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10 years in the field
as ‘accommodation for persons who require
treatment for substance misuse’. Unfortunately
CQC chose not employ someone to coordinate the
implementation of this regulation and, as this had
become my passion, I took early retirement and
sought to assist services as an independent
consultant. Sadly, in my view, CQC implemented
this inconsistently for the first five years. However
they have now decided that a policy manager for
substance misuse is needed and a separate
nationally recognised inspection methodology is
being developed.
The last decade has seen the passing of some
long-standing residential rehabs to be replaced by
newer ones. Regulation has also been extended to
many community-based services, many of which
are doing an excellent job. My passion is that
services are run respectfully and with a central
focus on the needs of people using the services,
with recovery as chief aim. My hope for the future
is that quality will win the day and the new rating
system introduced by CQC will highlight where
there is good, and even outstanding, practice
among treatment providers.
David Finney, independent social care consultant
‘WALES NOW HAS THE BEST
ROUTE OUT OF ADDICTION’
KALEIDOSCOPE BEGAN
its own rehabilitation by
establishing itself in Wales ten years ago. What we
saw when coming to Newport were huge waiting lists
for treatment and a lack of support for people with
drug and alcohol use in many parts of the country.
Today we see Welsh-based organisations
forgetting past rivalries and coming together and
sharing best practice. This has best been shown by
the establishment of Drug and Alcohol Charities
Wales (DACW), which ensures there are Welsh
solutions to the problems of substance use.
Innovation has flourished, be it through Peer
Mentoring (an ESF Funded Scheme) which saw
hundreds of people with drug and alcohol issues
obtain work; Change Step, which is a unique project
supporting veterans; the development of
computerised dispensing systems in our major
cities; and the establishment of social enterprises
for service users. Wales is fast becoming the best
country in the UK to be in when looking for a route
out of addiction, when it used to be the worst.
I am worried that the uniqueness of treatment
in Wales will be replaced by the huge English or
international companies in ten years’ time,
peddling average drug services at cut-price costs. In
Wales, service users have grown in confidence. In
Gwent,
The Voice
service users group works closely
with the local providers and is actively involved in
how treatment works. Its voice is heard because
management is close enough to hear, and is near
enough to meet with. As DACW has shown, with
drug services in a small country, networks with
trust can be formed which simply would not
happen with large faceless organisations.
Positively, I do see a change in legislation and the
re-emergence of harm reduction. The Welsh
Government policy of a drug and alcohol strategy is an
example where all mind-altering substances are looked
at rationally and not, as in the case with the UK
government, on ill-informed legislation governed more
by the
Daily Mail
than by the experts on the subject.
Martin Blakebrough, chief executive,
Kaleidoscope Project
‘MISTAKEN PARADIGM STILL
DOMINATES RESEARCH’
A STRIKING ASPECT
of treatment research from
the past ten years is the realisation forced on Project
MATCH researchers: that after the most
sophisticated research of the most highly technically
specified therapies ever seen in alcohol treatment,
their therapists were in essence doing nothing
different from the faith healers and witch doctors of
‘primitive’ societies – providing a culturally accepted
route to recovery which gave clients permission to
activate their pre-existing resolve and resources.
What was critical was cultural fit, and the status it
gave to the intervention and to the therapist. It was
an example of the creation of new understandings
from the rubble of a massively expensive and
unexpected failure – in this case, to match different
psychosocial therapies to different kinds of patients.
1
Underlying most research is a very different
preferred message – that we have found treatments
that work because they embody the right
psychological technology to treat a techno-medical
disorder of the body and mind. The car is not
working; as long as the technician uses the right
spanner on the right nut and turns it in the direction
and by the amount specified in the manual, then it
will be restored. Despite what (in The No. 1 Ladies’
Detective Agency novels) Mma Ramotswe’s
mechanic husband likes to believe, it matters not at
all how the technician talks to the car, whether he
loves or loathes it, shows respect or disdain, and the
car itself plays no part in the process.
For substance use, this profoundly mistaken
‘We’ll see challenges
dealing with an ageing
group of users.’
DAVID LIDDELL
‘My hope for the
future is that quality
will win the day.’
DAVID FINNEY
14 |
drinkanddrugsnews
| November 2014
www.drinkanddrugsnews.com