A GLOSSARY FOR OUR TIMES
REWRITING THE DICTIONARY
Tickboxers could eradicate war, disease, poverty and addiction in a mere few strokes of the pen, to meet targets – by rewriting the dictionary. Deirdre Boyd offers a glossary to recent claims.
Preview from the September 2010 Addiction Today journal.
Download Addiction Today Sept 2010 – Rewriting dictionary
In a sci-fi story, an apparatchik from earth arrives to tell the spaceship crew they would not recognise home. “We have got rid of war, disease, poverty,” he explained – we could add “addiction”.
“When did this happen?” asked the captain.
“When we rewrote the dictionary,” the apparatchik responded.
So how have today’s apparatchiks rewritten the dictionary to give a semblance of success? The words below – from the government’s National Treatment Agency for Substance Misuse – are given a meaning perceived by people generally. This is followed by the ‘target on paper’ definition, or Top, set in the NTA context.
Problematic drug user. Someone whose drug use causes a problem for them or others.
Top definition: someone who uses heroin or crack cocaine; only these make you eligible for ‘treatment’, only these are counted in targets.
PDU. A dehumanising word for a problematic drug user.
Top definition: a statistic.
Legal drugs. These include addictive drugs which can destroy lives, such as benzodiazepines; kill more people in the UK than illegal drugs – click here for details.
Top definition: does not come under definition of a PDU, so does not count towards targets, so you are ineligible for treatment/funding.
Alcohol/alcoholism. See “legal drugs”.
Treatment. The general public thinks that this means addicts and people with drug problems get help to become drug free and rebuild lives.
Top definition: someone somewhere made an appointment for you and got your name on file.
Retention/retained in treatment. Patient given consistent proactive therapy and other support to become drug free and reclaim life.
Top definition: patient is seen at one appointment, can be given a second appointment 12 weeks later (during which some died or were imprisoned), defined as hitting target of 12 weeks’ retention.
Rehab. More rigorously researched than NTA preferments, also proven to be the most successful in getting people off drugs long term. Also help people overcome methadone addiction. “Residential rehabs outstrip other sectors in every outcome group we measure,” concluded a government CSCI report.
Top definition: something to find a less-effective alternative to; over 20 closed under our regime. Click here for some details.
Balancing the treatment system. The need to balance a failed system created by the NTA where only 2-4% of patients manage to get to rehab, and a similar number to become drug free.
Top definition: aim of ARF and Recovery Group UK; copying phrase in NTA Business Plan 2010/2011 blurs NTA role in creating such imbalance.
Dependency. Another word for addiction, a “dysregulation of the mesolimbic dopamine system” or brain-chemical disorder, as opposed to misusing drugs through choice. Diagnosing between dependency and misuse is vital as each requires different care.
Top definition: “We don’t define dependency, just as we don’t define recovery,” stated NTA senior managers – which means targets in the NTA Annual Reports submitted to parliament are meaningless.
(2): drug users become dependent on state drugs and handouts due to lack of appropriate care.
(3): providers are dependent on NTA for referral revenue, cannot whistle-blow.
Free from dependency. The general public thinks that this means patients have been helped to quit drugs, are rebuilding their lives.
Top definition: patient stopped using main drug briefly, uses other drugs; patient is kept dependent on prescribing organisations for decades.
Recovery. First mention I found is in a book copyrighted 1954 to Alcoholics Anonymous and means quitting alcohol/other drugs, living in such a way as to stay stopped, repairing relationships and making amends for any wrongs done.
Top definition: “We do not define recovery” (see dependency); plus UKDPC redefinition as “control over drug use” – eg, control over using exactly nine grams of cocaine every day.
Prescribing. If used, should be for brief detox and/or stabilise patients, but drugs such as methadone are more addictive and harder to withdraw from than even heroin.
Top definition: “treatment”.
Harm reduction. Aims to reduce harm from drug use, addresses fallout not the cause.
Top definition: “treatment”.
Detox/ification. Getting toxic substances out of the body, such as the ancient romans vomiting so they could continue orgies of food and drink.Should be immediately followed by treatment so people do not relapse as the ancient romans did.
Top definition: “treatment”, “rehab”, “abstinence”, “successfully leaving treatment”.
Retox. Put patients back on drugs instead of giving recovery treatment after detox.
Top definition: recommended in papers by John Strang due to number of patients dying after detox at Maudsley clinic where he works; Strang is co-heading the NTA Business Plan 2010-2011.
Patient placement criteria. Created by the American Society of Addiction Medicine to give the most fitting type(s) of care to people with drug problems, in the most clinically- and cost-effective ways – click here.
Top definition: “[UK] criteria are based on failure,” NTA CEO Paul Hayes said this year; not the ASAM criteria, something to be created.
Top. Targets on paper; an unverified page of boxes to tick to show ‘treatment’ results, which omits legal addictive drugs and other outcomes which quality rehabs offer, including treating worse cases.
Top definition: Treatment Outcomes Profile, used by the NTA as official data for UK statistics.
Drug deaths. Something the NTA was set up to reduce, have instead increased under its regime.
Top definition: "drug deaths have reduced" – click here for facts.
Ideologists. Top definition: people who question us.