Drug misuse may immediately merit the suggestion whether a person should be rehabilitated, corrected, punished, or indeed, treated (Alterman et. Al.: 1993). Furthermore, the notion of chemical dependency as “disease” warrants examination. Just as there are an assortment of drugs and those who use them, there exists a rather diverse population for which treatments should also vary. Cunningham (2000) implies that where a doctor’s criteria of what constitutes abuse or dependency of alcohol or (other) drugs are generally restricted to medical and psychological aspects. More specifically, noted that rarely are the consequences of harmful use actually restricted to one or two spheres of a person’s life. (Cunningham:2000) The restricted aspects have set the premise for narrow minded thinking. Furthermore, it widens the gap of unsuccessful treatment.


Although causal use of drugs has slightly declined, there has been no apparent progress or change in the numbers of heavy users of heroin and cocaine (Chaney et. Al:1998). Hard-core drug abusers, those who use at least weekly and exhibit drug related behaviour problems, typically are at the bottom of the social ladder where drug treatment programs have had the poorest track record.  Currently, one of the nationwide initiatives and interventions within the U.K. include slapping Anti-social Behaviour orders to curb unacceptable behaviour, which may quite often be the result of misusing substances.


Within the UK the Drug and Alcohol Action Teams (DAAT) programmes continue to address national and local government objectives in the provision of treatment across all tiers of the profession.  I attended the recent launch of the DAAT Programme for 2004/05 (6th May 2004) in the borough of Hounslow, Middlesex.  Key themes and objectives of the DAAT’s work programme were presented and the local DAAT Treatment Plan had been agreed by the National Treatment Agency.  There were many themes, however the DAAT’s top priorities for 2004/05 for the borough of Hounslow are as follows:


·        Development of a Young people’s Substance Misuse Service


·        Reducing waiting times and improving GP prescribing levels.


·        Developing clearer responses to crack cocaine.


·        Developing provision to reflect more sophisticated understanding of needs of Hounslow’s diverse communities.


·        Improving data collection, including joint working with CDRP


(DAAT Programme 2004)


Advocates for expanded drug treatment argue that new programs will more than pay themselves in reduced crime, improved health and fewer broken families. It’s not clear which, if any, government and / or approaches really work, however counsellors working together in partnership with other service providers continue their endeavour in seeking appropriate therapeutic interventions with clients who misuse substances.


Drummond (1995) declares that, traditionally, we may oscillate between perceiving addiction as a medical hindrance and a social amiss. Similarly, the therapy of addiction has conceded in the course of sequences of medical attention ensued by disciplinary crackdowns.


Unfortunately, addiction models and consequent treatment approaches have been rigidly constructed. It is this generic programming and lack of flexibility that results in high recidivism and poor success rates. The completion of treatment, the “treated” individual is usually returned to the same environment that s/he struggled with prior to entering that program.


 


“The expectation is that the client is better equipped in dealing with the problems s/he entered treatment with. The degree to which many clients are able to cope is usually not sufficient to ensure long-term stabilization. Success ultimately boils down to an individual’s personal decisions.” (Drummond, 1995).


 


The individual’s capacity to decide would be less inhibited if s/he had a broader range in which to choose from. The current disease model short-circuits treatment potential. In fact, it holds an element of damage in itself, in that there seems to be a mentality of labelling accordingly (Drummond:1995).


Frequently, upon failing in treatment, a client is offered another chance by the same agency (“to get it right (Drummond:1995)”). Programs are more often than not geared toward delivering curricula that suits the protocol of the agency. Many programs tend to facilitate the same basic treatment to all clients, and fail to distinguish first time clients from “recycled” clients (Hay:2001). If the person in relapse enters another agency, s/he is likely to be re-assessed, and there’s a good chance that the client will be subjected to the same treatment regimen as previously prescribed, only the new program will have a different name.


The 12 steps of Alcoholics/Narcotics Anonymous are the foundation of many treatment centres. A.A. originated in the 1930s (Hay:2001). There is no cost, and it was designed as an outlet for chronic alcoholics who choose to attend. To administer treatment from a 12 step orientation is a question of ethics. It is important to note, if a program mandates attendance, let alone operates solely on the principles of the 12 steps and charges for such “services,” it conflicts with the notion of anonymity and the intrinsic features of AA. They may be a good supplement for many in recovery, but the 12 steps should not be the main component for any agency (Harwin and Forrester:2002).


 


 


 


 


 


 


 


 


References


 


 


Cherry, A., Dillon, M., & Rugh, D. (2002). Substance Abuse: A Global View. Westport, CT: Greenwood Press.


Drug and Alcohol Action Team. Drug misuse statistics United Kingdom 2004 . Edinburgh: ISD Publications.


 


Harwin, J and Forrester, D. (2002). Parental substance misuse and child welfare: A study of social work with families in which parents misuse drugs or alcohol. London: Interim Report for Nuffield Foundation.


 


Hay, G, McKeganey, N and Hutchinson, S.( 2001). Estimating the national and local prevalence of problem drug misuse in Scotland. Glasgow: University of Glasgow.


 


Schwartzberg, A. (1998). The Adolescent in Turmoil. Westport, CT: Praeger Publishers.


 



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