As one of those wicked doctors, the first (and possibly only) real research
I did was to compare medical and social models for detox: "Where and when to
detoxify single homeless drinkers" Rex Haigh, George Hibbert: British
Medical Journal 1990 (301) 848-9.
And - stunning conclusion - no significant difference except people
preferred the social model (in Simon House in Oxford, as opposed to the
Warneford Hospital).
But you're quite right about medicalising it too much - I remember it well
(wielding the stethoscope and clinical gadgets as a means of protection for
my fragile authority and clinical dignity). It was my first job in
psychiatry, and would have put me off for ever if they didn't do a good
group therapy programme as well - all long gone now, though.
Rex
-----Original Message-----
From: Therapeutic Communities
[mailto:[log in to unmask]] On Behalf Of Rowdy Yates
Sent: 07 January 2009 12:24
To: [log in to unmask]
Subject: Re: [EFTC] Methadone residents study
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: <BLOCKED::mailto:[log in to unmask]> [log in to unmask]
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http://www.dass.stir.ac.uk/sections/showsection.php?id=4 (home)
http://www.drugslibrary.stir.ac.uk
<http://www.drugslibrary.stir.ac.uk/> (library)
T: +44(0)1786 - 467737
M: 07894- 864897
________________________________
From: Therapeutic Communities
[mailto:[log in to unmask]] On Behalf Of Wendy
Dawson
Sent: 07 January 2009 11:31
To: [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
Tel: +44 (0) 1865 378600
Fax: +44 (0) 1865 842238
Email: <mailto:[log in to unmask]> [log in to unmask]
Website: <http://www.ley.co.uk> www.ley.co.uk
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________________________________
From: Therapeutic Communities
[mailto:[log in to unmask]] On Behalf Of Anthony
Slater
Sent: 07 January 2009 11:20
To: [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.
E-post: [log in to unmask]
www.phoenixhouse.no
www.eftc-europe.com
http://www.tc-of.org.uk/wiki/index.php/RadioTC_International_Norsk
________________________________
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The University of Stirling is a charity registered in Scotland, number
SC 011159.
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