announcement of residential rehab beds. meanwhile, will partly be used to was welcome it was hoped it Money will also be used to increase the number of treatment would be ‘the start of a longer- widen naloxone distribution and places for people leaving prison in drug treatment funding for 15 term commitment to increased help tackle stigma, with the aim of as well as offenders diverted into years’. However, while money will go funding’, said executive director at increasing the numbers of people community sentences, and forms towards funding naloxone provision Change Grow Live Nic Adamson. in treatment. The government said part of an ‘overall system-wide for ‘every heroin user in the country ‘Fundamentally, we need a shift it would also be ‘reassessing how approach’ to cut drug-related crime that needs it’ as well as ‘ending in perspective so that substance overdose prevention facilities might by providing extra resources to the postcode lottery’ for inpatient misuse and addiction are primarily be established’ despite legal barriers law enforcement to tackle supply treatment, the £80m represents addressed as health issues, not as from Westminster. ‘Anyone who combined with ‘the largest increase just half of the £160m estimated criminal justice issues.’ Substance staff prioritised for vaccine

has confirmed. A health and social care workers. letter to the chief However, the Joint Committee on ‘Immediate executives of all NHS Vaccination and Immunisation requirement’ trusts, foundation (JCVI) recommends that, within trusts and other this group, priority should be given to vaccinate organisations sets out to those ‘at high risk of acquiring operational guidance infection, at high individual risk frontline health for the ‘immediate of developing serious disease, or requirement’ to at risk of transmitting infection to staff, and ensure vaccinate frontline multiple vulnerable persons or other

Steven Cornfield / unsplash.com Cornfield Steven ‘maximum health staff, and ensure staff in a healthcare environment’. PEOPLE WORKING in community- ‘maximum uptake’ of vaccinations. This includes those working in uptake’ of based addiction services will be NHS trusts are being established as ‘independent, voluntary and non- given high priority in the current ‘hospital hubs’ with a responsibility standard healthcare settings such vaccinations. rollout of COVID-19 vaccinations for vaccine delivery to everyone in as hospices, and community-based to healthcare staff, NHS England priority risk group 2b – frontline mental health or addiction services’.

4 • DRINK AND DRUGS NEWS • FEBRUARY 2021 WWW.DRINKANDDRUGSNEWS.COM News DDN EVERY DAY All the news, updated daily www.drinkanddrugsnews.com

Scotland appoints minister Local News to tackle record drug deaths

icola Sturgeon has and working with those appointed a minister in our communities and for drug policy public health teams to lead work on who are providing such tackling Scotland’s valuable support,’ said Nrecord rates of drug-related deaths. Constance. ‘Government / Dreamstime.com Auaumon Angela Constance, a former social can and will do more.’ Targeted support worker, takes over responsibility Barry Sheridan and Projects for South Asian from public health minister Joe Ian McPhee wrote women and people Fitzpatrick, who is no longer in post in a recent issue of who identify as Roma, following publication of the country’s DDN that the long- www.gov.scot Gypsies and Travellers long-delayed drug death figures for accepted narrative are among the recipients 2019. These recorded 1,264 fatalities, about Scotland’s high death rate 'I intend to get of Alcohol Change UK’s up 6 per cent on 2018’s previous being the result of an ageing 2021 New Horizons grants record figure and the highest since cohort of drug users was no longer straight down programme. ‘Members records began – the country’s death acceptable (November 2020, page of marginalised groups rate is three and a half times higher 7). ‘In an advanced nation such as to business... can find themselves than that for the UK as a whole, Scotland we should not consider stigmatised because and the highest in the EU. ‘I intend being over 35 part of an ageing Government can of their drinking and to get straight down to business, cohort,’ they said, adding that and will do more.' struggling to access the meeting with people who are at risk blaming the death rate on a legacy right type of support,’ said of dying from drugs, learning from of Westminster pre-devolution ANGELA CONSTANCE director of research and the families of those we have lost economic policies was ‘shameful’. policy Lucy Holmes.

Training for tomorrow Students in Belfast Face time is crucial BBV boost and Glasgow have been awarded £2,000 FACE-TO-FACE CONTACT with interventions, particularly for MORE THAN 1,000 PEOPLE who had each as part of Which older adults receiving alcohol those with speech or hearing previously been sleeping rough were tested Rehab’s £40,000 national treatment is crucial, according impairments.’ for blood-borne viruses between May and healthcare scholarship to a survey commissioned by We We Are With You recently August last year, according to the London scheme. ‘We want to Are With You. Moving services to launched a free, confidential Joint Working Group on Substance Use encourage more students online or phone-based models helpline for people over 50 who and Hepatitis C (LJWG). Of those who were to train in addiction-related has presented ‘huge barriers may be worried about their tested for hepatitis C, more than one in ten services because there are a and challenges’ for older adults, drinking (DDN, December/ were found to have antibodies for the virus, spiralling number of people researchers found. January pages 5 and 8) as well with 7 per cent identified as having an that need support,’ said MD The study – by Glasgow as re-launching its Drink Wise, active infection. James McInally. Caledonian University and the Age Well website at www. The report details the efficient joint University of Bedfordshire – drinkwiseagewell.org.uk working between healthcare teams, peer Key players looked at the consequences of Addressing the needs of older workers and hotel staff during the ‘Everyone Substance services could the COVID-19 pandemic and adults receiving alcohol treatment In’ initiative, which saw people who had play a key role in rolling lockdowns on older service users, during the COVID-19 pandemic at been sleeping rough housed in temporary out the COVID-19 vaccine, their rates of alcohol consumption www.wearewithyou.org.uk accommodation during the COVID-19 said CEO of Wales-based and how services had adapted pandemic (DDN, May 2020, page 5). Kaleidoscope Martin to support them, as well as the ‘We could never have imagined when Blakebrough. ‘We simply long-term implications for service we launched our Routemap to eliminating cannot have a vaccination provision. hepatitis C how the world would have rollout that ignores those ‘Most of the service users changed by 2021,’ said LJWG coordinator more vulnerable as a result expressed a clear preference and Dee Cunniffe. ‘And yet thanks to the of negative mental health need for face-to-face support,’ incredible hard work and innovation of or substance misuse. It is said Dr Paulina Trevena of everyone working on the BBV testing our hope that Public Health Glasgow Caledonian University. initiative in London, we have continued Wales and the Welsh ‘It helps combat loneliness, a to find and treat people for hepatitis C, Government will support frequent reason behind drinking contributing significantly towards national our medical teams through in older age, and facilitates a elimination efforts.’ vaccine training.' better understanding of alcohol Report at http://ljwg.org.uk/

WWW.DRINKANDDRUGSNEWS.COM FEBRUARY 2021 • DRINK AND DRUGS NEWS • 5 ALCOHOL TREATMENT ALL or NOTHING

Condemned as ‘Russian roulette’, allowing dependent drinkers non-abstinence treatment goals was tested in some of the most controversial studies ever seen in alcohol treatment. Mike Ashton dips into the fascinating history of ‘controlled drinking’

our cholesterol is of dependence as a distinct resolved painful issues or removed critical high. The doctor disorder characterised by inevitable them from constant contact edge to says, ‘No butter, loss of control, or one end of a with alcohol. Yet he ended by this homage no cheese, no continuum of behaviour which partially endorsing the orthodoxy to his ‘mentor’. cholesterol-raising even at its most extreme could – he challenged: ‘...the majority of That edge had foods – full stop.’ You given the right circumstances and/ alcohol addicts are incapable of become apparent in complain, ‘Can’t I just cut down or support – revert to moderation. achieving “normal drinking”. All 1979 when the journal andY take some tablets?’ The doctor patients should be told to aim at Edwards edited published yields nothing. ‘If you want me to THE FIRST CRACK total abstinence.’ Nevertheless, an interview with Davies. The help, do as I recommend. Otherwise The first significant research-driven he claimed his findings gave interviewer – probably Edwards you are clearly not serious about crack in the abstinence consensus the lie to the aphorism, ‘once an himself – told Davies of a personal preventing strokes and heart opened in 1962 in the form of a alcoholic, always an alcoholic’. encounter at the Maudsley with attacks. Maybe you’ll see it my way report by British psychiatrist DL With sufficiently radical changes one of the seven patients. Contrary after you have one.’ Davies on seven ‘severely addicted’ in their lives – aided in these cases to the impression given to Davies’ Not so long ago that was patients said to have sustained by two to five months in hospital follow-up worker, the man had the stance dependent drinkers controlled drinking. These men – some who had evidenced severe confessed to ‘drinking like a fish could expect to face. It was not were very much in the minority of dependence could (re)join the ranks the whole time’ and threatening just a matter of what patients 93 patients discharged before 1955 of ‘normal’ drinkers. to ‘bash the living daylights’ out should be advised, but whether from south London’s Maudsley of his wife if she contradicted his they should be denied treatment hospital, but that they existed at all CRITICAL EDGE reassuring account. Significantly, until revelation or deterioration was considered remarkable. For his successor at the Institute Professor Davies also confessed impressed on them the need to Davies started by restating the of Psychiatry, Davies had been to something – ‘I never regarded stop drinking altogether. views of the time: due to presumed ‘a pioneer who made a daring myself...as a research worker.’ The heat the issue generated ‘irreversible’ changes after years exploration of what was at the The encounter with the patient was fired by concerns on the one of regular heavy drinking, there time virtually forbidden territory’, prompted Edwards to re-check hand that allowing some drinking was ‘...wide agreement that these questioning ‘not just a medical records and re-interview surviving would set the dependent up to fail, patients will never again be able consensus, but the central and patients, relatives and carers, and and on the other that insisting on to drink “normally”’. But the seven hallowed organising idea of the the results were published in 1985. abstinence did nothing to improve had – and for between seven American alcoholism movement’. Having died in 1982, Davies could outcomes while denying treatment and eleven years – conversions These comments came from not challenge findings which to all but a minority. Underlying associated with major changes in the prestigious figure of the late cast doubt on whether some of these views were opposing visions their domestic or working lives that Griffith Edwards, but there was a the seven had ever been severely CSA-Archive/iStock

6 • DRINK AND DRUGS NEWS • FEBRUARY 2021 WWW.DRINKANDDRUGSNEWS.COM ALL or NOTHING dependent, and whether most had ‘The heat the issue SCIENTIFIC FRAUD? drinking a private struggle’, adding really sustained ‘normal’ drinking. As with Davies, a follow-up of lack of support from the treatment How starkly different was the generated was the same patients conducted by sector to the lack of social support picture from two decades before other researchers cast doubt on which perpetuates dependence. can be appreciated by the notes fired by concerns the findings, leading one critic to on ‘case 2’. In 1961 Davies had publicly allege scientific fraud. SUITABLE GOALS seen a success story: ‘Drinks 1–2 on the one hand However, investigations – including After this vitriolic research journey, pints of an evening but no spirits. one commissioned by a committee this is how Drug and Alcohol Never drunk.’ In 1983, Edwards saw that allowing some of the US Congress – cleared the Findings summed up the evidence: a ‘catastrophic’ outcome: ‘Heavy drinking would set Sobells, whose research was judged ‘Treatment programmes for drinking recommenced not later fairly presented. dependent drinkers should not be than 1955; much subsequent the dependent up In 1995 and again in 2011 they predicated on either abstinence morbidity culminated in 1975 with revisited controlled drinking as a or controlled drinking goals but Wernicke-Korsakoff syndrome.’ to fail, and on the treatment objective in editorials offer both. Nor does the literature for Addiction. Accepting that offer much support for requiring RESEARCH-NAIVE other that insisting ‘Recoveries of individuals who have or imposing goals in the face of Nearly a decade later Professor on abstinence been severely dependent on alcohol the patient’s wishes. In general it Edwards revisited this episode, mainly involve abstinence,’ they seems that (perhaps especially after asserting that his follow-up did nothing to argued this was not necessarily a little time in treatment) patients had revealed Davies’ account to something that was inherent to themselves gravitate towards what be ‘substantially inaccurate’. A improve outcomes the condition, but because these for them are feasible and suitable research-naive clinician ‘had been individuals tend to have poor social goals, without services having to substantially misled’ by ‘intentionally while denying support and little stake in society – risk alienating them by insisting on unreliable witnesses,’ which his an echo of Davies’ contention that a currently unfavoured goal.’ flawed methodology was not up to treatment to all social circumstances can generate exposing. Be that as it may, later not- but a minority. ’ dependence, and changing these Mike Ashton is co-editor of Drug and so-flawed work was to come to the can reverse it. Treatment providers Alcohol Findings. https://findings. same conclusions as Davies. unwilling to countenance non- org.uk?s=dd. This episode was relatively study by US husband and wife abstinence objectives would See https://findings.org.uk/PHP/ gentlemanly and largely limited team Mark and Linda Sobell. ‘continue to force problem drinkers dl.php?f=cont_drink.hot&s=dd for a to professional circles, but in Among a randomly selected half to keep their pursuit of low-risk fuller account. the USA bitter disputes hit the of the patients considered suitable headlines and spread across TV for a controlled-drinking objective, networks, in one case spawning it tested a radical procedure which DAVID LEWIS DAVIES legal proceedings. A major spat allowed patients to drink, showed was a psychiatrist of distinction, centred on a 1976 report from them videos of how they looked and a man who inspired loyalty and the influential Rand Corporation drunk, and trained them how very special affection. It was the on new government treatment to manage or avoid situations centres. It found fairly complete conducive to excess. All the match of professional and personal remission was the norm, that most other patients were allocated to qualities that made him such an patients achieved this without abstinence-oriented treatment, influential figure. altogether giving up alcohol, and either through a similar procedure Davies was crucially involved with that as many resumed normal or conventional treatment. the fortunes of the Maudsley and drinking as sustained abstinence. The results seemed a clear Bethlem Royal Hospitals, and with the vindication of the judicious post-war development of the Institute BREAKING STORM allocation of even physically of Psychiatry. He identified strongly with Aubrey Lewis’s ideal of Aware of the storm their findings dependent patients to try to might provoke, the authors learn moderation. Suitability for eclectic scholarship and insistence on high standards of patient care. disavowed any intention to a controlled-drinking objective In 1979 his contributions to alcohol research were recognized recommend ‘alcoholics’ resume had been based partly on a by the award of the Jellinek memorial prize. He was elected drinking. Nevertheless, the storm patient’s ‘sincere dissatisfaction president of the Society for the Study of Addiction, and sat on broke, as holding out the prospect with [Alcoholics Anonymous] the editorial board of the British Journal of Addiction. of controlled drinking was likened and with traditional treatment After retiring from the Maudsley, he became chairman of the to ‘playing Russian roulette with modalities’; the study showed this Attendance Allowance Board, for which work he was, in 1982, the lives of human beings’. rejection of US orthodoxy need not Rand’s authors could anticipate condemn them to the progressive awarded the CBE. By J Griffith Edwards from biography at the the controversy from the reaction deterioration predicted for the Royal College of Physicians, https://history.rcplondon.ac.uk three years before to an audacious untreated.

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Much has been written in the press about how COVID and the lockdown have seen this year’s Dry January ‘cancelled’ for many people. But that’s far from the truth, says Richard Piper HOME AND DRY s I write this health, in a strong immune system, While the final results for 2021 alcohol may benefit some people January is not yet and in learning about ways to drink are not yet available, we know from in its own right, but aiming for a over, and yet a total more healthily, with the public- independent academic research into month off as part of a well-designed of 97,066 people facing sections of Alcohol Change previous campaigns that 80 per cent behaviour change campaign is so have already UK’s website seeing a huge growth of those who sign up feel more in much more effective. downloaded the in visitor numbers. Between late control of their drinking by the end Looking ahead, who knows Try Dry app in order to take part March 2020 and 21 January 2021, of the month and 67 per cent are where COVID-19 will take us and Ain Dry January – an increase of 35 our website was visited by nearly still drinking less six months’ later. where we’ll be next January. But per cent on same period last year, 1.2m people – a 67 per cent increase Those who don’t join the campaign our planning for January 2022 has which was itself higher than 2019. on the same period in 2019. and try to do an unsupported Dry begun and we hope all DDN readers In addition, many thousands of The Dry January campaign January, are far less likely to see will continue to actively support Dry people who previously downloaded has also ‘gone global’ in new these benefits. Having a month off January, in particular by continuing the app are still using – or have ways this year. Our small-scale reactivated – it. partnership in France has been The Dry January community much more significant in 2021, Facebook group had 6,695 members and we’ve developed exciting SO WAS 2021 THE BEST on 21 January 2021, compared new partnerships in Switzerland, to 5,006 last year – a 34 per cent the USA and the Netherlands, DRY JANUARY SO FAR? growth. And group members are including translating the app TO ANSWER THAT, we must mind. People learn some – or all extremely active, with around 42 into German and French. People be clear what success looks like. – of these seven things: posts, 1,190 comments and 3,789 from over 170 countries now use A successful Dry January is not reactions per day. the Try Dry app. And we’ve also necessarily defined as a totally 1. Breaking denial: ‘It seems I’ve So why such growth? COVID-19 boosted our marketing, both dry month. That would be a developed a drinking habit has undoubtedly played a multiple, improving our approach to social clumsy indicator and at odds and it’s not easy to break’. if complex, role. The long-term media advertising and shifting our with the campaign’s careful, stresses of the pandemic and of messaging away from positioning evidence-based approach to 2. Feeling less guilty about, growing levels of home drinking Dry January as a ‘challenge’ – few of behaviour change. A successful and alone with, their have generated a significant us feel we need more challenges in Dry January is one in which drinking problem: ‘This jump in the number of us seeking our lives right now – to emphasising experiential learning occurs is actually a much more to regain control of our alcohol the lived benefits, especially the and is embodied – that is, you common problem than I consumption. There has also been ability to help get your energy, your feel it, in your body and your realised. I’m not alone.’ even greater interest in personal calm and your freedom back.

8 • DRINK AND DRUGS NEWS • FEBRUARY 2021 WWW.DRINKANDDRUGSNEWS.COM THE INVISIBLE Family members are the hidden victims of 'As I write this lockdown substance use, warns Adfam

January is not he latest lockdown will in ten of us are coping with a loved yet over, and be extremely difficult one’s drug or alcohol problem. Yet for the 5m people their needs are often forgotten yet a total of struggling to cope with when we talk about the impact of 97,066 people a loved one’s drug or the pandemic, because the problem Talcohol use, Adfam has warned. is so hidden. With more support have already More than four fifths of adults available from charities online dealing with a loved one’s alcohol during this lockdown, it is vital that downloaded the or drug problem said the first people seek help when they need lockdown had ‘made a bad situation it. We want to say to people – you Try Dry app in worse’, according to the charity’s deserve help and support as much Families in Lockdown survey (DDN, as the person with the substance order to take part July/August 2020, page 5). Almost issue. Please don’t feel you have to in Dry January – half of those surveyed said that their suffer in silence.’ loved one’s substance use increased an increase of 35 during the first lockdown, with 50 per cent of respondents feeling per cent on same more anxious or stressed, almost 30 per cent reporting suffering more period last year.' verbal abuse than usual, and 13 per cent feeling more concerned for their own safety. The time has come for a ‘national conversation’ to alert the to spread the message that people consumed 29.4m fewer units. world to the impacts of drug and should join the proper campaign The app is free and it unlocks alcohol use during the pandemic, rather than try to go it alone. our other free resources – coaching the charity states, with children Thanks to all of you who emails, Facebook groups – all of suffering disproportionately. Many signpost people to the Try Dry app, which are designed for those risky, are missing the support they would 'One in ten of us not just for January, but all year heavy, habitual drinkers who don’t normally get from other family round. We know that it works – yet need full-blown treatment. We members and from school, while are coping with a since the app’s launch in December all want to support people sooner the stigma attached to a loved one’s 2018, users have collectively saved rather than later, before they need substance use means many are loved one’s drug or over £35m that they would have a treatment intervention. reluctant to speak out or seek help. alcohol problem. spent on alcohol if they’d continued Dr Richard Piper is CEO of Among the quotes from family drinking as before, and have also Alcohol Change UK members in touch with Adfam Yet their needs are are ‘Lockdown has been horrible. A nightmare. The system needs often forgotten 3. Inspiration role-modelled: 5. Self-efficacy: ‘I’ve learned to change – it’s been horrendous ‘Those people from previous techniques for beating getting support’; ‘The lockdown when we talk Dry January campaigns these triggers, overcoming has been horrific – the only way I about the impact were in my situation and are cravings, and dealing with can describe it is that it is like being just like me, but have now specific situations.’ held hostage in your own home. I of the pandemic...’ controlled their drinking wake up nervous of what his mood and are so much happier and 6. Seeing an alternative: is going to be like,’ and ‘It’s affecting VIVIENNE EVANS healthier. Maybe that could ‘Watching TV, cooking a me and my children more than happen to me.’ meal, relaxing, having fun usual – we have nowhere to go to and so on can all be done get away.’ A 2019 YOUGOV POLL revealed 4. Specific insights, making without alcohol.’ ‘Lockdown is like a tinderbox for that at least 5m people in the the subconscious families dealing with a loved one’s UK are affected by the alcohol conscious: ‘I’ve learned the 7. Wanting that alternative, alcohol or drug problem,’ said Adfam or drug problem of a family triggers and associations long-term: ‘Life in control of chief executive Vivienne Evans. member or friend. Adfam has – times, people, places, alcohol feels desirable and I ‘When you are already isolated, launched a fundraising appeal feelings – that particularly want it long-term.’ stressed or fearful, our research #Forgotton5million to increase the prompt me to drink.’ shows that lockdown takes an even support that it can offer online, bigger toll on you. A staggering one with details at adfam.org.uk

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DRY SPELL The former can be seen as a bit of a They said what..? Dry January? As someone in recovery challenge between family, and friends, from alcoholism and other addictions, with the possibility of longer-term and who has worked as an addictions change, a real potential. The resolution Spotlight on the national media therapist, I would not judge anyone who process is invariably a way to set chooses some behavioural change for yourself up for failure, with the negative WE HEAR OF COMPLEX PROBLEMS, medication- a healthier lifestyle, even if it was short feelings that will no doubt follow. If we assisted treatment, hard-to-reach subgroups and term. The experience, supported by a make a heart-felt, deep choice, profound reference groups – academic terms that deflect from collection of disparate people, either change is possible – with time, and the simple solutions that need to be implemented. visible, via social media, or some other support. We are trying to treat a large, infected wound with community, may create some desire for a Richard Renson, by email a sticking plaster. We cannot continue to roll out the deeper, long- term change. same old lines about ageing cohorts of drug users, As mind and mood altering wider naloxone provision and responding to non- substances have been around in some fatal overdose – all of which is important, but does form since forever, and alcohol is not provide the treatments needed for such a large, taxable and legally accepted by the infected wound… I have no doubt Nicola Sturgeon UK government, at present people and Angela Constance want to act. However bold have the choice to use it as they wish. and brave actions are needed – no more subgroups, Dependence is another process with working groups or published strategies. Let’s get its own challenges. Dry January overdose prevention centres open and safe supply participants may find that they struggle, optimal dose prescription medication to people when or indeed find it easy, and this might they need it. Peter Krykant, Daily Record, 13 January give insight into their relationship with alcohol. From there, a jumping off point THIS YEAR IS THE 50TH ANNIVERSARY of Westminster perhaps, for something of a deeper telling the world that its Misuse of Drugs Act (1971) nature. would stamp out illegal drugs for ever. The act failed In my experience life is not linear. utterly, but it has never been repealed. Among We may have a grand plan, or just a other horrors, the industry it created now enslaves daily programme for life. Whichever an estimated 27,000 children and teenagers, some it is, the world will always throw as young as eight, in ‘county lines’ drug gangs. The something unexpected at us, good POSITIVE CHANGES government has no answer but to throw a few of or bad. This in turn may cause us to For my doctoral thesis, I am interested them in jail… The Home Office in Whitehall is terrified change our behaviour due to emotional, in understanding more about people’s not of the facts, but of the tabloid press. physical, or mental challenges. We can views and experiences of positive life Simon Jenkins, Guardian, 15 January be drawn to actions that mollify, or change since being in recovery from mediate the turmoil effectively, for a problematic alcohol and/or drug use. SOME IN THE INDUSTRY suspect COVID is being used while, but eventually make our lives We would like to invite DDN readers covertly by neo-prohibitionists to permanently remove unmanageable. A period away from to participate in our online survey – the the pub from its central role in British life. If this were alcohol, or other drugs, can give clarity, link is here: https://sotonpsychology. true, it’s hard to imagine what the government would let the sediment settle in the foggy eu.qualtrics.com/jfe/form/SV_ have done differently. As with any conspiracy theory, brain. cT3rowGxRF0JS7P the more likely answer is lazy incompetence and I have worked with quite a number The survey will take approximately indifference. As the government’s farcical inability to of people whose lives were blighted 15 minutes to complete and is decide on what constitutes ‘a substantial meal’ in the by binge drinking. There was often anonymous (your email address will be autumn demonstrates, there was no real policy here no obvious pattern, trigger, or rational held separately from survey data). The beyond ‘look tough on pubs’, and no coherent rationale cause to these bouts of damaging study has been approved by University to support that policy. Pete Brown, Guardian, 23 January consumption. What was often a of Southampton's ethics committee. successful solution was abstinence – Dr Sophia Chambers, trainee clinical IT’S A VASTLY COMPLICATED PROBLEM and choosing to not drink every morning psychologist, Taunton & Somerset NHS contradictions abound. There is no pat answer to gave these individuals a much better Foundation Trust, School of Psychology, why Scotland’s drug story has become a public health quality of life, relationships, and sense University of Southampton emergency on such a scale. It’s easy to point to the of self-worth. ravages of de-industrialisation in the 1980s which I think reasons why individuals DDN welcomes all your comments. baked-in poverty for generations. Yes, Glasgow, take the Dry January journey can be Please email the editor, claire@ Ayrshire and Tayside suffered. But so did Merseyside, manifold. The impact may be great, or cjwellings.com, join any of the Tyneside and the Welsh Valleys… Ironically, and there may be no impact at all. People conversations on our Facebook page, tragically, it’s hard to remember a time when Britons who ask me why I don't drink are often or send letters to DDN, CJ Wellings Ltd, have been so attuned to public health data. And in interested only from the perspective of Romney House, School Road, Ashford, Scotland, where the COVID death toll has passed their relationship with alcohol. If my Kent TN27 0LT. Longer comments and 4,000, it’s hard to make the case that drug deaths life choices today offer some insight into letters may be edited for space or clarity. deserve more political and journalistic oxygen. At a change process for someone heading least, not right now. over a cliff with theirs, then that can /ddnmagazine Colin Brazier, Catholic Herald, 4 January only be helpful. I like the idea of Dry @ddnmagazine January, but not New Year's resolutions. www.drinkanddrugsnews.com

10 • DRINK AND DRUGS NEWS • FEBRUARY 2021 WWW.DRINKANDDRUGSNEWS.COM Is your organisation working to tackle blood borne viruses? Our toolkit can help.

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Change Grow Live Registered Office: 3rd Floor, Tower Point, 44 North Road, Brighton BN1 1YR. Registered Charity Number 1079327 (England and Wales) and SC039861 (Scotland). Company Registration Number 3861209 (England and Wales). HARM REDUCTION Dark secrets How have dark web drug sales been affected by the pandemic, and could suppliers be used to get vital harm reduction messages across? Renato Masetti decided to ask the dealers themselves

s an ‘old timer’ question may come as a surprise. activity. Over an in the field, I They were happy to engage with extended period, I had remember the me in delivering safety messages regular conversations seismic shift on their page or in their packaging, with two sellers that followed including information on dangerous and a series of the emergence interactions with other drugs. It messages ensued. of ‘legal highs’. Policy, however, became evident that they saw These messages Astayed frozen in shock, while the themselves as business people used methods of drugs changed and began their with a genuine passion for what communication that migration to online sales. And what they were selling, and had used have previously been of the suppliers? Only a handful of and enjoyed a range of substances used in researching research papers have attempted to themselves. Though the acquisition this cohort – email understand their motivations and of wealth was a driving force, so and asynchronous practices, so I thought it would be were positive experiences with and end-to-end interesting to contact some of them the chemicals they were selling. encrypted messaging. myself to hear the view from the This is an interesting twist on the ‘shop floor’. This resulted in some popular narrative of the dealer as UNDERSTANDING fascinating conversations and two purely motivated by money, and THE MARKET big questions. How had COVID-19 also reminds us that the distinction Over time I was able to disclose While one seller has now ceased affected their business, and would between user and dealer is often that I was a health professional trading (to become a delivery driver they be willing to help me reduce paper thin. who was interested in of course!) there are indications harm to their consumers? Clearly, ‘my’ sellers may not be understanding the market and that the other seller has become Their answers to the first representative of the whole sector assessing the potential for harm quite a significant presence on question mirrored what large-scale and as recent research has pointed reduction, rather than a customer. crypto markets – he is listed on a surveys and reports such as the out, crypto-market suppliers can be It is important to stress that Suffolk number of market places, which Global Drug Survey had already seen as being on the frontline of the Police had oversight of this work requires a level of organisation told us. Essentially, drug use had ‘gentrification’ of the drug business. and no laws were broken. Both and administration that would be developed its own version of the However, these conversations show sellers were eventually tolerant beyond a casual or opportunistic 5:2 diet – with shortages of product that some sellers recognise the of this approach and accepted supplier, and has recently started being followed by bulk orders importance of a healthy, happy the potential benefit of including selling in larger amounts. He stated encouraged through special deals customer base. messages around safer use. They that he had recently completed and offers. As others have pointed It is a small exploratory piece also both offered insights into how a single sale that accrued £1,800 out, crypto-markets are weathering of work to assess whether it may they had adapted following the profit, and that his annual income the storm rather well and a range be possible for larger studies to be emergence of COVID-19. was in six figures. of unfamiliar substances were conducted – it merely explores and Both individuals were UK based, During our discussions, it available if your favourite chemical questions the assumption that both sourced their supply directly seemed clear that both saw was not – Alpha-PHP anyone? suppliers of illicit drugs are not from China, and both appeared to themselves as vendors of products The answer to the second willing to engage in health-related have other professional careers. that were risky but also offered

12 • DRINK AND DRUGS NEWS • FEBRUARY 2021 WWW.DRINKANDDRUGSNEWS.COM ‘menu’ of products available and whether COVID-19 had limited the number. Again, surprisingly he stated that new substances such as 4f-mar and ‘Isophenidate’ were being acquired. This probably refers to isopropylphenidate hydrochloride, a recently Dark secrets synthesised compound with little history of human use. Lastly he was asked if he would be willing to add some harm reduction advice related to drug use and COVID-19 to his market page. He stated that he would participate if important new information needed dissemination, but advice was already posted on crypto-market sites and on ‘dark.fail’ – a dark web site that lists current crypto-markets and whether they are open for business.

REASONABLE ASSUMPTIONS These interactions show that it is possible to communicate ALFSnaiper/iStock effectively with some dealers of illicit drugs, and it is reasonable to ‘Though the He was also very interested in assume that many suppliers are products that would be viewed concerned about the welfare of acquisition of as positive by his customers and others – a feature of drug culture not cause obvious harm – this that could potentially be harnessed wealth was a again runs counter to the notion by organisations that wish to of a dealer who will sell any promote public health. driving force, so drug indiscriminately. This was In relation to COVID-19, these were positive illustrated by his request for interactions suggest that supply of ‘testers’ of his products to provide newer synthetic compounds has experiences with feedback on their effects. He was continued unabated as has the willing to include important harm invention and production of novel the chemicals they reduction messages within the psychoactive research chemicals. packaging – for example, each Perversely, it would appear were selling. This product distributed would include that logistical difficulties and is an interesting a short message, written by myself, interruptions to the postal system listing basic harm reduction advice. may encourage vendors to order in twist on the advance, source larger amounts of INITIAL RELUCTANCE product and sell in bulk. pleasure, similar to a supermarket popular narrative The other was initially very Clearly, bulk purchasing and sale selling alcohol. Both suppliers reluctant to engage but eventually could lead to negative impacts for mentioned that they had ‘preferred of the dealer as accepted that I did not represent a end users. But in contrast to the ‘evil customers’ who they trusted and purely motivated threat. As the pandemic developed, dealer’ narrative, gaining a better could be said to have become he was asked about how it was understanding of the motivations ‘friends’. They would share by money, and also impacting on his bulk deliveries and mindset of drug suppliers may information on purity and optimal from China. He responded that, ‘My mean it’s possible to reduce risks routes of administration as well as reminds us that the deliveries are still getting through, by further interaction between general ‘news’ with these clients. just taking longer.’ individual sellers and health distinction between During another exchange promotion agencies in key harm WILLING PARTICIPANTS user and dealer is he was asked how the current reduction areas such as drug alerts, The first seller was by far the most situation was impacting on the naloxone and needle exchange accepting of my position and often paper thin.’ quality or quantity of his products. distribution. With drug-related was willing to participate in the Interestingly, his strategy appeared deaths and drug harms soaring, it dissemination of harm reduction to be one of buying in advance and may be time to ask ourselves if we advice. He sold a range of NPS analysis to the Tic Tac database at selling in bulk rather than dealing should be engaging better with our including analogues of some St Georges Hospital (DDN, January in small amounts, suggesting online ‘drug supermarkets’. medications. In collaboration with 2014, page 14). Invariably, he was that availability of product was Renato Masetti is training co- key partners, a number of packages able to accurately list the active continuing unabated. He was also ordinator for Health Outreach NHS/ were purchased and sent for ingredients in his products. asked about any changes to the EPUT

WWW.DRINKANDDRUGSNEWS.COM FEBRUARY 2021 • DRINK AND DRUGS NEWS • 13 MUTUAL SUPPORT

The impact of COVID-19 has shown that mutual aid groups like AA may be even more beneficial than we realised, say Lisa Ogilvie and Jerome Carson

The feeling’s mutual

dmitting to being a high level of cohesion with AA purpose – to carry its message an alcoholic is hard. would improve wellbeing, and ‘The positive to the alcoholic who still suffers.’ It means conceding that AA members would have impact goes well This suggests cohesion is key to that your actions weathered the general decline in the success of AA in terms of both and decisions have wellbeing during the COVID-19 beyond healing altruistic motivation and increased led to a point of pandemic – as reported by the levels of wellbeing, a finding that failure, and fear of humiliation Office for National Statistics (ONS) health, family was further substantiated when Aand public stigma places a major in its Annual personal well-being it was noted that the length obstacle to those seeking help. estimates – better than people not life and personal of sobriety was also positively Science may yet prove that alcohol engaging with mutual support. associated with wellbeing. problems are inextricably linked The study included more than 200 recovery. It has to dysfunctional brain processes members of AA from 12 different led me to know RECOVERY IDENTITY rather than character flaws, but countries, including the UK, USA, Evidence of a specific recovery until then this perceived failure – Australia, South Africa and Turkey, myself...’ identity among AA members was and associated shame – is a driver and the demographic was further revealed when the findings indicated for people to seek solace in mutual varied in terms of age, gender and that working toward compassionate support groups like Alcoholics length of sobriety. Participants goals as a group establishes Anonymous (AA). completed a survey which included this was similarly true with the an identity that safeguards AA groups understand the questions that measured their personal characteristics reported close relationships, and rejects plight of the alcoholic through cohesion with AA, the significance by the participants. Those who characteristics associated with their own lived experience. An AA they placed on different aspects of reported higher levels of cohesion high-risk behaviours – such as binge group has compassionate goals, their character, and their wellbeing. were more likely to be altruistically drinking – in favour of upholding and an altruistic motivation toward They also described what being a motivated in supporting community values. As an example, supporting its members to achieve member of AA meant to them. others, and conveying empathy, one participant said that AA a better life in recovery. Iztvan et al acceptance and friendship. represents, ‘A sense of community (2016) identified inSecond wave COHESION AND WELLBEING This was summarised by one based on shared experiences and positive psychology: Embracing The importance of having a sense participant who said, ‘Before finding feelings that come from knowing the Dark Side of Life that having of cohesion with AA became AA I didn’t know it was possible to oneself as an addict and the a shared compassion can bring clear, as the findings showed a connect with people that want the particular way a mind wired that about a positive and transformative strong link between cohesion and best for me, who I had never met way, works. Nobody “gets” an addict adjustment in wellbeing, and it wellbeing – in fact, the level of before. It has opened up a world like an addict’. This indicates that was this that led to the idea of cohesion with AA was found to be of new friends and kindness, and cohesion with AA encourages its investigating how AA membership influential in predicting wellbeing. shown me the way to a better life’. members to adjust aspects of their affects its members’ wellbeing and Those participants reporting higher Interestingly, this finding resonates identity, so they might contribute to self-definition. levels of cohesion also experienced with one of the traditions of AA – successful inclusion in a supportive It was anticipated that having significantly better wellbeing, and ‘Each group has but one primary network of people living in recovery.

14 • DRINK AND DRUGS NEWS • FEBRUARY 2021 WWW.DRINKANDDRUGSNEWS.COM ‘Before finding AA I didn’t know it was possible to connect with people that want the best for me, who I had never met before...’

erwin_ps / iStock • Girts Ragelis / Alamy

To flourish is the pinnacle of living a shared compassion will have and how to enhance this process. a happy and meaningful life, a transformative effect on the It has long been known that AA and is the main focus of positive wellbeing of AA members. It members benefit from being part psychology (Seligman, 2011). To demonstrated that people in of a group of recovering addicts. see such clear evidence of this in a recovery who are members of AA It has not been known that such sample of recovering alcoholics was have better wellbeing than that membership actually leads to The feeling’s mutual an unexpected finding, perhaps of the general population during flourishing. best captured by one participant the COVID-19 pandemic. Most who said, ‘Belonging to AA has remarkably, evidence of flourishing Lisa Ogilvie recently completed an POSITIVE IMPACT meant many things to me during was discovered, indicating that MSc in counselling and positive The significance of AA to its my recovery. Inclusion, wisdom, cohesion with AA not only acted psychology at the University of members’ wellbeing during the support, guidance and spiritual as a protective factor against Bolton, and is a member of AA. pandemic was apparent when the growth. Above all it has given me the general decline in wellbeing Jerome Carson is professor data in the study were compared freedom and the freedom to just be seen during lockdown, but also of psychology at the University with two independent research me and that is a miracle’. improved it, with higher levels of Bolton. Previously a ‘high projects on COVID-19 and reported in this study than seen functioning alcoholic’ he has been wellbeing. The participants in this SHARED COMPASSION only in pre-pandemic research. abstinent for more than four years. study showed markedly higher This study convincingly All of this introduces an exciting A more detailed version of the levels of wellbeing than those supports the basis for the avenue for future study, looking at research can be obtained by emailing recorded in both COVID-19 studies, research – that being moved by flourishing and addiction recovery Lisa on [email protected] and demonstrates that AA has had an important and positive impact on its members’ wellbeing – so THE TWELVE STEPS 9 Made direct amends to such people wherever possible, except when to do so would much so that they have avoided The heart of the suggested programme of injure them or others. the overall decline seen in the personal recovery is contained in Twelve Steps. general population during lockdown 10 Continued to take personal inventory and 1 We admitted we were powerless when we were wrong promptly admitted it. (DDN, December/January, page 9). over alcohol - that our lives had become According to one participant, ‘The unmanageable. 11 Sought through prayer and meditation to positive impact goes well beyond 2 Came to believe that a Power greater than improve our conscious contact with God as we healing health, family life and ourselves could restore us to sanity. understood Him, praying only for knowledge of personal recovery. It has led me to His will for us and the power to carry that out. Made a decision to turn our will and our lives know myself, to access other help 3 over to the care of God as we understood Him. 12 Having had a spiritual awakening as the as needed. Today I have a healthy result of these steps, we tried to carry this 4 Made a searching and fearless moral relationship with myself and others’. message to alcoholics and to practise these inventory of ourselves. Further analysis showed principles in all our affairs. participant wellbeing compared 5 Admitted to God, to ourselves and to another human being the exact nature of our favourably with data collected Newcomers are not asked to accept or follow wrongs. by ONS prior to the COVID-19 these Twelve Steps in their entirety if they pandemic, which even exceeded the 6 Were entirely ready to have God remove all feel unwilling or unable to do so. They will threshold for having a high level of these defects of character. usually be asked to keep an open mind, to wellbeing as designated by ONS. 7 Humbly asked Him to remove our attend meetings at which recovered alcoholics This indicates that cohesion with shortcomings. describe their personal experiences in achieving AA not only improves wellbeing 8 Made a list of all persons we had harmed, sobriety, and to read AA literature describing but provides its members with a and became willing to make amends to them all. and interpreting the AA programme. foundation on which to flourish.

WWW.DRINKANDDRUGSNEWS.COM FEBRUARY 2021 • DRINK AND DRUGS NEWS • 15 PARLIAMENTARY GROUP

TOO MUCH, TOO OLD? We need to tackle issues around older people’s drinking with a strong public health campaign, heard the drugs, alcohol and justice parliamentary group

f we don’t act, we’ll see a and loss of purpose: 85 per cent INCLUSION STRATEGY significant public health reported depression, 75 per cent The COVID effect was making issue,’ said Julie Breslin, anxiety and 22 per cent were people even more difficult to head of Drink Wise, Age taking medication for mental find. ‘Remote support should Well, a programme that ran health issues. More than half said be provided in addition to other ‘Ifor five years with funding from the they felt lonely or isolated – and services,’ she said, as part of a National Lottery Community Fund 72 per cent said they had felt that strategy of digital inclusion – to bring together partnerships, life was not worth living. providing access to the internet, research and learning for long-term It was important to respond to technology and training to older strategy. She was sharing results this in a holistic way, suggested service recipients, as well as from the work with older adults, Breslin, and a key part of this was telephone helplines. and the headline issue was the increasing resilience, ‘in three These action points needed to extent to which they were drinking domains – individual, social and be written into future government at levels that were harmful to their environmental’, which would alcohol strategies, leading to physical and mental health. help people to adapt positively to tailored solutions for ageing While there were benefits to stressful life circumstances. ‘It’s People who populations. ‘We want to see drinking in moderation – relaxation important in older age as it can public health campaigns to raise and (normally) social cohesion be a challenging time of life, with had taken part awareness around alcohol harms – the programme found low retirement, bereavement and and ageing,’ she said. knowledge of units and guidance reduced physical mobility,’ she said. in ‘resilience Participants at the parliamentary on safe drinking levels. ‘As we group meeting were unanimous in age, we’re less able to metabolise POSITIVE NEWS interventions’ their support for a proactive public alcohol and are also more likely to The positive news was that people had experienced health approach – which needed to be on medications that interact,’ who had taken part in ‘resilience include full consideration of cultural said Breslin. Taking account of other interventions’ had experienced ‘dramatic variation and need. They agreed issues that went hand in hand with ‘dramatic improvements in that the data demonstrated the getting older – such as menopausal emotional health, sense of purpose improvements in level of the problem – particularly symptoms or a lack of balance that and relationships,’ she said. Many the clear link between drinking and made falls more likely – furthered also reported that their alcohol use emotional health, loneliness and with mental health the need for scrutiny. had reduced. After the programme sense of purpose issues. The question was, what it was recorded that 74 per cent could treatment providers be doing TRIGGERS FOR DRINKING of participants had improved their and relationships’. about it right now? Data from 3,600 participants wellbeing, which showed that in the Drink Wise, Age Well ‘multiple levels of support are really JULIE BRESLIN The second part of the meeting programme revealed that 80 per important’. of the of the Drugs, Alcohol and cent of people drank at home One of the major challenges for Justice Cross-Party Parliamentary alone and 55 per cent had one or us all was that ‘this group go below undiagnosed cognitive impairment, Group explored research relating more health conditions. The top the radar’, with alcohol problems which can make it difficult for to alcohol, violence, and anti-social three triggers for drinking were less likely to be identified in older them to engage with and benefit behaviour. We will be looking at this bereavement, relationship issues people. ‘Many have high levels of from treatment,’ said Breslin. in our March issue.

16 • DRINK AND DRUGS NEWS • FEBRUARY 2021 WWW.DRINKANDDRUGSNEWS.COM Passmores House Passmores House is a recovery community for people aged 18 years and over who are dependent on drugs or alcohol. Easily accessible by car and public transport, the facility combines tranquil surroundings with expert clinical care. );ruob7;bmr-ঞ;m|7;|obC1-ঞom-m7u;vb7;mঞ-Ѵ u;_-0bѴb|-ঞomruo]u-ll;v=ou-ѴѴ1olrѴ;b|Ѵ;;Ѵvĺ

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The pandemic may have forced us to adapt, but developing digitally delivered support has brought some exciting opportunities says Carwyn Gravell A GREATER CONNECTION ike many organisations, face-to-face support in the future, be vulnerable. I loved it from the ‘Anecdotal in late March 2020 we offering benefits such as greater first session and had no worries had to switch almost reach, safety and confidence, about coming again’, while an evidence overnight to a telephone- stronger engagement, service user East Kent client said, ‘I certainly based service – audio/ empowerment and wider influence. wasn’t technology minded with suggests that Lvideo calls and text messaging – to The services have proved no experience of online groups, maintain core support for our extremely popular with both chats or video calls – but I’ve seen our experience clients in the community. Once clients and staff – a survey of our fear and uncertainty replaced with bucks the trend of the initial phase was over we service users in East Kent showed confidence, courage and hope.’ piloted a wider, more ambitious a high degree of user satisfaction, While we can’t attribute causal declining referrals range of digital tools, aiming to with the Kaizala chat scoring effect to our digital and remote further enhance connection with highest (nine out of ten in terms services, over the lockdown period into treatment and between clients. The goal was of usefulness). Even the most our East Kent service has seen a to connect with people at every basic remote support (telephone- steady increase in the amount overall, made stage of recovery, from those not in based one-to-one appointments of referrals, and the number worse during treatment but who were worried with key workers) is seen by some of participants in our group by their substance misuse, right as preferable, or at least more programmes at the ReNew service lockdown.’ through to people in established convenient, than face-to-face in Hull has also increased. Though recovery groups. appointments that require travel to national average referral rates are More than ‘filling the gap’ a physical ‘hub’. One ReNew client not yet available for comparison, overall, made worse during during lockdown, our findings commented that, ‘I was sceptical anecdotal evidence suggests that lockdown. suggest that these digital tools about joining this online group our experience bucks the trend of Forward is committed to further Gerd Altmann / Pixabay can enhance traditional models of but I found myself letting myself declining referrals into treatment developing and evaluating these tools and approaches, as well as working with the wider sector, THE TOOLS • Social messaging apps – to enable peer-to-peer providers and commissioners, to connection and support for groups at various stages see how innovations can change of treatment and recovery, using the Kaizala app. the shape of community substance Reach Out – an online, text-based chat service • This became an efficient means for group leaders misuse services in the future. to reach people in need of advice and support, (practitioners and peer supporters) to keep in touch providing a ‘friendly voice’ of hope and motivation. with group participants ‘all at once’ – in addition Carwyn Gravell is divisional director This helped us to reach new people – the majority to regular one-to-one calls – as well as identify of business development at The of callers who contacted us through this platform problems at an early stage and enable 24/7 support. Forward Trust had never engaged with Forward before. This article is a shortened version • Online group programmes – using video call of information contained in our Digital workbooks – self-help resources • software to continue delivery of structured group most recent edition of Pulse, a series used by clients in our East Kent service to raise programmes for both service users and recovering of briefings from The Forward Trust awareness and help address problematic use of families. This was really well received, and even for staff, partners, commissioners alcohol, cannabis and powder cocaine during those who were originally nervous or unsure and stakeholders to communicate lockdown. For those who were motivated, quickly felt at ease once the meetings got going. insight, innovation and evidence of completion rates were good and clients seemed to For some, online meetings have provided a more our personal, social and economic benefit – post-completion matrix measures show secure and comfortable environment than face-to- impact. To read the full briefing, visit www.forwardtrust.org.uk/about-us/ an improvement in both mood and anxiety. face meetings. research-and-publications/pulse/

WWW.DRINKANDDRUGSNEWS.COM FEBRUARY 2021 • DRINK AND DRUGS NEWS • 19 To advertise in DDN contact [email protected]

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20 • DRINK AND DRUGS NEWS • FEBRUARY 2021 WWW.DRINKANDDRUGSNEWS.COM CAREERS

depending on what’s come up. The greatest gift you can give to someone is time. After bringing lunch, I make sure people get their afternoon medication on time – I AM A... especially important for those going through detox withdrawals. Then Since the beginning of the coronavirus if there’s chance, I like to get the pandemic, new admissions into rehab isolated residents out for a (socially distanced) walk and discuss what to have had to isolate. Stewart Bell tells expect when moving into the main community. A change of scenery us about his role as isolation support and a bit of freedom enables them to open up and have honest worker at Phoenix Futures’ Wirral conversations. Throughout the day I fit in admin, calls to doctors, logging Residential service medication and addressing any other needs, then issue the evening an effect in March 2020, I was medication before I leave. still volunteering and supporting There’s a lot I enjoy about this different parts of our work where job, but delivering groups is my ‘There’s a lot I enjoy needed. favourite part, as well as chatting So much of what used to be to the people in treatment. There’s about this job, but second nature changed overnight. nothing more satisfying than being People had to isolate for 14 days able to offer someone some advice delivering groups is (now ten) to make sure they didn’t and see them go on to achieve so my favourite part, have any symptoms before they much knowing I played a small part. joined the main community. I If someone wants to leave during as well as chatting needed to help keep the people detox and you convince them to in isolation separate and safe, stay, then six months later see them to the people but also keep them engaged. I complete their programme, it’s the introduced them to the language most rewarding feeling in the world. in treatment... of the therapeutic community, It’s frustrating that during COVID The greatest gift getting them started with written people can’t have all the usual work, and looked to increase their experiences around rebuilding you can give to y journey towards comfort by improving the facilities relationships – home leave and this role began in and entertainment available. As external commitments as people someone is time.’ 2017 when I was the year went on, we heard about move through the programme a resident here. more residential services closing are invaluable. We make the best Six months later their doors, which meant even of it and the team here at the through is similar. Whatever you do, MI moved into Phoenix’s supported more people needed our help, so I Wirral Residential are brilliant, but you’ve got to be passionate about housing and came back to do peer was offered a full-time contract as I sometimes worry for the people it, and job satisfaction in recovery is mentoring once a week at the isolation worker. coming into rehab that going into massive. residential. I start the day by administering isolation could feel like they’re stuck It’s thanks to Phoenix I’m I found myself enjoying it more medication to those in isolation, in a bubble. still here, and that gratitude is and more, especially building up followed by a morning check-in, When I came into treatment, I the foundation for me being so relationships with the staff team. including making a list of any had no intention of going into this passionate about this job. This last I took courses in health and social essentials they need. After serving work – I wanted to be a nurse. But year has been difficult, but in a care and mental health awareness, breakfast, I attend the staff the two careers aren’t so different strange way it’s also been great for and did everything available handover meeting, where I keep – the healing process people go my professional development. for personal and professional up with what’s happening in the development. I began delivering main house and give an update OUR ‘I AM A…’ CAREERS SERIES aims to share groups and enjoyed it so much on people’s progress in isolation. it made me want to get more Then I do a ‘feelings check’ with knowledge and experience of different careers in the involved, so I became a volunteer each individual in isolation, which sector. You can take part through the ‘get in touch’ button worker for three days a week. might take me half an hour on on our website: www.drinkanddrugsnews.com/i-am-a/ When the pandemic began having one day and three hours the next,

WWW.DRINKANDDRUGSNEWS.COM FEBRUARY 2021 • DRINK AND DRUGS NEWS • 21 Are you interested in changing people’s lives and supporting lasting recovery? Are you in recovery yourself with lived experience? We are interested to hear from people who want to make a difference to people’s lives, people who may or may not have lived experience in recovery, or as a family member of someone in recovery.

We are currently recruiting for: We offer: – Psychotherapists – Competitive salary VISIT US – Drug and Alcohol Practitioners – Simplyhealth cover – Team Leaders – Childcare vouchers on social media – Recovery workers – Therapy allowance – Substance Misuse Nurses – Career development – Apprentices & Volunteers – Up to 30 days annual leave and join the conversation

View our current vacancies at @ddnmagazine www.forwardtrust.org.uk/work-for-us/ /ddnmagazine

DETOX WORKERS Leeds RECOVERY WORKERS Nationwide NEEDLE EXCHANGE WORKERS Yorkshire Be a different HOMELESS RECOVERY WORKER Manchester kind of Nurse, HEALTH AND WELLBEING NURSE be a Delphi Nurse Crawley TRUSTEES Lancaster MORE JOBS ONLINE NOW www.drinkanddrugsnews.com/jobs @DelphiMedical To view our vacancies visit: Contact [email protected] DelphiMedical to advertise your next vacancy delphi-medical delphimedical.co.uk

22 • DRINK AND DRUGS NEWS • FEBRUARY 2021 WWW.DRINKANDDRUGSNEWS.COM

Turning Point Smithfield In-Patient Detox

Has Covid pushed you over the line If you are in need of a break and help with your alcohol use, we can look after you. We offer 7-day stays at our Smithfield Detox service in Manchester. All our services in the local area are integrated, including Rehab Residential Stay and Supported Living, so you can get any further help you need.

Book your stay now on 0161 827 8570 or [email protected] Visit our website at mytp.me/detox