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December 2014 |
drinkanddrugsnews
| 21
www.drinkanddrugsnews.com
Conference |
Post-its
‘Who better to deliver
training than people who
have been through the
whole process of
addiction themselves?’
YAINA SAMUELS
runs a charity that helps businesses manage the recovery of employees with
addiction problems, told the audience he’d like to change the perception of
addiction and other mental health issues.
He is also an advocate of the American idea of job applicants revealing
they are in ‘long-term recovery’ on their CV – ‘chiefly because this says more
about you as a person than any qualification ever could,’ he added.
Yaina Samuels, founder of Cardiff social enterprise Nu-Hi Training and winner
of the Welsh Government‘s citizenship award earlier this year, explained how
everyone working for her company – including herself – had personally
experienced addiction and were now delivering training. They had recently rolled
out a programme for more than 1,000 employees at Cardiff City Council.
‘Who better to deliver training than people who have been through the
whole process of addiction themselves?’ she said, advocating a ‘conversation
café’ approach. ‘To me, recovery meant getting my life back. It meant health
and it meant having conversations with people which didn’t centre on drugs.’
Offering a personal perspective, comedienne Janey Godley – herself from
Glasgow – revealed how heroin addiction had caused the death of her brother,
prescription drugs had meant she’d regularly come home from school and find
her mother ‘out cold on the kitchen floor,’ and her father had been in recovery
from alcohol for 34 years.
It was a group of bereaved mothers in the East End who had started the
biggest addiction recovery group in the city, and the initiative had made her
look again at her own life.
‘I used to look down on drug addicts when I lived in the East End,’ she
said. ‘Yet at the time I was a pub landlady selling booze. I asked myself what
the difference was between the two and realised there really wasn’t one.’
Jill Stevenson is a freelance journalist based in Glasgow
POST-ITS FROM PRACTICE
THERE IS
still a lot of – sometimes heated –
debate about whether drug services should be
recovery or harm-reduction based. Yet I rarely
hear the same passion when we talk about
treating viral hepatitis.
Services will talk about high levels of BBV
screening and uptake of hepatitis B vaccination
and yet have tiny numbers of service users
going into hepatitis C treatment. Now I admit
that I am biased – a good friend and colleague,
who did more than anyone else to show me
how important it was to treat drug users, died
of hepatocellular carcinoma, caused by his
hepatitis C. To my mind the failure to get people into treatment that will not
only potentially save their lives but also save large amounts of NHS funding
is a travesty.
We have effective and ever-improving curative treatments and yet many
people languish in primary care and community-based services knowing they
have chronic hepatitis, without referral. Perhaps we should stop talking
about ‘hard to reach patients’ and start accepting that we have ‘hard to
access treatment services’ instead.
We need to acknowledge that the current provision of BBV care for those
who are in drug treatment is failing. And if we can’t get those who are being
seen regularly and supported by clinicians and key workers into treatment for
their viral hepatitis then what hope of treatment is there for those who
aren’t on substitute prescribing and who are not in established treatment?
Treating active people who inject drugs has been shown to be effective,
and reducing the pool of people with chronic infection can help lessen the
spread. We need to create systems to support people into and through
treatment and these are the sorts of outcomes that should appear in primary
care and community-based drug treatment tender specifications. Public
health, primary and secondary care all working together – perhaps we could
call it something radical like a National Health Service!
At the SMMGP conference in Birmingham in October we heard about a
pilot project in Birmingham where the specialist hospital staff will be going
out into primary care and delivering treatment alongside service users’
regular reviews and key working sessions. I know similar services exist in
Newcastle, Nottingham and London.
The newer anti-viral treatments are producing cure rates of more than 90
per cent, even in the more difficult to treat genotypes of hepatitis C. Even
newer treatments promise ‘tablet-only’ therapies that will minimise many of
the side effects and adverse events seen in current treatment, albeit at
greater financial cost, but these will still be cost-effective interventions. The
only way we can advocate for these treatments to be available for our service
users is to have the right systems in place to make sure that they are
screened, referred and supported through treatment. The health gains for
someone who has successful viral hepatitis treatment are immense and at
least as important as them being ‘discharged treatment complete’.
Steve Brinksman is a GP in Birmingham and clinical lead of SMMGP,
www.smmgp.org.uk. He is also RCGP regional lead in substance misuse for the
West Midlands
Treatment complete?
Why are we failing so many people with
hepatitis C, even those already in drug
treatment, asks
Dr Steve Brinksman