From the perspective of an alcohol worker:

I got involved with Greystones Tameside Ltd – Supported Accommodation for Homeless Men, six years ago.  I originally got involved primarily in an administration role but this then led to the role of Support Worker.

Greystones was seeing a lot of men with alcohol issues coming to use the service because they were homeless and Greystones is now recognised as a specialist service for men with alcohol problems.  We worked with these men in a general support role but saw that there was a huge gap in services available to them with regard to their alcohol problems.  From the feedback the staff at Greystones received from residents it was obvious that most of them could see the damage to their health, and their lives, that alcohol was causing and that ultimately they would like to be abstinent continue to live their lives in that way.  In answer to this Greystones set up an abstinence group that would be held twice a week and was run by one of the staff.  It was decided that all the staff would take a diploma in order to achieve that qualifications needed to be drug and alcohol counsellors.

I eventually became more involved with this and started to run the abstinence group.  Initially I started doing research on the subject of alcoholism in order to help me run the groups, but I found that by listening to the guys in the groups that I learnt far more about alcoholism and a lot of my old thinking and perhaps prejudices were about to be turned on their heads!

Alcoholism is something that is generally viewed as self-inflicted (most of the alcoholics I have talked to don’t even like the taste!) and is not looked on as an addiction to the extent that drugs are.  I think this is because alcohol is legal, widely available and socially acceptable.  In fact, through talking to the guys in the abstinence groups, I have learnt that the costs to the alcoholic in terms of quality of life are vast i.e. family breakdown, homelessness, health problems etc.  It also brings about a loss of self-esteem which seems to me to be the greatest problem.  In my experience, people who are dependent on alcohol are very intelligent people who know what alcohol is doing to their lives but are unable to give up drinking without a lot of support (the best support being from others who are in the same position).

What seems to be happening is that when people realise they have a big problem eventually they are sent for a detox, but when they leave the detox centre are then left to their own devices and usually return to drinking almost immediately.  This seems to me to be the largest gap in the services.  When someone decides to make a change in their lives and they want to be abstinent, not only do they have to cope with the addiction, they often have to change everything about their lives and this may even involve moving out of the area, changing their friends and sometimes even cutting off family relationships.  These are problems for which they need ongoing support.

I have learnt a lot about alcoholism since working at Greystones but I think that the best lesson I have learned is that no matter what reason you give an alcoholic for stopping drinking this will not happen until they are ready !!!!! Until that tine you can only try to support them.

I have nothing but the utmost respect for anyone who has achieved abstinence because I now realise how hard that journey has been.

Andrea Boot
Support Worker

What does it mean for me and my service, and for us in Tameside?

My professional background and training is as a social worker, and I was first exposed to the concept of recovery and its key elements when working as a community mental health social worker in east Manchester in the late 80s.  For me, the key elements of recovery practice are valuing the strengths that people bring to their own personal recovery; respecting peoples’ self-directedness; and having a focus on quality of life outcomes.  So for me, the essence of recovery is quality of life, and quality of life outcomes are the best measure of recovery.

But how are we to gauge quality of life, indeed the quality of our own lives?

How much, for example, do we enjoy life? How often do we experience anxiety or depression?  How satisfied are we with our personal relationships? Our sex lives?  The place where we live? How satisfied are we with our health?  Do we have enough energy to get through the day?  And last but not least, how much do we depend on medication to function in our daily lives?

This last question, how much we depend on medication to function in our daily lives, is obviously an important one.  But it is only one question in a wider quality-of-life assessment.

How important the issue of medication is to any one person, (compared to any of those other questions for example) is going to vary from individual to individual.  And the extent to which medication is a help or hindrance can only defined by that person.  No one else can do that for them.

If I had to say in one word how a drug and alcohol service could promote recovery I would say it could be through helping its clients exercise choice. Drug services in particular have sometimes neglected the importance of the detoxification and abstinence option, and clients have expressed the view that their ability to choose this intervention has been restricted.  I am pleased to say that over the last few years my service has dramatically increased the numbers of service users undertaking drug and alcohol detoxifications, and undertaking residential rehabilitation placements.  As important as volume, however, is the quality of the work itself, which means that we need to help clients prepare well for these treatments, offer good support to them and their families during the process, and provide meaningful aftercare.  Currently the completion rate for detoxifications (which itself is a good indicator of future and sustained abstinence from drugs and/or alcohol) is 94%.  And that is an impressive figure.

It’s usually difficult to define something important in one word, so I will add two others to how I think services can best promote recovery, and those two words are social inclusion.  For me, this means making the most of the ‘wraparound’ services that exist (such as employment, training and education services, housing support agencies, and money problem/debt advice agencies) in order to maximise opportunities for promoting social reintegration. I also understand social inclusion to be about the involvement and participation of service users in the planning of their own care and treatment, and in making decisions related to how the service that they use operates.  And finally, for me, it is about offering aspirational roles for service users (through volunteering opportunities, for example) so that services can better represent our service user constituency.

Aligning our work wherever we can with the general social and economic inclusion initiatives in Tameside will pay dividends.  The establishment of credit unions; multi-agency working to tackle loan sharks; and the piloting of individualised budgets are all examples of some of the work beginning to happen locally and further afield. The local treatment system is making some advances in moving towards becoming a recovery-oriented system but, as always, there is much more to do.