The Alliance has reviewed its structure and purpose in light
of a new ‘era of recovery’. Chief executive Ken Stringer gives
the thought behind the organisation’s recent changes and
looks to the future
12 |
drinkanddrugsnews
| February 2012
Advocacy |
The Alliance
www.drinkanddrugsnews.com
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he Alliance was born as The Methadone Alliance almost 13 years ago
– in a time of optimism and of hope. The drug field was filled with
energy, creativity, imagination – and money. With a commitment to
stand up for people’s rights to make choices regarding their own
treatment, the Alliance focused on some clear objectives – to improve
service users’ experience of drug treatment and other services, to
lobby for improvements in access to services for all, and to improve the information
service users have about treatment and treatment options.
Since then we have helped and supported over 10,000 people through difficult
times. We continue to run an online forum and a helpline, we have been
responsible for setting up specific local projects to develop peer education and
local support groups and continue to deliver hands-on advocacy work. We have
helped people to access substitute prescribing and helped others to find reduction
programmes, detoxes and abstinence pathways. We train people in harm reduction
approaches and relapse prevention. All of this is geared towards supporting people
to become informed and to make choices, to gain control over their lives and be in
a position to determine their own future, their own recovery.
During this time we have seen many changes in the way drug treatment is
delivered. No one waits more than four weeks for assessment and treatment
anymore in England (when we started out, three- or four-month waiting lists were
not unusual). We have widespread agreement to a range of evidence-based
reliable treatments that should be available to everyone who needs them. This is
ratified by NICE, meaning that for the first time people in the UK have a right to
substitute prescribing, harm reduction services and psychosocial interventions.
Given these advances, The Alliance needed to take stock this year of where we
were, what was happening across the drugs field, and what the need was for an
organisation like ours in the new era of recovery.
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Recovery is the focus of this government’s approach to drugs and we were keen to
understand what impact this was having on the ground – what it meant for the
people who use our services. So this year we spent some time talking about this
with our stakeholders. We did this through a structured survey, brief analysis of
our helpline calls and advocacy cases, small focus groups and discussions, and
internet forums. We also drew on the experiences of our board members and
correspondence with workers and service users.
We know that recovery is fundamentally about self-determination – about
choice. It is not about simply getting what you are given, doing as you are told and
accepting someone else’s choice about what your options are. Given this, recovery
should be changing the way services are delivered, improving their quality, making
sure that individuals get a better deal – not just in terms of drug treatment but
across the range of things that build recovery capital, like housing, social care and
employment. And The Alliance should be out of a job.
In our survey, 80 per cent of our group told us that substitute prescribing – and
for many, long-term maintenance – was hugely important for their recovery. We
heard from people who had not had a job in 20 or more years for whom a reliable,
regular script had given them the stability to become a ‘long-term taxpayer’.
Sounds like recovery? Yet we have received more reports than ever from people
concerned about being coerced into abstinence. A number of service users have
reported being told by their provider that as newcomers to the service they can
only have a script for six months. Disturbingly, people who believe they are in
recovery have told us that they are being tapered off their medication because they
are now stable.
Some service users have spoken to us about the difficulties of quasi-compulsory
‘self-help’ groups, with users threatened with the withdrawal of their script if they
do not attend recovery meetings. We have also had a number of calls about
unnecessarily intrusive and ‘bullying’ regimes, including mandatory home visits to
inspect storage facilities for medication, excessive inappropriate screening, refusal
to move stable users off supervised consumption and the reinstitution of daily
pickup for users who have been stable and picking up weekly – in once case this
was threatening a service user’s continued employment.
More than half of the people who responded to our survey said that they had felt
pressurised by their key worker or doctor to make changes to their prescription they
didn’t want, and a further 13 per cent said they were worried this might happen.
A worker contacted us to tell us that they had been receiving explicit
instructions to move people to reduction and abstinence – particularly those who
are most stable. Despite their fears that these people would become less stable
and even start using again when their scripts were reduced or stopped, the worker
was told that it was a critical issue and that without doing this, the service would
be shut down as this was government and NTA policy. This is not true – but this
experience it seems is not unique and other workers have sought our advice about
whistleblowing around similar concerns.
Alongside all these changes there also seems to be an increasing stigmatisation
of those people on scripts. Echoing many others, one service user told us: ‘There is