My Journey

I return to UK from Western Australia in March 2009 to give a talk alongside Bill White at a conference in London organised by Wired In and Action on Addiction for leading UK recovery advocates. I then visit Scotland to attend recovery conferences, fly to Dubai to  pick up my children and take them to Australia, return them to Dubai, and travel back to the UK to visit various recovery initiatives. Wired In To Recovery is developing fast, but we are not able to attract funding. (4,076 words)

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1. Fundraising Efforts

My initial fundraising efforts for Wired In To Recovery were unsuccessful. I had asked five UK government departments if they would help kick-start our initiative with a contribution of £5,000 to our charity Wired International Ltd. The Scottish Government and Welsh Assembly Government both declined. The NTA said they were considering us amongst a large number of other requests for funding, but we never heard anymore. We received no reply from the Home Office and the Department of Health to both my original and follow-up emails. 

I contacted all English DATs/Community Safety Partnerships (around 150) but only received two replies—both said they couldn’t provide funding. I wrote to about 150 Primary Care Trusts (PCTs) in England and received a small number of responses, only one of which was positive, for a £1,000 Associate Sponsorship. Like the DATs, the vast majority of PCTs did not reply. 

The major outcome of this failure to obtain funding was that Lucie and Kevin had to start looking for other jobs to be able to live. The funding I was providing couldn’t continue, as I couldn’t keep using my personal money. I would now run the community, with part-time support from Lucie and Kevin, and would continue to try and raise funding. 

2. Bill White Conference

Early in March, I started my first trip back to the UK, staying in Dubai with my three youngest children for three days en route. On my arrival in the UK, I spent a few days with my brother and family. My mother had very recently passed away, so I visited where her ashes were buried in Fareham. I then headed to Cardiff to visit Lucie and Kevin, Gower to see good friends there, and Bracknell (with Lucie) for a meeting with Nathan Pitman about our online community website. 

Some months earlier, I had heard that US recovery advocate Bill White was going to be in the UK, so I asked if he would be willing to give a talk if I set up a one-day recovery event in London. He agreed. Nick Barton offered financial support from Action on Addiction for the event, to which we invited leading recovery advocates from around the UK, Pavel Nepustil from the Czech Republic, and three senior members of the NTA.

Tim Leighton of Action on Addiction introduced Bill by describing his enormous contribution to the field. The latter gave an awesome two-part presentation in the morning on ‘Recovery Advocacy, Recovery Management and Recovery-Oriented Systems of Care.’ After my presentation, ‘The Importance of Community in Facilitating Recovery’ in the first part of the afternoon, there was a long discussion session. 

The event, which was filmed by Alex Mackie of the Park View Project [1] in Liverpool, was very well-received by the vast majority of the audience. I felt deeply honoured to speak alongside Bill and greatly enjoyed our fruitful discussions. Sadly, the NTA members did not appear impressed and one of their team was heard to express strong derogatory words about Bill and that ‘f……’ word recovery.

Lucie and I really enjoyed catching up with old recovery friends and meeting other recovery advocates. There was a strong feeling that exciting things were beginning to happen and important connections being made in the UK. We thought that 18 March 2009 would go down as a special day in the history of the UK recovery advocacy movement.

On the night before the recovery event, Lucie and I met up with Carl Edwards, Alex Mackie and Nick Mercer. It was fascinating to hear how Carl had created the Park View Project in Liverpool, which involved the development in 2003 of a residential 12-step abstinence-based rehab where all the key workers and frontline staff were in recovery themselves.

Carl had started his recovery in the early 1990s through accessing AA, at a time when there was no rehab in Liverpool, and went on to gain a degree from the University of Liverpool. Later, he and two others started talking about the fact that there were rehabs in the south of England, but not in Liverpool. They simply asked themselves, ‘Why can’t we have one in Liverpool?’

Lucie and I were really impressed by the fact that not only did Park View offer a range of activities to counter the intensity of the therapeutic work clients did in treatment—complementary therapies, yoga, swimming, running, and football tournaments—but also held drama classes and workshops through their contacts with Liverpool’s Everyman Theatre, the Playhouse Theatre, and Liverpool Actors Studio.

They had also set up their own film, theatre and media production company, Genie in the Gutter, run by Carl’s sister Carolyn. They had also been commissioned by the Liverpool DAAT to produce an advocacy film that was distributed to agencies and prisons across the North West. [2]

3. Scotland

I flew to Edinburgh the day after the London event recovery, where I spent the evening with my daughter Annalie and the following day with patients and staff at LEAP.

After a weekend in the country, I attended a special recovery meeting in the Scottish Parliament building, organised by Scotland’s Futures Forum, at which Bill White spoke again. He was followed by Pat Taylor, Executive Director of Faces & Voices of Recovery (FAVOR), who gave a stirring talk on the new recovery advocacy movement in the US and how FAVOR is co-ordinating a multitude of activities conducted recovery groups/organisations across the country. Leading US researcher Professor Keith Humphries gave an excellent talk on self-help and mutual aid groups, which included research showing the considerable value of AA, NA and other mutual aid groups. 

On the following day, I headed off to Glasgow with Dave McCartney to attend the Recovery Master Class at STRADA  (Scottish Training on Drugs and Alcohol), an event organised by Marion Logan at which Bill and Pat spoke again. David Best gave a passionate and informative talk describing his research on the treatment system over the years. I was struck by how little therapeutic help clients received in the agencies in which David conducted his research? How could any genuine caring person not have been disturbed by this appalling state of affairs?

On Wednesday, I was really excited by Mark Gilman’s talk in Stirling on his Recovery Oriented Integrated Systems (ROIS) approach. Mark of the NTA, and colleagues throughout the North West of England, had been implementing a recovery-oriented approach in that region over the past four years. It was absolutely fascinating hearing Mark and he really made me feel optimistic what could be achieved with the right sort of people, environment and support.

After hearing what I had heard during my UK visit, I wondered what was the agenda of those people at the top of the system who were quite clearly annoyed by what was happening on the ground with the new Recovery Movement. Why were they against what is happening? What was wrong with helping people get better? What was wrong with challenging a system that was not working? What was wrong with bringing the leading world experts to talk to interested parties in the UK?

After Mark’s Stirling talk, where I met that great fellow Rowdy Yates again [3], I met up with some friends. I listened to a mother’s story of her daughter, who had been using heroin, and her granddaughter. I watched her face, the emotions she showed as she described her experiences and expressed her views about what she could see going on in the treatment system. She could not understand why her daughter was treated as badly as she was.

It was difficult to explain to her what is going on in the treatment system. I did though and I was honest. When you talk to a mother in this situation and see their gratitude, you know that you are doing the right thing! No matter what the powers above think of you!!’

4. Being a Dad Again 

On 3 April, I headed to Dubai where I picked up Ben, Sam and Natasha and flew with them to Perth. Linda and Sophie were so excited to see them again and the four children spent no time at all becoming the best of friends. Before I knew it, the children’s three weeks‘ was over and I was on a night flight back to Dubai. I dropped the children off to the mother and charged off to catch my second flight on to the UK for a nine-day visit. [4] Mike Ashton later made the comment that most people take their children to school by car each day. My life, sadly, was far more complicated.

5. A Mini Tour

After spending two days with Lucie in Penarth to discuss various matters relating to Wired In and our charity Wired International Ltd, I headed to Manchester to meet Geoff Allman, Director of Spoken Image, who was still doing some multimedia work for us.

Mark Gilman picked me up the next day and took me to meet Stuart Honor and his team at The Basement Recovery Project in Halifax. We arrived for one of the ‘breakfast mornings’. The excellent breakfast was cooked by Brad Miah-Phillips—years later, I would write Brad’s remarkable Recovery Story. [5]

I was really impressed by the approach used by Stuart, and his recently appointed CEO Michelle Foster, in building an indigenous recovery community. I also enjoyed my time with Mark Gilman, who not only was an incredible recovery carrier, but also a very funny person. He could have had a successful career as a stand-up comedian.

I spent the night with Stuart, his wife Tamsin and their young boys in their lovely house in the country. It was a real pleasure to spend an evening with such lovely, kind people. I realised I was so lucky to be working in the addiction recovery field, meeting and interacting with such good friends. Here, I also had the opportunity to learn more about Stuart’s other career—he was a member of the UK rowing squad, preparing for the upcoming London Olympics in 2012. He was the only part-time member of the squad—the rest of the rowers were training full-time. Simply remarkable!

I caught the train to Liverpool the next day where I was met at the station by Carl Edwards of the Park View Project (see earlier in this chapter). Carl took me to the residential treatment centre where I had a chance to talk with a number of the clients, and then on to their associated project, Genie in the Gutter, run by his sister Carolyn. This is the project which offered people with substance use problems and those on the path to recovery, film, theatre and media opportunities. Once again, I was so impressed by all that I saw and heard. I spent the night with Carl and his family. 

On the following day, I headed to Edinburgh to visit my daughter Annalie and to meet up with Dave McCartney and his team at LEAP. I loved chatting to Dave, his Clinical Lead Eddie Conroy, another person in recovery, and the rest of the team… and the patients. I learnt so much and once again felt so inspired. I also attended a client graduation, which was very moving. I also realised how much I loved sitting in on group sessions whenever I visited LEAP. The following short discussion occurred in group during this visit.

One of the clients hesitatingly said, ‘Professor Clark, we were…’

‘Sorry to interrupt, but please call me, David. There is no need for the professor bit.’

‘Prof… I mean David. We’ve been wondering why you come to our groups sessions. Is it because you have a drug or alcohol problem?’

‘Well, I certainly don’t have a drug problem. I drink alcohol, but not excessively. The reason I come to group sessions is because I rarely ever meet such brave people, people like yourselves trying to overcome adversities you have faced and in some cases are still facing. And then some recovering people go on to help others. In fact, I see you helping each other in your discussions in group. I have learnt a lot from attending group sessions. And it’s much more fun being with you guys than with a bunch of university academics.’

Whilst in Edinburgh, I met up with my old best university mate Saifullah Syed who worked for the Food and Agricultural Organisation (FAO) in Rome. Coincidentally, he was in Scotland on a golfing holiday. I wrote in my latest blog: ‘It’s been a hectic time—I’m getting too old for this stuff—made worse by the fact that I have been editing Daily Dose each early morning and in the evening. Stop feeling sorry for yourself, DC!’

6. Dad Again

I returned to Perth at the beginning of May and life was much quieter for a while. I quickly adapted to the Western Australian lifestyle and the wonderful Mediterranean climate that we experience here. My youngest daughter Natasha was now old enough to travel as an unaccompanied minor with her brothers. They came to stay with us for a few weeks in July (our winter) and later in December.

I will never forget standing at the airport with Linda waiting for the children to arrive. We would suddenly see them coming out of the arrival area with a member of Emirates staff and hear the yells of ‘Daddy!’ and the sounds of running feet. Those memories still bring tears to my eyes. 

7. Wired In To Recovery

Wired In To Recovery was six-months old on 20 May. I was really enjoying myself running the website. I couldn’t get over the quality of the writing and the really supportive atmosphere that had been generated. The community was growing at a rate which pleased me—not too slow, but not too fast that I became overwhelmed

I was reading every blog—there had been over 700 so far—as I had to choose which ones to highlight for the channel pages, select a short lead-in for each selected blog, and chose appropriate keywords. I also had  to edit some blogs, correcting typographical errors, and slightly altering sentences that didn’t make sense. I also broke some blog posts down into shorter paragraphs, as short paragraphs are easier to read on a computer. 

I also looked over the comments made about blogs, as I wanted to ensure that members weren’t being offensive or upsetting other people. We had it clear in our Terms and Conditions, based on those of the Guardian and BBC, that members must not, ‘… harass or cause distress or inconvenience to any person, transmit obscene or offensive content, or disrupt the normal flow of communication within wiredin.org.uk.’

We had rightly assumed that some of our members would be traumatised and/or vulnerable, and we did not want them becoming distressed. Early on, we did have a few people who aggressively attacked other members, and we had to bring in a system of ‘yellow cards’ (warning) and ‘red cards’ (suspension for a period, and permanent removal from the community for continued aggression). This led to some people arguing for a complete ‘freedom of speech’ on the website, although these people were a distinct minority. Some people got really fired up about AA and the 12-Step Fellowship, constantly criticising them.

Nearly 500 people had now signed up as Wired In To Recovery members. Google analytics allowed me to collect all sorts of statistics over time. I had a period of what I’ll call ‘number insanity’.

A total of 15,571 different people visited the website during our first six months, creating a total of over 160,000 page views. We had 52% more unique visits than the typical website of this size and 83% more page views. The time spent on our site was 73% greater than the average website. I also compared our numbers with those of substance use (Americans call it abuse) websites of a similar size. In the previous month, we had double the number of visits and time spent on the website, and three times more pages viewed, than other substance use websites.

We were doing well. As I wrote in my update blog, ‘Thanks to you all. As a collective, you’ve been great. Some great friendships have been made!’ However, one downside was that we were still not attracting sponsors.

8. A Major Statement

I returned to the UK again in August to see Annalie in Edinburgh—where I once again visited LEAP—Kevin and Lucie, and other recovery advocates. Lucie was now going to start a clinical psychology PhD in Cardiff and would later become a successful clinical psychologist. Sarah Davies (now Vaile) would now help out with Wired In To Recovery. Whilst in the UK and through our online community, I was beginning to sense changes in the treatment field, some of which were not good, as described in my blog post of 1 October entitled The Real Recovery Agenda:

‘Recovery is becoming a buzz-word in the UK treatment community. I may be sitting on the other side of the world at present, but plenty of people are communicating with me about what is happening. There is genuine excitement! However…

… it is also very clear that many people (possibly a majority) are jumping on this bandwagon, without understanding what recovery means or what constitutes a recovery oriented system of care. (I’ve seen some worrying stuff purporting to be about recovery.)

Sadly, some of these people have no intention of changing what they do, and are even frustrated by what is happening. Some feel they will lose their position of power and control. (I am sorry I may sound cynical). Some see that there is money to be made here. ‘Let’s position ourselves so we get the dosh when it starts flowing’. So they put on the Emperor’s Clothes.

Such moves will not just annoying and frustrating for those people who are genuinely concerned about the recovery agenda, they will also threaten the very existence of what we are doing.

Big organisations have power and by putting on the Emperor’s Clothes and pretending they are interested in recovery—and just tweaking what they do (at best)—they may control potential funds. This is a reality. Remember, big organisations can throw some money at this – and money brings money. So we need to be very wary. We need to help ensure that future funding goes to the right people.

Consider this potential scenario. Most of future funding goes to organisations who already get most of the funds. They do not change. No one gets better. Recovery is seen to be a failure. Bang goes our opportunity. And government decides nothing helps people with serious substance use problems get better, so stop spending.

In moving to a recovery based system, you cannot just tweak the system. You need a major overhaul. We are on the verge of a revolution. There needs to be a rethink of the nature and delivery of our care system from ground up. (This has already been happening in some parts of the country such as the North-West of England due to some visionary people.) There need to be changes in theory, practice and policy.

It would be easy to become cynical about terms such as ‘revolutionary’, but we really must appreciate that we have a window of opportunity here. We mustn’t miss it. With all the best intention in the world, we have to accept that we are not currently providing the best care possible. We are a very long way from that.

Many people would argue that the UK treatment system, in main, is simply managing symptoms and accepting long-term disability or discomfort of people with serious substance use problems. These same people would not argue against the value of treatment per se, rather it needs to be provided in a different way.

The recovery movement is first and foremost a civil rights movement. It is about helping disadvantaged people, people with problems, improve their well-being. It is about helping people with substance use problems (and often many other problems) reclaiming or claiming their right to a safe, dignified, meaningful and gratifying life in the community, sometimes despite their problems.

A recovery oriented system of care places the person with the problem at the centre of the system. It does not just build places where people go and get ‘treatment’—it builds forms of support throughout the community. It accepts that the struggles of the person are not just with what is going on within their own body and mind—it is about their social struggles, which they experience because of the prejudice, discrimination, stigma and marginalisation that occurs in society.

I remember going to the first service user conference and hearing Paul Hayes, CEO of the NTA, telling his audience that the only reason that the government was interested in their problems, was because they committed crime. How far is that from a recovery perspective? That is why there must be a complete rethink of the way that we care for people with substance use problems.

I’ll end this blog by saying there is so much for all us all to do. One thing we must do is educate ourselves about recovery and recovery oriented systems of care. Please read the writings of Bill White…. Read the many relevant blogs on this site. Also read the mental health literature on recovery—their field is well ahead of ours. For starters in relation to this aspect, anyone committed to this agenda should read A Practical Guide to Recovery-Oriented Practice by Larry Davidson and colleagues. I leave you with this quote from Davidson’s book:

“For such a revolution to occur in metal health, we will need to shift from viewing people with serious metal illness as being themselves the problem we must address to accord them the power to redefine the problem in their own terms.

Rather than attempt to ‘fix’ people with serious mental illness through treatment or rehabilitative interventions administered by caring others, the work of transformation entails accepting that these people represent the greatest, if also least tapped, resource a mental health system possesses.

Instead of being considered deficient, disordered, or dysfunctional, people with mental illness must come to be seen as the experts in defining their own needs, wants and preferences.”

Is our field ready to accept this sort of thinking?’

Endnotes:

[1] You can read an article about the Park View Project in Drink and Drugs News, 17 November 2008, p.8. It is well worth reading.

[2] Ten years after opening, the Park View project had 70 beds. Mark Gilman, Strategic Recovery Lead at Public Health England, said, ‘Liverpool is the recovery capital of the UK. There is nowhere else in the country where the rate of people recovering from addiction is as high. The difference for Liverpool is that it has a community rehab and services which generate an indigenous recovery community.’ Liverpool Echo, 19 June 2013.

[3] Rowdy Yates sadly passed away on 14 February 2022. Rowdy was a very special person and made an enormous contribution to the addiction recovery field. Please check out the amazing tribute for Rowdy Yates written by Karen Biggs, Chief Executive of Phoenix Futures UK, and Bob Campbell which is on the European Federation of Therapeutic Communities, an organisation for which Rowdy did so much work. He is sorely missed by those who were fortunate enough to know him.

[4] You might wonder why I was flying to the UK again, particularly as I had no specific event to attend. In fact, it was much cheaper to purchase a return flight from Perth to London than it was to buy one from Perth to Dubai.

[5] Brad passed away on 10 February 2023 in the Royal Calderdale Hospital in Halifax. He is sorely missed. Please read a Recovery Stories blog post I wrote in memory of Brad. You might also like to read Brad’s Recovery Story, A Life Beyond My Wildest Dreams.

> More To Come

> ‘My Journey’ chapter links (and biography)

I finish a very rewarding period as External Examiner for the Foundation Degree on Addictions Counselling run by Action on Addiction and the University of Bath. The Wired In team and volunteers work hard in the period leading up to the launch of Wired In To Recovery. We launch our online community on 19 November 2008, with me lying in bed with a serious back injury.  I eventually decide to move to Perth in Western Australia to be with my new partner Linda. (2,828 words)

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1. Romance in Western Australia

During my trip to Australia with my children in 2007/8 (Chapter 17), we spent some time with a good friend of one of my old schoolmates. Linda and her daughter Sophie got on really well with my children. Just before we left Australia, Linda, who had separated from her husband some years earlier, invited me out to dinner at a restaurant overlooking Cottesloe Beach. We enjoyed the dinner and sunset, and realised we had a lot of common interests. We then took a romantic stroll along the beach. It was the first romantic evening I had experienced in years.

Linda, along with Sophie, attended our farewell the night before our departure, and she and I agreed to email and Skype each other. Eventually, we decided I would visit her and my sister’s family in late June. 

I had a wonderful time in Western Australia in June/July. Linda surprised me by booking us a 10-day holiday in Broome, a magical town located just over 1,000 miles north of Perth. The weather was great, high 20s and dry (no humidity) every day. I fell in love with Cable Beach (just down the road from where we are staying), the town, the crocodiles (in a crocodile park), our hotel, the swimming pool… and, most importantly, Linda.

On my birthday, Bastille Day, we enjoyed one of Broome’s fabulous sunsets on The Willie, an old pearl lugger. Before my departure to the UK, we decided that Linda would visit me in Wales in September.  

I returned to the UK on 22 July and saw Ben, Sam and Natasha in Reading. We then spent a special time together in Cowbridge, before they left for Dubai in late August. I was devastated. 

2. Impressed and Inspired

At the end of August, I finished my three-year tenure as External Examiner for the Foundation Degree on Addictions Counselling run by Action on Addiction and the Division for Lifelong Learning at the University of Bath. I finished this role with some sadness, handing over to new External Examiner, leading recovery advocate and researcher David Best. 

It was a pleasure and privilege working with the Action on Addiction and University of Bath teams. I pointed out early on the amount of work covered in the Foundation degree (two years) was far more than a normal three-year Honours degree. And some of the students were exceptional.

I was really amazed how much work the Action on Addiction team (led by Tim Leighton) put into the course, and in helping and stimulating the students. The team recognised the urgent need to greatly improve the level of knowledge and understanding in the treatment field, including how we help people move from the culture of addiction to the culture of recovery.

I had two great benefits in working with the Action on Addiction team, other than spending time with some really nice people. Firstly, the time I spent discussing the field with Tim Leighton and his introducing me to the work of US recovery advocate, historian and researcher William L (Bill) White. Tim is one of the most knowledgeable and inspirational people I have met in the addiction recovery field. I really enjoyed my discussions with Tim whenever I visited Clouds House in East Knoyle, and later Action of Addiction’s Centre for Addiction Treatment Studies in Warminster.

Secondly, Tim asked me if I would supervise the degree project of one of the students who lived not far from me in South Wales. Wynford Ellis Owen came over to Cowbridge, and we immediately got along well. He later gained a Churchill Fellowship to travel around America visiting recovery centres and recovery advocates. This experience helped him set up the Living Room, a community-based recovery centre in Cardiff.

Wynford, who is over 30 years in recovery, has been a close friend since that initial meeting. His book No Room To Live: a journey from addiction to recovery is a great read. I loved visiting Living Room Cardiff—it was a very special place of healing. [NB. Wynford is no longer CEO of Living Room Cardiff. It is run by Adferiad, an organisation which appears to offer services in a wide range of fields.]

3. A Visitor from Afar

Linda came over from Perth in mid-September and I showed her around Gower and Cardiff, and introduced her to Kevin and Lucie and other friends. She attended a talk I gave on recovery at a ‘Who Cares?’ Carers’s conference in Gloucester.

I had been invited to give a talk at the conference by Andrea Wilson, and Ian and Irene MacDonald, and was given a 90-minute slot. Ian had first contacted me some years earlier and we had met several times over the years. He and Irene had lost their son Robin to a heroin overdose, and since then they had set up Carer and Parent Support Gloucestershire (CPSG), which provided one-to-one support sessions.

I was thrilled by the response to my talk, which I broke up with a short version of Kevin’s Story. I felt genuine interest (and excitement!) in the room during and after the talk. I later received many positive responses, my favourite being that I (or my message) should be bottled and passed around services (treatment agencies and generic) in the area. I thought at the time: ‘If someone wants to “bottle me” to get the recovery message out there and improve matters for people directly or indirectly affected by substance use problems, then so be it!’ Interestingly, the NTA representative at the conference never approached me during the day.

Two days later, Linda and I flew up to Edinburgh, where she met my daughter Annalie and her boyfriend Max. They got on very well with Linda. Before leaving Edinburgh, Annalie took me aside and said that she could see that Linda and I were in love. She pointed out that rather than regularly sitting around for two weeks waiting for my three youngsters’ visit, I would now be waiting around several months between each relatively short visit they made from Dubai. And that could go on for years.

I’ll never forget the words she then said: ‘Dad, you need to get a life.’ I could tell that Annalie cared greatly and was very worried about me.

Linda and I then drove around some of my favourite places in Scotland for 11 days, starting in Dinnet (cf. Chapter 15) and then meandering our way to Skye where we stayed with friends and explored the island for three days. We then headed back to Edinburgh, via Glasgow, where we dropped in on Neil McKeganey in Glasgow. Sadly, he was not at work.

Before Linda left for Australia, we talked about our future. She wanted me to move to Australia, but fully understood if I could not make that commitment. I had spoken with my three youngest before they left for Dubai and asked if they would approve me moving if I ever wanted to do that. They really liked Linda and said that I should move to be with her if that is what I wanted. I’m not sure whether the youngest two fully appreciated the situation, but they all were enthusiastic about being able to visit Perth regularly and see family and friends they had there. I spoke to them on Skype after Linda left and they were still enthusiastic. They wanted me to be happy, they said.

Of course, my three youngest weren’t the only issue. I was still committed to Wired In and to funding Lucie and Kevan. I knew that I could oversee Wired In To Recovery from Australia, keep in touch with other recovery advocates and our volunteers, and make trips back to the UK to see people. I had additional savings from selling my house that could be used, but I really needed to raise external funding to keep things going.

And of course there was my beloved dog Tessa, who had not only been my faithful companion for the past 15 years, but had also helped me keep sane after the children had moved to Reading… and then to Dubai. However, Tessa was now struggling with her back legs and the vet who had known her all her life had pointed out to me she didn’t have long to be with us. Anyway, I told Linda that I needed to talk to people, including my mother, and think things through. She understood.

4. Launch of Wired In To Recovery

Nathan now handed over the Wired In To Recovery content management system for testing and uploading content. He had built the system from scratch and a great deal of programming was involved. As I started to upload content, I found programme bugs, which is what I had expected. I had spent some years computer programming when I ran my neuroscience laboratory, so I was well used to testing new software and finding bugs. It’s all part of the process. And I loved it. 

A few days later, Kevin, Lucie and Jim went on holiday and I was left holding the Wired In, Wired In To Recovery, and Daily Dose forts. I loaded over 200 blog posts and related written material from our Google blogs… then there was new content to write, and our films needed to be linked to. I also had sections like Terms & Conditions and Privacy Policy to write. And of course, I continued to test functionality of the website.

Now, please don’t get me wrong and think I was moaning at the time. Far from it! I loved what I was doing and taking up the challenge. I also had the opportunity to read Kevin’s blogs again and I realised the talents of this young man. Amazing to think that this former heroin addict had already done so much for Wired In and for the new recovery advocacy movement in the UK. I was so proud of him. 

I now gave our volunteers, both local and around the country, access to the website. They were able to set up their own profile, view content, which included that content in which they had been involved in generating (e.g. their Personal Story), and comment when they wished. They were also part of the testing process—a number of the volunteers told me that they felt privileged to be in that situation.

I had decided back in April that it was time that I joined a gym, as I was fast losing the fitness I once had, and I was putting on weight. I thought I should do weights as well as lots of cardio exercise, even though I had always found the thought of weightlifting very boring.

I was also concerned about my back, which sometimes had caused great concern in the past due to deterioration at the bottom of my spine. Therefore, I decided to hire a personal trainer for some of my gym sessions, to ensure that I didn’t do anything silly, and also to monitor and motivate me. What a great decision, as Lewis was a godsend! He pushed me to some extremes and I really loved it. We had long talks about the nature of motivation, and his sister eventually became a volunteer with us.

One day, I was lying on a bench pushing up a massive weight, or at least as I thought. I then looked to my side and was surprised to see Scott Gibbs, one of the great all-time Welsh rugby players, pushing a weight that made mine look like nothing. I mentioned this to Lewis after the session and he said I had seen nothing yet. If I came in next week he would introduce me to a current Welsh rugby player, Lee Byrne I think it was, who pushed the heaviest weights of anyone in the gym. I was excited!

By this time, Tessa has passed away, and I had decided to move to Australia. I was slowly getting rid of my furniture. My neighbour came around on the Sunday before I would meet Lee and asked if we could move the wardrobe I was giving him. I ran upstairs and without any preparation started to lift the wardrobe. Snap! My back went completely. I couldn’t get up off the floor initially. I had to drag myself to the loo and then scream in pain as I lifted myself onto my knees to urinate. And this happened just three days before we were due to launch Wired In Recovery. I was lying in bed when:

‘We soft-launch the Wired In online recovery community at 17.00 on Weds, 19 November 2008. No fan-fair about it, Nathan just strips off the ‘/site’ from the domain name and wiredin.org.uk goes live. Lucie and I high-five and she heads off to run her recovery support group. It’s almost anti-climactic…. I spend the evening “lurking around” the site, too drained and in pain to do much else… I feel very proud of what we have achieved. My long-lasting dream and vision has been realised—at least the first stage.’  Blog Post, 19 November

Dr. David McCartney is one of the first to come through with a congratulations. Pavel Nepustil writes a new blog in both English and Czech! At this stage, we have 57 community members. An early email from Bill White that makes my day, ‘Congratulations on the site launch.  It looks fabulous!’ 

Peter McDermott says, ‘… I’m seriously impressed by the commitment that it must have taken to invest your retirement fund in the project. I’m always complaining about how self-centred and lacking in vision practitioners are, but clearly nobody could ever accuse you of that!’

And Nathan sends through an email from the web community world, ‘Incredibly impressive site! Fantastic and monolithic…Awesome work!’

Soon after Wired In To Recovery was launched, I started fund-raising efforts for Wired In.

5. Farewells

I had earlier sent off 12 standard crates, containing mainly books and DVDs (Linda reminds me), and a specially made crate for my large Apple monitor, to Perth. Now, I had to sell and give away the rest of my belongings, which wasn’t easy when I was hobbling around with my injured back. One lady, who had bought various items off me, came back and offered to take the remains of my very large book collection to a charity shop, if I allowed her to choose what she wanted for herself. I agreed, but the only problem was that there were only two boxes. So, we carried box after box of books to her car and just piled them in. She took off with a car-full of books.

Natasha, Sam and Ben had returned from Dubai, and I rented a house in Reynoldston, just down the road from our old place. I organised a farewell party in the restaurant at the King Arthur Hotel in the village, which was attended by various Wired In members (Becky Hancock, Sarah Davies, Lucie James, and Kevin Manley), my good friends at WGCADA (including Keith Morgan, Dave Watkins, Angie Welch and Esther Mead), and my old schoolmate Jeff Zorko and his wife Marian and daughter Rosie.

It was a very emotional time, not just leaving such good friends, but also knowing that my children would be missed, as they were loved by all who attended the farewell. I felt so grateful to have worked with these good friends, and to share so many fond memories. 

After dropping the children off in Reading, I headed to Fareham to say goodbye to my brother and his family, and drop off my car which I sold back to the Honda garage where it had been purchased. I then caught the train to Brighton to say goodbye to Annalie and her mother Jenny. On the day of my flight, they insisted on taking me to Gatwick airport and transporting my luggage to the check-in desk. They were so worried that I might injure my back again. When I reached the front of the queue, I was told there was a problem. The economy seats were all taken… ‘would I mind being upgraded to business class?’ I smiled.

My new life adventure had begun. And I knew I would be seeing Annalie and my three youngest in a few months time. 

> 22. Two Sides of the World

> ‘My Journey’ chapter links (and biography)

Lucie James, Kevin Manley and I meet recovery advocates, and people on their recovery journey, in Edinburgh, Glasgow, Liverpool and Manchester. I write about problems in the treatment system in my Google blog. Members of our Cardiff Recovery Community tell their stories, start posting on their personal blog, and participate in Wired In films made by our colleague Jonathan Kerr-Smith. One of our YouTube films now has over 300,000 views. (2,789 words)

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1. Scotland

Lucie, Kevin and I headed to Scotland in early June to visit Lothians and Edinburgh Abstinence Programme  (LEAP), run by Dr David McCartney, and to attend a conference in Glasgow. Here’s what Kevin had to say about the former: 

‘Firstly, I visited LEAP in Edinburgh and was amazed by everything about the place. I sat in on the morning group and the guys there made me very welcome and then got straight down to business—honesty, frankness and companionship were the order of the day. LEAP has only been open since the end of last year, but is having a massive impact on the local scene already. I think they’ve got the balance of structure/supervision and freedom of the clients as close to perfect as I’ve seen.

This is hard to explain but the guys there had light and goodness emanating from them; they were totally unashamedly, themselves. Not pretending to be something they weren’t, like we see all too often on the street! It was captivating, and it’s because they have found/come to terms with their real self, that they are going to make it in their recovery.

To be honest, the field of substance misuse in Wales was getting me down a bit. I think a lot of people can see that the emphasis is in the wrong area. All of our eggs have been in the one basket! I just hope and pray that the rest of the UK can follow Scotland’s example and listen to the recovering addicts and alcoholics, and find out what they think might help others into recovery.

Recovery communities are the way forward, real life survivors supporting others in the same boat. Of course, there are many other facets to a sustained recovery, but I’m leaning more and more towards support from like-minded people being up towards the top of the list! In supporting others (and that doesn’t mean much, just listening will do!), you are building up both your confidence and self-esteem, which then carries you through the tough times too. Simple but effective! Wired In is hoping we’ll get the chance to work a lot closer with LEAP in the near future—fingers crossed!’

And here is what I had to say in my blog post of 12 June:

‘Lucie could not get over the energy that she felt in LEAP. The welcoming atmosphere was special, although clients thought that Kev and Lucie were there for their first session [as clients]. Lots of people came up to them, and were positive and open about what they would receive at LEAP. Lucie could not get over the fact that LEAP offered a two-year aftercare programme. Now, this is a serious recovery-orientated programme, as far as we can see. They have what seems to matter, positive community spirit. Can’t wait to work with them!

We then moved on to Glasgow for the ‘Drugs and Alcohol Today’ conference, armed with lots of pieces of paper (e.g. Personal Stories, Wired In ‘Way Forward’ document), DVDs, and a Mac to show the films and Blogs. We were thrilled with the response that we had at the meeting. Treatment workers really wanted to get involved with what we were doing, and wanted to be able to get their clients involved. A number of workers, as well as service users, signed up to the Wired In Recovery Movement. Lucie pointed out that lots of people were talking about recovery, sorry Recovery. They were excited!’

2. Propaganda

Kevin’s comment about Wales rang true with me. Dr Brian Gibbons, the Welsh Assembly Government minister in charge of the substance misuse agenda—he who did not respond to my emails—had been on a week of spin during the National Tackling Drugs Week. He stated that there have been ‘massive strides forward’ in tackling the drugs problem in Wales. ‘Utter poppycock!’, I wrote on my post of 26 May.

I very rarely ever heard anyone pay a compliment about the Assembly’s efforts to help people overcome substance use problems, except those people working for the Assembly, and I was always hearing criticisms. The real sad thing is that Welsh practitioners told me that they are frightened to speak out in case their treatment agency lost money. There was a climate of fear and Wired In was not the only organisation to hear these criticisms and concerns.

I also spoke out (18 June) about a comment made in the Guardian newspaper by Paul Hayes, that the criticisms he received about his claims that the NTA treatment programme was working came from ‘a few academics, politicians and ideologies stoked up by the media.’ He also stated that the ‘idea that treatment based on harm reduction could be replaced in future by an “abstentionist” approach, where success is measured primarily by the number of addicts “cured”, is misguided…’

I pointed out that there were many people out there—users, ex-users, family members, practitioners, commissioners, members of the general public—who knew that the current treatment system was not working and was causing damage to many people. My criticism of the NTA’s treatment approach was not of the use of methadone per se, it was the fact that their strategy focused on the use of this drug at the expense of other treatment options.

People needed choice. Recovery advocates like myself were not arguing for replacing harm reduction policies, or for an ‘abstentionist approach’, or talking about addicts being ‘cured’. Paul was either talking rubbish or was trying to confuse the issue, a strategy used by other people attacking addiction recovery advocates in the UK.

This blog post attracted a large number of visitors and comments. In one of my comments, I pointed out that we had conducted a survey on Daily Dose which included one question: ‘Do you believe the current UK drug strategy is addressing substance use problems effectively?’ Of 204 respondents, 194 (95%) replied ‘No’. 

A major aim of our work was to tell us many people as possible about the recovery advocacy movement in the US and the incredible work being done by Bill White. I was thrilled when Bill agreed to join our Wired In International Advisory Board in May, and when I was able to speak with him on the phone for 45 minutes in early June.

3. North-West of England

In mid-June, Lucie, Kevin and I visited the North-West of England, where there was a fast-growing Recovery Movement. We initially travelled to Manchester where we met Geoff Allman, Director of Spoken Image. Geoff was kind enough to drive us around for two days, which gave him the opportunity to see some things happening in the field.

We stayed two nights in a bed & breakfast run by a close friend of Geoff’s. When I headed down to the kitchen on the first morning, Lucie asked if I recognised the room. I didn’t. She told me to look around again, but still no recognition. Finally, she had to point out that I was in Pete and Jenny’s kitchen from Cold Feet, one of my favourite TV shows. Lucie then asked if I had recognised my bedroom. I hadn’t. She told me that I had slept in the room that Adam had woken up in at the beginning of the first ever episode. Our host’s house had been used for two of the ‘Cold Feet houses’.

On the first day, we visited Jacquie Johnston-Lynch who ran SHARP Liverpool, which offered a structured day recovery programme based on the 12-Step approach. We talked with the SHARP clients in a group session and Kevin and I were both greatly moved by the occasion (I had tears in my eyes). The session emphasised to me the power of the supportive community or social network. I just felt the empathy and positive feeling throughout the room.

We also met Mark Gilman of the NTA, a man committed to the development of a recovery culture, and Peter Naylor of the Spider Project, a creative arts wellbeing recovery community project. Mark not only has a wealth of knowledge, but is one of the funniest people I have ever met. I was fascinated by the ideas behind the Spider Project, which still runs today. They offered a range of Creative Arts Courses, Holistic Therapies, and Physical Exercise sessions.

Mark Gilman arranged for us to join him and a group of recovery advocates in a Manchester café—Stuart Honor (researcher and recovery advocate), John Hopkins (ADAS/Acorn in Stockport), Colin Wiseley (Commissioner, Salford DAT) and Ian Wardle (Lifeline Project).

When some of us moved to another café, two lads who were sitting across from us on a nearby table recognised me from my DDN photo and Kevin from his film—and then Stuart, an old mate. We were thrilled that this wonderful coincidence had linked us to Paul Hutchins and Jason of the Thomas Project in Blackburn. Stuart was pleased to see them doing so well in their recovery.

Our trip to the North West had enabled us to interact with an inspiring group of Recovery Carriers, a term used by US recovery advocate Bill White.

It was a long trip back to Cowbridge, and I was pretty tired by the time I got home at 21.15. No rest for the wicked though, since Kevin Skyped me two hours later. He was absolutely ‘buzzing’. He pointed out to me that he wanted to develop a Recovery Community here in Cardiff, although I had to remind him he had already started the process. There was an expression on his face I had not seen before—a sort of serenity.

I realised how much fun it was talking to, and working with, people in recovery. I was lucky and proud to be associated with such people. 

4. Wired In Recovery Community

A few days later, Kevin posted a blog which launched the Wired In Recovery Community (‘Our Community’)—eight members in Cardiff and surrounds, and one in Luton—on to the Google Web Creators Community. In addition to the main Our Community page, each member had their own personal page with an introduction and other posts.

Members were Chris Goodge (Luton), Chris Hobbs, Chris Ling, Patrick M, Kerry Manley, Kevin Manley, Mark Saunders, Brian White, and David Wright (all Cardiff or thereabouts). Here is how Chris Hobbs introduced himself:

‘Last summer, after meeting the Wired In team, I decided to do my Personal Story. I wanted others to learn about addiction from someone who had experienced it themselves. I’ve experienced the depths of addiction and I hoped that my story would put people off going down the same route as I did. For those trapped in the cycle of addiction, I hope that my story shows you that there is a way out.

To start with, I didn’t really know what I was going to say. I sat down with Lucie and we decided that we would record us talking about my addiction and recovery and then write the story from the recording. I thought it would take about an hour. Six hours later, we were still going strong!

When I saw my story on paper I couldn’t believe it. It was quite hard reading through everything, although it did help me realise how far I had actually come since my drug-using days. I felt proud of what I had achieved, and it felt good to have the opportunity to show others that addiction can be overcome.

I now live with my girlfriend and beautiful baby boy. Don’t get me wrong, life is tough, but in comparison to my life in addiction, it is 1000% better. I hope that you enjoy reading my story. If you would like to get in touch with me please leave a comment on my blog. Thanks, Chris.’

Six of the Community were interviewed by Lucie, who wrote their Personal Story. Community members also posted on their personal blog pages their answers to the question What Recovery Means to Me, and participated in a Questions and Answer section. Mark Saunders, for example, covered three Q&A topics—Deciding to Change, Overdose and Methadone for the latter. These writings would later appear on Wired In To Recovery.

A number of the community members were also involved in our film work. On 1 June, we launched Our films blog page and the first two parts of a film project, Life as a Heroin Addict, that Jonathan Kerr-Smith, Lucie and Kevin had undertaken. This project involved three of our Community members, Chris Hobbs, Brian White and David Wright, along with six other recovering heroin addicts—David, John, Cerri, Andy, David and Donna.

They were interviewed in the place they were accessing treatment—either at Swansea Drugs Project, In 2 Change (Newport), or The Bridge Project, Salvation Army (Cardiff). Interviews were conducted by either Lucie or Kevin. While one did the interview, the other chatted to the next interviewee or other service users.

Here’s what Lucie said on Our films blog on 1 June:

‘Last summer, Wired In grabbed the camera and went to speak to some service users about their experiences with addiction, treatment and recovery. We were blown away by the footage we got, and the enthusiasm that our ‘film stars’ demonstrated. 

Initially, we were a bit concerned with whether people would want to be filmed—but our concerns were certainly not met!!! In fact, at one point we had people queuing out the door wanting to get involved!!

Once the footage had been edited, we met up with the service users again and showed them their film clips—their reactions were fantastic. Although some of the footage was hard for them to watch, they were all really pleased with what they had achieved. They were really excited to have the opportunity to educate others about addiction, treatment and recovery, and they hoped that others would learn from their experiences.

The amount of material that we got in just three days was astounding. We decided to cut the footage up into bite-size sections covering the topics that the service users felt were the most important.

Over the coming weeks we will be showing you this material. This week, we start by introducing you to the service users involved in our film. We will also be showing you a section where heroin use is discussed, in particular the reasons that people start using heroin in the first place, and then why that usage escalates into addiction.’

Two of these films—Introduction and Part 1—have over 308,000 and 159,000, respectively, YouTube views to date. We ended up posting ten films in this series totalling just over an hour of edited footage. Brian White was also interviewed for a nine-minute film entitled Recovery from heroin addiction.

The footage obtained from these interviews, along with film of other interviews, was edited into a various series of clips and posted on my Vimeo film channel. The topics were Recovery (19 films), Heroin Addiction (9), Life as a Heroin Addict (6), Stigma (2), Opiate Substitute Prescribing (4) and Treatment (6). It’s been quite an emotional experience looking at these clips again at the present time. I am very grateful to all those who were involved. [These films can also be found on the wiredinrecovery YouTube channel, although they are not organised in the above categories]

It had been a very busy and rewarding five months since my return from Australia. I was in much need of the break I had planned in Australia. I set off to Perth on 24 June. My personal life was about to change, in more ways than one. A month or two after my previous trip to Australia, I learned that my ex-partner Karen was intending to move to Dubai with our three children and her husband. She said she was willing to have the children come back to the UK each school holidays to spend time with me and she would share the cost of the flights. 

I was devastated by this news, more so when I soon learnt that there was nothing legally I could do to prevent this move. Unlike in Australia, men in the UK are unable to prevent their ex-partner from taking their shared children abroad permanently. Our children were also upset, not only being able to see their father regularly, but they would also miss their beloved dog Tessa. We had a very close relationship, so I knew it was going to be tough for the four of us.

> 21. Wired In To Recovery

> ‘My Journey’ chapter links (and biography)

Wired In colleague Lucie James conducts a qualitative research study with inmates of one male and one female prison participating in the RAPt (the Rehabilitation for Addicted Prisoners Trust) treatment programme. Four factors are shown to create positive change in the inmates—gaining a sense of belonging, socialisation, understanding and support. Positive changes in these four factors enhanced self-esteem and increased the participants’ motivation, and confidence in their ability, to change. (3,886 words)

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One of the pieces of research that I am most proud of being involved in was a qualitative research study conducted in 2007 by my colleague Lucie James that focused on the views and experiences of inmates who were participating in the highly regarded RAPt (the Rehabilitation for Addicted Prisoners Trust) treatment programme in one male and one female prison in the UK. [1]

The RAPt treatment programme was a three-phase, abstinence-based 12-Step programme conducted over approximately 16 weeks. It aimed to facilitate cognitive, emotional and behavioural changes in inmates, so that they were less likely to use drugs and alcohol, and to reoffend, when released from prison. Our research, which was commissioned by RAPt, was focused on identifying the processes that led to such changes.  

The induction phase of the programme, PreAds (women) and M.E.T. (men), had three main aims: to prepare participants for engagement in an intensive treatment programme; to continue the assessment of participants’ suitability for the 12-step treatment programme, and to build a rapport with the participants. This induction phase was generally conducted over a two-week period. 

The Primary programme focused on the first five Steps of the 12-Step programme. Some of the core components of Primary included group therapy, one-to-one counselling, assignment sessions, peer evaluations, group goals, and attendance of AA/NA meetings. Primary was complemented by formal motivational enhancement, as well as skills training, cognitive restructuring, and relapse prevention drawn from the cognitive-behavioural tradition. The RAPt programme also comprised an Aftercare phase, but the analyses of this phase added little further information to that described here.  

A total of 15 males and 15 females, who had a long history of substance use problems and criminal offending, participated in the study. For the female inmates, 11 described crack/cocaine or opiates as being their drug of choice. The average time they had been using their drug of choice was 15.6 years. Twelve of the male inmates named crack/cocaine or opiates as their drug of choice, and they had used this drug on average for 20.6 years.

Subjects participated in semi-structured interviews [2] that covered their experiences and views prior to entering the RAPt programme, on the programme, and since completing the programme (where applicable). Transcripts of the semi-structured interviews were analysed with Grounded Theory.

Study participants described being desperate for help in tackling their substance use problem prior to being sent to prison. Many had felt that they could not give up using/drinking on their own. For some, this belief came from repeated failed attempts to stop using and/or drinking; for others, their low self-esteem left them feeling that they were not capable of achieving their goal alone.

Study participants believed that the RAPt treatment programme was life-changing. They had decided to not use drugs once they left prison. They found that a wide variety of elements operating within the treatment programme were critical in helping bring about the cognitive, emotional and behavioural changes occurring in themselves. They emphasised the importance of the programme focusing on all aspects of their lives, not just their problematic substance use.

1. Induction Phase 

The female participants expressed more positive views about the PreAds phase than the men did of their M.E.T phase, and they believed that many positive changes in their thoughts and behaviours occurred, or began to occur, during this induction phase. This was not the case with the men, who discussed only minimal thought or behavioural changes occurring in M.E.T, most of which were related to social interactions.

The women described how they had failed to understand why they could not stop taking drugs and/or alcohol until they were educated about addiction in PreAds. Learning about addiction led them to realise and admit that they were addicted. Learning about the disease model of addiction helped the women to change their opinion of themselves as they no longer believed that their past behaviours were due to their being ‘evil’ or ‘weak’, but rather they were the victim of a disease.

This enhanced understanding of addiction allowed them to begin to consider that they could address their substance use. Understanding and accepting that the use of any substance could lead a person back to using their drug of choice played an important role in changing the thinking of many of the women. They felt they better understood what was required in order for them to achieve recovery.

The women described how they had had difficulty in trusting others and with being honest, both with themselves and with others, prior to entering the programme. This had led to an inability to talk about their thoughts, feelings and problems with other people, and many found that they bottled up, or blocked out, many of their issues rather than sharing them with others. 

A key element of PreAds (women) and M.E.T (men) was that they provided an opportunity for participants to get to know their peers, and more importantly to begin to relate to them. They learnt to adapt to a group environment, and the process of belonging to a group helped to boost their self-esteem. They stopped feeling so isolated in their addiction and began to share their thoughts and experiences with other people.

Participants stated that by learning that they were not the ‘only one to do bad things’, they felt that their self-esteem improved and they began to ask for help from their peers and counsellors.

Relating to their peers also led to the women learning to trust others, which further led them to be able to ask for help when necessary, and give help to others when needed. All of these factors helped to make the women more honest with themselves and with others, and helped to further increase their confidence and improve their self-esteem.

By developing relationships built on honesty and trust, the women found that they began to listen to others’ points of view, and learn from the feedback that they were receiving from their peers and counsellors. This led to an increase in respect for others, and the women continued to learn a great deal about themselves from others. This resulted in a further increase in confidence which was a key component in them deciding, and feeling able, to leave their old lifestyles behind.

During PreAds, the women began to realise that they needed to change their previous destructive thought and behavioural patterns. This realisation was further consolidated in Primary when they began their Step-work.

The women spoke highly of the education they had received about the disease model, the 12-step philosophy, and cross-addiction. The men spoke less about their education programme (which was different) and their views were mixed, with some believing it was unhelpful and confusing.

Whilst all participants thought that the Induction phase helped prepare them for the Primary phase, and allowed them to get to know their peers and become used to being in a group environment, the men rarely discussed changes in thoughts and behaviour occurring in this phase. For the men, these sorts of changes occurred during the Primary phase of treatment.  

2. Working the Steps 

All of the interviewees talked very positively about the Steps and the Step-work. Although they all experienced low points where they found the work difficult or distressing, they all felt that they had benefited greatly from the Step-work by the end of Primary. They could clearly see that the Steps contributed to positive psychological and behavioural changes. 

During Step One, the interviewees began to see how uncontrollable their lives had become due to their substance use. The written assignments were portrayed as making the participants’ past seem more real. The process of writing down their thoughts and memories evoked numerous emotions, and was described as difficult and upsetting at times. During the Steps, the interviewees were taught to identify and deal with specific emotions.

Whilst revisiting their pasts was an extremely painful process, the interviewees came to terms with the previous unmanageability of their lives, which gave them the determination and motivation to change their behaviours and futures. This motivation was further strengthened when they considered the harmful effects that their addiction had previously had on others. For some, this was the first time that they had considered that those around them were victims of their substance use.

The Step-work helped the interviewees to deal with the impact of their substance on themselves and others, so that they were able to accept, and let go of, the past, and focus on their recovery and future well-being. The peer evaluations were described as an ‘eye-opener’ by the women, as they had not previously realised how their behaviours were perceived by others.

Believing in, accepting and handing their lives over to their Higher Power, evoked important changes in the interviewees’ thinking in relation to their addiction and recovery. Many believed that Step Three was an important stage in further strengthening their determination to abstain from substance use. 

As the participants began to put what they had learnt from the first three Steps into their everyday lives, they began to see what a difference it was making to their thinking and behaviours. Seeing evidence that the Steps were impacting on their lives, and that they were achieving change, led to further increases in the participants’ self-esteem and resolve to overcome addiction.

Whilst Steps Four [‘We made a searching and fearless moral inventory of ourselves’] and Five [‘We admitted to God, to ourselves, and to another human being the exact nature of our wrongs’ were emotional and difficult for all the interviewees, they evoked motivation for behavioural change. The subjects described being as honest and truthful as possible during these Steps, and they felt great relief and unburdening at sharing their most in-depth experiences and thoughts, despite the distress that this sometimes caused.

Some of the participants described completing Step Four as having a weight lifted off their shoulders. During Step Four, many of the interviewees felt that they were able to let go of resentment that they had carried through large portions of their lives. This was a huge relief and helped the participants let go of the past and focus on the future. 

3. Group Therapy  

All of the interviewees strongly believed that group therapy played an essential role in their behavioural change and recovery. For many, group therapy, and the programme in general, provided them with the opportunity to ‘belong’ for the first time in their lives. This sense of belonging helped to build their self-esteem and therefore helped their journey through the programme.

Group therapy was an environment where many of the social skills leading to behavioural change were learnt. The interviewees learnt to speak in front of others, open up and share their problems, trust others, talk honestly and freely about sensitive issues, be challenged, and provide constructive feedback to others. A number of the participants stated that they had opened up for the first time in their lives. Many felt that it was essential to talk in depth about issues underlying their substance use.

Another useful component of group therapy was goal-setting, which led to group discussion of goal progress and specific behaviours. Group therapy was one of the most discussed topics during the interviews, and evidently played a key role in the success of the participants’ time on the programme.

4. Fellowship Meetings  

One of the key components to emerge from this study was the beneficial role that the Fellowship meetings played in the interviewees’ recovery. Although all the subjects discussed the meetings, the women went into far more depth and the meetings appeared to have a larger impact on them than they did for the men. These meetings, which were held outside the prison, gave the interviewees further hope and determination that they could achieve abstinence and lead a healthy and fulfilled life. For many, it was the first time that they had interacted with people who were in recovery from addiction.

The participants emphasised that the meetings further enabled them to feel that they belonged to something, and they were not alone in the things they had done. Feedback from others during these meetings also enhanced the self-learning process, boosted self-esteem, and facilitated the learning of social skills. The interviewees stated that it was a great comfort and support to know that they would always be able to attend Fellowship meetings. 

5. Staff and Peer Supporters  

The RAPt staff and peer supporters were believed to play crucial roles in the changes that the interviewees experienced, and in their recovery. Staff members were praised for their ability to remain patient, helping the subjects to open up, and being there at any time to offer advice and support. Over time, the women looked to the staff as positive role models, who helped them to build up their confidence and self-esteem. The interviewees also believed that the peer supporters provided them with essential support, guidance and advice, and hope that they too could achieve abstinence. 

6. Counselling  

One-to-one counselling was described as being crucial in helping the interviewees to open up and share their problems. The counsellors provided the encouragement and support that the subjects needed so that they had the courage to later bring up difficult issues in group therapy—leading to additional support, advice and help from their peers. 

7. Family Relationships 

The interviewees described a great improvement in their family relationships during Primary. They were proud that their families were noticing a change in their thought patterns and behaviour. They were grateful for the support that they received from their loved ones. This helped their self-esteem to grow further, and facilitated a more positive outlook of the future. 

The family conferences during Primary were mentioned by nearly all of the women as being very useful—even turning-points in their recovery. Half of the women pointed out that the family conferences provided them with the opportunity to be honest with their families for the first time in many years. They were able to learn about the impact their addiction had had on the family, and educate their families about addiction and recovery. Family conferences were not a theme that emerged from the men’s interviews.

8. Other Elements

The interviewees emphasised that it was the RAPt package as a whole that led to the positive changes in their thoughts, emotions and behaviours. They also indicated that the programme was hard work, and that people entering it had to want to change, since personal effort was required for beneficial changes to occur.

During the programme, the interviewees were educated in recognising their thoughts and behavioural patterns, which helped them to divert potentially destructive behaviours. They learnt coping skills and strategies to deal with problems that would otherwise have led to substance use.

They described a noticeable change in their behaviour, including an increase in honesty, trust, patience and confidence. These changes led to them being able to discuss their problems more openly with others. They also felt that they had learnt a lot about themselves and that they had ‘grown up’. Many of the interviewees learnt to like themselves and felt that they were beginning to understand who they really were. 

The interviewees felt that one of the biggest improvements in their lives was the change in relationships that occurred during the programme, in particular the vast improvement in family relationships. Moreover, an extremely close bond was formed between the programme participants, and many felt that they had developed lasting friendships. 

At the end of Primary, all of the interviewees had very definite positive plans for their futures. They wished to remain abstinent, and felt that that they had the skills, support and mindset to avoid drugs/alcohol and have a bright future. They felt confident in their ability to recognise and deal with different emotions, instead of blocking them out with substance use, as they had done in the past. 

9. Grounded Theory Analysis

Four inter-related themes were derived from the Grounded Theory analysis, labelled: ‘Belonging’, ‘Socialisation’, ‘Learning’, and ‘Support’. Each of these themes impacted on a fifth theme, ‘Personal Change’, comprising two key components, motivation to change and self-esteem.

Belonging: On the RAPt treatment programme, inmates met other people with similar experiences and realised that they were not alone. A sense of belonging helped them to open up and share their thoughts and experiences. It enabled them to build trusting relationships, leading them to feel more able to be honest with themselves and others.

Belonging to a group of people who had similar experiences and problems, but who were successfully changing their emotions, thoughts and behaviours, as well as feeling more confident they would address their substance use on release, also enhanced the participants’ motivation and self-belief in overcoming addiction. It facilitated the learning of new skills revolving around improved communication and better quality interpersonal relationships.

Socialisation: Participants got to know and relate to other people on the programme, and share thoughts and experiences. They learned that they were not the only one to have certain experiences and beliefs. They also learned to ask for and give help, and listen to and provide feedback. They became more able to trust, be honest, respect others, and learn about themselves. They began to feel they could talk to their counsellors and peer supporters.

Study participants described how their self-esteem and confidence increased as they learnt more social skills and became better at interacting with other people. The development of social skills contributed to an increased self-awareness, an understanding that participants needed to change their previous destructive thought and behavioural patterns, and a belief that they could leave their old lifestyles behind and work towards a more positive future.

Learning: Learning about the disease model of addiction and admitting to being addicted helped to change self-image, as participants no longer blamed themselves for their prior destructive behaviours. [3] Understanding that they would have to abstain from all substances if they were to attain the goal of recovery led to significant changes in the participants’ thinking.

During the Step-work, participants began to see how out-of-control their lives had become and how their substance use had impacted negatively on others. They were helped to come to terms with, and let go of, their pasts and focused on a positive future free of substance use, a process which was facilitated by understanding and utilising the concept of a Higher Power.

As they learnt about addiction, themselves and their capabilities, the participants became more motivated and determined to change and abstain from substance use. Meeting other people who had gone through the same stages also helped to motivate and give hope that recovery was attainable.

Participants began to understand the relationships between their drug use and their thoughts and behaviours. They learnt a great deal about recognising certain thoughts, feelings and behaviours, and became better ‘armed’ to deal with any potentially destructive thoughts or behavioural patterns.

Support: Support was a key factor in the perceived success of the RAPt programme, and in the changes that the participants saw in their thinking and behaviours. This support came from various sources—staff, peers, peer supporters, family members—and involved different aspects of the programme, e.g. group therapy, one-to-one counselling, family conferences, Fellowship meetings.

In addition, the participants developed the ability to offer support to others, which helped boost their confidence and made them feel like a valued member of the group.

Support was paramount in enabling and encouraging the participants to open up about their thoughts and experiences, and let go of the past and focus on the future. The participants received positive feedback at every step they made towards developing their new lives, and this reinforcement helped to boost self-esteem and confidence.

Personal Change: The participants frequently referred to their self-esteem and confidence, and to their motivation to change. Other research has shown that these are critical elements influencing a person’s ability to overcome their substance use problems and find their path to recovery.

In the present research, a variety of elements related to the themes described above enhanced self-esteem and increased the participants’ motivation, and confidence in their ability, to change. These elements included aspects related to the socialisation process and belonging, the education programme, and the feedback and support available from various sources.

Seeing others doing well in the programme and in Fellowship meetings also played a significant role in enhancing hope and motivation to change.

The interviewees emphasised that a critical element of the success of the programme was that attention paid to all aspects of the participants’ lives, not just their substance use issues. The programme showed participants that their problematic substance use stemmed from issues that occurred in their lives. This completely changed the way that many viewed themselves, as they had previously thought that it was their own fault that they couldn’t stop taking drugs/alcohol.

Participants also obtained a better understanding of themselves, and the relationship between their thoughts and behaviours, and were taught how to divert potentially destructive behaviours. This all enhanced self-esteem and helped them become more confident in their ability to abstain from substances.

As they implemented what they had been taught during the Step-work, they saw the positive changes that this made, and this acted as a further reinforcement to change. Many of the participants described beginning to like themselves and understand who they really were. Seeing oneself differently (in a positive sense), and liking oneself, are powerful facilitators of recovery.

One final aspect of personal change emphasised by interviewees was that programme participants must want to change, and must work hard if change is to occur. Many of the clients described periods of emotional distress occurring during the programme, which they considered an important part of the change process.

10. Conclusions 

Our research revealed that interviewees perceived a wide variety of interacting interpersonal and intrapersonal elements to be important in changing their thinking, emotions and behaviours, and in contributing to the success of the RAPt treatment programme.

We concluded that treatment needs to involve a socially engaging environment with multifaceted activities in which clients can learn, implement new skills, and receive feedback from a variety of sources (practitioners, peers, others in recovery, and family members), in order to facilitate motivation to change and enhance self-esteem of clients.

Of course, the ultimate ‘test’ for each of these participants was when they left prison and faced everyday challenges in their life in the community. Whatever challenges they were to face, we believe that they were in a much stronger position to deal with issues and problems as a result of the RAPt treatment programme. 

Endnotes:

[1] RAPt is now known as the Forward Trust.

[2] Interviews were conducted by Lucie James and Sarah Davies (now Vaile), who is currently Director of Recovery Cymru.

[3] It is not necessarily learning about the disease model per se that is important here. It is likely that learning about another addiction model or combination of models as an explanatory framework would likely have been as important. The person must understand and relate to the model—it must be believable and ‘actionable’ to them.

> 20. On the Road and Filmmaking

> ‘My Journey’ chapter links (and biography)

I develop the Wired In Charter and a new strategy early in 2008, and launch ‘the prof speaks out’ blog. At the first Service User Conference organised by Drink and Drugs News (DDN), NTA CEO Paul Hayes says that ‘as drug users are seen as a threat, the government is prepared to spend money on drug treatment.’ Kevin Manley launches his ‘I did it my way’ blog, and Wired In realises a 35-minute film of his Recovery Story, made by Jonathan Kerr-Smith in association with Lucie James. (2,451 words)

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1. Wired In Charter

On my return from Australia with my children on 22 January 2008, I settled down to develop a new Wired In strategy, as well as a Wired In Charter, which was published in April. I wanted people to get a better feel for what we were about. I felt very strongly about the second point below.

1. Wired In exists because of the problems that drugs and alcohol can sometimes cause for individuals and their families.

2. Wired In is founded upon Trust: we are independent, objective and honest. Wired In is about being creative, and having the courage to challenge.

3. We aim to create an environment of opportunity, choice and hope for people affected by substance use problems.

4. We treat people with respect and dignity, and work as a mutually supportive team, in a spirit that we hope inspires others.

5. Wired In is an inclusive, non-competitive initiative that seeks to enhance the impact and reach of the best practice of successful organisations.

6. We are not about a quick fix, but realise that positive change often takes time. Poor systems and protocols must be improved to ensure that people get the help that they deserve.

7. We challenge society over the stigmatisation and stereotyping of people affected by substance use problems.

8. We believe it is essential to provide information and support and to people experiencing all levels of substance use problems, rather than simply focusing on those with the most serious needs.

9. We do not promote any one particular philosophy or treatment intervention. We take an approach that focuses upon key principles that are known to lead to behavioural change and facilitate the path to recovery.

10. The energy and experience of people affected by substance use problems is at the core of what we do. We harness this to give them a voice, enabling them to help themselves and others, and influence practice and policy and the views of society.

2. Community Development and Blogs

I had been dreaming about developing an online recovery community since reading Amy Jo Kim’s book Community Building on the Web: Secret Strategies for Successful Online Communities in 2001. I’d never raised the funding to build such a community, but now I realised I had no option but to continue to use my early retirement funds.

Nathan Pitman of Nine Four was hired to develop the Wired In To Recovery website and its underlying content management system, since Ash Whitney, who I had worked with for over seven years, did not have the appropriate programming skills at that time. I continued to hire Lucie James and Kevin Manley as my core Wired In team, with filmmaker Jonathan Kerr-Smith hired on a consultancy basis. Sarah Davies (now Vaile) was sadly ill for the best part of a year and did not join us in our new venture for some time. She was sorely missed.

We did not expect the content management system to be built until much later in the year, so in the meantime I developed a new blog on the Google Web Creators Community called ‘the prof speaks out.’ In my first post of 23 March 2008, I stated ‘It’s time to join the blogging world and speak out for the people who are affected by substance use problems. There are nowhere enough people doing this… I also want to keep you in touch with what is happening at Wired In.’  

I also pointed out that we were now changing our name from the original WIRED to Wired In, as suggested by my old school mate Tom Wragg. We also revealed a new logo which had been developed for us by a leading sign-writer recruited by our collaborator Geoff Allman of Spoken Image. The title of this blog, and later other blogs, was added to the core logo image, which itself was later used for our online community.

Kevin Manley started his own blog, ‘I did it my way’, in March which used the same core logo image. The idea was for us both to post regularly and all posts would later be added to the Wired In To Recovery content management system ready for our online community launch. As it turned out, we were not able to launch the website until late 2008. A good deal of content was prepared by this time by our core team and volunteers. 

I had struggled raising funding for Daily Dose ever since it was launched in early 2001. I now couldn’t keep paying Jim Young out of my own money, as I had recently been doing, and therefore I stated on Daily Dose, and on my new blog, that I had no option but to close the news portal unless we could attract serious sponsorship quickly.

I was thrilled by the heart-warming response, in the form of e-mails of support and suggestions, along with some donations. Two weeks later, our target sum of sponsorship was reached! 

The other good news at the end of March was the Scottish Government stating that recovery would be key in their new drugs strategy. In my Well done Scotland! post of 28 March I wrote:

‘It’s going to take time to educate and train people to understand recovery and how we can move people from the culture of addiction to the culture of recovery. Wired In is committed to educating, training and informing people about recovery, and in supporting recovery communities.

We must prevent people getting bogged down in the issue of ‘abstinence vs. harm reduction’. So many people who do not understand recovery want to reduce things to a simplistic black and white. This must stop. Pushing the recovery agenda does NOT mean attacking harm reduction or harm minimisation—unless the person intends that to be the case.’

3. Service User Conference

Earlier in February, I had been thrilled to attend, with Kevin and Lucie, the first DDN / Alliance Service User Conference, which was organised by Claire Brown and Ian Ralph of DDN and held in Birmingham.

Around 500 people attended, two-thirds of them service users, a very successful conference. The three of us certainly enjoyed our day and made some new friends. A special issue of DDN was devoted to the conference. Prejudice towards service users was obviously an issue that was discussed during the afternoon’s discussion tables.

One speech during the conference caused me great concern. The NTA CEO Paul Hayes emphasised that service users had to understand the reality of the world in which they operated, rather than having a ‘rose-tinted view’. He pointed out that service users as a group were unpopular with the public, ‘compared to old ladies who need hip replacements or babies in incubators. They are seen as the authors of your own misfortune—there is no way we can hide from that.’

Paul continued by saying that, ‘substance misusers’ were also far from a priority in the NHS, as tobacco and alcohol were seen as far greater issues from a health harm perspective. Drug users were more likely to be seen as a danger to public health, community safety and the economy.

‘Because you are seen as a threat, the government is prepared to spend money on drug treatment.’

While I can understand Paul Hayes thinking he needed to portray the reality as he saw it, I thought his message caused much more harm than good. In fact, I found it rather offensive. It was sad to hear the CEO of the government department in charge of most of the country’s drug addiction treatment services stating that the only reason service users were helped was because they committed crimes.

The UK drugs strategy itself, and the way it was being implemented and portrayed, was in reality demonising people with substance use problems, and those people on the journey to recovery, thereby reducing the likelihood that they would be accepted as normal by so-called ‘normal’ society and also gain employment. They were fuelling the fire of prejudice towards a vulnerable population, and creating/maintaining a barrier to recovery.

By the nature of his comments, Paul Hayes was indirectly implying that people who took heroin and did not commit crime, were not a priority for treatment… even if they needed and wanted help. 

I was touched by a letter from Hayley Brooks in the 10 March edition of DDN, in which she challenged Paul Hayes’s statement that people at the conference needed to reject the fantasy ‘that if everyone would stop stigmatising you everything would be all right.’

Hayley had stopped using illicit drugs seven years earlier and had been off methadone for four years. She was finishing her final year on a social work degree but was having great difficulty finding a job because of her past heroin using career and criminal record. Apparently, she was considered ‘vulnerable’. She went on to say:

‘I am constantly faced with this type of discrimination from people. I am determined to succeed and have a successful career. In response to Mr Hayes, I feel that he is the one who needs a reality check, as I am a prime example of someone who has turned their life around and battles on a regular basis against prejudice, due to past mistakes.

I can indeed sometimes understand why some service users feel that there is no point in changing, as I thought I had won the battle by staying clean. However, the real battle begins when you have to constantly fight for your rights to be treated as an equal, especially when you work hard to achieve a career and are constantly faced with brick walls.’

If you want to read more about prejudice towards drug users, please read my article Recovery, Reintegration, and Anti-Discrimination: Julian Buchanan.

4. Kevin’s Personal Story: Film

On 11 May, we released the film version of Kevin’s Personal Story, made by Jonathan Kerr-Smith in association with Lucie James, which focused on Kevin’s 15-year addiction to illicit drugs and subsequent experiences in finding his path to recovery.

During the film, Kevin’s mother Kerry talked about the ‘hell’ that the family had experienced during his problems, and her feelings about his recovery. We had to break up the 35-minute film into eight parts to fit it onto YouTube, as one couldn’t post long films at that time. We also uploaded an 8-minute version of the film. [The first part of the 8-part version, all parts of which are available, can be found on our wiredinrecovery YouTube channel.]

I loved the film that the team had created—I say the team, but I can take no credit, other than providing finance and support. The film still brings tears to my eyes watching it. Two days after Kevin’s film was released, I said in my blog post:

‘… I have been totally infected by the passion that exists in this field. I see people overcome substantial problems, and I am humbled by the incredible courage that they show. And I see the same people being unjustly stigmatised.

I also see so much good quality work going on in this field, so many talented people, so many great ideas. But so much of this is not getting the credit it deserves, and it is not impacting to the extent that it could. One of the major messages this field must give is ‘hope’. We don’t do it enough, and well enough. All this must change! As a field, we have what it takes to do so much better and help many more people overcome their problems. Let’s do it!…’

Kevin wrote the following blog post on 23 June, My Wired In experience [NB. I have shortened the length of Kevin’s paragraphs.]:

‘It was early 2005 when I first had any contact with Wired In. At the time, I was a chaotic drug addict and no matter what I tried, I couldn’t quit using. In fact, I had given up even trying. I just wanted everything to end; I’d simply had enough of life on my knees.

Then I met Sarah, who worked for Wired In; we got talking and hit it off. I could see that she genuinely cared and that really surprised me. She was young, pretty and she wanted to spend time talking to me, a no-good drug addict (that was how I felt about myself). Very strange!

I then started to volunteer with Wired In, but I didn’t really do a lot at first, as my life was so chaotic. Usually, I would just meet up with Sarah and have a good chat. I think that was what I really needed at the time. Sarah helped me to realise that there was more to the world than just darkness and pain. She had no ulterior motives for being my friend, it was only because she cared about what I was going through and wanted to support me.

It was when I realised this, that my outlook on life started to change. For me to accept, and believe I was actually worth that friendship was a huge step for me. In fact, it was the first step on the pathway to my recovery.

Since then I have got involved in lots of different activities with Wired In, and all of them served to increase my self-esteem, confidence, knowledge and skills. In fact, I learnt a lot of new skills—public speaking, facilitating group sessions, conducting filmed interviews, and about addiction/recovery as a whole, but more important than this I also learnt a lot about myself—my strengths, weaknesses, even who I really was and what I wanted to do with my life.

It soon became clear to me that I wanted to work full-time in the substance misuse field and in October 2007, I secured a paid post with The Salvation Army as a Substance Misuse Worker. I’ve recently changed jobs and now work as the Community Development Co-ordinator with Wired In. My job is both challenging and very rewarding; I wouldn’t change it for the world!

Volunteering for Wired In has changed my life in so many, positive ways, I am indebted to all of the team, Sarah especially. I am now living a happy, fulfilled life and volunteering with Wired In was one of the main factors that helped me to turn my life around.’

> 19. Factors Involved in Facilitating Change

> ‘My Journey’ chapter links (and biography)

I move to Cowbridge, near to Cardiff, and my house becomes the centre for Wired In operations. Lucie brings together a group of recovering local people to form our first recovery community. We make a film about young heroin users, and give talks at conferences on this topic and on drug overdose. I talk at the Annual FDAP meeting about Wired In’s recovery advocacy work, and challenge government policy focused on substance use problems and the way that the treatment system operates. (2,931 words)

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Now that I wasn’t tied to the university, I decided to move nearer to Cardiff, so I was closer to the Wired In team who lived in the vicinity of the Welsh capital. Lucie helped me to look for a house to rent. I’d planned to rent somewhere small, but she emphasised that I must rent something larger, a place that would be like home for my three youngest children when they visited every other weekend and during their school holidays. I saw the logic in what she was saying.

Eventually, I found a lovely place to rent on a farm just outside of Cowbridge, a small town located 12 miles west of Cardiff. It was a fairly expensive house, but the children had the space they needed, and they could walk out of the front door and immediately be in the countryside. They loved ‘Ivy Dene’, as I did, so I’m grateful to Lucie for insisting that we find such a place.

In November 2006, Dave Watkins and Keith Morgan of WGCADA helped move my furniture from my old house. Soon after moving in, I headed to Australia again to see my family and friends there. These trips to Australia were an important part of my healing process.

In April 2007, we had a birthday party for my youngest son Sam at the house in Cowbridge, now the centre of  Wired In ‘operations’. Annalie had come down from Edinburgh to be there for Sam, and so were members of our Wired In Family—Keith Morgan, Dave Watkins, Becky Hancock and her mother Cheryl, Kevin Manley and his mother Kerry, Lucie and her mother Carol, Sarah Davies (now Vaile), filmmaker Jonathan Kerr-Smith, and my best schoolmate Jeff Zorko (one of our charity Trustees) and his wife Marian and daughter Rosie. The closeness of my families—biological and work—was very special to me.

Around this time, I met up with my cousin Simon Tarry, who was a successful manager in a medical instruments company. He loved what we were doing with Wired In, but thought that we needed some solid marketing experience. He suggested that I work with his friend Inga Rose, who had set up her own company Air Marketing.

Inga agreed to work with us on a consultancy basis, and later introduced me to Geoff Allman of Spoken Image, who ran a multimedia company in Manchester, and web-designer Nathan Pitman of Nine Four.  She also introduced me to a few business people who offered to act as Advisors for Wired In. 

We decided the best way forward at this time was to develop education and training packages about addiction and recovery for the field. A number of people working in the field who loved what we were doing had suggested that we start preparing multimedia CDs, as they felt that treatment services urgently needed educational content and would be willing to purchase such material. They felt that film of recovering people talking about their lives would be of particular value.

We started preparing content for our first CD-ROM,  ‘A taster of the unique approach adopted by Wired In to tackle substance use problems’, which was developed by Geoff Allman and his colleague at Spoken Image. We were proud of the final product. 

In August, Jeff Zorko and I arranged a reunion in Cowbridge with two of our old best schoolmates, Tom Wragg and Bruce Marriott, both of whom I had not seen in over 35 years. Both had done really well over the years. Tom had worked in the media business for many years and at one time was Head of Production for BBC TV News and Current Affairs. Despite never having shown any interest in ballet as a youngster, Bruce became a well-known ballet journalist and even entertained the Bolshoi Ballet when they came to London. The four of us spent a special day together. 

Whilst staying at my place, Tom read through a draft business plan I had put together with one of our business advisors. He was really impressed with what Wired In was doing and thought it had a potentially amazing future. However, he strongly suggested I change the name from WIRED to Wired In, to distinguish ourselves from the technology magazine WIRED.

Tom also suggested that if we were to try and finance the initiative, at least in part, by selling training and education material, we needed to find a bulk-purchaser. He suggested that I approach the National Treatment Agency (NTA), who were ultimately ‘in charge’ of most of the drug treatment field, and offer to develop education and training packages on interactive CD-ROMs that they purchase in bulk and supply to all treatment services. Tom also offered to come with me to the NTA if I could set up a meeting. 

We visited Annette Dale Perera, Director of Quality at the NTA, and showed her our interactive CD-ROM taster. She seemed impressed by what she viewed, in particular our film clips, and was enthusiastic about our suggestion that the NTA buy our education and training materials in bulk and distribute. However, she pointed out that she must show the CD-ROM to a new Director of Communications (Jon Hibbs) the NTA had just hired, before making any firm decision.

I went back to the NTA to meet Jon Hibbs, this time without Tom. When he viewed one of the film clips of Kevin Manley, he said, ‘We can’t be involved with this. He’s criticising treatment.’ I replied, ‘No, he’s criticising bad treatment practices and praising good practices.’ ‘No, we’re not getting involved with this,’ was the response. That was the end of Tom’s great idea!

I had the feeling that Annette was disappointed by what had happened. To her credit, she later organised for the NTA to provide urgently needed sponsorship for Daily Dose.

Meanwhile, we eventually decided that producing Wired In education and training CD-ROMs was not the best way forward. This approach was not going to provide a sufficient income to help sustain Wired In. As it was, I was now paying Lucie, Kevin and another person, as well as Air Marketing and Spoken Image, out of my ‘retirement fund’.

Lucie was bringing together a group of people in South Wales who were recovering from drug and alcohol problems, our first local recovery community. They had regular evening gatherings, where they would hold a recovery group gathering and also enjoy themselves socially. Kevin Manley and Mark Saunders was also real stalwarts of the group.

Over time, participants told their stories, reflected on key issues related to addiction recovery, and discussed their experiences in treatment. They were all proud when Lucie ‘signed them up’ as Wired In volunteers. They wanted their voice of recovery to be heard far and wide.

I was not involved in the regular recovery meetings, as I didn’t want the group to feel restrained in any way by the presence of the ‘Prof’. Besides, this was Lucy’s ‘baby’, ably supported by Kevin and Mark. However, I did participate in the occasional social gathering, like tenpin bowling. And Kevin and Mark used to come over to parties at my house and spend time with my children, who came to love them both.

I also organised a restaurant lunch for some of the group when we were visited by Pavel Nepustil, an addiction researcher and worker, from the Czech Republic. He was also working on his PhD thesis, Identity Shifts in Former Drug Users. Team members and I were deeply touched by a blog post that Pavel later wrote about that day:

‘One year ago, I visited a group of people in Cardiff headed by Prof David Clark. They had called themselves Wired, later they turned into Wired In and today they are creating, in my opinion, the future of the substance misuse field. From the very beginning, I have noticed several things which clearly distinguished these people from the drug workers I have known from Czech Republic. 

Firstly, it was the goal-orientation, self-efficacy, strong belief that they will achieve what they want. I saw people who are used to winning and who are not afraid to risk. Then, it was something more abstract that was tying them together—an idea, belief—the commitment for which we do not have any proper word in Czech Republic. And finally, I have noticed the radical shift from the common relationship between ‘professionals’ and ‘ex-users’. There was not any kind of hierarchy.

We went to a restaurant together (the prof, two university graduates, three ex-users and myself), and we were talking together about everything. I noticed no kind of prejudice or presumptions. Even if the life experience of everyone was totally different, everybody was using it in order to achieve common goals. In short, I saw the community which is committed to recovery.

Currently, this community is making a huge and crucial step. Wired In is in amazing way reflecting the huge digital technology expansion and they are creating an online space which will be open to the whole world. Ex-users are sending the message to the world that it is possible to live happy and meaningful lives after long period of drug use.

Their families are calling that one does not need to be alone through all their troubles, and practitioners have a possibility to talk freely and openly about their own dilemmas, dissatisfactions, and critical reflections. I am just happy to be part of this community.’

In June 2007, Kevin, Mark and I were asked to give a talk about drug overdose at a one-day conference in Swansea organised by Ifor Glyn of the treatment service Swansea Drugs Project (SAND). Lucie and I were so proud of the professional and inspiring talks given by the two young men. I could see their talks had really impacted emotionally on members of the audience.

My talk included reference to some of our earlier qualitative research conducted by two of our undergraduate students, Laura Davies and Emma Murphy. One project focused on the experiences and views of family members about drug overdose, whilst the other focused on people who had overdosed or seen someone else overdose.

Ifor later commissioned Wired In to make a film about young heroin users who were accessing SAND in Swansea. He wanted to highlight the negative impact that heroin use was having on young people, who were starting to use the drug at a younger and younger age.

Jonathan Kerr-Smith filmed Lucie interviewing five youngsters, aged between 17 and 19 years. I still vividly remember Lucie coming back to Cowbridge after the first day’s filming and just breaking down crying. She described how young the girls she interviewed that day were—one was 14 when she first used—and how they lived in an environment where heroin use was rife and the drug easily obtained. And what chance did a youngster have when her or his parents were heroin users?

Lucie was deeply moved by the bravery of her interviewees in coming forward, and how committed they were to speaking out about their experiences, in the hope that other young people would avoid the mistake they had made in starting to use heroin. 

I presented the 20-minute film that Jonathan and Lucie made at the SAND conference on young heroin users. There was no doubt that the film had an enormous impact on members of the audience, many of whom came to talk to Lucie, Jon and me afterwards.

I was deeply moved by the film. I was also saddened by some of the beliefs of the young participants, their acceptance: that in their environment, using heroin would happen to them; that addiction develops fast; that when you start ‘clucking’ (experiencing drug withdrawal), that’s it; and of the substitute-prescribing mind-set.

At least the youngsters knew that recovery had to come from them, rather than a treatment practitioner. It was so pleasing that the last interviewee, Sam, had stopped using and now had a house and a partner, and was expecting a baby. ‘There were no future for me before, but now there is.’

After the talk, Keith Morgan approached me in a near-state of shock. He had known the mother of one of the girls and used to hold the girl when she was a baby. The mother had died of a heroin overdose.

Lucie, John, Ifor, Jamie (a SAND drug-worker who had helped set up the project) and I discussed whether we should keep showing the film (in public talks and on YouTube) and distributing it as an education resource—the brave youngsters had agreed that we should do that.

However, we decided that it was in their best interests that the film never be shown publicly. We felt that they were too young to make such a decision. How would they feel the film being shown years later when they were in recovery? It would be different situation with older interviewees who wanted their film shown. The youngsters did emphasise to us how much they had got out of the experience of being interviewed. It did a lot for their self-esteem.

Simon Shepherd asked if I would give the main talk at the 2007 FDAP Annual meeting in November and introduce my audience, who were mainly treatment practitioners, to the concept of recovery and Bill White’s recovery work in the USA. Up to that time, I had met only a few people in the UK who knew anything about leading recovery advocate Bill White, which was amazing (and concerning) given the importance of his work.

This was an important talk for me, as I was also going to introduce Wired In’s recovery advocacy work, and challenge government policy focused on substance use problems and the way that the treatment system operated.

I started by reminding my audience that the treatment system in the UK was focused on: reducing crime rather than trying to help people overcome addiction; the number of people accessing treatment, not on people getting better; and substitute (mainly methadone) prescribing with little other choice of treatment. There was a paucity of ambition for clients, and the system had become a revolving door, with clients accessing treatment, leaving, and then accessing again (and repeating that cycle).

The system had become dominated by paperwork, more and more practitioners were becoming disillusioned, and clients were being blamed for failing. At the same time, the NTA was talking up their successes, despite the fact that there was very little evidence of success. I emphasised that what happened in the US—people realising that the addiction treatment system did not work, despite the slogan ‘Treatment Works’—would likely happen here.

I then went on to talk about empowerment, the nature of recovery, the concept of behavioural change, therapeutic principles, recovery capital, and the need to develop recovery communities, to which treatment services needed to be connected. There was a lot of ‘new stuff’ being introduced to my audience, but I needed to tell this story, and it was exactly what Simon wanted. 

Afterwards, I talked to a PR expert (Deborah Parritt) who had attended my talk and was volunteering as a Wired In consultant at the time, and she said that many of the audience looked disinterested and bored. However, she also said that there were many people who were absolutely ‘hooked’ to what I was saying and she could feel their excitement.

I didn’t expect the majority of this audience to be interested—I was attacking the system in which they worked and calling for change—but I wanted to excite some people so they went away to think, read and act. There would be no tidal wave of change; it would occur slowly and in only some places. But the implementation of change and the subsequent successes would lead to more change.

I was pleased that I had given this talk and thrilled by the number of people who came up afterwards and congratulated me. Deborah was pleased with the talk and the positive response it received. It was a big moment in my working life. 

After my earlier trips to Australia, I thought it was time that I took my three youngest children to meet my sister and her family. Their mother agreed that we could make the trip.

We arrived at the Emirates check-in at Heathrow on Christmas Day, 2007. I handed over the passports to the lady at the desk. She looked at them and said, ‘There’s one passport missing.’ I told her that they were all there. She smiled at me, ‘Three young children and just you. I wish you the very best of luck.’ I laughed. It was nice to have a bit of humour before our great adventure. I guess that not many fathers travelled alone with three young children to the other side of the world.

That trip was so very special, bringing my three youngest children together with my Australian family and friends. Little did Ben, Sam and Natasha know then, this was just the first of their Australian adventures.

> 18. A Charter, Vision and Film

> ‘My Journey’ chapter links (and biography)

Wired In attracts new volunteers and stories of recovery, the latter of which are uploaded to our websites. I return from a holiday in Australia, only to experience bad anxiety at the thought of returning to the toxic environment in my university department. I am advised by my doctor to take extended leave. Just before I am due to return to work, I visit a counsellor who diagnoses me with post-traumatic stress disorder (PTSD). An interesting conversation follows in the university. (2,710 words)

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1. Wired In Activities

Soon after I had returned to the UK in early January 2006, I wrote the Annual Report for the Trustees (Canon Peter Williams [Chair], Michael Ashley, Margaret Wilson and Jeff Zorko) of our charity Wired International Ltd. I used to get anxious about our charity’s Annual Meeting every year, since I felt guilty about attracting the low level of funding on which we operated. However, I needn’t have worried, as our Trustees were very understanding and impressed by how much work we had done with so little funding.  

Ironically, many people thought Wired In was a well-funded research institute. They were shocked when I told them our small operating budget! And the fact that our team members were my past and present Psychology students.

Kevin Manley, a recovering heroin addict, and David Wright, both living in Cardiff, now became Wired In volunteers, joining Mark Saunders. Kevin’s mother Kerry later became a volunteer. David Wright had written his Personal Story, Diary of a heroin addict, in six instalments for Drinks and Drugs News which started in the 21 March 2005 edition (p. 14).

We were now receiving Personal Stories from other parts of the country, including from Stuart and Mark, both of whom had been physically abused as children by violent step-fathers. Stuart from Inverness had experienced long periods of incarceration in different prisons. However, he was now two years into his recovery, getting high marks (75%+) on an Open University Health and Social Care course, doing various forms of voluntary work, and acting as a group facilitator for SMART Recovery.

Mark wrote his three-part Story for Wired In whilst serving a custodial sentence in HMP Bullingdon. He had been on the RAPt treatment programme and now strongly related to the 12-Steps of Narcotics Anonymous (NA). 

We also started receiving stories from people recovering from benzodiazepine (e.g. Librium) addiction. These stories revealed how severe the physical and psychological withdrawal symptoms could be after withdrawal from long-term use of ‘benzos’.

2. Anxiety

When I had arrived back in the UK after my latest trip to Australia in January, I immediately started to experience strong anxiety about returning to the toxic environment in which I worked in my university department.

This anxiety condition had developed back in 2001 and resurfaced from time-to-time. When I met my good friend Keith Morgan of WGCADA soon after my return from Australia, he saw I was not travelling well and insisted I should take time away from the university. Another good friend who had known what had been going on in the department over the past decade also insisted I take leave—she pointed out that I could take six months sick leave on full pay. 

I went to see my doctor, who I had kept informed of what had been happening to me in the university over time, and he insisted I take extended leave to protect my health. He was greatly concerned with what I had experienced over the years, and now wrote to the university saying I needed to take extended leave. As an aside, he knew my negative thoughts about the use of prescription drugs to manage anxiety.

My doctor also pointed out that I could continue supervising the research of Lucie James from my home—Lucie had been awarded a prestigious PhD studentship from the University of Wales and was now conducting qualitative research into recovery from heroin without treatment.

The university agreed to me taking extended sick leave on full pay. However, my Head of Department (HOD) told Lucie that if I was not willing to come to work, then I could not supervise her PhD. She would be supervised by someone else in the department, and have to change the topic of her research. ‘No one recovers from heroin addiction without treatment,’ he told her.

Lucie pointed out that he was wrong—he knew nothing about recovery from heroin addiction—and that she was also being supervised by Linda Sobell in the US, the leading addiction researcher in the self-change field. That made no difference to my HOD. Lucie therefore gave up her studentship and left the department. I was never contacted about the matter by my HOD. [1]

I now slowed down, although Lucie and I maintained our Wired In activities. I did a great deal of reading about addiction and recovery, and spent time walking the hills and beaches of Gower with my dog Tessa. I also continued to see my children regularly. I stayed in Reynoldston, as I could not sell our house. There was a big price differential between houses in Swansea and on Gower, and few people were moving into the area at that time. 

In April, I travelled to Perth with my oldest daughter Annalie to attend my nephew Graham’s wedding. It was fun watching his shocked reaction when he first saw Annalie—he had no idea she was going to be there. Graham’s family and fiancée knew what was going on! Graham and Annalie had previously met only once, over a decade earlier in the UK. It was wonderful spending quality time with Annalie and seeing her interact with her relatives.

3. A Diagnosis and Offer

In the later phase of being away from work, I decided to take up the first of six free counselling sessions to which I was entitled. My decision to see this counsellor was the best thing I could have done at the time.

I talked and she listened, reflecting back to me from time to time. I told her my story and after an initial concern, I felt really good in telling her what had happened to me in the university. When we finished, we both got up, but my counsellor nearly fell over. I asked her if she was okay and she replied:

‘I just suddenly felt faint. I have to tell you that I have never ever heard such a story. I have no idea how you ever put up with and survived all the terrible events you have had to deal with. Your trouble was that you are incredibly resilient, but no one can be that resilient. Finally, you just broke. You are suffering from post-traumatic stress disorder (PTSD).’

She went on to tell me more about PTSD. Now, I am not a great believer in diagnoses, but in this case my counsellor’s diagnosis made so much sense. She helped me no end, in just giving me an explanation for what had happened and was still happening to me. The anxiety I had been experiencing now made sense to me. I left her office feeling so relieved that I had gone there in the first place.

I continued my counselling sessions and they were of great help. I won’t say that my anxiety disappeared—I still get anxious today—but it didn’t happen as much and I learnt to control its intensity (most of the time]. The real test of course would come when I went back to work. 

The time for my return was rapidly approaching and I was asked to visit the Head of Personnel (Human Resources) at the university, who I knew well. After asking me how I was doing, he pointed out that the university didn’t want me to return to the department. He and his colleagues felt that it wasn’t safe for me to return at that time! The environment was too toxic.

I pointed out that I had to return; if I stayed away longer I would be on half-pay. He replied by saying that the university had made a special rule for me and that I could remain on sick-leave on full pay. I agreed to stay away.

The Head of Personnel then told me that the university wanted me to help them address the issue of the toxic environment in my department by naming the person or people who were causing the problems.

I looked at him in shock and asked if he knew what had been happening to me over the years? How a government department and the university had first asked me to be a whistle-blower against a department Professor in a case of laboratory animal abuse nearly a decade earlier. How I had to become a whistle-blower again when a PhD student approached me about her data being manipulated by her PhD supervisor (the same person as in the first case) and then sent off to a drug company. Again, the matter was not dealt with properly. I had to be a witness again when external investigators approached the university about this same case of scientific fraud.

After the PhD supervisor left the university, an anonymous letter with false accusations about me was sent to the university. The university brought in auditors who conducted a financial investigation, leading to the Vice-Chancellor detailing a variety of problems in a letter to me. I responded immediately to the allegations, which were all nonsense.

In the same letter, I informed the Vice-Chancellor that I was now heading off to be at the birth of my second son. I had informed my doctor about the situation and he said he would approach the university if anything went wrong with the birth. We were both concerned that the whole situation with the university, and the stress I was under, would have affected my partner.

I was investigated and found to be innocent of all of the allegations. However, the university took one year to inform me of my innocence, during which time I developed my anxiety condition. Day after day, I would head into work worrying why the university was not getting back to me about the case—even when I asked—when it was very clear that I was innocent of all the allegations. [2]

The Head of Personnel had no idea of what had been happening and was shocked to hear the story. I was surprised that no senior member of the university had told him about my past, although to be fair, the original Vice-Chancellor had retired.

I told the Head of Personnel in no uncertain terms that I could not again become a whistle-blower. My health wouldn’t hold up. He undoubtedly understood my situation. I then said to him that as far as I was concerned, the best option would be for the university to offer me an early retirement package.

I now knew that I could not go back to that toxic environment. I also couldn’t be sure that the university would do the right thing. If they had addressed the initial problem properly nearly a decade earlier, then subsequent events would not have occurred. The student would not have been put in the insidious position in which she found herself, and she and I would not have gone through so much stress.

On top of all of this, I realised that my heart lay in my addiction recovery work in the community. It was time to take a gamble, get an early retirement package, and use that money to finance my Wired In work until I could raise external funds.

I would certainly be taking a big gamble in taking early retirement from the university at the age of only 52. I knew that I would not be able to survive on a small pension—it would be a greatly reduced pension, due to me be being abroad for years in my early career, and leaving the university early—so I needed to generate income from Wired In.  This was a worry, as we had experienced so much difficulty in obtaining funding to date.

Fortunately, the university gave me a lump-sum early retirement payment which would give me some leeway. I was also made a Professor Emeritus, in recognition of my research standing and contribution to the university over the years. 

Endnotes:

[1] Check out my article Stopping Heroin Use Without Treatment in which I describe research by Partick Biernacki in the mid-1980s which was carried out with 101 people who had recovered from heroin addiction without treatment. You can also read my article Self-Change and Recovery Capital, in which I describe similar research carried out by Robert Granfield and William Cloud and written about in their book Coming Clean: Overcoming Addiction Without Treatment.

[2] One of the accusations was that I had stolen money from the university. This money was the consultancy I was paid by the Welsh Assembly Government for leading the Drug and Alcohol Treatment Fund (DATF) evaluation [cf. Chapter 6], for which a contract had been drawn up between government and university so that I would be paid by the latter. When I told the person overseeing the DATF evaluation for the Welsh Assembly Government what I had been accused of, he was very angry and immediately called the university to clear up the matter. The auditor had not seen the contract!

The auditor made a variety of other allegations, such as the fact that I had claimed for a copy of the Guardian newspaper when I claimed for petrol for my lease car which was used for the DATF evaluation. The receipt showed clearly that I had only claimed for the petrol! He or she measured the distance of each of my trips and said that I had claimed for an extra ten miles or so on one trip. I had to divert on my trip to pick up a team member! I had to work through one petty allegation after another, all of which were auditor errors. I hope the university gave the large company conducting the audit a piece of their mind and insisted they reimburse their costs!

Things didn’t settle down over the next few years. One day, a new Head of Department informed me that I needed to ‘buck up my ideas’ and improve my teaching standards, as I was the worst lecturer in the department. I asked him where he had obtained this information, but he would not tell me. He just informed me it was fact.

I told him that he needed to come with me to the Department Administrator and view the student ratings of staff lecturers. Contrary to what he was saying, I knew I had the highest rating of all members of staff. The Head of Department would not come and view the ratings. I insisted, but he walked away. 

On another occasion, I was informed by my PhD student that a fellow PhD student had been asked by her supervisor to collect whatever dirt she could on me and let him know.  I was aware of other efforts being made to destroy my reputation.

The toxic nature of my work environment started to affect me badly—I never knew what I would be facing when I turned up for work. At the same time, I had such a great relationship with the students and this helped me to deal with the adverse experiences. 

I spent a good deal time deciding whether I should include these events here. I eventually decided it was important to include this section because the events, and my psychological reactions to them, helped me to relate to the nature of trauma and its consequences, which I will discuss in more detail in a later chapter. Traumas don’t need to be major one-off events, such as being raped as a child or being in a major car accident, but can take the form of repeated uncontrollable negative events such as I experienced.

I also think it was important I describe these events—which are very much a summary of what happened over the years—so that other whistleblowers or potential whistleblowers are aware of the negative things that can happen. I cannot regret the actions I took—that’s what an honest person does—even though events that started nearly 30 years ago periodically affect me today.

> 17. Wired In’s Cardiff Recovery Community

> ‘My Journey’ chapter links (and biography)

My funding applications  to build an online recovery community to help people overcome substance use problems, and to help SMART Recovery ‘spread’ their approach in the UK, are unsuccessful. We launch our first Wired In film, the story of Mark Saunders, and I spend time with the inspiring self-change expert Linda Sobell in the US and Scotland. I start collaborating with the team at Clouds House, where I hear about the leading US recovery advocate Bill White.

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1. Online Community Development

I was greatly inspired by the book Community Building on the Web by Amy Jo Kim back in 2002, before Facebook was launched. Through reading this book, I became convinced of the potential power of web communities for helping tackle social issues. My vision was to build a Wired In virtual meeting place for peers to communicate with, and help, each other. A place where ideas could be developed and exchanged, and stories told.

I talked over my ideas with my web-developer Ash Whitney and Anni Stonebridge, the former local evaluator for the North Wales DAAT during the DATF evaluation (cf. Chapter 6). Anni had moved to Aberdeenshire in 2003 and became the Drug & Alcohol Development Officer for Aberdeenshire Council. We had remained in touch and Anni had become a member of our Wired In team. She was conducting a range of interesting projects in Scotland which we publicised on our websites. 

Anni and I started to plan the development of a web community for family members affected by their loved one’s substance use problems. She arranged for us to meet with people in the Scottish Government to discuss our ideas and explore the possibility of funding. They seemed enthusiastic about the initiative and said they would get back to us.

Meanwhile, I met Tony Roberts of Datasmith Ltd., who had developed an internet-based system that allowed the gambling addiction charity Gordon House to provide 24-hour online counselling, support, and aftercare. Tony’s brother Kevin, a social worker and CEO of Gordon House, had masterminded the therapeutic elements of the service. Unlike other similar systems at that time, Datasmith’s technology (which had a patent pending) was completely secure and confidential.

Simon Shepherd and I agreed to ask Tony if he would be willing to develop a new system for Wired In and FDAP, which we would call Virtual Outreach, if we were able to raise the funding. Anni Stonebridge would be an integral part of the project. 

I now started to spend more time in Scotland. Anni arranged for me to stay as a B&B guest at beautiful Dinnet House, on the River Dee, which was located a few miles from where she lived. Sabrina and Marcus Humphrey were perfect hosts and the former was very encouraging about what I was doing with Wired In.

Anni and I worked on our Wired In plans in Sabrina’s magnificent lounge. Whilst in Edinburgh during one trip, I met with a Scottish Government civil servant about Virtual Outreach and he was encouraging about the possibility of providing funding. 

My daughter Annalie started studying medicine at The University of Edinburgh in September 2004, so there was an added reason to visit Scotland regularly. I love Edinburgh!

In June 2005, I travelled with Anni Stonebridge to Loch Ness to meet John Sinclair, former keyboard player with Uriah Heep and Ozzy Osbourne’s band, who was now in recovery from addiction and working with troubled youngsters. I loved my meeting with John and the philosophy behind his work.

He thought that today’s youngsters, ‘… were born into an increasingly cold and indifferent world, thus being easily driven {and often resorting} to making irrational choices to establish some sense of self-worth.’ He aimed to provide a musical environment that helped enhance essential life skills such as motivation, communication, determination, and self-worth.

In September, I took Keith Morgan of WGCADA up with me to Dinnet, and he, Anni and I then travelled to see John Sinclair at his home. Keith and John started jamming together soon after we arrived. They planned to write about recovery together. It was amazing to see their interaction.

Unbeknownst to Keith, WGCADA had invited John to give a talk at their Annual General Meeting some months later. They asked Keith to pick up their speaker at Bristol airport. Keith was thrilled to find that the speaker was John Sinclair, and the pair had a great time together in Swansea.

Meanwhile, Anni had been very busy on our collaborative projects. She had convinced Aberdeenshire Alcohol and Drug Action Team (ADAT) to provide some funding for Wired In to develop content for our planned family web community. Aimee Hopkins started preparing content based on the SMART Recovery approach (see below).

However, the Scottish Government failed to come through with the additional support that was needed. Although we were unable to raise any other support for this specific project, we thought that the content could be used on Virtual Outreach.

I started writing to a large number of drug and alcohol rehabs in the UK to inform them about our work and to see if they would be interested in funding Wired In. I pointed out that we could develop an aftercare system (which could involve on-line counselling, information provision, stories) for which all their ex-clients could benefit.

I received only one reply, from Nick Barton of Clouds House. This communication was the beginning of a fruitful collaboration with Nick Barton and his team at Clouds House. The failure to receive any other replies from rehabs was both surprising and very disappointing.  

Anni pointed out to me that Virtual Outreach would be an ideal tool for organisations located in rural regions and islands of Scotland. Following meetings and discussions with various members of the Remote and Rural Subgroup of the Scottish DAT Association, she assembled a list of ten areas which had expressed serious interest in offering a service supplied via Virtual Outreach. Each of the areas described ways in which they would like to use our proposed new tool. 

We submitted a proposal to the Scottish Government to fund the development of Virtual Outreach, for which Distance Therapy were generously going to charge a minimal amount, and a one-year pilot during which the ten areas would use the tool in a variety of ways and help provide feedback so that we could write a final evaluation report. Despite their initial interest and my trips up to Scotland to meet relevant civil servants, for which I paid the airfares, the Scottish Government did not fund the project.

In early November, I gave an invited talk at the Scottish Association of Alcohol Action Team Expert Seminar on ‘Rural Issues in Scotland’ in Glasgow. I talked about Virtual Outreach and the project for which we were trying to get funding. I was approached by George Howie of Health Scotland and asked to submit the original Scottish Government proposal to his organisation, as he was sure they would fund the project. 

I submitted the proposal in late November, only to have it rejected. Other efforts to fund development of Virtual Outreach also failed. This was all so disappointing, not just because of what could have been achieved in helping people with this important tool, but also that it would eventually have become self-funding.

Simon Shepherd and I agreed that Virtual Outreach had to be quality assured, and therefore professionals or organisations wishing to use it would need to become Associated Members of FDAP (Federation of Drug and Alcohol Professionals] and abide by their Codes of Practice. They would pay for use of the tool either by the hour, or by a fixed sum for 24x7x365 use. Sadly, Virtual Outreach was not going to happen.

2. Film Projects

The Wales Council for Voluntary Action (WCVA) provided funding for Wired In to engage and empower people who were, or had been, homeless and were misusing illicit drugs and/or alcohol. The project was conceived as a way to engage homeless people to: find out factors that facilitate their engagement in treatment for substance use problems; provide them with the opportunity to acquire social and practical skills; and involve them in a project that would enhance public awareness of ‘addiction on the streets.’

Sarah Davies and young filmmaker Simon Roberts spent a good deal of time getting to know the twenty homeless people who would eventually speak on film, and this stood the project in good stead. Sarah and Simon also worked with nine organisations in Cardiff and Swansea, as well as a Swansea street nurse. They collected over 24 hours of footage which was passed on to the WCVA. Simon edited a promotional piece using clips that were selected by homeless people who were involved in the project.

Lucie James and a talented filmmaker friend of hers from Penarth, Jonathan Kerr-Smith, made a 10-minute film, The Personal Story of Mark Saunders.

Mark was a Wired In volunteer and former heroin addict. We had met him through Angela Brinkworth, a drama therapist who ran an organisation called Make a Change that worked with people who had a substance use problem and had committed criminal offences. These young people gave something back to the community by sharing their knowledge and experience of drug addiction through Forum Theatre to schools, youth groups, young offender groups, and to inmates in a prison. 

Mark’s film was first shown publicly at a Make a Change conference on empowerment in Newport in December 2005, where I gave a talk on ‘Empowering Others’. We decided that Mark’s Story should be the first of a series of Wired In film stories and when the National Treatment Agency (NTA) later asked for submissions for funding of new projects, I submitted an application for this project. Sadly, the proposal was rejected.

Forum Theatre, developed by Augusto Boal in Brazil, often deals with social justice issues, and involves spectators influencing and engaging with the performance as both spectators and actors, termed ‘spect-actors’, with the power to stop and change the performance.

I invited Mark to create a piece of Forum Theatre for the students attending my Clinical Masters course on addiction that focused on the dilemmas faced by people recovering from heroin addiction. The class was a huge success, and Mark was really touched by the positive reception and feedback he received from the students. He really gained a powerful sense of agency! Mind you, I’m not sure that some of the staff in my department would have appreciated a former heroin addict taking a class! I loved it!!

3. SMART Recovery and Linda Sobell

I was invited to attend the SMART Recovery Annual Meeting in Chicago, US, in October 2005. SMART (Self-Management and Recovery Training), founded in 1994, is the largest of the non-12-step mutual help groups. It differs to the 12-step approach in viewing addiction as a dysfunctional habit, rather than a disease.

The organisation emphasises four areas in the process of recovery: build and maintain motivation; cope with cravings and urges; manage thoughts, feelings and behaviours; and live a balanced life. Participants are empowered to help themselves and others using a variety of cognitive behavioural therapy (CBT) and motivational tools and techniques. SMART Recovery meetings, which are educational, supportive and involve open discussions, are free.

I learnt a great deal at this conference and was inspired by a number of people I met, in particular the current SMART Recovery President Tom Horvath and Executive Director Shari Allwood. Whilst I was there, the SMART Board invited Wired In to develop and promote a SMART programme in the UK and Europe. This was a wonderful opportunity for our team to be involved in rolling out a major self-help approach, although we would need to raise funding to make it happen.

Fraser Ross, a SMART Board member from Inverness in Scotland, and Anni Stonebridge helped me develop a strategy to enable a programme of activities. The Robertson Trust, a Scottish charity, seemed very interested in funding the project—yes, another flight to Scotland for discussions—but eventually rejected our application. 

These rejections were becoming commonplace. Charities would hear about the work we were doing and tell me how interested they were in supporting us to do something different to what was being done by government.  They would express a keen interest in our grassroots approach. However, once I’d submitted an application they would tell me that Wired In should be following the government approach. 

I haven’t mentioned to date, but I had also written to a large number of companies and to some well-known individuals (e.g. Richard Branson) over the years, in an effort to raise funding for Wired In, but without success. It would have been easy to lose faith at this stage, but I knew of people I held in high regard who really loved what we were doing. Surely, we would have a break-through soon?

Just prior to the SMART Recovery conference, I attended a one-day session on Motivational Enhancement Therapy—a directive, person-centred approach to therapy that focuses on improving an individual’s motivation to change—run by Linda Sobell. Linda was a world-leading figure in the addictions field, and recipient of a number of prestigious awards for her research and activities related to self-change and motivational interventions. 

Linda and I were to meet again just two weeks later, where we had both been invited to give talks at a conference in Aberdeen, Alcohol Recovery: A Natural Progression. Other invited speakers included SMART members Barry Grant and Rich Dowling, along with John Sinclair.

Anni Stonebridge, who was involved in the setting up of the conference, and I arranged for Linda, Barry and Rich to stay at my favourite Dinnet House. They were enamoured by the place, and completely taken aback by the wonderful dinner that Sabrina cooked for us to celebrate their stay.

We all attended Linda’s one-day session on Motivational Enhancement Therapy prior to the conference. The real highlight of the conference for me was an amazing talk by Barry Grant. Barry had overcome 23 years of criminal and addictive behaviour—and a five year prison sentence—to become a professional counsellor with a master’s degree in human services, and a global ambassador for SMART Recovery. His talk was truly inspirational—I had not known that Barry was a well-known motivational speaker.

Linda and I spent a good deal of time talking about Wired In. She was very excited by what we were doing and thought that Wired In had a great future. She asked if I had read Malcolm Gladwell’s book The Tipping Point, which refers to ‘that magic moment when ideas, trends and social behaviors cross a threshold, tip and spread like wild fire.’

Gladwell points out that three types of people are critical for social epidemics to occur: Connectors (who know lots of people from different areas of life), Mavens (knowledge collectors who want to help others and know how to pass on knowledge); and Salesmen (self-explanatory).

Linda pointed out that I was all three ‘characters wrapped up in one’, which was very unusual. I had not read Gladwell’s book and was humbled, and rather excited, by what Linda had to say. However, I did not consider myself a good salesman, at least when trying to convince people to fund Wired In! 

Anyway, Linda suggested that I set up an International Advisory Board for Wired In and offered herself and husband Mark as members. She also suggested that I contact Carlo Di Clemente of Stages and Processes of Change fame and Harold Klingemann of Switzerland, who was a leading figure in the addiction self-change field. They both accepted my invite, as did Barry Grant. The Advisory Board eventually numbered 13 and included Nick Barton, Neil McKeganey and Simon Shepherd who I have previously mentioned. 

As soon as the Aberdeen conference ended, I headed to Edinburgh Airport, where I bought a copy of Malcolm Gladwell’s book, to catch a flight to London where I was to give a talk at the FDAP Annual Conference. I enjoyed giving the FDAP talk and the celebration afterwards with Claire, Ian and Simon for DDN’s 1st Anniversary.

However, I had to be up early to catch a flight to Glasgow for my talk that day at the Scottish Association of Alcohol Action Teams Expert Seminar on ‘Rural Issues’. It was a busy time and I was glad to get home to Wales. As an aside, I should point out that I had finished Malcolm Gladwell’s book by the time I reached my hotel in London on the day I left Edinburgh. It was a fascinating read and I was greatly inspired.

4. Professional Roles

I had taken on several administrative roles in the field during the year. Simon Shepherd had invited me to be Chair of The Professional Certification Advisory Panel for FDAP, and I had also been invited to be a member of the Accreditation Panel for the European Association of Treatment Agencies (EATA).

I had started visiting Clouds House, the residential rehab run by Action on Addiction, and discussed potential collaborative projects with Nick Barton and Tim Leighton. In 2004, I was appointed as External Examiner for their two-year Foundation degree in Addiction Counselling, which was linked to Bath University.

This meant that after I had helped them plan the degree (as External Assessor), I ‘oversaw’ the marking of students’ work each year. I was thrilled to be asked to act in this role, as the field desperately needed a course like this delivered by experts like Tim Leighton and his colleagues.

I loved visiting Clouds. Tim, one of the most knowledgeable and inspiring people I have ever met in the field, and I couldn’t wait until I had finished my official examination work during a visit, so that we could sit down and catch up with all that each of us had read and seen since our last meeting. It was Tim who first introduced me to the amazing writings of William (Bill) L. White, the leading addiction recovery advocate in the US.

5. A Break

As you might imagine, 2005 was a very busy time for me. In addition to my Wired In work, I had my teaching and administrative duties at the university. Moreover, there was a lot going on in my personal life that had a huge emotional impact on me. 

In June 2004, my partner Karen and I had our third child Natasha Elena Maria Clark, who I still call my beautiful Indian Princess. (My mother was born in Madras, now known as Chennai, in India.) Three months later, Karen said she was leaving me, taking the children with her. She left in February 2005. I was devastated by the loss of my children.

However, I travelled every other week up to Reading from the Gower on a Friday to pick up Ben, Sam and Natasha, and delivered them back on a Sunday, a total of 650 miles. The children spent part of the school holidays with me. I was trying to sell our house, lived in just by my loyal dog Tessa and I most of the time, but to no avail.

Eventually, I decided to take a break and visit my sister Susan and her family in Western Australia. I had spent five years living in Perth as a child. My parents were £10 Poms, but had decided to return to the UK in 1968, before oscillating between the two countries a couple of times. Eventually, Sue got married and settled down in Narrogin, a small country town located about 110 miles south-east of Perth. 

I set off for Perth in early December. During my visit, I spent a good deal of my time with my niece Katherine and her boyfriend Brad in Perth. I had a wonderful time. My Australian family knew I was hurting and did their best to cheer me up. The break certainly helped, to an extent.

> My Journey: 16. A Major Life Change

> ‘My Journey’ chapter links (and biography)

In 2004, I became a regular writer for Drink and Drugs News, which was soon the UK’s leading magazine on addiction treatment. We conducted several research projects and wrote a booklet of Stories for the Peterborough Nene Drug Interventions Programme (Nene DIP), carried out qualitative research on harm reduction services in South Wales, and wrote an extensive profile of WGCADA. My talented undergraduate students played a significant role in our activities. (2,060 words)

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1. Wired In Websites

By 2004, Daily Dose had become the world’s best-known news portal on drug and alcohol use and misuse. The website was updated daily (365 days a year) and on average contained links to 15 articles from professional organisations, the media, and other sources.

By its fifth birthday at the end of January 2006, it had over 4,000 daily subscribers (this later reached 8,000) and the equivalent of 20 million ‘hits’ per annum. Over 150 other websites linked to Daily Dose. The website seemed well appreciated, not just be these numbers but also the wealth of positive testimonials we received from around the world. Some of the testimonials can be viewed here.

Mind you, things were not always rosy with Daily Dose. I had struggled to raise the funding required to maintain the service for a long time. Also, there was an 18-month period previously when I was running the service myself (unpaid), getting up at 05.15 in the morning to work for 90 minutes before getting my two boys ready, taking them to school and nursery, and going off to work in the University. I returned to Daily Dose after dinner every night. Things were easier when Jim Young was working with us, and when we finally managed to get new sponsors from the UK and US.

We also ran the news portal Drugs in Sport (www.drugsinsport.net), which was similar in operation to Daily Dose but focused on a specific issue. The website was unique and held a key niche in the field. Our website www.substancemisuse.net continued to have customised content for practitioners, problem users and the general public, and formed part of the news portal service. It contained a unique collection of professional reports stretching back over four years.

Our other website, www.wiredinitiative.com, continued to keep readers updated about Wired In activities, including our Personal Stories, research reports, magazine articles, and my university lectures. All our websites were developed by Ash Whitney of Wired Up Wales. 

2. Drink and Drugs News

In the summer of 2004, Simon Shepherd of the Federation of Drug and Alcohol Professionals (FDAP) was approached by Claire Brown and Ian Ralph, who worked for a public health magazine. They asked him whether there was a case for a regular magazine focused on the treatment of substance use problems to be distributed bi-weekly for free to the field. The idea was for costs of the magazine to be covered by advertising. Together, they sketched out the bones of what the magazine might look like, and came up with the name Drink and Drugs News (DDN). 

Simon contacted me and asked if I would meet with Claire and Ian, as he thought that Wired In could play an important role in this venture. The four of us met and planned a strategy. Soon after, Claire and Ian left their jobs, rented a new office near the Thames River in London, and a special new venture began. 

I remember how thrilled I was when I saw the first issue of a high-quality DDN come out on 1 November 2004, with a banner at the top reading ‘From FDAP in association with WIRED’. Mind you, I must make it absolutely clear that Simon and I (and our organisations) had little to do with the preparation of the magazine and almost all of the content. Our organisation’s names were used to help the magazine ‘take off’ and become part of the field. Simon and I did all we could to promote the magazine. 

Claire commissioned me to write content for the magazine. In the first edition, I wrote an article on ‘the story behind the WIRED initiative’ (p. 7), as well as the first part of Natalie’s Story about her recovery from heroin addiction (p. 6). I also arranged for Dave Watkins to write an article, A day in the life…, which focused on his activities as a community support worker for WGCADA (p. 12). 

The second edition of DDN, which appeared two weeks later, contained the second part of Natalie’s Story (p. 8), along with an article I wrote on Internet treatment and support (p. 11) in which I argued ‘that there is an urgent need to be innovative in developing ways of tackling substance misuse.’

My first Background Briefing, Drugs in society, appeared in this second edition (p. 13). My Background Briefings, an educational piece related to addiction and recovery (and related matters) of just over 900 words, appeared in almost all editions of DDN until late 2008. I also wrote a number of other articles for the magazine during this time. You can find links to some of my Background Briefings here.

Claire and Ian, and their team, have done a remarkable job with DDN over the years. Today, it still remains a magazine of the highest quality. It helped realise my (and Simon’s) dream of seeing a field that is much better informed than it was all those years ago when I started Wired In. It helped me find a new audience for my writing, for which I will always be grateful. 

I remember fondly the four of us having a number of good times together, as well as Claire’s telephone calls warning me that I only had ‘two hours to deadline. Get your act together, your audience awaits!’ Claire had a real bubbly personality and was so much fun. And she was very, very good at her job. We are still in touch all these years later, despite living on the other side of the world.

3. Research, Stories and WGCADA Profile

Wired In’s research and stories programmes expanded in 2005, in part due to a commission from the Peterborough DAT and the Peterborough Nene Drug Interventions Programme (Nene DIP) to work on several projects. This commission turned out to be a very productive and enjoyable piece of work, and our team was grateful for the collaborative efforts of Inspector Mike Beale of Peterborough Police, along with his colleagues, and the DAT Co-ordinator Verina McEwen. We had some great feedback from our colleagues in Peterborough.

The first project involved creating a book of Personal Stories of people who were accessing the Nene DIP, a police-led initiative with heroin users who also had a history of acquisitive crime to fund their drug use. Clients were initially ‘stabilised’ on methadone or subutex (in a few cases), and given access to a range of services in the community which helped provide lifestyle support.

Aimee Hopkins, a former Swansea Psychology undergraduate, interviewed 19 clients of the Nene DIP and used this material to create individual Personal Stories. The semi-structured interviews covered participants’ lives prior to their use of heroin, their early experiences of the drug, consequences of drug use, attempts to stop using, previous treatment episodes, and time spent with the Nene DIP. The Personal Stories were published in the form of a booklet.

Keith Morgan from WGCADA—who was now a Wired In team member—helped Aimee create a short CD on which she described the main findings of the project, using the voices of some of her interviewees. The booklet and CD were distributed to participants, new clients, and staff of the Nene DIP, as well as staff from other sections of the community that were working with the Nene DIP.

Aimee also conducted a piece of qualitative research using Grounded Theory to identify various themes arising from her interviews. Her report was distributed by the Nene DIP. I also used the interviews to help me write two articles on heroin use that I later wrote for this website—Journeys, Part 1: Descent Into Heroin Addiction and Journeys, Part 2: Living With Heroin Addiction.

We were also commissioned to interview seven mothers and girlfriends of people with substance use problems who were accessing support from the Nene DIP. Sarah Davies conducted a qualitative analysis of these interviews and wrote a report of the experiences, needs, and views of these family members. Her findings were very similar to Gemma Salter’s in her earlier research at WGCADA (cf. Chapter 10).

Sarah also conducted qualitative research investigating the experiences, needs and views of 18 young people who were accessing one of six services in Peterborough that worked with disadvantaged young people. The eighteen participants were a heterogeneous group in terms of which drugs (including alcohol) they had used, although none used heroin or crack cocaine.

All the young participants felt that the services offered them a range of different types of support, and reinforced the value of the holistic approach to service provision that each organisation was offering. They felt that they were benefiting in many different ways from their engagement. They also provided insight into how their experiences could be used to refine and further develop service provision. Sarah also interviewed 15 members of staff of the four services.

Overall, we were impressed with what we saw with the Nene DIP and the services they offered, although there were some shortcomings as you would expect. We outlined some of the issues raised by our study participants (young people and staff) and made suggestions about how to improve practice—these were well received by the people who had commissioned our research. The young people were thrilled to know that their suggestions were respected and could make a difference.

Wired In was commissioned by the National Public Health Service for Wales to carry out a qualitative research project on needle exchange services in South Wales. This research was carried out by another former Swansea Psychology undergraduate, Louise Watts, and was conducted in collaboration with The Centre for Research on Drugs and Health Behaviour at Imperial College, London. The research involved interviews with 49 heroin users who accessed needle exchange services, with 41 of them using services offered by Inroads (Cardiff), Drug Aid (Merthyr Tydfil) and WGCADA (Bridgend). 

In general, study participants praised the needle exchange service offered by each of these centres. However, Louise’s research did reveal a number of problems and the final report from Imperial College outlined clear recommendations to improve the system. The most prominent problem was the negative attitude and prejudice of staff at chemists or pharmacies where the interviewees picked up their needles and syringes. These negative experiences could have a serious impact on an already vulnerable individual. 

After seeing the evaluation and hearing about our other work with BAC O’Conner, Chief Executive Norman Preddy asked if I would do a profile of WGCADA which looked at all aspects of their work coming out of their offices in Swansea, Neath, Port Talbot and Bridgend. This project, which also involved Sarah Davies and Lucie James, was a large undertaking and took a number of months to complete. We eventually wrote a 181-page profile entitled Breaking Boundaries.

4. University Students

One of my great joys (and benefits) from those early years of Wired In development—and working in a university department—was my interaction with talented and enthusiastic Psychology undergraduate and Masters students in Swansea. Sarah, Aimee and Louise all worked with Wired In after completing their undergraduate degree, while Gemma Salter and Lucie James worked with Wired In both during and after their undergraduate studies.

Four undergraduate students (Emma Murphy, Richard Francis, Philippa Hoare and Carly McDaid) and three Masters students (Laura Davies, Chris James and Hannah Harry) conducted research in the community. A number of undergraduate students and one Masters student (Sophie Capo-Bianco) conducted questionnaire research that involved other students on the campus.

Overall, we conducted a range of projects on recovery, addiction, treatment (including harm reduction approaches), drug overdose, prejudice, family issues, drug laws, alcohol consumption and risky behaviours,  prescription psychoactive drugs, the need for a drug information service for professional footballers, and more.

Becky Hancock, who had worked with me on the DATF National Evaluation in 2000-2, joined the Clinical Masters in our department in 2005 and conducted an excellent piece of qualitative research with people who were accessing treatment services at WGCADA entitled Alcoholism – there and back: A qualitative analysis of interviews with clients engaging with a 12 Step based treatment programme. 

> 15. Wired In Ups and Downs, Part 2 

> ‘My Journey’ chapter links (and biography)

Wired In conducts a qualitative research project with clients of BAC O’Connor to facilitate understanding of the recovery process. Treatment led to various positive personal changes other than a cessation of substance use. A number of factors facilitated these changes, including: an empathic and understanding environment; being with people at various stages of recovery; being able to discuss their problems in counselling and group therapy sessions; education, and an holistic approach to treatment. (1,968 words)

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When Sarah Davies and I first visited BAC O’Connor, we were able to talk to clients and gain initial insights into the factors that they believed were helping them on their recovery journey. Gemma Salter, one of our Wired In team, later conducted a qualitative research project on the views and experiences of people who used this treatment service.

This research provided insights into the positive effects of the structured day care treatment programme at BAC O’Connor, as well as the factors that contributed to these beneficial effects. I later wrote an article based on this research, entitled Learning from the Experts, for the bi-weekly magazine Drink and Drugs News which appeared on 21 March 2005 (p. 8).

In this chapter, I focus on client views of the treatment process, obtained from this research and my discussions with clients. I include quotes, which were not used in the Drink and Drugs News article due to space limitation. Whilst these findings reflect the experiences and views of a population of clients undergoing one specific treatment programme, they provide important insights about addiction recovery and addiction treatment in general.

The participants in our study had many unsuccessful attempts to change their substance use before joining the structured day care programme at BAC Connor. Several of the participants expressed the opinion that they may have died an early death if they had not accessed BAC O’Connor. 

1. Positive Effects of Treatment

Participants reported numerous positive effects of treatment over and above helping them to stop using drugs and alcohol. One of the clearest improvements related to the participants’ understanding of themselves, their behaviour, and their addiction. 

‘What it’s done is to enlighten me on addiction. It’s given me more confidence. I’m learning about my addiction and myself and other people… it’s amazing how things can change so much.’

Treatment helped participants to achieve a clearer perspective of the nature of their substance use problem, and the negative effects of it. After a period in treatment, participants were able to see what life without their substance use problem could be like. Physical health improved. Treatment was thought to enhance confidence, reduce feelings of guilt, shame and isolation, and lead to the use of better coping strategies.

‘It’s made me realise I’m not alone… when you’re in active addiction it seems like everyone around you have not got a clue what you are going through.’ 

‘Learning to deal with your emotions and feelings, that is the main thing, because as addicts you can play on your feelings to the extent that you will go out and use just to suppress them.’ 

Treatment produced clear changes in participants’ lifestyle, perspective and identity. During treatment, participants gained a new optimism for life and a desire to rebuild their life with better/new relationships, and college and job placements. Other reported improvements related to self-care, maturity, and anger management. 

2. Factors Facilitating the Positive Effects of Treatment

One of the clearest factors contributing to the positive effects of treatment was common experience, both in terms of being around other problematic users in treatment and the fact that many of the BAC O’Connor staff had themselves previously experienced a substance use problem.

This common experience was beneficial in that it helped provide a more empathic and understanding environment, where clients and staff could more easily relate to each other, and draw upon their own experiences to provide practical advice and useful support. Common experience helped reduce participants’ feelings of isolation, which had been so prominent prior to BAC O’Connor treatment, and meant that they were less able to ‘blag’ treatment or conceal what was going on.

‘It’s good to be with like-minded people because unless you’ve experienced it, it’s very, very difficult to understand where we’re coming from.’ 

‘There’s no way you can blag ‘cos they’ve been there themselves… If you are struggling at any point, there’s always somebody that’s weeks ahead of you and they can offer you the advice and support.’ 

Many participants described the benefits of being surrounded by people at different stages of their addiction and recovery, with new and relapsing addicts serving as a reminder of the negative effects of using, and successful recovering addicts (e.g. people in aftercare) providing hope and serving as potential role models, revealing goals to which one could aspire. 

Another crucial component of treatment was having a welcoming, friendly, and safe environment. Considering that one of the difficulties of treatment highlighted in our study was that participants often felt nervous, scared, lost and unsure of what to expect at the start of treatment, the presence of a welcoming and supportive environment was especially important in helping to ease some of the apprehension experienced. 

Most study participants described the positive experience of talking about problems, and getting feedback and advice in both one-to-one counselling sessions and group therapy.

Much emphasis was placed on the positives of group therapy. The group environment seemed to provide a situation in which participants could get intimately involved, through the two-way process of feedback. Participants strongly advocated the process of both receiving and giving. Often, this group setting seemed to enhance confidence and self-esteem, as well as reduce feelings of isolation, e.g. through bonding with peers.

Participants highlighted the value of being able to talk to others about the stresses and strains involved in trying to recover from their substance use and related problems. 

‘I love feedback… it helps me to look at myself… I need that for me to be able to recover… and I think, “Yeah, that’s ok and that needs looking at.” I feedback to other people as well, and your confidence grows.’ 

Education about various aspects of addiction was widely considered to be a key component of successful treatment. Many participants referred to the importance of learning about the disease model of addiction, how to deal with cravings, and to the fact that excessive drug use could have induced their psychotic and paranoid experiences. 

A further factor reported to be influential in producing positive effects was the adoption of a holistic approach, whereby the ‘whole package’ of the person was addressed in treatment, and not simply the substance use problem. The range of targets included behaviours, coping methods, physical and psychological emotional problems, practical problems, social and relationship difficulties, and self-awareness.

‘The whole programme is just brilliant, basically. It’s taken a complete look at your addictions, but it’s things you never even knew about.’ 

‘It’s not just the alcohol and drugs, it’s about your own self-awareness and well-being.’ 

Participants reported that alternative therapies and activities were considered beneficial in numerous ways, such as increasing self-awareness, distracting the participant from their substance use problem, and providing valuable time away from therapy to prevent overload.

‘Obviously alcohol and drugs are the main priority, but when you’ve not got those what can you do? How can you look after yourself? How can you relax, take time out, not get too stressed out? So instead of getting stressed out and looking at the bottle, you’ve got alternatives to use to take your mind away from it… I’ve found it really, really enlightening.’ 

An additional component that was considered integral to successful treatment, was good support networks. Practical support was also considered beneficial, which is unsurprising considering the number of negative practical consequences that had occurred for participants as a result of their substance use problem (e.g. housing, childcare).

A further element that was considered necessary for treatment to be successful related to personal factors, such as effort, hard work, and commitment. This is fundamental, since without the effort and commitment of the individual, treatment cannot be effective no matter how good it may be. Study participants emphasised the need to change their behaviour for themselves, rather than for others. 

The interviews also revealed various factors which had helped, or were helping, participants to achieve or sustain their abstinence beyond the main treatment programme. One of the factors considered to be of most value was the continued use of post-treatment aftercare and counselling, and the importance/security of having a safe environment to return to if required. Interviewees valued the ability to drop into the Centre without prior arrangement, since challenges to their recovery could occur at any time. 

‘There’s no way I can go through rehab and expect to be clean or away from drugs if I just leave [treatment] and don’t do anything else. Support groups are vital, and I try to impress that to everybody.’

Another highly important factor assisting recovery was the learning and use of a range of strategies to combat the various factors or reasons leading to substance use. These strategies were either learned through treatment, or over time by experience, and included strategies such as changing social circles from users to non-users to reduce temptation, and using distraction to avoid boredom, which may trigger use.

Other factors motivating participants in their recovery included the fear of death from resuming use, the potential guilt or shame associated with a relapse, the support of significant others, and seeing the positive effects of their change on others, in particular family members.

Interviews revealed that a particularly important strategy was learning how to deal with cravings for drugs and/or alcohol. This learning process helped participants to avoid panicking when they experienced such cravings and use effective coping strategies.

The BAC O’Connor treatment approach was considered crucial by participants, who emphasised the benefits of an abstinence-based, structured day care programme over a relatively long period of time. 

3. Other Reflections on Treatment

Our analysis revealed a number of potential barriers to accessing treatment, the most common being lack of services or lack of awareness of existing services. Other common barriers included long waiting lists, which potentially deterred people from accessing treatment, or personal circumstances or feelings (shame, pride, fear), which stood in the way of asking for help.

‘… there’s people out there who have been waiting months and months [for treatment] and have got to the point where they have given up on the agencies… I have three mates who have killed themselves through overdosing while they’ve been waiting to get into treatment.’

Many participants reported having previously received substitute prescribing without any other form of other help. They emphasised the need for some kind of therapy (one-to-one and/or group) and education alongside substitute prescriptions.

The interviews revealed other difficulties that participants experienced in treatment, either at BAC or at other agencies they had accessed previously. The clearest difficulty was the need to accept complete abstinence. Many participants described experiencing continued desire to use some sort of substance, most commonly cannabis, while attempting to give up their substance of choice. Generally, however, participants did concede that the acceptance of complete abstinence was an important requirement of recovery.

A difficulty participants experienced prior to coming to BAC O’Connor was related to various contradictions in treatment services—for example, when receiving advice about controlled use despite wanting abstinence-based treatment, engaging with a service that would only treat a person’s drug problem and not their alcohol problem, or having a disagreement with an agency regarding how the detoxification should be managed.

4. A Final Comment

Our research revealed that many participants experienced, or were experiencing, numerous changes in their emotions, thoughts, and behaviours during their recovery journey. The process of recovery was changing the person, in terms of their lifestyle, identity and perspectives.  

> My Journey: 14. Wired In Ups and Downs, Part 1

> ‘My Journey’ chapter links (and biography)

In 2004, we conduct an evaluation of the structured day care treatment programme at Burton Addiction Centre (now BAC O’Connor). This highly impressive programme provides therapeutic and educational interventions, along with accommodation, in the community in which the person’s addiction has developed. We visit a genuine recovery community which demonstrates good outcomes for people with serious substance use problems. I learn that recovery is infectious. (4,652 words)

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NB. This part of My Journey is dedicated to my special friend Noreen Oliver, Founder and former CEO of BAC O’Connor, who passed away on 16 December 2023. Noreen was quite an extraordinary person, both in terms of what she achieved in the field and also as a caring human being.

In December 2023, I wrote two articles about Noreen, An Extraordinary Recovery Champion: Noreen Oliver RIP and Reflections On, and Quotes From Noreen Oliver MBE (RIP), which I posted on this website and the Recovery Voices website I run with Wulf Livingston. The second article contains content taken from this part of My Journey.

This Chapter relates how I first met Noreen and what I learnt from her and her structured day care treatment programme.

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Kevin Flemen of KFx [1] first suggested I get together with Simon Shepherd, Chief Executive of the Federation of Drug and Alcohol Professionals (FDAP), the professional body for the drugs and alcohol field that worked to improve practitioner standards. Kevin thought that more people outside of Wales needed to hear what Wired In was doing and he considered Simon to be a perfect person to help with that.

When we first met early in 2004, Simon asked if I would attend a FDAP Management Group meeting in the Houses of Parliament so that he could introduce me to some of the ‘movers and shakers’ in the field.

The first of these people I met and visited in their ‘treatment setting’ was Noreen Oliver, Chief Executive of Burton Addiction Centre (BAC; now BAC O’Connor) in Burton-on-Trent. Noreen asked if I would conduct an evaluation of her structured day care treatment programme, so I headed up to BAC with Wired In team member (and former psychology student) Sarah Davies (now Vaile). Sarah is now CEO of Recovery Cymru, a peer-led, mutual-aid, recovery community that operates in Cardiff and the Vale of Glamorgan.

Our visit led to a large scale piece of work at BAC involving the planned evaluation, the writing of 19 Stories of BAC clients (written up by daughter Annalie), and two pieces of qualitative research, conducted by my former student Gemma Salter (who had just received a First Class Honours degree) and current student Lucie James (who went on to gain a First Class Honours). One piece of research focused on recovery and the role of treatment processes, and the other on recovering heroin users’ views on substitute prescribing (methadone versus Subutex).

1. Noreen Oliver and BAC O’Connor 

How did Noreen Oliver come to be Chief Executive of BAC O’Connor? For years, she was a functioning alcoholic who held down two jobs. She had her first alcohol detox treatment when she was 25 years old. By 1992, at age 31, she was drinking a bottle of gin a day and was hospitalised with cirrhosis. She was malnourished and weighed just 6 stone (38kg). At one point, she was so ill she was given the last rites by a priest; after surviving, she vowed to turn her life around. Noreen’s family then arranged for her to attend a rehabilitation clinic in Nottingham. She recalled: 

‘I shared a room with a female crack addict who also worked the streets. This was a completely alien thing to me and, at first, I was horrified but soon realised she was not so different to me.’ 

Noreen stopped drinking completely in 1993. She sought doctors’ advice on how she could help others and ultimately founded her own treatment centre, BAC, which started in two rooms in Burton-on-Trent in 1998. She re-mortgaged her home and the Centre started to grow. A sister organisation, The O’Connor Centre, opened in Newcastle-under-Lyme in 2002. 

Both Centres provided a rehabilitation programme for people with a drug and/or alcohol misuse problem in their own community, via an abstinence-based, structured day care programme, which involved a central role of supported housing for clients.

At the time of our visits, the accommodation was just outside the town centre, but BAC O’Connor were later given four large houses by Coors Brewery for which they paid a peppercorn rent. This meant that accommodation for the clients was in the same location as the main Centre in Burton-on-Trent. (I’ll now refer to both Centres as BAC O’Connor, even though our evaluation in 2004 only focused on BAC.)

Providing a rehabilitation programme in the community in which addiction has developed, allows clients to face life without drugs/alcohol in an everyday setting that is proactively geared to ‘protect’ them at all times. They can learn to take up life’s challenges, and be supported in doing so, in the environment in which they are likely to continue their lives. This contrasts with the situation where people leave their community for a distant residential rehab, before returning to their home community.

In setting up BAC O’Connor, Noreen recognised that rehabilitation necessitates addressing the client’s problems in their entirety, which requires a variety of different forms of expertise, beyond what can be achieved by a single agency. Therefore, BAC O’Connor set out to develop partnerships in the community that would allow them to provide various components of the rehabilitative process, and be able to signpost people and make referrals where necessary.

When we conducted our evaluation, BAC O’Connor was working with Social Services, GPs across the county, Primary Care Trusts, East Staffordshire Borough Council, police, probation, judges and magistrates, the Staffordshire Drug Action Team (DAT), ADSIS treatment service, housing, voluntary agencies, Burton College, and local businesses. Importantly, some judges and magistrates had spent time in BAC O’Connor, and had also sat in on service user groups.

The organisations also hired an in-house team which, as a whole, comprised a multitude of skills. A wide range of therapeutic interventions were available to clients. Along with their professional qualifications, a number of staff members had ‘walked the walk’ and travelled their own personal journey into recovery. 

When Sarah and I visited BAC O’Connor in Burton-on-Trent in 2004, the structured day care programme involved a number of therapeutic and educational interventions for five and a half days a week, for a minimum of twelve weeks. There were normally two groups of 12 clients going through the programme at any one time. The main programme was followed by an aftercare programme which was available for at least two years after graduation. 

Whilst the programme had some small roots in the 12-step based philosophy, staff at BAC O’Connor had changed some of the principals, since the former was considered to be too rigid. For example, ‘powerlessness’ was not emphasised; the Centres talked about ‘loss of control whilst in active addiction’ instead. Whilst it was recognised that ‘living one day at a time’ might be a useful approach in the early stages of abstinence, staff believed it had more limited value later in a person’s recovery journey. The person needed to move forward and plan for the future—’that is where they are going.’ The Centres empowered clients to take responsibility for all aspects of self.  

2. The Therapeutic Programme

The majority of the clients at BAC O’Connor had severe and chaotic drug and/or alcohol use, a variety of other problems, including being homeless, and/or a strong engagement in criminal activities. The supported housing programme allowed BAC O’Connor to house and help rehabilitate this particularly vulnerable population of clients. 

 2.1. Induction

The first stage of the therapeutic process at BAC O’Connor was the induction process, which was facilitated by a peer supporter, someone who had graduated from the programme. The Induction process was paced in part by the client, although it generally lasted three to five days. During the process, the individual was introduced to the programme, team, and client group. Work began on improving the person’s self-esteem right from the first contact.

The person was introduced to their key therapist who began the process, together with the client, of developing the latter’s personal Care Plan and looking at their therapeutic needs. This Care Plan was reviewed throughout the programme, as the client’s needs changed across time. Clients often referred to certain issues only after they had developed a certain level of trust in the therapist and programme.

The clients began and ended each day of their Induction with their key therapist to discuss any concerns, clarify any issues, and develop a relationship that involved trust, respect and confidentiality. Clients also met the nurses and began to discuss and implement their own individual Health and Nutritional Care Plan. This process included looking at personal health and medication needs, personal hygiene, nutritional needs, relaxation and sleep patterns, and mental health needs.

The client also met the Community Development Officer and discussed their immediate issues of concern, which often included debts which they had incurred during their active addiction. The Community Development Officer contacted the person who was owed money and started to negotiate on the client’s behalf. They were able to get an agreement where the debt was either written off or reduced to a level which could reasonably be paid off. 

The beginnings of a Community and Reintegration Plan were developed, which included: benefit and welfare needs; housing needs; disability needs and requirements; employment, voluntary, educational needs, and integration back into the community needs. Some clients needed money for food and clothing. The BAC O’Connor had a large supply of donated clothes, and held stock of other essentials such as toiletries.

During the Induction stage, clients were invited to observe group therapy, participating only when they felt comfortable. They were also encouraged to associate with peers and attend educational workshops.

2.2. Intensive Day Care Programme

Group therapy sessions, which covered a wide range of topics, took place on a daily basis. A number of workshops and educational sessions were provided, again covering a wide range of topics. Complementary therapy sessions were also part of the programme: Indian head massage, Shamanic Healing, reflexology, aromatherapy, Rieki healing, acupuncture, and relaxation techniques. There were a variety of recreational activities, involving day trips and camping trips, or sports such as tenpin bowling, football, and golf, all of which were by client choice and vote. Noreen Oliver said:

‘As well as doing treatment and the rehabilitation, it is also really important for this client group to see that you can have fun without drugs and alcohol. You can laugh without drugs and alcohol. And that’s what is important. Instead of telling somebody we are taking away your drugs and alcohol, which a lot of the time is taking away their whole life style, their whole social circle, everything, we tell them what we are giving them instead.’

Regular one-to-one therapy sessions helped clients address their personal issues. A significant proportion of clients had mental health needs, some of which were recognised only after the client had become abstinent from drugs and/or alcohol. These needs were met by a Mental Health nurse and, in a supporting role, the client’s GP. Some clients were linked to a specialist Mental Health team. An out-of-hours bleep was held by a therapist for clients who were day attendees and the aftercare clients. Therefore, clients received 24/7 care.

Clients had to be abstinent, although some were on prescribed Subutex for the first 4 – 6 weeks of the programme. However, these clients all worked towards abstinence and the BAC O’Connor liked them to have had 10 – 12 weeks of abstinence by the later stage of the programme. Some clients were on medication for mental health needs. Clients were introduced, and encouraged, to use a variety of outside support groups and activities.

2.3. Completion and Graduation

When a client finished the programme, a staff member at BAC O’Connor wrote to them and emphasised the need to be aware of the dangers of taking drugs again after a period of abstinence (e.g. drug overdose) and how important it is to maintain their various forms of support. They were also strongly encouraged to attend the aftercare programme. Upon completing the day care programme, the client had a graduation ceremony where upon they invited their fellow peers, family, and friends to welcome a new chapter in their life. 

2.4. Aftercare 

In theory, the aftercare programme was two years long. However, in practice the Centres were always available to any client or significant other who required support or advice. Clients who had graduated still called into the Centres to say ‘hello’, and to let people in the Centres share in their achievements, or support them in their sorrow. BAC O’Connor believed that recovery may need lifetime maintenance: there are no short, sharp solutions.

Saturday activities, such as individual relaxation sessions, groups and socialising with peers, were open to all aftercare clients. An Aftercare Support Group, held once a week in the evening, was facilitated by a therapist. A number of clients attended outside support groups. Individual one-to-one sessions were continued if required and were available at the request of the client. In fact, clients were encouraged to come back and see a key worker.

3. Relapse

BAC O’Connor were more realistic about relapse than many other treatment agencies. Relapse was considered part-and-parcel of the recovery process and was an issue that was addressed in a pragmatic and humanistic manner. Clients who continually relapsed and left the Centres were always given the opportunity to return and receive the help they needed. Noreen said to me:

‘… and to actually slap someone on the knuckles and say, “You’ve relapsed, away you go you bad boy,” is a complete waste of time and it totally destroys what has already been achieved. You’ve built up self-esteem and self-worth…’

‘… you are dealing with a group of people who are experiencing for the first-time emotions and experiences without, in a sense, an aesthetic and without entrenched coping skills. If a client disappoints you, then you need to look at your own expectations, and your understanding of addiction.’

 Staff, including the doctor, worked with clients who were struggling and relapsed. If the situation continued, then the client was discharged. However, they were not made to feel they had failed. They were referred on, and always given the opportunity to return and receive the help they needed.

If a client brought drugs into the centre or houses this was viewed seriously, since it threatened the safety of other clients and put them and staff at risk. This had only happened twice in the Centres’ history up to the time of our evaluation.

4. Community Integration or ‘Moving On’

The process of helping a person integrate (back) into the community started on day one, and continued throughout the intensive day care and aftercare programmes. Learning to ‘move on’ was a key part of the recovery process.

Clients learnt to use, and practice, skills and tools that helped them remain abstinent, engage in ‘normal’ social patterns of behaviour, maintain mutually beneficial interpersonal relationships, and live an independent life. They learnt and practiced these new skills and tools in a supportive environment, alongside their peers. They gained the confidence to use the skills and tools and felt good when they saw the benefits of applying what they had learnt. In effect, clients learnt and then maintained a new positive identity.

Martin, the Community Development Officer, described his role in this integration process. He saw himself as building a platform for a client, so that they could have a base from which to start their new life. He described how he would accompany the client to meetings with their GP, the local hospital, benefits office, solicitor, courts, probation and Social Services, as and when required.

Some of these situations were intimidating for clients—they sometimes involved panels of people—and they felt scared. They had little confidence and even at later stages of their recovery their confidence ebbed and flowed. Martin played an invaluable role in helping the client deal with these situations, holding their hands until they were ready to do it themselves.

The programme also taught clients to act in a respectful way, use the right dialogue, and present themselves correctly. Clients were taught how to get people to understand what they needed. The process was sometimes re-education, sometimes education. Clients had been let down so many times, they often had difficulty in believing that they could get what they needed from other people. 

Martin saw himself as helping the client’s development as a person. Some had dropped out of school at 12 years of age, missing big slices of life development. Some of them wanted to take up these missed parts of life, e.g. by gaining a better education.

‘It’s about opening doors for them in the right way, instead of having them slapped in their face. My role is purely about developing that person to a point where they are empowered to continue that progress, whatever progress they wish to make. A lot of this is about the decisions they make along the way to give them a stability to work from… because a lot of them are just scared, scared of just standing still.’

Martin believed that he had to empower the client. He had seen clients move from the ‘third party syndrome’ (having Martin attend meetings) to standing up for themselves and telling people, in a respectful way, what they wanted. One client worked through getting his divorce and access to his children sorted out. It was hard and frustrating having to work through many problems, but the client never lost his temper. The change in the client from this empowering process was substantial.

Martin felt strongly about people who showed discrimination and prejudice towards people with a substance use problem and people in recovery. He believed that it was important to challenge stereotypes and he never stopped doing that. 

‘I know what is like to be discriminated against, and I just won’t have it. So I’m looking for those words … and I’ll challenge that. I hope that clients seeing that challenge gives them the courage to challenge. And they do. I’ve seen them do it. They won’t stand for being labelled either.’

Martin believed it is not just about getting a client into a job or college. It’s also about getting them accepted by society. He was excited by people’s perceptions of clients from the agency. People outside of the agency were often puzzled because the client did not match their negative expectations. Clients were helping people outside the agency change their views about people with substance use problems. 

5. Other Services and Activities

Clients who were waiting for a detox or a place on the BAC O’Connor day care programme could join a pre-rehab group. This group met an afternoon a week and provided people with a support group, educational sessions, motivational enhancement, and details of the day care programme.

BAC O’Connor ran a programme for family members, carers, and significant others which provided a safe, caring environment where participants could address their own feelings, behaviour, and reactions to living with someone else’s addiction. This client group learnt coping skills, problem solving techniques, and received tangible support with financial and other social problems. The programme aimed to help clients improve their relationships with family members for the purpose of facilitating recovery for both parties.

Service user involvement was a vital part of the programme, management structure, and the review and implementation process in BAC O’Connor. There was service user representation on the Drug Action Team (DAT) and the management group reviewing substance misuse services throughout Staffordshire.

Some of the clients who had graduated became peer supporters, supporting new clients throughout the programme. Service users were actively involved in the further development of the Centres, by being involved in painting, gardening, cleaning, and providing feedback on the services the Centres deliver.

The previous year, service users had organised and held a charity event that raised over £4,000 (worth £6,900 today) for North Staffs hospital neonatal unit. Football teams from probation, police, Social Services, health, housing, and both Centres competed. Service users also had stalls, and held an auction of items donated by local businesses. 

A large group of BAC O’Connor service users represented service users across the county of Staffordshire by forming the group ‘The Voice’, a Service User Forum. They prepared questions focused on treatment issues, collated the answers back from service users in various agencies, and then held a conference with professionals and service users. Over 200 service users attended! This conference focused on what is good, where the gaps are, and involved some clients telling their story. 

6. Outcomes and Cost-Effectiveness

In the year prior to our visit, 231 clients accessed the BAC O’Connor day care programme. A total of 87% of these clients had been involved with the criminal justice system; many, possibly most, were prolific offenders. 90% of the clients were unemployed, whilst 28% were officially classed as homeless. However, the latter percentage was realistically 67%, since 14% were due to be evicted for arrears or ASB (Anti-Social Behaviour), while 25% were staying with friends or relatives on a temporary basis and did not have a permanent home.

Of these 231 clients, two-thirds completed the programme drug-free. This was a very successful outcome, given the ‘challenging’ nature of the clients entering the programme. A total 52% of the clients attended aftercare on a regular basis. BAC O’Connor was not in a position to track long-term outcomes at the time of our visit, but they were trying to set up a project to do so.

I was particularly interested in Noreen’s views on client motivation. Over the years, I frequently heard treatment agency workers say that clients must be ready (be motivated) to access treatment, otherwise treatment will not work. Some agencies ‘cherry pick’ clients, picking out those who they consider are highly motivated to overcome their problem.

Noreen emphasised that BAC O’Connor did not screen clients and adjust their admission criteria to help ensure successful outcomes. They did not believe that clients should jump through hoops to get into the service; they believed that motivation is part of the treatment process. It was up to BAC O’Connor staff to motivate clients into wanting to take the journey towards recovery. If they couldn’t do that, how were they going to keep the client motivated on their recovery journey? 

‘Time and time again, professionals elsewhere say, “I want to test their motivation first”, or “You’re not ready, it’s not the right time.”’  

Noreen also pointed out that some people with a substance use problem came into the Centres thinking, ‘This will be my get out of jail card’. She considered it the job of her staff and herself to change that attitude. These clients were usually not aware of any other way of thinking. They had become so entrenched in the drug and criminal culture that they have never seen people in their environment break that cycle. 

‘It is our job to change that entrenched behaviour, to motivate clients to change, and instil in them the belief they can do it and move on.’

In our evaluation report, we considered the cost-effectiveness of the BAC O’Connor day care programme. A piece of research from 1998 by Edmunds and colleagues had estimated that the average problem drug user could be costing the community £25,000 per annum (criminal justice costs, costs to crime victims, benefits), excluding health costs. [2] On the basis of this outdated estimate, and given the core funding that BAC O’Connor received from Social Services, they only needed to keep 15 people away from crime for a year for the service to be ‘cost-effective’. On the evidence we saw, the Centres were probably doing this easily. 

7. Noreen Oliver

It was great to work with someone as inspirational as Noreen Oliver. Over the years, I have watched from afar as Noreen continued to build and facilitate BAC O’Connor and related activities. We met periodically, even after I moved to Australia, and it was always great to catch up. Noreen took me to see Langan’s Tea Rooms, a social enterprise that employed former addicts who had recovered through the BAC O’Connor programme. The Tea Rooms took their name from Noreen’s maiden name, and was located in a former restaurant in the historic Burton House. 

The charity that Noreen established, The O’Connor Gateway Trust, also ran Recovery Is Out There (RIOT), a community of recovering addicts who had been through the BAC O’Connor programme. RIOT Radio was set up in the heart of Burton-on-Trent and eventually streamed music and other content 24 hours a day, 365 days a year. 

In 2011, Noreen informed the BBC that BAC O’Connor’s research showed that ‘74% of drug users and 83% of 83% of alcoholics’ were sober two years after completing what was then an 18-week programme at BAC O’Connor. Over 2,000 people had completed the programme since BAC opened in 1998. Noreen was now a strong advocate for drug and alcohol policy reform at a national level. 

Noreen was made a Member of the Order of the British Empire (MBE), for services to disadvantaged people in Staffordshire, as part of the 2009 New Year Honours.

8. Our Trips to BAC O’Connor

My first trip to BAC O’Connor with Sarah was such an eye-opener for us both! Here was a genuine recovery community, a place where recovery literally oozed out of the walls. The enthusiasm was palpable. Smiling faces everywhere. Everyone was so friendly.

It was a special experience and I learnt so much from my visits to BAC O’Connor. We talked to a wide range of staff, collaborators working in other services, and people who had turned to the Centre for help. I remember turning up to the room where we were due to talk to clients as a group, to find the room packed. Everyone was so upbeat about how they had been treated in the Centre, and what a difference being there had made to their lives! Here is what I wrote in our Evaluation report:

‘During our visit, we noticed the bright colours in the Centre, the nice furniture, the pretty flowers … and the way that staff and clients mingled together. It was difficult to work out at times who was client and who was staff. Clients commented that there was no hierarchy. The largest room was for clients—and it filled up quickly when our focus group was announced!

One of the commissioners pointed out, “they even have the best biscuits … and the clients have them as well.” Clients dropped into the CEO’s office to ask if we needed tea or coffee.’

As an aside, Noreen told me a memorable story. She turned up to work very early one day to find a queue at the Centre’s door, longer than she had ever seen. When she asked who they were and what they wanted, they said they were friends of a well-known criminal in the area who had visited the Centre. They said that he was so impressed by the way that BAC O’Connor had helped him change his life, they had decided they all wanted what he had got! I was learning that recovery could be infectious!

It is well worth reading my article ‘Recovery, Reintegration, and Anti-Discrimination: Julian Buchanan’, which describes the challenges (e.g. social exclusion) that people with serious substance use problems face in their everyday lives. The work of Julian Buchanan and his colleagues also involved interviewing drug users who attended a Structured Day Programme in Liverpool. 

Endnotes:

[1] Kevin Flemen still runs a very popular training programme in the field. At the end of 2023, he apologised on social media that he has been so busy he has not been able to update his KFx website, on which there are lots of resources, for some time.

[2] M. Edmunds, T. May, I. Hearnden and M. Hough, Arrest Referral: Emerging Lessons from Research, Drug Prevention Initiative Paper No. 23, London: Central Drug Prevention Unit, Home Office, 1998.

> My Journey: 13. Learning From the Experts at BAC O’Connor

> ‘My Journey’ chapter links (and biography)

Three short stories from people affected by a loved one’s heroin problem, two of which refer to the stigma associated with heroin addiction, whilst the third relates to ‘not taking ownership’ of a loved one’s addiction. The last two are excerpts from longer stories. The first story concerns a conference speech, given by a mother who attended a family support group. (3,675 words)

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1. A Conference Speech

‘Good morning, ladies and gentlemen. I am a mother and I have been invited here today to talk about my experiences as a service user. I have a son who is living at home with my husband and myself. He is addicted to drugs.

He first started dabbling with substances when he was still in school. At first it was ‘glue sniffing’, but it wasn’t long before he started experimenting with cannabis. When I tried to approach him to warn him of the dangers of drug abuse, his typical reaction was to say, ‘Don’t worry Mam, I can handle it.’

Well, like he said, he’s ‘handled it’. Since then, though, he’s handled other substances, amongst which, there has been cocaine and heroin. He is currently handling amphetamine by injecting it into his veins. It seems to me a very strange way of handling it.  ‘Don’t worry,’ he said. I have done nothing else but worry.

Back last year when he was so-called ‘handling things’, he was doing heroin and he overdosed. My husband and I had to rush him down to the Accident and Emergency Department at our local hospital, where he was admitted overnight for observation. We stayed in that room with him all night long. He underwent a series of blood tests, but as for treatment, it was mainly my husband and myself who observed him through the night. One of the nursing staff made the comment, ‘If he was a son of mine, I’d kick him out.’

At the time, I could have done without this attitude. What good is it to me making such loose and judgemental comments as she made during what was a very traumatic time for all of us? That kind of attitude does nothing to help my son, or us, and we were left feeling that they were judging all of us for my son’s actions.

In the morning, a member of the psychiatric team came to see my son, my husband and myself. We were told, that because our son wasn’t suicidal, they were unable to take him on. He was promptly discharged from the hospital. What good was it discharging him? Clearly, my son desperately needed help to fight his addiction to this drug. In my view, there wouldn’t have been a better time for him. He was frightened and really wanted to stop using right there and then, but he needed help to do it. There wasn’t anything or anyone available that would give him the help that he needed.

Since that time, my son visited the Gwent Specialist Substance Misuse Service, but because of the length of time it takes to get treatment in this area, an average of up to 16 months for a methadone programme, he became totally despondent and utterly frustrated. Even though he felt determined in himself to beat this addiction, he ultimately relapsed and went back on the drugs again. Determination alone is not enough. He had made a very hard decision in asking for help, but it wasn’t there when he needed it.

It is absolutely essential and critical that help for this kind of issue is immediate right when you need it. I am 100% certain that if the help had been in place for immediate access, then he would have had a much better chance of curing his addiction to drugs.

There is still an enormous stigma attached to drug addiction by many people, including those in the medical profession. The addiction isn’t targeted or treated as an illness, but rather it is seen as self-inflicted, and therefore it’s the user’s problem to deal with. Hence, you have this, ‘It’s your problem so get on with it’ syndrome, that both the user and the family have to cut through before being able to help support him in his fight to beat the illness of addiction.

Obviously, the whole scenario has been extremely stressful for my husband and I and this can be seen clearly by a deterioration in our health. Everywhere we turned we seemed to come up against a brick wall, time and time again. Although we were able to discuss the issue of our son’s drug addiction, and subsequent behaviour, with the rest of the family, emotions would sometimes run quite high, sometimes eventually to the point where my husband and myself would end up arguing over it.

Eventually, we got to hear of an organisation called Drugs and Family Support, or DAFS as it is more commonly known, which caters solely to the needs of families and friends affected by another family member’s substance misuse. What a God send! By this time my husband and I were really stressed right out with feelings of guilt, shame, and hopelessness.

When we visited DAFS, we were soon put at ease, and members helped to put our problems into perspective. The caring attitude shown to us on that very first visit gave us the incentive to not to give up trying. Subsequent visits enabled us to realise that we shouldn’t feel guilty over our son’s actions. It was my son’s decision to take drugs, and it would be his decision alone to come off them.

We now regularly attend weekly group meetings at DAFS, and have been able to meet other parents who are going through similar experiences themselves, albeit not always concerning the same drug. Confidentiality was a major issue for us, as no family in this position wants to ‘wash their dirty laundry in public’. Since then, we have had discussions over individual situations, without the fear and stigma of being judged by others and, more often than not, with a bit of humour. This is most welcome when faced with the dire circumstances that each of us is enduring day after day.

Through attending these meetings, we learn something different every week and we are able to draw strength and support from each other. It is enlightening to find that similar problems can be dealt with in a variety of ways. No one way is right for everyone and each of us has gained a great deal of insight into coping with the horrendous problems that substance misuse brings upon the family as a whole. Both my husband and I have gained so much, not least the many new friends that we have made through DAFS.

The people at DAFS are very approachable. Obviously, we still get our bad days as well as the good days, but it is refreshing to know that we only have to pick the phone up, or call at the office, if a problem arises, and they will do their utmost to help us through it. Sometimes, it’s just the fact that you can talk with them and know that you are not being judged at all, and that everything said is in the strictest of confidence.

Quite honestly, I don’t know how my husband and I would have coped without the support and guidance that we’ve received through DAFS. I feel that this type of agency is a must, and should be expanded for more people to access it. I understand that although it is essential for the user to receive immediate specialised treatment to combat their addiction, the families are also suffering. There has to be support services, such as DAFS, that are dedicated solely to helping us, the families, through the trauma that drug addiction brings.

I ‘d like to thank you for inviting me and I hope that I have given you some insight into the problems that families such as ours are facing on a day-to-day basis and the limited help that has been invaluable to us. Thank you.’

 2. A Mother’s Story

The second story is from Kerry Manley, later to become a volunteer for Wired In, who writes about a stage of her son Kevin’s heroin addiction when he was seriously ill. Kevin was later one of my right-hand people at Wired In. The full  two-part Kevin and Kerry’s Recovery Journey, A Family’s Story, can be found on this website (Part 1 and Part 2).

‘When Kevin was desperately ill with what we would later learn was septicaemia, I’d go to his house every day. He was deteriorating rapidly in front of my eyes. We’d been to a hospital Casualty Department, but nobody picked up on how desperately ill he was. I actually attended Casualty twice with Kevin, to try and give him some sort of credibility, but twice he was turned away, even though his condition warranted him being admitted. I’m sure that they saw no further than the fact that he was an addict.

Even though Kevin was so unwell, he was still using heroin. I sort of understood it, because at this point I knew that if he didn’t, he’d be even more unwell. He was at such a stage that I think he might have died if he hadn’t continued using to some degree. He was already having rigours (uncontrollable shaking, fever etc), chest pains, and numerous other problems. So, what would the effects of withdrawal have done on top of that?

I remember thinking what a terrible thing addiction is, that it could do this to someone. I’d also be thinking, ‘How could it get like this? How could it get any worse?’ If he’d died at that point, it wouldn’t have been worse; it would have been better. In his eyes, as well as mine.

This isn’t easy to say, but I really did debate whether to end Kevin’s life. I could have done so easily. To see him there, like a skeleton, in agony and struggling for breath. He was comatose at times, and I used to think how easy it would be to put a pillow over his head and end all his agony. I just couldn’t though. I just wanted so much for him to be better.

I was nursing Kevin at his home every day. Every time I went there, and let myself in, I was prepared to find him dead. I really thought the end had come.

In the end, I absolutely insisted they take him into hospital. And they let him in. Thank God he didn’t die, but I could so easily have helped him on his way. God forgive me. It wasn’t for any selfish reason, I just didn’t want him to suffer any more. I don’t think anybody quite understood what I was doing day in, day out, keeping him alive. I felt so isolated with him.

When he was finally admitted to hospital, Kevin’s body was wracked with septicaemia and we were told that he was only days from total organ failure. The lack of understanding from the medical staff about the addiction side of Kevin’s problems was very apparent. He was admitted to the poisons unit, but they just didn’t have an understanding of the psyche of an addict. The nursing care was nil, and the lack of physical care was apparent.

Strangely enough, even after the way he had lived, Kevin was always worried about disinfecting things and making sure things were clean. He always has and always will be like that, thank God, but the staff just didn’t expect him to have those standards. He was an addict, a junkie, his illness was self-inflicted, and he didn’t deserve better care. It upset Kevin, it annoyed him, and he was very angry at times. Mentally, he was desperate for the right attitude.

Things did change a little when I spoke to the Ward Manager, and read out something from Kevin’s notebook about how he’d been treated. She burst into tears and said that she had no idea of how he was feeling. Luckily, she was a good Ward Manager. She took his comments on board and did make changes.

Some doctors and nurses believed in Kevin and they really made a difference. There really needs to be more education given to medical staff about addiction. I’ve talked to senior nurses in emergency units and they’ve said themselves that there’s a distinct lack of understanding about these issues.

Basically, it should be part of their training. There ought to be something put in place to help them to look past the façade of addiction. What you see in front of you is not necessarily what is there. Addicts are labelled. Most, but not all, nurses use derogatory terms when discussing addicts. It is sickening. There should be more understanding of the psyche of an addict.

For a long time, I kept it secret that my son was an addict, but when Kevin was ill in the hospital where I worked, I had to be open. It really taught me, more than ever, that addiction is an illness and something can be done about it—and it should be.

Since Kevin left hospital, I have talked freely about his problems in a way that I would never have thought I could—in a less emotional way. It’s the only way I can think of to show people that we are an ordinary family.

Kevin was brought up with values, the same as his sister. He chose one way and she chose another way. So how can it be the way you bring a child up? It can’t be, otherwise Kate would have been an addict as well. I think it’s important for people to realise that it could happen to them. For example, even their husband could become addicted to pain relief after an operation—so don’t be complacent.

The worst thing for me was the attitudes of some of my work colleagues. It’s very strange because I work in a caring profession in the health service, but some of the attitudes of workers were truly awful. Over the time that Kevin was an inpatient, I heard that the staff had been gossiping about him, not only on their ward but on other wards. They discussed Kevin and our whole family in a very derogatory manner. Much of what they said was unfounded or damn right untrue. I find it incredible that they can break confidentiality with other members of staff.

I was angry and hurt, and felt dreadfully bad for Kevin. He was desperately ill and they were discussing him in such a malevolent way. Gossiping, saying, ‘Why hasn’t his father visited?’, or ‘His sister has cut him off?’, which was quite untrue at that time.

My manager found out and said that it was a breach of confidentiality, and the relevant staff should be disciplined. However, she could only take things further if I made an official complaint. I felt that I couldn’t, because I wanted to keep working there. I’ve been made more and more aware, since I’ve had problems of my own, how nasty gossip can be. It’s made me far more aware of people’s feelings.

People are really unaware of the deeper issues surrounding addiction. I would have thought the people I was close to at work would have understood. Yet all they could say was, ‘She should cut him out of her life.’ I actually had someone say that to me, not in a nasty way, but thinking that she was being helpful. I took it as well-intentioned, because she wasn’t malicious, but I said, ‘There’s no way I could do that, he’s my son.’

3. A Sister’s Story

Some years later, I received a story written by Anna, who lives here in Australia, which relates how her family coped with her brother’s heroin addiction. I published Anna’s Story, Should I or Shouldn’t I, on this website in 2013. Anna’s story highlights the need for family members to accept that they cannot take ownership of their loved one’s addiction. They are not responsible for the addiction, and they cannot do recovery for their loved one. Here is a particularly pertinent section of Anna’s story. At this stage, she was becoming overwhelmed by the whole situation concerning her brother’s addiction. 

‘After this incident in the city, I became unhealthily obsessed with finding out as much as I could about heroin, as well as trying to monitor my brother’s behaviour and uncover his lies. I read every book I could get my hands on, including a few books I’d had as a teenager—Go Ask Alice, Junky and H: Diary of a Heroin Addict.

Every time my brother made up some excuse about needing money, I’d be straight on the phone to my parents, ‘dobbing’ on him. I’d check his pupils and follow him to the bathroom whenever he came over to my place to return the car. It was around this time that I said to him, “Why can’t you just give up? Why is it so hard for you? I smoked and gave it up, why can’t you?” 

He said, “For one, tobacco is not the same thing as heroin. And for two, you’re not me and I’m not you so stop trying to make your experiences, my experiences.” It was an important reminder that I needed to be less judgmental and stop trying to force my ideas about how the world worked on to others.

Not that I managed to stop doing this overnight! I began to talk about my brother’s heroin dependence non-stop to my friends. I’d go over the details again and again and then I’d get upset when they started to get bored or frustrated if they couldn’t help me. I couldn’t see that my brother’s problem was his own.

At the time, it was all about me, and I was very angry with him for hurting me. Why was he doing this to our family? Didn’t he know how much he was destroying us? We loved him so much and he was treating us like crap. Why couldn’t he quit? How could he keep lying to us all the time? How could he steal from us? How could he expect us to ever trust him again?

Once I understood that it wasn’t all about me, that my brother was not purposely trying to hurt me—he was hurting himself and as a result, the rest of our family suffered—I became terribly sad and depressed and would cry most days. My brother, who was an amazingly talented musician as well as an intelligent, caring, funny, gorgeous guy, was now a junkie who spent all of his time scamming, stealing, and doing whatever he could to get heroin. It was such a waste of a life and I started to really fear that he might die.’

And then, Anna had a Moment of Clarity: ‘My parents could see that I wasn’t really coping with what was happening and they convinced me to go and see a counsellor. I went to see a very expensive psychologist for three sessions. The first two sessions were spent crying and telling the same story I’d told everyone else a thousand times. In the third session, the psychologist said to me, “Anna, I’ve been hearing a lot about your brother and all of his problems. What about you? Do you think you might have a problem with drugs too?”

I said, “Yes.” I was drinking every night to cope with what was going on, and my boyfriend at the time was also a heavy drinker.

She said that I needed to accept that I couldn’t change my brother’s behaviour or anyone else’s, I could only change my own. She also said that I needed to focus on my own life and stop focusing so much on my brother’s.

After the session finished, I went out to my car and bawled my eyes out, but it was a different type of emotional release. I felt an overwhelming sense of relief. I knew that things would be different for me, and that I could change the way I was thinking and feeling. It was the first time in about a year that I could see a way forward. I then went to see a counsellor for a while, who was much cheaper than the psychologist, but I didn’t find her all that helpful, and I decided that I already had the tools, I just needed to practice using them.’

Near the end of Anna’s Story, she wrote: ‘On a much more positive note, there’s no way I can tell this story without saying that my brother is truly the most inspirational person I know. I am in awe of who he is and what he’s achieved. He has taught me so much about life, including the most valuable lesson I could ever possibly learn—that you can get through anything. I have learnt that things might be bad, but they won’t be bad forever. I also know that it’s not impossible to make changes—even if they seem small and irrelevant at the time, they can lead to bigger and better things further down the track.

It’s also possible to learn something new or change the way you think if you’re prepared to work at it. Not only has my brother overcome his drug dependence and rebuilt his life and his career, he has travelled the world, has a gorgeous family, and can speak another language fluently, which he had to learn from scratch when he moved overseas. It may take time, it can’t be rushed, but we are all responsible for our own happiness, and it’s up to us to create the lives we want for ourselves.’

Seven years later in 2020, Anna’s brother is leading a happy, successful life free of heroin. He has found recovery, as has Anna.

> My Journey: 12. Recovery Oozing Out of the Walls

> ‘My Journey’ chapter links (and biography)

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We conduct a qualitative research project to gain insight into the problems faced by family members of people with a substance use problem. A number of inter-related themes emerge: confusion/lack of awareness; imbalance/pervasion of the problem; heightened negative emotions; family support/treatment; coping; outcomes; family, and other stressors. The important role of family support groups is emphasised. (2,761 words)

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The book Beating the Dragon: The Recovery from Dependent Drug Use by Scottish academics James McIntosh and Neil McKeganey [1] had a huge impact on me. It not only helped me gain a better understanding of recovery from drug addiction (cf. Chapter 7), but also emphasised to me the importance of listening to the voices of people affected by substance use problems, either directly or indirectly. It really opened my eyes to the value of qualitative research in helping individuals, families and communities tackle substance use problems.

The qualitative research methodology Grounded Theory was developed two sociologists, Barney Glaser and Anselm Strauss [2]. I started to learn about, and then teach some of my talented Psychology undergraduate students how to use, the approach after reading Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory by Anselm Strauss and Juliet Corbin [3].

The first piece of qualitative research we conducted was carried out by Gemma Salter for her final year psychology project in 2003/4. After talking with Sian Howells, the WGCADA Family Worker, and Mike Blanche, who set up Drug and Alcohol Family Support (DAFS) in Blaenau Gwent, South Wales, I had gained some insight into the problems faced by family members of people with a substance use problem. Sian and Mike were keen for us to conduct research with family members with whom they interacted, in order to provide insights into how they were negatively affected by their loved one’s substance use problem and how these consequences might be ameliorated. Our findings would then be disseminated to a wider audience. 

From what I had read and heard, there was far too little support in the community for people indirectly affected by substance use problems. Figures at the time suggested that there were at least 250,000 – 300,000 people with a serious drug problem and over 1.8 million drinking alcohol at a harmful level in the UK. If two close family members (a conservative estimate) were affected, this meant that there were at least 4.2 million people in the UK alone living with the negative consequences of someone else’s drug and/or alcohol problem.

Gemma’s research involved semi-structured interviews (lasting 42 – 129 minutes) with nine parents and one grandparent (who had assumed the role of parent) of people with a drug and/or alcohol problem. The participants were recruited from WGCADA (Swansea) and DAFS. Interviews were taped, transcribed, and then analysed using Grounded Theory. 

Eight important themes emerged from Gemma’s analysis, which she termed: confusion/lack of awareness; imbalance/pervasion of the problem; heightened negative emotions; family support/treatment; coping; outcomes; family, and other stressors. These inter-related themes, each comprising various concepts, were integrated into a preliminary model describing the impact of substance misuse on the families interviewed, and various related matters. The following summary of Gemma’s findings is based, in large part, on an article I wrote for the magazine Drink and Drugs News in November 2004 (p. 12). Some quotes from study participants have been added.

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Families face a number of difficulties when one of their children develop a substance use problem. Parents, as well as siblings and relatives, are likely to feel extremely stressed about a whole range of problems—initial confusion about the nature of the substance use, imbalance as the problem takes over, a barrage of negative and contradictory emotions, the stigma associated with substance use, and problems associated with the treatment system.

Confusion arises and increases because parents are not aware of what is going on with their loved one, and because of a lack of knowledge about substance use and its associated problems. Initially, parents are not aware of what substances are being used, the method of administration, and the seriousness of use. For some parents, confusion and uncertainty continue for a long time.

There is usually a gradual process of realisation, as family members witness the consequences of use, rather than a clear-cut understanding of what is going on. Some parents are constantly trying to ‘catch-up’, in order to fully understand new or different stages of their loved one’s addiction or recovery process.

‘I found out within less than a year that he was injecting himself. Purely, I found out because… he had phlebitis in the legs. He had infections there, and ulcers.’

The process of understanding what is going on is often confounded by the user’s deceit and lies, which create an atmosphere of mistrust. Even if they are not deceitful, users can be in denial about their problem. Some parents are also in denial, generally because they don’t know how to deal with the problem. They experience contradictory thoughts and behaviours, particularly towards their loved one. All these factors add to the ongoing confusion.

‘I seemed to be looking for the good in him…I know he hurt me by pinching [stealing], but he’s family… As a son he leaves a lot to be desired, but he’s still my son, and this is the hard part about it.’ 

Parents are involved in a learning process about the nature of their loved one’s problem and how it can be overcome. In order to achieve a greater degree of clarity, they must learn about and understand the drug(s) involved, the reasons for use and consequences of use (e.g. drug withdrawal, overdose), the nature of recovery, and what different forms of treatment involve and how they can be accessed. Confusion can be exacerbated by information obtained from questionable sources, such as some elements of the media.

Parents’ lives are knocked off balance, as the substance use problem pervades and dominates the family. This imbalance is characterised by a series of worries, which tend to dominate parents’ thoughts, and cause a significant amount of stress. These worries are either general in nature or specifically relate to fears regarding the user’s safety or health. 

‘I was frightened we were going to have a phone call to say he was dead, or he was in hospital with an overdose… We were just waiting for a knock on the door to say they’d found him in the gutter or something like that.’

Some parents whose family member is in recovery from addiction worry about them relapsing. 

‘You’ve always got that worry that they will relapse and go back, and I think I will always have that. I don’t think I will ever get away from that.’ 

In the turmoil of worry about their loved one’s health and safety, parents often feel as if they dislike or even hate their child, hoping that they would die or disappear to remove the problem altogether. In most cases, this feeling contradicts concurrent feelings of parental love and obligation and serves to further confuse and stress the parent. Many of the parents also experience other negative emotions, such as feelings of isolation, shame, grief, and anger.

The addiction treatment system offers little initial comfort, as parents become frustrated with long waiting times for their loved one.

‘I get annoyed about it, angry and frustrated as well…I think the access [to treatment] is very, very slow, and I think this is where a lot of problems arise. As is the case with my son, they get frustrated, and they get despondent, and they think… what’s the use?… Access needs to be a lot, lot quicker.’

Then comes the stress of stigma and prejudice. Although most parents don’t experience stigma aimed at them directly, they suffer when it’s targeted at their child and often try and conceal the problem. There is a tendency for a parent to feel that other people think the user’s problem is the parents’ fault.

‘You could tell by the tone in her voice that she was pointing the finger. It makes you feel that you haven’t done things right for your family. Where have you gone wrong, is what you say to yourself?’

It doesn’t take long for the effects of stress to manifest itself in physical and psychological health problems. Physical symptoms come in the form of eating and sleeping problems, high blood pressure, stomach problems, irritable bowel syndrome, and tension aches. The emotional effect is severe enough that parents often visit their GP for help, where they are often prescribed anti-depressants. These drugs can cause problems for the family member, i.e. they may not alleviate the symptoms, they may produce side effects or withdrawal effects, or may be highly addictive, e.g. Librium.

‘I lost two stone in weight because of not eating properly. My husband developed two ulcers… We weren’t sleeping… My oldest son thought we were having problems in our marriage because we’d both gone to looking terrible.’

Other practical concerns can soon weigh in, not least the financial implications of paying for the user’s treatment, paying off their debts and, in some cases, actually paying for drugs to support the user’s habit.

Parents often put their social life on hold, fearing for the health and safety of their child every time they go out, or worrying what condition their house might be in when they return. They might not feel well enough to socialise, or they might simply not be able to take a holiday anymore because of lack of money.

Immediate members of the family feel the disruption, as they become wary of the unpredictable, and sometimes thieving, nature of the user. Often the user repeatedly returns to the family home after living away, and the parents are faced with a grown adult being dependant on them again.

‘I would not have expected to still be responsible in the way I feel responsible for a son of 30… It feels almost as though I still have a child in the home… even though in some ways he is an adult… Overall, it’s like still being responsible for a child.’

Arguments and tension increase, which is not helped when there are contradictions in the way that different members of the family feel and act. The user often steps in to divide the parents, creating further problems between them.

‘I approach it a completely different way my wife approaches it…I mean at the end of it, she was telling me I can’t go on with this, he’s gotta go. And at that time, I was saying no, we’ve done so much work… so we bicker about that quite a lot.’

With all attention on the user, it is not surprising that the user’s siblings can be neglected. The parent spends so long worrying about the user, that they have little time to see to others in the family—they are left to look after themselves. Relations between the user and their brother or sister sometimes have little hope of staying civil.

The wider family may provide whatever support they can by talking about problems, but there is rarely any active involvement. This is not usually intentional—merely a symptom of a lack of understanding of the issues involved, or how best they could help.

Parents use different coping methods—these are sometimes helpful, but at other times cause further stress. Some parents are deliberately non-confrontational, giving the user money, buying substances for them, and caring for them—but not confronting them directly about their problem. Others use avoidance coping, avoiding actively dealing with the problem and its consequences, denying the problem, concealing it, and refusing to let the user move back into the family home. Many parents try their best at active coping, trying to do something to improve the situation by threatening, giving the user an ultimatum, or helping them with their treatment.

Many parents also reported coping on a day-to-day basis. Some parents feel that this way of getting by is an improvement, at least offering them flexibility and exposing them less to the risk of feeling let down if plans or promises are broken. Others feel this is a negative approach.

‘You’re just living day-to-day. I come home from work thinking… “what am I going to expect now? What have I got to deal with now?”…You can’t look ahead because there isn’t a way forward. You just live day-to-day and hope you can cope with it.’

For many parents, it is important to be able to explain, or attribute some cause to, their loved one’s substance use problem. They might turn to the disease model of addiction, or look to blaming themselves or others. There is no consistent method of coping, and parents are likely to vary their method in response to different problems, and in an effort to find the best way to cope. The fluctuations in coping may clash with their partner’s opposing fluctuations, further increasing tension within the family.

Parents who belong to a family support group find tremendous support from sharing experience with other people in the same situation. Learning about various issues relating to substance use is, in itself, a way of learning to cope, and the groups reduce isolation by bringing people together into an empathic and hopeful social environment. Parents report that they can put their problems into perspective, and feel better by having the opportunity to help others.

‘I came out feeling marvellous… These people know what I’m going through, nobody else had known. I thought I was the only one that was going through this terrible time… Listening to these people’s stories I realised how other people… had coped, how things had got better… Every week I go… I get something out of it, and if I don’t get anything out of it then at least I think I’ve helped somebody else.’

Many of the barriers that parents experience, in trying to get family support, relate to ‘the system’. Parents find that there is a lack of services dedicated to families—or if they are there, they don’t know about them, or how to find them. Sometimes the long delay in accessing help is more about personal barriers. Parents are often reluctant to talk about or admit that there is a substance use problem in the family. Often, they are simply too preoccupied with the user’s needs to seek help for their own.

Finally, it should be noted that parents often alter their views on substance-related issues, through their personal experience and interacting with the treatment system. Many make practical changes in their lives and some start to work in the substance use and counselling fields.

‘I think I’ve become a lot more tolerant to addictive behaviour… Whereas before my initial reaction was… making a moral judgement… I’ve really moved away from that to feeling a bit sorry for people who’ve fallen into what I see now is a trap.’

‘It pushed me down a really different road to which I would have gone… I think I’m a lot stronger now and I think I’ve achieved something since then. I got back into education, I’ve become a counsellor, I’ve done a management course, I’m running this [family support organisation].

The present research study of family members who have accessed a family support group was small-scale, but intensively analysed. The insights from it show the multi-faceted nature of the impact of substance misuse on the family. One message is clear: society must learn to attend to the many needs of the families and carers of people with a substance use problem.

In finishing this chapter, I must emphasise how thrilled I was with the quality of Gemma’s research. She was awarded the Departmental Project Prize for that year and went on to graduate with a First Class Honours degree. Gemma Salter was one of the most talented students with whom I have had the pleasure of working. As you will see from a later chapter, her ‘career’ with Wired In had not ended. 

The photograph is of a dinner for members of WGCADA and the Wired In team at the King Arthur in Reynoldston, Gower, South Wales. Sian Howells, WGCADA Family Worker is at the front, with Lucie James (Wired In) on her left and Norman Preddy (CEO, WGCADA) to her right. Photograph was taken 2004. 

Endnotes:

1. James McIntosh and Neil McKeganey, Beating the Dragon: The Recovery From Dependent Drug Use, Pearson Education Limited, 2002.

2. Barney Glaser and Anselm Strauss, The Discovery of Grounded Theory, Chicago: Aldine, 1967.

3. Anselm Strauss and Juliet Corbin, Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory, Sage Publications Inc, 1998.

> My Journey: 11. Stories of Loved Ones Indirectly Affected by Substance Use Problems

> ‘My Journey’ chapter links (and biography)

When I first met Natalie back in 2000, I didn’t realise that she would play a role in my decision to change career from neuroscientist to addiction recovery advocate, researcher and educator. Her words also contributed to my decision to write a collection of Recovery Stories. Thank you, Natalie. (1,746 words)

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I remember vividly to this day Natalie saying to me back in 2000 that if I wanted to help people overcome serious substance use problems, I needed to start telling stories of people finding recovery.

She also emphasised to me that when your life has fallen apart and you are physically and mentally unwell, you have become isolated in your addiction, feel shame and disgust about yourself, and know that others think of you as nothing more than a ‘worthless junkie’, you give up on trying to change. It’s all too difficult; you see no escape. The easiest thing to do is to kill all the pain with more heroin, or more drink.

The conversations I had with Natalie have always stuck in my mind. They have had an enormous impact on me even today, over 23 years later.

I had spent all those years as a neuroscientist trying to understand brain function and its role in addiction and had never considered such things as those described by Natalie and other recovering addicts. That people would continue to use heroin use because they had no hope and saw no escape (no-one else they knew had escaped), and so they could kill the shame and guilt they felt, and the feelings they experienced from knowing their life had fallen apart.

I asked Natalie whether we could tell her story. She agreed to be interviewed by Becky Hancock, a former psychology student of mine who was now working with me on the Welsh Drug and Alcohol Treatment Fund (DATF) evaluation at the time. That Story, first ‘told’ by Becky, has appeared in various forms over the years, including in the first and second editions of Drink and Drugs News. Here is a summary of part of Natalie’s Story.

When Natalie was eleven years old and having just moved to a city from the countryside, her father was arrested for a drug offence and eventually sentenced to 22 years in prison. The impact of this and related events on this young girl’s social and emotional wellbeing must have been substantial.

‘I couldn’t understand what was going on. I was having to go to a new school not knowing anyone, but feeling that everyone knew about what had happened to my family. Every single day, I was extremely anxious about someone finding out that I was the daughter of the ‘evil drug smuggler’ who was written about on the front page of newspapers. It was one of the biggest drug busts in the country at that time, and the papers kept saying that my Dad was the evil mastermind behind the whole operation. To me, my Dad wasn’t evil!

I got so anxious that I used to wake up and pray every morning that no one would mention my Dad or anything about prisons. The hardest thing I’ve ever done in my whole life was to enter my classroom, walk to the back, and sit down at my desk, not knowing who knew what and whether anyone would say anything. As it turned out, nothing was ever said, but I wasn’t to know that then.’

Natalie’s anxiety did not lessen over the next two years. She would experience what she would later learn were panic attacks when a teacher would say something like, ‘We’re going to be discussing a case that happened some time ago…’

In addition, Natalie had to regularly visit her Dad in prison whilst he was on remand over a two-year period. She had to live through two trials, the first being abandoned just prior to completion. She regularly visited her Dad in a prison on the other side of the country once he was sentenced. The nature of these visits was not easy. Natalie missed her Dad and could not come to terms with the media’s portrayal of him.

When she was fourteen, Natalie started to hang out with people who were a little wilder than her previous friends. She started to smoke cigarettes and cannabis, and skip school. For the first time in years, she started to fit in somewhere. The cannabis helped her deal with her ongoing emotional pain.

She became pregnant and had a son (Joshua) when she was sixteen. The father had disappeared by the time of Joshua’s birth. Natalie then started using amphetamines and drinking alcohol more. She started going out with a dealer (John) who ended up going to prison.

Natalie’s Dad was released from prison early, when she was nineteen years old. When he came home, he was very different to the man she remembered. After about a year, the family discovered that Dad had picked up a heroin habit in prison. He started dealing heroin to Natalie’s boyfriend John, who had also gotten a heroin habit whilst in prison. Not long after, she started using heroin.

The family dynamic was now all over the place. Natalie’s Mum was struggling with the situation—no wonder, with her husband and oldest daughter addicted to heroin, another daughter playing up, and a grandchild to look after. All those promises about being a happy family after Dad’s release had not come to fruition.

Is it any surprise that Natalie turned to regular heroin use given all that previously happened to her, life as it was at the current time, and once she had experienced the psychological pain-killing effects of the drug? Here are some excerpts from Natalie’s original Recovery Story, I Didn’t Plan To Be An Addict. The first quote relates to a time after she had started using heroin regularly:

‘At this time, I was completely lost. I remember thinking, ‘I’m scared’, but I couldn’t see a way out. I felt completely trapped. I absolutely hated using gear because of what it was doing. I felt totally controlled by John and heroin. My heroin use was taking its toll on my body. I collapsed twice from using too much, once in front of Joshua [Natalie’s son]….

I was too afraid to go to the doctor for help because I thought they would take Joshua off me. Even though I was addicted to drugs and they were my priority, I still loved my son and no way did I want to lose him….’

The following quotes are from the time Natalie was attending her treatment service:

‘When I went for my appointment, I was offered a place on the pre-treatment programme. The treatment agency worker kept saying to me, ‘You’ll do this, kid’ and I was like, ‘Oh my God, do you really think so!?’ I really honestly couldn’t believe him. I just didn’t think I would be able to get out of my situation….’

‘… I was still using heroin when I first attended the agency. There were about fifteen other treatment agency clients in my first group session, one of whom was an ex-heroin user who had been clean for about 16 years. She came over to talk to me and I was in awe. She had done exactly what I was doing and she had gotten through it. It was a Light Bulb Moment. From that moment on, I didn’t feel so alone. For the first time, I was with a group of people who understood me and my addiction, and I understood and related to them and with what they were saying.

You have to realise my state of thinking prior to that first group meeting in the treatment agency. Once I had become addicted to heroin, I did not see that there was any alternative to the life I was living. I didn’t know anyone who had overcome heroin addiction. I had never heard of anyone who had done so. I could find no information on the internet on how to give up using the drug. That was it! I just had to carry on doing what I was doing….’

‘… As time passed, being at the agency and attending NA meetings felt fantastic. They were the right places for me. I actually felt like I belonged. It was really nice having something in common with other people. I also started to understand my addiction, and came to realise that my behaviour was part of my illness.…’

‘… One of the hardest things to deal with was the mental frustration. I had so many things going around my head and I was really scared. I had tried to change so many times before and I was battling with thoughts that I was going to mess up again. I had all these feelings rushing around my head, but I didn’t realise what they were because I had suppressed them for so long with heroin.

I can remember not being able to distinguish between feelings of hurt and anger. My counsellor really helped me to re-learn what different feelings stood for, which really helped. The hardest thing was having to face up to my past problems and seeing the damage I had caused to myself and others by taking drugs. I didn’t want to face up to the bad things that had happened and that I’d done. It was so difficult trying to sort all of that out raw, without using drugs to cope….’

‘… The treatment agency also helped me to re-build the relationship with my son, which had been damaged over the years. When I first approached the agency, I didn’t know how to be a mother.…’

‘… Whilst in treatment, I began to do non-vocational courses (e.g. pottery and dress making) and help out at the local school. This allowed me to mix with people who were not addicts. This was a big step, because I had become quite isolated from ‘normal’ people. It was also the first time that I had ever completed a course.’

Natalie is now over twenty years into her recovery. You can read her full Story here.

Many people with a serious substance use problem know what they want—a valued and meaningful life without drugs. They just do not know how to achieve what they want, and they lack the internal and external resources to take the journey to recovery and the life they want.

> My Journey: 6. Drug and Alcohol Treatment Fund (DATF) Evaluation

> ‘My Journey’ chapter links (and biography)