Well it's been a while!!

Things have taken a big change this year! The recession has hit me hard. Wired In couldn't afford to keep me employed so I've been working as a chef since February this year!

I'm going to be blogging regularly again soon so keep an eye out for it!

Kevin

Kia Sedona

I wanted to direct everyone attention to this terrible customer service displayed by Kia. Nathan is a friend of mine that bought a brand spanking new car, a Kia Sedona,  that he's had nothing but problems with ever since getting it off the forecourt. To see the details click here.

Hit the link baby!!

A problem forgotten

It's a problem that has been getting steadily worse over the last decade, lots of it has to do with the boom in heavy and hard drug use being seen as the 'main' substance misuse issue that our society has to deal with. 

I'm talking about alcohol and more directly about alcoholism, which doesn't seem to bother people anywhere near as much as drug use. To my thinking alcoholism, heroin addiction, even over the counter (OTC) medicine addiction are essentially one and the same in the way they affect the person in the end - addiction is alcoholism is addiction - Any one who just can't stop using a substance when the negative aspects out way the positive aspect of that use, is in big trouble - lies, deceit, denial and total emotional shutdown followed by increasing self-loathing is not far off! 

Another aspect of alcohol abuse that's causing chronic liver problems in people as young as their early twenty's is binge drinking, which has become a very popular pastime indeed. But there is a big difference between an alcoholic and a binge drinker. A friend of mine, Tom, once described this difference as -

"If a doctor tells a binge drinker that he will die within a year if he continues to drink, he will stop straight away. The alcoholic in the same situation, wouldn't be able to"

Why should alcoholics be treated any differently to addicts? Is it because treating them wouldn't bring a big crime rate dividend? 

The National Audit Office (NAO) has recently looked at what the NHS Primary Care Trusts (PCT) have been doing in the way of providing alcohol services. Primary Care Trusts are a very important part of the NHS, and they get about 80% of the total NHS budget. PCTs decide what health services a local community needs, and they are responsible for providing them. 

The NAO found that a quarter of PCTs had not carried out assessments of the problem locally, four in 10 did not have a strategy in place and a third did not know what they were spending on the problem.

Where evidence on investment was available, just £600,000 a year - or 0.1% of the budget - was spent on average.

The report said, because of the lack of co-ordination, the services were not providing value for money.

The NHS spends £2.7bn a year on alcohol abuse, treating ailments such as liver disease. Why not spend a bit more than the frankly laughable amount of £600,000 on trying to stop the problems getting this far along? There are lots of people out there that would respond to a brief intervention from their GP with some aftercare to follow up. Come on, the problems there, now do something about it.

Thank you to the BBC for the facts and figures

Methadone withdrawals...

I wake up, bleary eyed and dis-orientated, frustration bubbles through my veins as sleep has evaded me for what seems like the whole night. My legs feel like two logs after an eternity of unsolicited movement, twitching and kicking repeatedly and I smell like a chemical soaked rag. Anger erupts into a flurry of violence as I try to beat my addiction into submission, after punching myself on the temple, I'm seeing stars.

Eyes closed the water pounds away at my body; my mind meanwhile is frantically searching for peace. A peace that will only come with total exhaustion, and so not really peace but more like unconsciousness. I know searching is useless but I have little control of that part of me, instead I attempt to wash the stench from me - soap, rinse, soap, rinse, soap, rinse. I notice that I have goosebumps all over me still, the heat of the water has no effect on that symptom.

I lie back on the bed, my body, for the moment, feels rather numb. The heat helping to ease the cramps, but my mind still is a tightly wound spring. I start to drift into blackness, noticing as I do so the soap hasn't helped - I still smell like roadkill. All I want is to sleep - to simply not be, anymore.

Twice in my life I've had to stop using methadone without the luxury of reducing slowly. Compared to a heroin detox it isn't as violent but for me it was far, far longer lasting. Something else I noticed too was that even if I had a hit of smack I still didn't feel 100%, they may both be opiates but they affect me slightly differently. Only methadone would get rid of all the withdrawal symptoms. This told me that I wasn't a heroin addict, I wasn't even an opiate addict but rather a methadone addict. Other opiates might help a bit but not even dia-morphine would sort the withdrawals out completely - only methadone would do that now.

But far better than methadone for sorting out withdrawals, is time (and time, goes by, so slowly, and time, can do so much) but enough of the Righteous Bros! I wanted to write about this subject today as I believe it's important to remind ourselves of our past, the good, the bad and the ugly.

Wired In's new Recovery Support Group

Well, with Monday's rant behind me I've decided to let you know about the new Wired In To Recovery Support Group!! 

It's been set up as peer-support group, enabling those in recovery from substance use to give and get support from others in the same boat as them. We meet once a week, every week, on a Wednesday evening from 6 - 8pm. As well as a group sessions, we also have a big social aspect to the group. 

The Wired In volunteers that have helped to set this group up, felt that is was very important to have a social aspect to the group as it can be hard to socialise in a safe environment, drink and drug free, once you're in recovery. The groups are held at the premises of a local Housing association (2A Alexander Street, Cathays, Cardiff), where there is a chill out room with a pool table and a kitchen that can be used at every meeting, also helping people to make and strengthen friendships within the group.

This group is run by people in recovery for others in recovery, enabling experiences and support to be shared by like-minded people. As with all Wired In projects, there is no charge for these services. If anyone is interested in coming to this group or just wants some more information then please email me on kevinm@wiredin.org.uk or give me a call on 07541216011.

NTA's annual figures

I've been following with interest the debate that has followed since the release of the NTA's annual figures. Mark Easton, the BBC's home editor has reported on what he, like many others, sees as the farce that the NTA is trying to sell.

The NTA's figures concentrate on having 202,000 people in treatment last year but the people that left treatment drug-free was a bit lower - 7,324! I notice that they aren't shouting about that one! The NTA's focus is on getting people into treatment, that much is obvious, but for only a short time - 12 weeks. I say this because they have targets of 'retention in treatment' in which the box is ticked once people have lasted 12 weeks. But they don't have any targets for people leaving treatment drug-free! How can this be?

It seems to me that it's because the NTA aren't interested in getting people out the other side of treatment drug-free but rather more interested in getting people in for 12 weeks and job done! They don't care whether or not the service user achieves abstinence but rather that they are retained in treatment. The reason? So the public will think they're doing a good job and sleep safely in their beds tonight.

They do this by refusing point-blank to reduce the amount of methadone an individual will be receiving. It doesn't matter whether that person is stable, giving clear urine tests and meeting every demand they have. They will not reduce that methadone or send you to rehab, because they are scared to death that people will achieve a stable drug-free recovery and that will put them out of a job. The whole system stinks and people are starting to realise that, the charade is coming to an end. As the saying goes - you can't fool all the people all the time!

Millions upon millions are being wasted because the NTA won't admit they are wrong and change direction to focus on recovery and the things that will aid recovery, and not just keep on with their present tack of treatment for treatments sake, which, as their figures show, isn't actually helping many people to achieve drug-free lives. My fear is that when the public, as a whole, realise this there will be such a outrage at the wasted money that the drug and alcohol field's budget will be slashed and we'll be lucky to help many people at all.

Wired In Recovery Support group

I've had a brilliant day of travelling around treatment providers in Cardiff giving a talk to let people know about the new support group we're setting up. The response I got was very encouraging from everywhere I went, although I got drenched while cycling around!

We had our first group last Wednesday, to which the turnout was great for a first group, a whole 4 people! It's going to be happening once a week from now on and is going to consist of a meeting in which participants will discuss their recovery and what's happening from day to day for them. There will be positive feedback encouraged as it's essentially a peer-support group, run by those in recovery, for those in recovery. After that there will be a chill out time for people to get to know each other over a cuppa and a game of pool. 

Well I didn't publish this straight away so it's a couple of days later now and we've had another group since writing this. I've been blown away by the response that I have received from people while telling them about this group. It's so encouraging to be told by people in recovery that they would like to attend this group. I've even had staff members from treatment providers I've visited asking if they can volunteer- it's been an amazing experience!!

I'm going to keep you all posted on how things go.

No smoking!!!

It's now well into the second week and my mission to stop smoking is continuing. Apart from a lapse on the weekend of half a ciggie, (bloody awful that it was!) everything is going well. I even stopped using the patches after a couple of days as I didn't really think they were necessary for me.

As for cravings, they only seem to bother me in the evenings after I've had my dinner and I'm relaxing on the sofa. But what I've found is that as long as I distract myself initially, by thinking or doing something else, the cravings don't last long and are easily managed. Physically I don't feel any different at all, not worse or better and I certainly haven't had any physical withdrawals!

Mentally though I'm feeling a whole lot better. I've finally conquered the fags! Hopefully no lung cancer or the like for me! My mental outlook changed after I had that lapse on the week end. It tasted awful and after that I realised that I don't want to smoke. It's been plain sailing since then. 

If you smoke and are considering giving up my advice would be to go for it. I didn't find it as hard as I thought I would and the same may apply to you!

Nicotine free!!

Well I'm into my second day 'nicotine free' and it's a lot easier than I expected, I'm glad to say! Stopping smoking has been on my mind for some time now and the crunch point came on Sunday evening when my stockpiled tobacco had run out and I needed to buy more. Yes that's right, my decision had nothing to do with the health implications of smoking but rather the dent in my wallet.

I whacked a patch on halfway through yesterday, courtesy of my GP ( but which had sat in my kitchen drawer for over 6 months!) It made me feel a little dizzy at first but then it did it's job just fine. I might be talking a little too soon but I've not experienced any major cravings so far! Last night was the only time I found hard. I'd just had dinner and was relaxing on the sofa when the craving came, but, thankfully it didn't last long and wasn't too much to handle.

I'd always thought I could give up the fags if I'd wanted to and I'm starting to feel that I was right in thinking that! The thing is, I've never wanted to before, so I've never tried! There's been a bit of a discussion progressing on the comment board of one of the films on our You Tube channel - Wired In Recovery, on whether nicotine or heroin is harder to get off! Check it out.

At this early stage, I'd say that heroin was a lot tougher to kick!

Heroin addicted elephant is out of rehab

The bull elephant, named Xiguang or Big Brother, has finally finished his 3 year detox program, based on a tropical Island.

He had been force-fed heroin laced bananas by his captors, who were illegal traders based in China, so they would be able to control him. When these captors were arrested in 2005, Big Brother went into 'care' but initial attempts to detox him proved too dangerous as 'even iron chains could not contain him', the Chiana daily newspaper reported.

After this first, failed attempt he was transported to Hainan to start his medicated detox. Here he was given methadone injections at a dosage of 5 times the usual human dose. After a year the frequency of these injections was gradually reduced, at a very slow rate to minimise his discomfort. He was also treated to bathing and massage treatments as part of his detox program. 

Since finishing his program he has been relocated to a new home in the mainland city of Kunming, the capital city of his home province, Yunnan.  

I read this story in the Cardiff Metro newspaper on 5/09/08 and at first it seemed very sad, upseting me greatly. An elephant that couldn't have fully realised what was going on, was put through the hell of living with addiction and withdrawal. On thinking about it further though, it then occured to me that during his detox this elephant had received better treatment than most of the people I know who struggle with substance misuse problems - A holistic detox program which included substitute prescribing in a reduction plan, with massage and hot baths to boot, and to top it off, an aftercare program which included re-housing!

If only the treatment services for human beings were so caring and thorough in the delivery of their service. 

August weather

Well what a terrible summer we've had! I was travelling home from work a week or so ago when it was absolutely tipping it down. I noticed that as we were sitting in traffic and the rain had built up on the windscreen creating what I thought was an interesting effect. So I whiped my camera out and grabbed a photo.

I first got into photography about 15 years ago but haven't really taken any photo's for the past 10 years. I've recently purchased a new camera and I'm really enjoying taking pictures again!

Outside the law?

I read with interest an newspaper article from around a month ago which highlighted the arrest of Hans and Eve Rausing for drugs offences after she was caught trying to smuggle heroin and crack into a function at the American embassy in London. When police searched the couples home in an exclusive part of Chelsea, they found more crack and heroin and nearly £2000 worth of cocaine. Hans is a heir to the multi-billion pound Tetra Pak drinks carton empire and Eve is the daughter of a Pepsi-Cola executive.

But none of this so far is very unusual, well ok, getting caught with class A drugs whilst trying to get into a party at the American Embassy has never happened to me but it's what I read next that bothered me. At a hearing at Westminster Magistrates it was announced that all charges are to be dropped. Yes, dropped! They are to receive conditional cautions. Exactly what this means I'm not sure but it's probable that they will have to attend some kind drug misuse programmes.

Why, just because they're well known socialites, should they be treated any differently? How can the Crown Prosecution Service justify treating this case differently to any other drug possession case? 

What gets me the most about this isn't the fact that they've been 'let off' but that this course of action isn't normally used. Surely it's better to offer the opportunity of good treatment options to those with substance misuse issues? We all know that throwing people in jail doesn't 'cure' addiction! It's obvious from this that when it's one of the middle/upper classes own that's been caught with drugs and admitted they have an addiction; they're treated a lot differently to the working class addict.

If this course of action is the right one for this kind of case why isn't it the course of action taken that is normally taken?

Addiction shouldn't be treated as a criminal issue. It's a health and social issue and therefore the answers to it will come from the health and social field.

Big brother

A while back I was talking to somebody about the new DIP (drug intervention program) in Cardiff. He had just had his prescription taken over by the DIP after, I think, being caught offending but I might have got that wrong.

It was what he told me about how he picks up his methadone that I couldn't get my head around. He said there was a machine that scans your retina and then dispenses the methadone to you. I thought this geezer had lost it - that he'd been watching too much Star trek or something!! So I politely nodded and made the right noises and didn't believe a word of it!

But, weeks later it was still on my mind. The thing was I couldn't bring myself to ask anyone about this for thinking I'd make a right tit out of myself! But I finally decided to find out once and for all and it was true. When you first go there it's all set up and the machine takes an image of your retina which is recorded, so then everyday when you want your juice all you have to do is go in, stick your head in the right place and out comes your meth - bish, bash, bosh, simple as that... right?

Well no, it's not right - retina scanning???? Bollocks to that!! What better way to implement totalitarian measures than on an already vulnerable element of our society. Let's face it, the DIP gets it's clients from people made to go there after they've been drug tested by courts. They've got to go otherwise they go to jail, then they're made to have their retina scanned and recorded to be able to pick up their methadone. 

The other way to get in the DIP is to refer yourself. But you might ask why would people refer themselves to something like that? Because they can get a script within 2-3 weeks rather than waiting 1-2 years going the NHS Community Addiction route. Most people think the only treatment for heroin addiction is methadone, that's what is banded about by so-called professionals. So, desperate to get off the gear they turn to the green saviour, methadone, thinking it'll make everything better well unfortunately that's not the case. If addiction was that simple we wouldn't be in the mess we're in today. 

The next thing we know they'll be putting microchips in those seeking treatment for addiction. When is all the bullshit going to stop? How can the waiting list be so long at the Community Addiction Unit (where, incidentally, there's no retina scanning or finger printing) and so very short at the DIP where they employ such big brother tactics as this??

If they really wanted to help addicts and help communities then put some decent money into the kind of services that are going to do that, not just napalm people with methadone and record their retina scans so they can be kept track of in the future.

To pinch a quote from Stuart Honor - "Poverty isn't soluble in methadone hydrochloride"

Heroin drought in the South West

Apparently the police are doing well in their fight against heroin trafficking to the UK as there has been a severe shortage of heroin across the Midlands, into Mersey side and especially in Bristol, Cardiff and Newport.

Drug users are reporting heroin has been increasingly harder to come by over the last few weeks and the little that is about, is of a poor quality. This has got me thinking, how does this affect the heroin user? Some I know have actually stopped using, preferring to sit out the drought and wait for something better to come along. But from my past experience the usual response is one of desperation; frantic phone calls and a search to rival that of the 'great escape' to find something of some kind of quality. If that fails, people will buy whatever they can get their hands on to see them through. 

This can be dangerous, more so to the IV heroin user, as the only gear they can get their hands on is very weak, containing a very high percentage of adulterants and can cause even more damage to veins, liver etc than the heroin they're used to using plus of course they need to use more of it due to it's weak nature.

More worrying though is what happens when stronger gear finally makes it way through to street level. How a drought normally works is that there is a lot of rubbish gear around for a month or so, interspersed with gear of a better quality but only available in small amounts for a very limited time. So, everyone's tolerance drops during this time (quite severely in a lot of cases) and they're also injecting more gear in every hit. Then as quick as it has come, it's gone, and everything goes back to 'normal'.

It's obvious what can happen during this time - lots of overdoses. People aren't prepared for the stronger heroin and by the time you find out it can be too late. Two types of heroin can be exactly the same in colour and consistency etc but be very different in strength. Nobody believes a dealer when they tell you their gear is top quality and to take it easy - because they always say that, even if their gear is shite!

So I'd like to ask people to be careful and warn others to be careful too - the drought won't last forever so if you're going to use IV heroin then ask questions of fellow addicts about the gear your buying and if there is any doubt just push a little in, wait for it to hit you, settle into it, find out how strong it is before you put the whole hit in. If it is strong you can always keep it in the pin until a bit later.

To reach recovery you need to stay alive long enough for everything to click into place - use safely!

Knife culture

Yesterday evening I was riding through the centre of Cardiff at 7pm when I saw 4 youths running after another teenager who was riding a bike. At first I thought they were all messing about, but then when one of the boys caught up with the lad on the bike, I saw him hit him a couple of times, the lad fell to the ground and it was then I realised he'd been stabbed twice. Blood was spurting out of his arm as the 4 boys ran off.

He then walked over to me, asking me to help him. My first instinct was to get as far away from him as I could, there was blood everywhere and I didn't want to risk the possibility of getting infected with anything. But I knew he was loosing a lot of blood and panicking and he didn't know what to do about it. I told him to place his hand over the wound that was bleeding a lot, while I phoned an ambulance. 

The blood was still coming out very fast between his fingers so I used a t-shirt as a makeshift bandage/tourniquet, and put that over the wound. That had sorted the bleeding out,slowing it right down. Meanwhile the lad was really panicking so I sat him down, asked him his name and tried to calm him down a bit. There was a crowd around by then and the police had just turned up, also a doctor driving by had stopped and come over to help. I was still reassuring the lad, Daniel that he was going to be alright but that he was going to have to go to hospital to get stitches. Really I thought he was going to need an operation to fix whatever had been cut, I think it was a major vein and not an artery as his arm was still getting a good blood supply. 

Daniel asked me to phone his parents and let them know what was happening, I tried to get away with just telling his dad that he'd been hurt and was going to hospital. But his father was having none of this and prised out of me that he'd been stabbed. I could here his mother crying in the background, which only made the whole experience even harder. I never want to make another telephone call like that, ever again. It was horrific.

I'd noticed another wound to his chest, just below his nipple. It looked exactly the same as the other wound so I knew it was deep, but it wasn't bleeding, so I took no more notice of it. My concern was to stop the bleeding in the other wound. Amazingly I was quite calm throughout all of this, I knew what had to be done and once I'd made the decision to help him, in spite of knowing I'd be covered with his blood, I simply got on with it. 

When the ambulance left with Daniel, I looked down at myself; I was drenched in his blood. That was when the severity of the situation hit me, I think I was in a bit of shock myself. I knew he was lucky that there wasn't anymore damage done.

I telephoned his parents today to see how Daniel was doing. He's still in hospital but doing fine and likely to go home tomorrow. The wound on his chest turned out to have been lucky not to have killed him - 2inches deep and directly over his heart, apparently half an inch further and it would have punctured his heart. It's baffled the doctors too, as it wasn't bleeding at all! The wound on his arm was 3 inches deep and needed a good amount of stitches, inside and out, to fix.

It turns out that Daniel knew his attacker's,  it was a disagreement from junior school that started all of this. What I can't comprehend is why a teenage boy would throw away 3-5 years of his life in an unprovoked attack - he ran up behind Daniel and stabbed him twice. What a waste of his life and his talents. I hope this doesn't start a never ending cycle of prison sentences for that young boy, and that he's able to make something of his life.

I'm just glad that I was there and able to help Daniel, it was definitely the right thing to have done.

Another day in recovery...

I was on the train earlier, travelling back from meeting up with one of our volunteers, and it was absolutely lashing it down! It got me thinking about rain and how it makes me feel!

Watching and listening to the rain has always had a theraputic effect on me. It does a number of things for me - It helps me to take stock of my life, short and longer term; It helps me to feel more positively about what's going on in my life at the time; But most of all it's a time when I can ground myself again - to get back in touch with the real me! I find it a lot easier to think when I'm sat watching the rain fall.

When it's raining I like to sit in my outhouse, drink tea, smoke and contemplate life, it works for me!

Celebrity's drug rehabilitation

Earlier tonight on the 'Living' channel, I was watching a program about celebrity's and rehabs, the successes and the failures and all the hype that goes along with it. It pisses me off when I think about celeb's with loads of money, taking shed loads of drugs, because that's what celeb's are supposed to do, aren't they? It feels to me like they're making a shambles and a joke out of real addiction and real people with real problems.

When everything starts to get too much, up comes the manager to pay for a top class, 5 star rehab for them. The cynic in me says more often than not, it's for the publicity, the old adage- any publicity, even bad publicity, is good publicity! We can all think of at least a couple of celeb's that would fit into that bracket. 

The example they're setting to the thousands of youngsters that look up to them is a very dangerous one - 'yes, you can use and abuse drugs and drink and when you've had enough, just go to rehab'. Well I'm afraid it's not like that in the real world. What really pisses me off is that these are the stories of rehab's that make it into the media, and they're the stories that help to lead public opinion on them. In my world, the odds of getting into a rehab at the time that it could actually help, is about the same as having a white Christmas!

Well, I feel a lot better for getting that off my chest!

"Parasite told of drug cost"

'Each class A drug addict costs society over three quarters of a million pounds, a judge reminded one heroin user.

Judge Stephen QC said some would describe people like Ashley Blower, 31, of Maesteg, as parasites.

"You don't work, you steal from other people, spending your benefits on drugs and obtaining additional money you need from wholesale shoplifting," he told him.

"People may be interested to know that the Ministry of Justice published figures recently indicating how much it costs society to look after a class A addict and the cost was £800,000 for each one."

Blower had been cleared by a jury of possessing heroin with intent but convicted of possession. He was sentanced to 18 months' supervision with attendance on a substance abuse program and an enhanced thinking course. He spent 259 days in custody awaiting trial, during which time he said he has been drug free.'

This story was printed in Monday July 7th edition of The South Wales Echo. I decided to highlight it here to see what other people thought of it.

The 'Recovery Movement'

I decided to get involved with the “Recovery Movement’ as I feel the substance misuse field really needs rejuvenating. There is a lot about the field that is good but I’m afraid there is more that is both negative and non-productive. If we all speak up about this, that is addicts, recovered addicts, and all those working in the field, and say what we think about treatment services, the good, the bad and the ugly, then just maybe the policy makers will start listening and actually develop a new, recovery based treatment service that will help more people into sustained recovery from their addictions.

Those with addiction problems should be shown all the treatment/recovery options when they present asking for help, including – abstinence based, maintenance based, counselling, CBT etc, with an explanation of what all of the options entail.

The concept of a ‘Recovery Movement’ is very simple – the joining together of like-minded, ambitious people who are willing to do what they can to adapt the treatment system so it will help more people into sustained recovery. My aim is to highlight the areas, both good and bad, that need looking at with a view to improving them, so that we can maximise the good that this field does for those with substance misuse issues and also remove some of the barriers that are in the way for those seeking to change their behaviour.

There are lots of people and services around the UK that are pushing the recovery agenda on their own, cut off from others who are trying to do the same. By bringing all of these people together, we will make a stronger, louder voice, a voice that will reach Westminster with so much energy, it will demand a response!

Well, they're my thought's on the 'Recovery Movement', to see what the Prof has to say please visit 'The Prof speaks out'.

The black or white approach to treatment

I read with interest the story highlighted on today's Daily Dose - 'Tackling substance abuse in families'. Bruce Thomson starts by saying-

"Debate regarding the most appropriate ways to help people to get off drugs has resulted in what often seem to be polarised positions in favour of either methadone prescribing or abstinence-based interventions."

This has long been the case in the substance misuse field - why it is so I'm not sure, as it is a pointless debate with both sides losing out. In my opinion the "extras" that usually come with abstinence based programs, i.e. counselling, fellowship groups, reflection/meditation groups, one to one/group therapy etc, are what make the difference. 

Why aren't all of these "extra" interventions offered with methadone maintenance or reduction prescribing? I don't see any reasons why they couldn't fit together, in fact, I've worked in a project myself that offered this kind of methadone prescribing service, which was then reduced leading to abstinence as the final goal - with good success rates I'd like to add. To my knowledge this project is the only one of it's kind. It could work just as well with methadone maintenance for those wanting that.

I'd like to see the whole range of interventions being offered to prospective clients with a kind of self-selection (with professional guidance) of the particular services they'd like to have in their recovery program, kind of like choosing what subjects to take for your GCSE's! This way service users aren't being forced into doing something that they don't need just to get the services that will help them. Of course for this to happen there would need to be co-operation between different services throughout treatment, all governed by a new kind of direct access free service, doing the initial assessment, referrals and overseeing/supporting the clients throughout the whole process including the aftercare.

That would be my 'perfect world' answer to substance misuse! No black or white but black AND white - I think I'd call it 'The zebra intervention'!