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'!
