GRASSROOTS RECOVERY:POCKETS OF GROWTH IN BARREN GROUND
The oft-quoted recovery researcher, writer and advocate William White interviewed Laura Graham about UK grassroots recovery support and advocacy.Our deﬁnitive guide oﬀers a wealth of resources.
WW: Recovery advocacy movements can be diﬃcult to track at a global level. They often involve multiple grassroots organisations and activities unfolding simultaneously across expansive geographical regions. This is what is unfolding in the UK. I asked Laura Graham to help connect the dots to see what larger picture is emerging there. In her role with the Addiction Recovery Foundation, Laura has tracked the recent boom in recovery support and advocacy activities in the UK and oﬀers insightful glimpses into these projects and the larger movement. Please join me in this sweeping review.
WW: How would you describe the rise and current state of interest in recovery in the UK?
LG: “Recovery” has become fashionable over the last few years in the UK. However, there is a lot of confusion about recovery means. For many years, we had a drugs policy that had harm reduction at its core. The focus concentrated on reducing crime, reducing blood-borne viruses, and getting as many people into ‘treatment’ as possible. A disgraceful term used to describe the people targeted in this system is pdu, abbreviated from problematic drug user, with an emphasis on heroin and crack cocaine users.
A few years ago, concerns started to be raised about the large numbers of people going into treatment but the tiny proportion leaving drug treatment. It was found that our treatment system developed into a culture of a methadone-script-and-not-much-else service where abstinence-based treatment has become marginalised. Some people have been stuck in this system for years.
There is very little mainstream treatment for people requiring help with drugs other than heroin or crack. Little help exists for alcohol or cannabis dependency and there is terrible denial about our prescription-drug addiction problem.We have a situation where drugs workers, commissioners and others in the ﬁeld don’t know what residential rehab is, they’ve never been encouraged to visit one or trained how to refer a client to one, never met anybody in recovery nor been to a fellowship or other mutual-aid meeting. It is stunning that only 2% of people seeking help with drug problems have funded access to rehab.
In December 2010, our government published a new drug strategy which attempts to put recovery at its core. Our politicians get it, the public gets it – our civil servants and commissioners don’t, and at times it seems they are determined to undermine it! This sadly means that recovery advocates must work harder to be heard. Our civil servants are supported by a few who have vested interests in retaining the status quo and are putting great eﬀort into rebranding the old system rather than changing it in line with the new strategy. Drug treatment is big business in the UK and for years has been dominated by a few big organisations and others who, it seems, are in no hurry to change the way they work in order to help people get “better than well”.
Despite this, there are some great advocates and advocacy work and they are happy to stand up to this challenge and educate those who need it. I remain optimistic and I can even see some humour in the current debate. You really do have to laugh when you hear people say things like “there are some great drugs to support abstinence” or that people who are abstinent have “hijacked” the very recovery agenda they created.
WW: There is a long history of recovery mutual aid in the UK, but recovery advocacy—the mobilisation of people in recovery to create advocacy and peer recovery support organizations distinct from these mutual aid societies—seems a relatively recent development. How did such a movement develop in the UK?
LG: I think that in recent years the growth of these groups and recovery advocacy has largely arisen in response to our treatment system which has supported the myth that people don’t recover. The system has grown on the mantra that addiction is a chronically relapsing condition but where are the longitudinal studies to support this? When people in recovery keep hearing that people can’t recover and it is not their experience, or that of their peers, they have to speak up; and the more who do, the more others will. It’s an incredibly powerful message and I believe the system will change as the result. Th e myths and those who use them can’t last.
Many of our really great recovery support organisations have come from people in recovery developing an idea based on what would have helped them but was missing or underdeveloped or poorly designed. Spaces to meet people and socialise is a biggy, advice hubs is another, and support without much else is another. Largely, none of these organisations relied on funding or waited for an evidence base; it’s happened with innovation, determination, skill, hard work and a deep belief that it’s right thing to do.
WW: What are the key organisations that are providing leadership of this movement in England, Scotland and Wales?
LG: I am not sure that we have key leaders representing countries of the UK but we do we have pockets of recovery communities across the UK and it’s relatively easy to identify the leaders or the driving forces within them.
Jacquie Johnston-Lynch at Self Help Addiction Recovery Programme, an abstinence-based structured day facility in Liverpool, and Carl Edwards at the Parkview Project in Liverpool are examples of that. Carl and Jacquie have been at the core of creating an environment for a recovery community to develop up in Liverpool. It was Jacquie and her team at Sharp who instigated the UK’s fi rst national recovery walk in 2009 although, technically, Fraser Ross and the Highlands Faces and Voices of Recovery were the first recovery walk, startring at a ridiculously early time of the morning.
Norman Preddy, Karen Ozzatti and their team at the West Glamorgan Advisory Council on Drugs and Alcohol Abuse in Wales are a similar example. Norman’s recently retired but WGCADA has been in operation for 31 years and does everything from general advice, needle exchange, 12-step treatment, post-treatment aftercare, family support, tenancy support, employer relations, criminal justice involvement, a service user network with its own facilities (the Sun Lounge) and The Pad for young people.
Since 1997, the Domino project has run parallel to all their other services. Development of Motivation In New Outlooks is led by a musician Keith Morgan, and provides activities such as relaxation techniques, assertiveness training, computer classes, sport, gardening, cookery and music. Music is loved here and they have a band called the Box of Frogs where people can learn to play any instrument they choose, they write songs, they produce CDs… People stay involved with Domino for years because it’s such good fun.
ARF, the Addiction Recovery Foundation, have had a major influence on changing the current system. If it wasn’t for people like Deirdre Boyd, none of the current debate would be happening. It hasn’t been easy for her and she has had to take some really tough attacks from detractors but she has never shifted from her advocacy work and is held in huge esteem for it. We’re very lucky to have her although she will probably tell me off for saying it! For many years she was out in the wilderness as a recovery advocate but she carried on. It helps that she has a brain the size of a planet and is utterly charming.
I think we are just starting to assess this moment in our history and where we’re at and where we’re heading. Some early analysis is already being debated and it is interesting to see key moments have included ARF and the importance of UKESAD symposia and Addiction Today, both part of ARF. None of the work of ARF was designed with the sole intention of developing a movement but it has happened organically, a movement has grown up around it as people have gravitated towards it.
WW: How do you see the rising recovery advocacy movement influencing the design and delivery of addiction treatment in the UK?
LG: Earlier this year, ARF were approached by various residential rehabs in the UK concerned about the lack of funded places available to people in need of rehab. After many discussions, the Concordat was formed, convened by ARF. Concordat is made up of 50-60, of the UK’s residential rehab providers, mostly independent and small charities run by people in recovery and some of the larger charities like the Salvation Army and RAPt, to campaign for greater access for people needing rehab.
As I said earlier, currently only 2% of people seeking treatment get referred to rehab and Concordat is hoping to improve access for many more. It is shocking that people seeking treatment are placed on a waiting list when rehabs can provide a place immediately! It is also shocking that people who need help are bumped around inappropriate services for years before they can secure a place in rehab. It’s only since Concordat was formed that these issues are being discussed but some of the evidence now being gathered is horrific – we know of people virtually dying on the doorstep at the rehab or turning up with broken bones and they have been engaged with other treatment services for years! People have to try and exhaust every other avenue first – it’s cruel and inhumane.
Concordat has already achieved a great deal. This has included raising awareness about the lack of access to rehab, educating policy makers and politicians about what residential rehab can do, challenging much of the misinformation, ignorance and mythology about rehabs and gathering data for research. I love working with Concordat who have real passion for what they do in helping people to get well and the dignity with which they conduct their campaign and support each other. The individuals of Concordat speak as one voice with a shared aim and put principles over personalities.
WW: Is anything being done to support and mobilise those who have completed rehab?
LG: Yes, an off shoot of the Concordat is the mighty Graduates! The clue is in the title: they are a network of thousands of people who have graduated from residential rehab and who want to be involved in the Concordat campaign in supporting greater access to rehab. They have also said that they as “graduates” of treatment they don’t feel represented by other groups which have a tendency to focus on “service users”.
Additionally, the recent debates about what recovery is have caused confusion to the point where those who have graduated from treatment are joining “recovery groups” but are having to explain that they are in “abstinent recovery” rather than on substitute drugs and all the other shades of recovery debated by vested interests.
So, now the Graduates have a representative body and they are huge… about 20,000 people from across the UK so far and growing as the word gets round, and this is before any official launch! Already, the Graduates are meeting their local MPs, working locally to raise awareness, challenging perceptions and, as they are drawn from such a diverse population, they bring skills, experience and resources to the party… an army of rehabilitation revolutionaries!
WW: I would like to talk about what you see as innovative approaches to recovery support in the UK.
LG: Perhaps we could start with Riot, or Recovery Is Out There, which is led by the young and handsome James McDermott. James set up Riot, an abstinence-based organisation when he was about six months into his recovery with support from Noreen Oliver OBE, founder of BAC O’Connor, a peer-run residential rehab in Burton. Riot provides recovery champions to local community-based treatment services and criminal justice services. It also works with the local police to go into schools to give talks. I used to work for the National Offender Management Service developing the offender drug strategy and would have Riot join me at conferences to help educate prison staff, police and probation staff . It is so successful that it now has funding for four paid ‘recovery champions’. Alongside ARF, Riot are also members of the UK Recovery Group, a lobby group which campaigns for an improved treatment system in the UK.
WW: If you were to pick an organisation that links music and recovery, what would be the first that comes to mind?
LG: I’ve mentioned Domino’s Box of Frogs. There is also Jim Smith and his Two Different Roads whereby he travels to rehabs across the UK and across the world with his guitar and tells his addiction and recovery story through music, encouraging others to do the same. He’s about to finish touring the US, visiting music projects under a Winston Churchill Fellowship and exchanging expertise internationally.
On a larger scale, we have John Sinclair, former keyboard player with Ozzy Osbourne, now in recovery, who offers Motivation Through Music at this recording studio in the scottish Highlands. He is also part of a project called Rock School where he and a group of musicians travel across the country to engage marginalised young people and adults in a musical performance.
WW: Are there other organisations that integrate the arts into recovery support process?
LG: The Outside Edge Theatre Company, based in London, is an 11-year old “chemically independent” theatre company led by founder and artistic director Phil Fox. The company welcomes anyone affected by substance misuse to be involved in writing, performing and directing plays. They run support groups on Tuesday nights including an informal group of people in early recovery with little or no experience of drama but with an emphasis on having fun, and another group for people further down the road of recovery to develop performance projects. They have just started a women-only group on Thursday evenings. Outside Edge also go into rehabs to stage psychodrama plays to rehearse real-life scenarios and options to prevent relapse.
WW: You have referenced recovery cafés.
LG: Recently, there have been café evenings and day events across the UK providing a local space
for people in recovery to socialise in a safe and welcoming environment. There are the Serenity Cafes in Edinburgh and Newcastle, and the Recovery Link Up Cafes blooming across London. These are great for developing local recovery networks. We are now getting designed-for-purpose recovery cafes, too. The Brink, a recovery social enterprise, is about to open in central Liverpool. It will offer hot and cold food and non-alcoholic drinks seven days and nights per week and intends to promote health and wellbeing initiatives through cultural events. There are plans for bike clubs, baking clubs, yoga clubs… and more.
Later in the year, the O’Connor Gateway Charitable Trust cafe will open, managed and staffed by people who complete the BAC O’Connor abstinence based programme in paid and voluntary work placements. The café will provide a “Victorian style tea-room” with home made food, a shop, an internet café, a gym, complementary therapies and, in the evenings, a drug and alcohol-free lounge with a pool table and wide screen TV’s for major sporting events. There will a space for a broad range of peer-led mutual aid groups including family groups.
WW: Are there other recovery-focused social outlets emerging?
LG: Godspeed (meaning successful journey) is one example. Since November 2009, Godspeed has operated as a monthly nightclub in London’s King Cross led by recovering DJs Tony Gordon (aka Fat Tony), Mark Pavey and Boy George. The venue is an up-market nightclub which, on Godspeed night, has its bar removed and replaced with mocktails (Safe Sex on the Beach, Virgin Mary etc) and no drugs. It attracts people in recovery but also in residential rehab which is a tremendous development. People can go there with their sponsors, recovery groups or on their own.
WW: What other projects come to mind?
LG: The Freedom from Addiction Project: founder and coordinator Gary Topley set up this peer-run and peer-led project in Derbyshire last year for people with alcohol problems. His group meets every Tuesday evening in a space provided in a GP surgery and off ers non-judgemental peer support to promote wellbeing and recovery in a safe environment. The group work through issues relating to alcohol, or plan activities including social events. Last year, the group was offered some wasteland by the Local Authority and they have now established a sizeable allotment where they grow fresh vegetables. The wasteland has been rejuvenated into an oasis of calm, so good for the local community. The group also have training with a local gym and enjoy going out as a group of friends to comedy clubs, a film or the theatre. They would like to do more but are unfunded.
WW: A project we discussed is Recovery Cymru.
LG: Recovery Cymru is a mutual-aid support community in Cardiff for people in or seeking recovery. It was founded by Sarah Davies in March 2010, achieving charity status in January 2011, from the origins of a weekly support group established two years before. RC members have a shared passion about developing and strengthening recovery communities and support and empower people to initiate and continue recovery journeys, exploring skills and interests and improving their quality of life.
RC has a music project, For-Matt, where people learn to play instruments and make music. It has activity groups such as crafts, and “activity Saturdays”. Volunteering in local community events included the “Great Taff Tidy” to clean up the river Taff . RC is at the heart of organising the first welsh Recovery Walk in September. It includes family members, volunteers and professionals; three student doctors will undertake work placements, to understand recovery from addiction. It is supported by the Welsh Assembly government and has full funding for two years.
WW: I’ve recently become interested in projects that integrate athletic competition into recovery support activities. Are there any such projects in the UK?
LG: Sadly, we lost David Bruce earlier this year but his legacy of Glasgow-based Carlton Athletic Recovery Group will hopefully run for years. David established Carg in 1985 as a football team and support group for people in recovery. Based on his own experience of addiction, he was clear that participation at Carg required abstinence and a willingness to change. He wanted Carg to be ambassadors of what addicts can achieve. Carg concentrates on fitness through including running, fitness training and football. David published a book about this in 2005 called Alive and Kicking. Carg members have got involved with adventures including mountain climbing, following the Inca Trail in Peru, marathons,
winning football matches and tournaments, all off their own steam (again, Carg is unfunded), and their own hard work in getting to fitness levels enough to be able to participate.
In Bournemouth, treatment charity Streetscene developed links with Boscombe Celtic football club which was started by a member of staff at Streetscene. People in early recovery there can take part in local Football Association games. Streetscene also have a fishing club.
WW: You made a special plea about the need to include offenders in recovery.
LG: Our prisons are hives of peer support activity. Listener schemes, PADs and RAPt are amazing.