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I came across an interesting article on the DS Daily website this week that highlights the release of ‘Medications in Recovery Re-orientating Drug Dependence Treatment’ a new report aimed at addressing the effectiveness of substitute opioid prescribing with regard to recovery focused treatment. The report is the product of a two year inquiry carried out by GP’s, psychologists, psychiatrists, nurses and service users and was chaired by one of the UK’s leading addictions specialists Professor John Strang of the National Addiction Centre.

At first glance this would seem to be a significant step forward on the journey toward a more cohesive recovery service in our local communities. Here is a direct quotation from the executive summary of the report “The ambition for more people to recover is legitimate, deliverable and overdue. Previous drug strategies focused on reducing crime and drug related harm to public health, where the benefit to society accrued from people being retained in treatment programmes as much from completing them. However, this allowed a culture of commissioning and practice to develop that gave insufficient priority to an individual’s desire to overcome his or her drug or alcohol dependence.” (Medications in Recovery Re-orientating Drug Dependence Treatment 2012 p.4)

This is strong language aimed at re-orientating (as the report title suggests) a culture of treatment retention that has gone unchallenged for many years. In 2000 prominent American psychologist Jeffrey A. Schaler released a book entitled ‘Addiction is a Choice’ this publication sent ripples around the field of addiction therapies and turned existing treatment concepts on their heads. The book was both revered and reviled across the addiction universe, with one review stating “To argue that an individual has control over whether he/she takes drugs, as Schaler demonstrates, is viewed by many as heretical. And, if it were to become conventional wisdom, this new perspective would have significant consequences for drug policy in the United States. . . . Schaler emphasizes studies which indicate the rhetorical phenomenon of 'self-fulfilling prophecy' contributes to the perception of 'loss-of-control' . . . Schaler views 'addiction treatments' as rhetoric masquerading as medicine. . . . the book relies on empirical evidence and consistent logic to place responsibility for excessive drug-taking where it is usually absent in public discourse: on the individual drug-user." (Journal of Health Communication 2003).

With the emergence of CBT (Cognitive Behaviour Therapies) as a key component of drug treatment service delivery over the past 10 years, many therapists have adopted the philosophy of choice within addiction and applied it to their working practice not only in the US but the UK and beyond. This has led to an interesting juxtaposition in relation to medical and psycho social interventions delivered by drug and alcohol treatment services over the last decade.

It certainly would appear that this latest report will go some way to aligning these opposing parallels, and thus creating a smoother path for those individuals wishing to achieve recovery from their addiction issues, the proverbial ‘same song sheet’. At the very least it will be a welcome response for those that have long championed empowerment and recovery for all.


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