SMMGP - Substance Misuse Management Good Practice

Substance Misuse Management Good Practice

Supporting good practice in drug and alcohol treatment

Post-its from Practice:
Humanity is the essential qualification for drugs workers (Sep 2008)

Last week I went to the best leaving party ever. Until you have seen the whole of the Lonsdale Staff singing karaoke to "I don't want to go to rehab", and "I will survive" with the words changed to "I will prescribe", you haven't lived!

But there was sadness as James, our specialist drugs counsellor, was leaving to continue his psychotherapy training. Interestingly the course organizers insisted on him doing more generic counselling to complete his studies. Yet, the range of people he had worked with in general practice was large and wide, from 17 year olds smoking cannabis, but struggling really to find themselves, to 75 year olds using benzodiazepines to sleep, but really coming to terms with their Parkinson's disease.

It was testimony to James' character and work that everyone from the practice who was in the country (even those that said they wouldn't ever be seen singing karaoke yet on the night wouldn't leave the platform!), came to the party. It was a celebration of James, a man who came quietly into our lives and taught us so much. In five years, a bad word was never said about him from either patients or staff. Patients who had previously resisted using "talking therapies", worked with James and made change. Many services say they practice patient-centred care, but James showed us that is what we do. He reinforced our philosophy of caring and that in caring it was OK to get cross, if behaviour was unacceptable (which is rare) or if boundaries had been breeched. This was not being punitive, it was being caring enough to challenge people.

He reinforced our philosophy that it is the person who should be the focus, not the taking of drugs. We need to understand the context and meaning of drugs in people's lives, look at the person behind the drug and not make the people who take them the problem. The belief that people who have drug problems can never be trusted is pervasive. This often sets up a punitive dynamic when users of the service are punished for taking drugs - the very reason they are presenting. They are seen too often as "bad", and less often as individual people with complex needs who are asking for help. The label of "drug user" or "addict" is very negative, and can overshadow everything else that a person is.

Personally, he helped me see I was OK and that the service we ran was sound and healthy. So often in this "tick-box" culture we can forget that the only important issue in drug treatment is care and supporting people to be who they want to be and where they want to get to. We can be the facilitators or the inhibitors of people's journeys. What is it about the drugs field that can so often make us lose our humanity?

To quote a wonderful friend Bill Nelles, creator of the Alliance, "We must take the moralising out of drug treatment and put the humanity back in". James sees the person, whether they are patients or staff and I will miss him.

- Dr Chris Ford