LETTERS AND COMMENT
might feel that you ’ d emerged into a dystopian other world . Drug ‘ addicts ’ in wheelchairs with limbs missing ( as result of infected femoral vein injection sites ) slumber in pubic under the influence of Lady Morphia or wheel around in crack cocaine induced confusion . Homeless people lie in shop doorways or on the pavement .
The inner city of Manchester today makes the Piccadilly Gardens of 1985 look like the lawns of Downton Abbey . How has this happened , and what role has drug treatment had in such a spectacular and depressing downturn ? Are the actors in the Piccadilly Gardens dance of despair in drug treatment ? If not , why not ? If yes , why are they in such a sad state of disrepair ? Can we not get them into , or keep them in , treatment ? What part of our offer is not sufficient to improve their lives ?
Every town and city in the UK has its own version of Piccadilly Gardens , and some places are worse . There are some explanations for this decline . In 1985 , few heroin users were also dependent drinkers . Crack cocaine wasn ’ t widely available . ‘ Spice ’ still meant chilli powder . Illicit benzodiazepines weren ’ t available at pocket money prices . Heroin wasn ’ t available 24 / 7 , 365 days of the year . Dealers didn ’ t make their daily heroin and crack offers available via mobile phone .
Now ... and then
I now find myself , at the tender age of 68 , living near Blackpool with regular visits to Manchester and Bradford . When I came into the drug treatment world I was a fundamental ‘ harm reductionist ’, and I ’ m back there again .
I ’ m all too aware that all this can sound like your grandad saying ‘ In my day … blah , blah , blah ’. For the record , I happen to be a person with ‘ lived experience ’. For many years , I was a staunch advocate for ‘ recovery ’ in general and 12-step mutual aid in particular . To an extent I still am , but as a result of my lived experience I have many critiques and criticisms of all that . I ’ ve made many bad decisions in my life but the worst mistakes I ’ ve made have been while ‘ clean and sober ’ and engaged in 12-step mutual aid . As a direct result of those mistakes I now find myself , at the tender age of 68 , living near Blackpool with regular visits to Manchester and Bradford . When I came into the drug treatment world I was a fundamental ‘ harm reductionist ’, and I ’ m back there again .
It seems to me that the primary response to the challenges that face us today is good old fashioned harm reduction . At the time of writing the working class are once again being demonised by polite middle class society . Who would have thought that John Major ’ s ‘ condemn more , understand less ’ would be repeated by progressive middle class liberals ? It ’ s a funny old world .
Mark Gilman is a freelance consultant in substance use and is expressing his personal opinion in this article
KNOWLEDGE GAP
Regarding dual diagnosis ( DDN , September , p20 ): I feel we need to upskill mental health staff with better understanding of co-occurring conditions . I continue to see poor outcomes on mental health wards and in the community due to lack of knowledge around cooccurring conditions , and a lack of professional curiosity in assessments and care planning around substance and alcohol use .
Integration of substance misuse workers into mental health teams is the way forward , not standalone services with limiting criteria and lack of joint working . Daniel Finch , specialist substance misuse worker , Midlands Partnership University NHS Foundation Trust / South Staffordshire Mental Health and Social Inclusion Hub
ASK THE FAMILY
The UK recovery services are very much stuck in the 1930s when it comes to family support . We get our support online from Australia and our training from the CMCFFC in New York . We have been supporting UK families since 2016 and globally since the start of COVID . Why do we have to bypass the UK services to make progress ? We get referrals from professionals around the world , give talks internationally – and do all this with zero funding .
Is it time the UK took family support more seriously ? Harm reduction can start years before the recovery services show up and there are five times as many of us ! We are happy to share our experience – or pop into our open twice weekly meetings .
Come on UK , stop blanking family members when they walk into your service , they might know more about addiction than you guys do – and if they don ’ t , they are so willing and easy to train . Dave and Tina , www . alternat-i-ves . org
SAFE SPACES
I absolutely agree with the article about safe consumption rooms ( DDN , June , p6 ) and think they ’ re much needed in Brighton . Hopefully these will be agreed and run by NHS services . Mia , Brighton
From DDN magazine on Facebook – Thoughts on alcohol …
MINIMUM PRICING is a blunt tool and using it simply suggests a lack of understanding and control that ’ s nothing short of desperation . So , it will fit in nicely with the rest of our dumb drug policy . Nick Goldstein
ARE STUDENTS DRINKING LESS or are they simply buying the even cheaper alcohol available at certain shops and taking it home with them ? A quick look at student union bar prices shows that they consistently seem to charge about 50 per cent more than discount alcohol outlets . SW Dunlevy
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
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