Another major challenge is the ever-changing drugs market – how is the sector meant to keep abreast of new information ? Since 2009 there have been 803 new substances identified by the UN
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this information , leading to an e-learning course evaluated by the Royal College of Psychiatrists , to disseminate the information more widely . As well as increasing their knowledge , participants had reported improvements in their confidence and morale through being able to identify NPS .
Another area of the sector where information and support were needed urgently was for problematic gambling , and Dr Henrietta Bowden-Jones shared her expertise as a doctor , neuroscience researcher and founder / director of the National Problem Gambling Clinic . With half a million problem gamblers and 2m people at risk , there were ‘ many organic reasons why people gamble ,’ she said . ‘ It ’ s not all about the bookmaker around the corner .
‘ Gambling was something I came across by chance in my research on alcohol dependency and I became obsessed with understanding the illness ,’ she explained . People used to wait years to come forward , but it was now becoming recognised as a condition to be treated .
‘ Most people will walk away from a table when they are losing ,’ she said , describing the pattern of behaviour that could become a preoccupation from first thing in the morning and escalate into lies and deceit .
Cognitive Behavioural Therapy ( CBT ) was being used to treat gambling – very successfully in many cases . For those who didn ’ t respond to CBT , naltrexone ( as used to reduce cravings for alcohol ) had been trialled successfully . Bowden-Jones had written guidelines on naltrexone and found that it ‘ gives an opportunity ’ if CBT had been ineffective .
The National Problem Gambling Clinic was the only multidisciplinary treatment centre in the UK for problem gambling and had been inundated with referrals since opening ten years ago . With a gambling culture that was rife – including in prisons , where inmates could inherit a bunk with debts – NHS England really needed to take the problem on board , she said .
Another extremely valuable – and under-used resource – was families , according to Vivienne Evans OBE , chief executive of the national support service Adfam . There was still a culture of seeing family members as part of a patient ’ s problems , but in fact they could be agents for change , she explained .
Commissioning family support should also be viewed as an investment , rather than an ‘ add on ’ to recovery services . The effects of substance misuse were a high factor in incidents of domestic violence , family break-up and divorce so it made sense to commission strategically : ‘ They should be seen as more than supporting an individual ’ s recovery and receive the support they deserve in their own right ,’ she said .
Another major challenge is the ever-changing drugs market – how is the sector meant to keep abreast of new information ? Since 2009 there have been 803 new substances identified by the UN
Throughout the conference there had been frequent mention of the need to harness the power of service user involvement – in his opening speech Danny Hames talked about the value of a ‘ strong and equipped service user voice ’.
In the final session Rob Eyres , founder of the Telford After Care Team ( TACT ), demonstrated what that could mean . Caught up in a destructive cycle of drug dealing and addiction , he served time in young offenders ’ units and then prison . He carried on using drugs and drink after he was released , right through his relationship and break-up of his family , until a new keyworker confronted him with the responsibility of changing his attitude to his addiction , telling him ‘ it ’ s your addiction – I ’ m here to support you ’.
Committing himself to treatment ( which involved a subutex script ) Eyers discovered the support of SMART Recovery meetings , then decided to begin his own support group . He rented a room in a leisure centre and for 12 weeks no one came – ‘ the cleaner used to hoover around me ’. Then people started to join him and when the group began to become more established , they began a gardening project , alongside regular meetings .
Seven years on , their blossoming project had its own premises and works on four NHS projects , running social enterprises that include a café , a landscape gardening company and a printing business . With 28 full-time staff and more than 40 volunteers , they had around 100 people accessing their services each day .
The peer support was an essential element ; staff all formerly had problematic substance use and now worked with people at all stages of recovery . ‘ If people turn up and are intoxicated , we will talk to them and get them to come tomorrow and try again ,’ said Eyres . ‘ We don ’ t turn people away – it ’ s a recovery centre , not a recovered centre .’
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