Drug and alcohol abuse can be a taboo subject, making it all the more difficult for families trying to get help for their loved ones. Behind much of addiction often lies trauma – some predating substance abuse, dating from childhood or adolescence, whilst other trauma is consequently triggered by the dangerous lifestyle addiction inflicts – that leads to loss, breaks relationship ties, places people at risk of a downward spiral into antisocial peer groups, homelessness and sometimes crime.
It has always perplexed me that when people summon the enormous courage needed to ask for help, often in crisis, that they are frequently turned away. Turned away from A&E due to being intoxicated, turned away from mental health services as they need to get dry first or turned away from substance misuse services, because by the time they wait weeks and months to be seen, they have relapsed back to the lifestyle that they were trying to escape.
If we are going to address substance misuse problems across our communities, services need to be responsive to people’s needs and to work with them at their stage of recovery. Some people may be in denial that any problem exists and harm reduction strategies might be the most effective intervention at this stage; some people may be contemplating change and need motivational strategies to support this, whilst others may have taken some action towards change already and be looking for maintenance support; others may conversely be relapsing and in need of help to renew their efforts.
There is no one treatment fits all, but access to rehabilitation should surely always be a feature of what is offered when someone seeks helps. Only when we treat people holistically and address their psychological, physical and social needs will we and more importantly they, be effective in addressing their problems.
If we are serious about behaviour change, mental health supports and are crucial to building skills, self-belief and the resilience required to change lifestyles and recover from the cycle of addiction. In treatment people often say they are self-medicating using substances to modulate their emotions, block out their distress or cope with everyday problems. We must listen to them because unless we help people deal with their underlying triggers, vulnerability to substance abuse and relapse will always remain.
Families struggling with addiction issues also need significant help to overcome the stigma, shock and impact that this brings to their families lives, alongside support from those who have been on this difficult journey alongside them.
As Chair of the 12 Steps All Party Parliamentary Group in the House of Commons, we are working with Ministers and Government to address need for access to varied treatments to support those in our communities struggling with drug and alcohol abuse. AA and NA can offer confidential support that many of those in recovery and their families can benefit from, but we would never suggest that it provides the answer for everyone.
The key to success is to place the service user at the centre of their own recovery and care. They must have ownership of their treatment plan and lives. People need timeous help and support, and a choice of what works for them, whenever they are ready to engage. This is user led rather than service led recovery – and requires a massive sea change in the way that services are configured.
Helping those who are vulnerable and struggling though, is a mark of the society that we seek to be, so we need to start in our local communities, addressing the impact of addiction, promoting wellbeing and offering opportunities for alternative lifestyles. When people have alternatives, alongside support and holistic care that meets their needs, psychologically and physically, then they can begin to see their way out of the dark precipice of addiction.