HARM REDUCTION AND RECOVERY

Sarah VaileRecovery Cymru02920 227 019

sarah@recoverycymru.org.ukwww.recoverycymru.org.uk

Purposes and aims Lots of talk about recovery Collaboration is the key! Crossed-wires? Where are we at as a sector? Different approaches to recovery focused

treatment in Wales, England, Scotland…

Agree, Disagree, Don’t know

Recovery = Abstinence

Agree, Disagree, Don’t know

Recovery is just a new buzz word – it’s what we were

doing all along!

Agree, Disagree, Don’t know

Recovery is the opposite of harm reduction

Agree, Disagree, Don’t know

The Recovery approach is not suitable for everyone

What are we talking about when we talk about ‘Recovery’?

Recovery for the individual The Recovery Model for Treatment Community-led recovery support

Recovery for the individual

A journey, process, experience Self-defined About quality of life Reduction in problems Different for each individual

The Recovery Model – why? Waiting lists Service User feedback – disempowerment,

communication, treatment is ‘done to’ someone, lack of options for people seeking abstinence

‘The methadone issue’ / ‘Script & nothing else’

Perceived lack of psycho-social interventions Treatment exits The revolving door – aftercare / sustaining

change

The Recovery Model – main messages

Recovery is a process that occurs in the community with others

Treatment may be one part of this process

Client ownership of the treatment process Greater emphasis on long term goals and

aspirations vs. symptom management Valuing the contribution of professional

expertise and the expertise of lived experience

The Recovery Model – main messages

Recovery Oriented Integrated Systems - services are not isolated pockets of care but should form a ‘greater whole’

A range of treatment options and client choice

Planning for exit Early re-intervention and re-linkage to

treatment and recovery supports Recovery communities

Community-led recovery support

Treatment – Aftercare – Community is not linear

The grass-roots peer-led recovery movement

Supports individuals on all stages of their journey, including throughout treatment

Independent life in the community

Implementing the Recovery Model: Concerns

Differences in the English, Scottish and Welsh approach

What does recovery mean for methadone prescribing, non-abstinence based recovery, client choice and treatment options

Perceived differences between alcohol and drug recovery

Perceived differences in options needed depending on the severity of problem

Philosophical differences re: abstinence

The Recovery Model and Harm Reduction

Are not separate or opposing paradigms! Focus on individual journeys You need to be alive to recover! A recovery oriented treatment system

needs a range of options for people on all stages of their journey and to support all client choices.

Medication Assisted Recovery: A ‘culture of prescribing’

Focus on engagement in treatment and treatment retention… then what?

Disempowering prescribing practices Long term prescribing with little / no

choice to attempt reduction Lack of psycho-social options available

Medication Assisted Recovery

Don’t throw the baby out with the bathwater

Medication can be a powerful tool Options and choice People’s needs and choices may change

over time We need to validate all recovery

pathways: the recovery community is a big tent

The MARS Project, New York Medication Assisted Recovery Support

Project Collaboration between the National

Alliance of Methadone Advocates (NAMA) and the Albert Einstein College of Medicine

Opiate addiction has both medical and behavioural components.

Walter Ginter, Director M-A-R advocate

The MARS Project, New York

“Methadone is not Recovery, Recovery is Recovery. Methadone is a pathway, a road, a tool. Recovery is a life and a particular way of living your life”

The methadone debates de-values the individual’s process of change and achievements

We should be focusing on a person’s life functioning.

Recovery Oriented Methadone Prescribing

A partnership prescribing plan Psycho-social-spiritual options alongside

prescribing Focus on recovery capital and quality of

life Choice and encouragement: to attempt

reduction (abstinence is not a dirty word!)

Validation of medication assisted recovery: challenging stigma

Harm Reduction and Recovery Harm reduction is a necessary and critical

part of a recovery oriented treatment system

The recovery community and harm reduction should work together

Recovery is about an individual’s quality of life, not about treatment philosophies

Policy, commissioning and system design need to support all elements of a recovery oriented treatment system and all recovery pathways!

The Welsh ApproachDefinition of Recovery for the individual: “Recovery from alcohol and drug

problems is a process of change over time that facilitates an individual to make positive choices and improve the quality of his or her life.” (2012)

Still a work in progress!

The Welsh ApproachThe definition will be used to support the development of: A definition of a Welsh Recovery

Oriented Treatment System An audit criteria to measure

recovery-focused practice

A shameless plug!

“Embracing Recovery Training”

In partnership with