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20 |
drinkanddrugsnews
| April 2014
Soapbox |
Alan Rushmore
Soapbox
DDN’s monthly column
offering a platform
for
a range of diverse
views.
OPENING
DOORS
Drug treatment within
custody needs an overhaul,
says
Alan Rushmore
DRUG TREATMENT IN PRISON
lacks consistency and is over-burdened and over-complicated by
assessment. It need not be so.
Many clients will simply require an assessment of need and possibly a brief intervention.
Others may benefit from coursework and/or individual support to confront their offending
behaviour. Some will not perceive an issue with their recreational use but may benefit from
some information or guidance.
Poly-substance using clients will require more intensive support and involvement with a
wider stream of expertise. Others will be on Integrated Drug Treatment System (IDTS) and
will need support to withdraw.
Even after 15 years of working ‘behind the wire’ I am often surprised and impressed by
the level of commitment from both clients and colleagues to implement change. Yet I am
also saddened by the obstacles and lack of communication thrown up by the prison system
or organisations that employ us.
It would be easier if each service provider employed the same assessment tool, and if the
client’s care plan was reviewed upon transfer. Presently the payment by results culture
dictates repetition of assessment, with files rarely transferred with the client. If this were
routinely done, clients could be seen promptly and we would have greater continuity of care.
IDTS should be about reduction from methadone and Subutex, not about maintenance.
To do this we need to provide the relevant support and guidance and elicit the appropriate
community support to encourage self-control and abstinence.
Ideally it would be good to have a national service that enabled prisoners to be met and
accompanied to probation, housing providers or rehab. Meet and greet services should be
national and not confined to specific service providers.
As drug and alcohol practitioners we need to
work closely with our colleagues in healthcare,
mental health and discipline. Again, I have been
fortunate in that I have always believed that I
have worked successfully with my colleagues
from other disciplines, but sadly mental health
services are often over burdened and under
resourced. This has to be rectified as the
majority of my clients (and possibly yours) have
demonstrated either primary or secondary
mental health concerns.
Those who work within addiction recovery
possess an array of skills. The opportunity to
share ‘best practice’ – a cross-pollination of skills
to improve services to clients and to improve
dialogue and understanding between custody
and community – would be welcomed. DIP
teams are actually quite remarkable and have
demonstrated excellent practice, but we need to
use them more.
Access to alternative therapies and fellowship groups (NA, CA, AA etc) is presently limited
and enhanced access would be beneficial. Personally speaking, prison should be about
rehabilitation and promoting positive lifestyle choices. Sadly it appears more to be about
containment, punishment and retribution.
Our clients are often stigmatised and disenfranchised by their addictions. We should be
empowering our clients to confront and take control of their drug use, to rebuild
relationships, to access support, to develop trust and enable them to transfer to the
community as ‘well’.
As practitioners we run the risk of working in isolation. We need to recognise and understand
the difficulties and frustrations of working within different institutions and organisations. We
need to widen our experience of different environments to make us better practitioners.
We read and hear about ‘the war on drugs’. It is not a battle, but it certainly is a struggle
to cope with the global pandemic of drug use. Addiction does not discriminate but sadly it is
only too easy to be criminalised and thereby marginalised by becoming infected by
substance abuse.
‘Let’s work together, come on, come on, let’s work together’ to confront the disease of
addiction and addictive behaviour. We need to replace use with positive lifestyle choices to
enable our clients to make balanced decisions based upon informed choice. By communicating
and demonstrating consistency we can encourage empowerment. We’re all on the same side.
Alan Rushmore is a drug and alcohol counsellor and therapist
‘Addiction does
not discriminate
but sadly it is
only too easy to
be criminalised
and thereby
marginalised...’