» What are you hoping for?
» What has worked before?
» What worries you?
» What support do you need right now?
» And crucially, what are the treatment options available to you?
CLEARER CONVERSATIONS
Clearer conversations do not necessarily require new interventions. Sometimes they begin with simple questions.
» What are you hoping for?
» What has worked before?
» What worries you?
» What support do you need right now?
» And crucially, what are the treatment options available to you?
Constantinis / iStock
One of the biggest improvements he’ s seen is rapid access to prescribing and same-day restarts.‘ So it’ s great to be able to say, come on, let’ s go and get your script sorted today. It gives them a bit of reassurance.’
But he also sees how quickly motivation can disappear when they don’ t get the structure or support to address their use, or when there’ s a long wait to get it.‘ The intervention is needed now, rather than later,’ he says.
He mentions a client who’ s going into detox on Monday after waiting three months. He’ s been seeing a clinical worker weekly to have bloods taken, plus tests and an alcohol diary to assess drinking levels – all needed by the facility to see how long the detox period needs to be. So keeping the client engaged is absolutely essential:‘ This is the first time he’ s set foot into any sort of treatment at all. So it’ s huge for him... his life is dependent on it because he doesn’ t see any other way out of his alcohol dependency.’
‘ Dragging people to these appointments’ can be made slightly easier when the services involved are proactive about the relationship, keeping the support worker updated about care plans.‘ I’ m really fortunate because we have Horizons, a team that work at the hostels, and I’ ve got a really good relationship with them,’ he says.‘ But it does feel like we have to go out of our way to get a foot in the door, to get to be known. I think services can be better about just coming in and introducing themselves.’
He’ s grateful for the computer system that’ s made things easier:‘ I can log on and see anyone’ s treatment plan and what they’ re doing, where they’ re at, when their script needs renewing, and if they’ ve been collecting their script on a daily basis … It’ s a real holistic approach whereby everyone can see everyone’ s involvement.’
COLLABORATION LEADS TO CHANGE
FOR CRAIG, A SERVICE USER ON A SIMILAR PROGRAMME IN CARDIFF, ENTERING TREATMENT WHILE IN PRISON FELT VERY DIFFERENT FROM HIS EXPERIENCE IN THE COMMUNITY. Wanting help, he disclosed his use and asked for support, only to be told he needed to provide three positive urine tests before he could access medication.‘ I said, so what’ s the point of me telling you that I’ ve got a fucking problem?’ he remembers.‘ You’ ve just had a positive off me, isn’ t that enough?’
The process took a month, during which he had to continue sourcing drugs inside prison. He remembers feeling that there were few conversations about alternatives and little discussion about different treatment options:‘ They just said methadone. They didn’ t really say anything else. I don’ t think there were any options.’
Yet his experience began to change once he entered community treatment – but only when he had a supportive keyworker and the conversations became more collaborative. When he wanted to slow his
‘ Support is there if you want it... They can only offer so much and then it’ s down to you to take it.’
methadone reduction, she listened:‘ I said I was really clammy at night and asked if I could stay on the same dose for another couple of weeks. She was like, yes, all right, don’ t worry.’
He’ s now preparing to transition to longacting buprenorphine and feels much more involved in his treatment.‘ Support is there if you want it,’ he says.‘ They can only offer so much and then it’ s down to you to take it.’
For people seeking help, these conversations may determine whether they engage, walk away, or try again another day. For treatment providers, they are a reminder that while clinical guidance matters, the human side of treatment matters too. And very often it’ s that first conversation – and the willingness to keep having it – that can make all the difference. DDN
Grateful thanks to Zoe Jenkins, colleagues and clients at The Salvation Army
This series on Clearer Conversations in OST has been made possible by a grant from Camurus, who have had no involvement in the content of these articles.
Clearer Conversations is an ongoing series and we would love to hear from you if you are willing to share your experiences of treatment – please email the editor, claire @ cjwellings. com
24 • DRINK AND DRUGS NEWS • JULY / AUGUST 2026 WWW. DRINKANDDRUGSNEWS. COM