LETTERS AND COMMENT
arc-w . nihr . ac . uk on that day . We give them that space and someone to listen to them .’ They were guided by an informal and compassionate approach . Flexibility was equally important , with no ‘ two strikes and you ’ re out ’ policy .
Alongside forming multiagency partnerships , they worked with schools , reminding them of guidelines and evidence to reduce exclusions – and she acknowledged that this wasn ’ t always easy : ‘ We have teachers who have their own ideas on what drugs education should be . It ’ s about breaking down barriers .’
LAST CHANCE TO LISTEN End-of-life care was one of the most important opportunities to listen and respond , said Sarah Galvani as she shared research from conversations with people in hospitals and hospices .
Her project at Manchester Metropolitan University aimed to find out about responses to people who use drugs , when they were at the end of their lives . The conversations included people with experience ( with an age range of 38-71 ) and their families , friends , and carers .
Firstly , it was found that while hospices ’ knowledge around alcohol was good they were ‘ a bit at sea ’ with other drugs . Then it became clear that there was a general lack of end-of-life communication – some wouldn ’ t talk about it ; others struggled to understand . Hospice staff often assumed that somebody else would have already told the person they were dying .
The person concerned often anticipated discrimination , and assumed they would be treated differently . But they were likely to be afraid and need support , and often had a sense of being
‘ We want young people to know what support could look like .’
NATALIE BROUGHTON
somewhere that was not ageappropriate and not set up for younger people . Hospices were a real comfort and relieved loneliness , but there needed to be more understanding of selfstigma and the accompanying defensiveness that were so often present .
NEW MODELS Research colleague Sam gave the views of carers and families – a snapshot of ‘ the chronic strain of caring ’. People didn ’ t know what to do for the best and there was often no one around to advise . The impact of chronic strain could reveal emotional limitations – ‘ I despised him ’ – and there was a lack of support and communication , often accompanied by the social isolation that came with the burden of care . People had a fear of opening up about this , and a lack of trust in the response they would get .
The result of the project was an objective – to develop a new model of care , with short , medium and long-term outcomes . It was also important to consider the impact on the professional , added Galvani , both from personal grieving and from it being an ‘ unsuccessful completion ’. ‘ Talking about death and dying in our services is so important ,’ she said . Information and resources at endoflifecaresubstanceuse . com
FALSE DICHOTOMY
People on Twitter , now known as X , who are involved in issues around the use of drugs , will probably have followed a discussion involving Annemarie Ward – for whom I have great respect for her commitment to making the lives of people who use drugs better – and Thomas Leonard Ross KC . The gist of the discussion was about how the Scottish government should spend money allocated to dealing with illegal drugs . In one corner , Mr Ross , and in the other corner a furious Annemarie who was bemoaning the fact that the Scottish government seemed to be favouring a harm reduction approach . Two hundred and eighteen recovery projects have not been funded in favour of funding drug consumption rooms .
Annemarie asked , ‘ If it were your own child , where would you want your hard-earned tax money to go ? Do you opt for a transformative programme that guides them towards healing and a fresh start , or do you settle for a facility that does nothing more than oversee their “ safe ” substance use ?’
This is almost the same question that was asked many times in Liverpool over 40 years ago . HIV was spreading and the priority was to stop it spreading through the sharing of injection equipment by injecting drug users . Our opponents claimed that we were not valuing every
‘ If it were your own child , where would you want your hard-earned tax money to go ?’
life . We took a public health-based population approach . According to Dr Qutub Sayed , the regional medical officer , this resulted in an unmeasurably low incidence of HIV in the region . At the same time in Scotland the HIV rate was 18 per cent .
According to Annemarie the way the Scottish government is allocating funding is ‘ a clear case of favouring short-sighted political agendas over meaningful , long-term recovery solutions ’. On this occasion , I must beg to differ with my friend , Annemarie . Pat O ’ Hare , executive director , HIT
DRAMATIC HELP
I was really interested in the two kinds of drama described by the authors in your last issue . I have always shied away from theatrical stuff and role play ! Yet the anonymous drama in particular really spoke to me and I ’ ve also begun to see how we might use drama in our service , particularly in tackling trauma in a non-intrusive way . Thank you DDN for making me think about things in a different way , again . Anne Barnes , by email
DDN welcomes all your comments . Please email the editor , claire @ cjwellings . com , join any of the conversations on our Facebook page , or send letters to DDN , CJ Wellings Ltd , Romney House , School Road , Ashford , Kent TN27 0LT . Longer comments and letters may be edited for space or clarity .
/ ddnmagazine @ ddnmagazine www . drinkanddrugsnews . com
18 • DRINK AND DRUGS NEWS • DEC 2023 – JAN 2024 WWW . DRINKANDDRUGSNEWS . COM