thoughts could speak with a person who understood both addiction and mental health through lived experience.
Someone arriving in that condition may be frightened, intoxicated, confused or unable to explain what has brought them there. A livedexperience practitioner would not replace clinical assessment or mental health and addiction professionals. Instead, participants saw the potential for such a role to provide connection, help somebody communicate what is happening, and support navigation between services that can otherwise feel disconnected.
The same thinking led to discussion about livedexperience dual-diagnosis roles more broadly. Rather than treating mental health and substance use separately, such roles could help explore how the two interact in a person’ s life. What is the substance use doing for that person? Is it helping them manage distress or experiences that preceded it? Has substance use itself contributed to deteriorating mental health? What other support might be needed if the substance is removed? These are not questions with simple answers, but participants felt that lived experience could bring an important perspective alongside professional expertise.
THE SAME MESSAGE Across the three groups, the same message kept resurfacing. Mental health and addiction may be divided across different services, funding streams, professional roles and referral pathways. The person experiencing them is not. What people were asking for was greater understanding across services, better communication, clearer pathways and more oppor tunities for lived experience to work alongside professional expertise. They wanted fewer points at which somebody seek ing help is told, in effect,‘ deal with that problem first, then come back’.
Nobody was suggesting that every service should do everything. Specialist knowledge matters, and different services have different roles and responsibilities. But specialism should not become separation. Better joined-up working means finding ways to connect that expertise around the person, particularly when their needs cross more than one area.
When mental distress and substance use occur together, understanding how they interact may be more helpful than expecting one to be resolved before support for the other can begin. Perhaps the question is not whether somebody is ready for support. It’ s whether our systems are ready to support the person in front of them.
Dr Lisa Ogilvie is a psychologist for Acorn Recovery Projects and visiting senior lecturer at the University of Greater Manchester
Stephanie Ash is a CQCregistered manager and therapist at Acorn Recovery Projects.
Bernard Shaw founded Project Free, a LERO that supports adults affected by substance use across Greater Manchester.
GETTING THE PICTURE
Acorn’ s specialist work with people affected by ketamine use has reached a national audience through a BBC Three documentary, writes Sarah Tattersall
F
ilmed largely at Acorn Recovery Projects’ Stockport and Burnley services, Down the K-Hole presented by Stacey Dooley explores ketamine addiction, treatment and recovery at a time when we’ re seeing increasing numbers of younger people experiencing problems linked to the drug.
As a LERO operating across Lancashire and Greater Manchester, we’ ve been responding to ketamine use through peerled support, changes to our residential rehabilitation provision and specialist interventions shaped around the experiences of the people using our services. This has grown to include dedicated pathways and a ketamine support service commissioned as part of the Lancashire substance misuse contract.
Participating in the documentary has given us an opportunity to make treatment and recovery part of the wider discussion about ketamine – we see first-hand the impact ketamine can have on people and their families. It’ s a particular challenge for treatment and recovery services, as established approaches to drug and alcohol use will not necessarily meet the needs of younger people experiencing difficulties with ketamine. Services need to understand why and how people are using the drug, the harms they are experiencing and what will make support feel relevant and accessible. We’ ve developed ketamine-specific interventions rather than trying to fit people into existing generic models.
Illicit ketamine use has continued to rise, particularly among younger people, with the 18-24 age range recording the highest rates of use. The number entering treatment for ketamine use is now reported to be eight times higher than it was a decade ago. Frequent use can result in serious physical and psychological harm, including damage to the bladder and urinary tract, chronic abdominal pain, memory problems and dissociation. In some cases, the physical damage can be irreversible.
At Acorn we combine specialist knowledge with lived experience, putting peer support at the centre of our approach. People across our services have put so much into understanding and responding to ketamine use; I’ m incredibly proud that their work, and the value lived experience brings to recovery, is being given this platform.
The documentary has helped bring a rapidly developing issue to a much larger audience. The next challenge for all of us is ensuring that people affected by ketamine can find support that understands their experiences and is designed around their needs.
Stacey Dooley: Down the K Hole is available to view on BBC iPlayer Sarah Tattersall is head of operations at Acorn Recovery Projects.
22 • DRINK AND DRUGS NEWS • NOVEMBER 2026 WWW. DRINKANDDRUGSNEWS. COM