Hi Rowdy,
This man has been trying to get to rehab for about 9 months, trying to get funding has been horrific and he has had to jump through hoops.
He had to write a letter as well explaining why he wants to go to rehab, what he wants to achieve in rehab and what he will do when he gets out of rehab just to be put forward to the community care team to see if he is suitable.
We have been unable to get him his own accommodation due to lack of council housing.
He is currently in supported homeless accommodation and they could have helped him to get a private let but because he wants to go to rehab they will not get him his own place just in case he does go to rehab and has to give up the tenancy.
His whole life is on hold at present while he is waiting on a rehab place.
As I said before we have tried numerous ways to try and support this man to get drug free, but so far all we have managed to do is to help him to be stable and healthy.
One of the main problems I have had is that he was only given a one year order and the first six months were spent helping him to pull himself out of chaos due to the breakdown of his marriage, his personality disorder, getting him to engage with us was also a problem because of previous treatment regimes and how he was treated.
Calum
>>> Rowdy Yates <[log in to unmask]> 07/01/2009 13:58 >>>
Calum
I'd echo Richard's remarks about Phoenix Sheffield. I was there for a protracted period to interview and test residents for my dyslexia study. This was a TC that REALLY felt like a therapeutic community and not just a comunal house doing work + counselling.
BUT - how long has this individual been asking for a detox/rehab and how long has he been on a methadone script and how long has he been homeless and why are his MMT providers not sorting out this issue as part of his treatment plan!! What is it exactly that doctors and keyworkers DO on MMT programmes (other than manage the whirlwind)?
Rowdy Yates
Senior Research Fellow
Scottish Addiction Studies
Sociology, Social Policy & Criminology Section
Department of Applied Social Science
University of Stirling
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________________________________
From: Therapeutic Communities [mailto:[log in to unmask]] On Behalf Of Richard Phillips
Sent: 07 January 2009 13:35
To: [log in to unmask]
Subject: Re: [EFTC] Methadone residents study
Hi Calum
Going from 100 to 50 is no fun, and if the client doesn't have good housing and support this might be hard to achieved before admission - if you can get funding, doing the detox (or get down to 50mls) prior to admission sounds wise. Sheffield is a great service, so if you can get him to the door lets hope he finds his path from there.
Regards
Richard
----------------------------
Richard Phillips
----------------------------
2009/1/7 Calum Blair <[log in to unmask]<mailto:[log in to unmask]>>
I currently have someone who is going to Sheffield to be assessed, they are currently on 100mg of methadone and they need to reduce that to 50mg before they can enter the community.
The detox will then last for around 3 weeks.
The problem is that this person has tried a numerous home detoxs but has had no joy because he is in homeless accommodation
with other drug users. So he is worried that he is never going to get into rehab, some would say that he cant be motivated, but when you have failed so many times and have neg self efficacy it is easy to look as if you are not totally motivated and committed to getting drug free.
But I believe that it should always be the person who should decide what they want, and if they want to go to rehab then why not, if it does not work they will have learned a lot that will help for the next time.
What he now wants is to go to Red Towers to detox then go down to Sheffield.
As i said he has tried self detox numerous times including stopping his Methadone outright, but he has never managed to stay drug free for very long before returning to Heroin as he is staying in homeless accommodation and there is always someone there in the wee small hours that offer freebies.
Calum
>>> Rowdy Yates <[log in to unmask]<mailto:[log in to unmask]>> 07/01/2009 12:24 >>>
Wendy
As you know, I think there are some real positives for your idea. Certainly, I feel the voluntary sector in general (at least in the UK) has lost touch with it's old skills-base in this respect. Certainly, when I was working at Lifeline in the 1970s we developed a real ability to do home-based detoxs (effectively and with low levels of discomfort) because that's all there was! By and large the medical profession didn't want to know and if they did, they stuck folk on some godawful general psychiatric ward (usually excusing the appalling conditions as a "test of motivation"!!) and detoxified people with librium.
The early Synanon was characterised by the fact that people could come in off the street and detox in the lobby of the hotel in which the TC was based. I've said before on this list, my view is that this had a positive impact on the dynamic of the community. When you started to get pull-ups, as often as not, the people doing the pulling up were the same community members who soothed your troubled brow and mopped up your sick when you first arrived.
My view is that the medical profession has consistently demonised home-based non-medical detoxification in their inexorable drive to medicalise the whole of addiction. The tendency of most doctors (apologies to all the doctors on this list - but you know it's the truth!!) to revert to the security blanket of the disease model of addiction is profoundly depressing. It's as if the work of Zinberg, Engel, Kantzian, Schaz and all the other addiction theorists of the past four decades had never existed!!
But maybe this is just the pining of an old man for those far-off good old days when drug workers were able to work out whether someone was stoned (and on what) without having to wait for the results of an observed urine test (shudder!!).
One other thing though. You say:
"indeed policy will not allow them to enter into a residential TC treatment until successful completion of a detox"
Whose policy is this? It sounds completely daft to me. It should be up to the TC itself to decide the most appropriate entry conditions/regulations. Certainly, Phoenix Sheffield have for some time accepted clients on reducing doses of methadone - I'm not sure of the exact amounts/timescales and unfortunately, I don't think anyone from Phoenix Sheffield is on the list - and my impression was that it had been an extraordinarily uneventful development for them. Certainly when I was there about 18 months ago, it wasn't really possible to work out who the detoxing residents were (though I suppose other residents would be more critically aware.
Rowdy Yates
Senior Research Fellow
Scottish Addiction Studies
Sociology, Social Policy & Criminology Section
Department of Applied Social Science
University of Stirling
E: [log in to unmask]<mailto:[log in to unmask]><BLOCKED::mailto:[log in to unmask]<mailto:[log in to unmask]>>
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http://www.drugslibrary.stir.ac.uk<http://www.drugslibrary.stir.ac.uk/> (library)
T: +44(0)1786 - 467737
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________________________________
From: Therapeutic Communities [mailto:[log in to unmask]<mailto:[log in to unmask]>] On Behalf Of Wendy Dawson
Sent: 07 January 2009 11:31
To: [log in to unmask]<mailto:[log in to unmask]>
Subject: Re: [EFTC] Methadone residents study
Hi
This is disturbing news!
Particularly as I am keen to challenge NTA guidelines by developing a detox unit without prescribed medication here at the Ley. We have 15 people waiting to come into the Ley but their funders and indeed policy will not allow them to enter into a residential TC treatment until successful completion of a detox. However with increasing demand and waiting time for detox these people may possibly be dead, change their mind or decide to be maintained for the rest of their lives on a script - where is the client choice in all of this?
Best wishes
Wendy
Wendy Dawson
Chief Executive
The Ley Community
Sandy Croft, Sandy Lane
Yarnton
Oxford
OX5 1PB
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From: Therapeutic Communities [mailto:[log in to unmask]<mailto:[log in to unmask]>] On Behalf Of Anthony Slater
Sent: 07 January 2009 11:20
To: [log in to unmask]<mailto:[log in to unmask]>
Subject: [EFTC] Methadone residents study
Hi,
This study is now being promoted in Norway via various news groups.
In some ways this will be, I think, unfortunate for drug free addiction tc's, as we have already been under a great deal of pressure to take people on methadone in to treatment, in drug free recovery tc's.
A real dilemma is that the medical authorities / advisors strongly also recommend that individuals stay on it for life.
More to come on this topic no doubt...............................
Best wishes,
As ever
Anthony Slater,
Director - Phoenix House Haga,
President, E.F.T.C.
Folkenborgveien 198,
1850 Mysen, Norway.
tlf. +47 69 89 82 50 / fax. + 47 69 89 82 51.
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http://www.tc-of.org.uk/wiki/index.php/RadioTC_International_Norsk
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