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David Best: Why the UK lags behind in recovery for drug users

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Published: 08/09/15

It's rare that you'll see Blackpool praised by a professor of criminology, but when it comes to leading the way in changing how the powers that be handle recovery from substance abuse and dependency, it is certainly a shining example of success.

I am evaluating a social enterprise in the town called Jobs, Friends and HousesLed by a serving police officer with the official backing of Lancashire Constabulary, all profits from the project are re-invested back into a mission – to support and sustain abstinent recovery. The more profit it makes, the more individuals and communities we can help.

The social enterprise provides meaningful employment, stable accommodation, positive peer friendship and role models and health and wellbeing support, with an emphasis on property development - buying, renovating and refurbishing properties.

Its vision is to integrate the recovery community with the wider community and vice versa. It wants people to see the power and potential of recovery rather than the stigma of addiction or offending.

It is not entirely unique in this country, but it's certainly not the norm.

This week, to mark National Recovery Month, I've written to Professor Dame Carol Black, head of the independent review into the impact on employment outcomes of drug or alcohol addiction, and obesity, hailing Jobs, Friends and Houses as a shining light in a UK recovery programme that lags behind many countries across the world.

There is a growing evidence base about what works in recovery both at the individual level and at the level of services and systems that could be translated into a set of professional standards for community recovery organisations.

This would form the basis of quality systems, innovation capture, training and management that is essential for maximising the return on investment in recovery services, including, but not restricted to, employment. My own work has summarised recovery innovation in the UK but this has not been widely undertaken and there is considerable reinvention of the wheel and poor practice and management in recovery services that goes unchallenged.

Jobs, Friends and Houses has bucked the trend about relapse and drop-out. Some initial indications from our evaluation include a strong leadership and a dynamic and flexible model, a social enterprise run as a business, not as a charity or a treatment centre and a vision and mission (building a recovery community for Blackpool and giving people back a sense of pride and dignity through meaningful work) bought into by staff and stakeholders.

Furthermore, it is not connected to treatment, abstinence is a prerequisite and a condition, and no participants are on substitute prescriptions.

Later this month, Sheffield Hallam University's pioneering Helena Kennedy Centre for International Justice will launch the UK's first-ever Life In Recovery survey. Results are still coming in, but initial assessment suggests they echo an earlier Australian survey where just under 75 per cent of participants remain in steady employment in recovery, suggesting that recovery is associated with wellbeing.

My earlier Glasgow Recovery Survey based on 205 people in recovery from alcohol and heroin addiction showed that the strongest predictors of long-term recovery were engagement in meaningful activities and being surrounded by a positive social network.

Stopping meaningful activities appears to lead to reductions in wellbeing. This is a strong justification for using meaningful activities as a mechanism of priming wellbeing, and suggests that we should not wait for people to be well before encouraging them back to work.

So why is the UK's recovery still not getting it right?

Most people agree that achieving abstinence is only the starting point - 50-70 per cent of people relapse in the first year after detoxification; the risk of relapse drops to around 15 per cent at five years abstinent time and plateaus at that point.

There is a five-year journey from initially achieving abstinence to what is regarded as 'stable recovery': the initial phase is the task of clinical services, the subsequent five-year journey is about reintegration, community engagement, houses, jobs and friends.

The psychological changes people need to sustain recovery are coping skills; a desire and commitment to a recovery lifestyle; recovering role models and embedding in social networks that are barriers to drinking and taking drugs.

There are currently two flaws with the current model. The first is that too little resource is spent on continuity of care that focuses on social connectedness, mutual aid involvement, housing, employment, training and education.

The second flaw is that majority of so-called recovery services in the UK are delivered by people who 10 years ago were called drug or alcohol workers who have neither the skills nor the mind-set to deliver effective recovery services.

Also, many organisations have the wrong structures and systems in place to help people engage effectively in the community. Providers have a reduced incentive to address issues that do not form part of a financial measurement structure and view employment as someone else’s responsibility.

Here at Sheffield Hallam we are running a series of events to support National Recovery Month, and want to place the city at the heart of best practice for leading the UK's recovery revolution.

It is on this basis that I have written to Dame Black making three recommendations for the future direction of the UK's life in recovery. There is no shortage of best practice out there, but some alarming failings too.

When it works right, as in the case of Jobs, Friends and Houses, recovery is entirely attainable and, when those in recovery achieve it, a positive experience can be waiting to enable them to survive and thrive.

The author:

"Blackpool is leading the way in changing the way the powers that be handle recovery from substance abuse and dependency"