Dithering dogma…!

As UK pubs reopened to a mixed response, after the last three months of isolation Brits still seemingly still have a thirst on and aren’t too fussed about distancing.

With news articles declaring consumption has risen during lock-down, and some early studies also looking at potential increases it may be a good time to reflect on our choices. It has undoubtedly been a difficult period, particularly for many of our dependent drinkers, and the lure of getting back out there ‘connecting with friends’ or ‘disconnecting from current reality’. I’ve noticed it both on my social media timelines with friends and family’s daytime drinking patterns, and at work with those i support. One of the biggest protective factors for many was connection, and we have long stressed the importance of this as part of the 5 ways to wellbeing. So as social isolation has grown, as seen in Dr Alexanders rat park experiments of the 70s addictive behaviour invariably escalates.

So what is out there now if i want to get help?

There is of course your local treatment provider commissioned by your local authority, who can put you in touch with all local community assets. A quick online search should find the current one, after initially stopping seeing people face to face many are now opening their doors again. I know many people that simply will not engage with these services due to barriers, either real or perceived varying from stigma to a previous bad experience. There are also mutual aid meetings such as 12 step fellowships like AA or NA that are avidly promoted by GP’s and other public services. Some barriers to engaging with these groups can be the perceived ‘GOD issue’, the ‘powerlessness talk’, the ‘drunkalogues’ or just the perceived monotony of perpetual meetings. Alternatively there is SMART; barriers to engagement – over reliance on confusing concepts or acronyms, lack of community, and ‘recovery know it all’s’. You will often hear the phrase within the recovery community “take what you like and leave the rest” and that is generally the way to go. Whatever you decide do it with an open mind and positive intention. There are some excellent parts that make up the whole and can act as helpful recovery capital to support your goals.

So what about the large majority of those over reliant on substances that find the barriers to engaging with treatment providers or mutual aid too much or too stigmatising?

Recent PHE figures [1][2] before the pandemic also showed disturbing trends of fewer alcohol dependent people engaging with treatment services. Over the last few years we have also seen record numbers of drug related deaths across the UK. It is clear something is not working for many, as services have also faced drastic cuts to their commissioned treatment budgets repeatedly in recent years. The sector is asked to do more with less, but at what cost?

Having worked in “recovery services” of various guises over the last 9 years, and as a person who had a serious substance misuse problem/substance use disorder/addict/person in recovery/recovered* (*delete as appropriate today) I now find myself walking away from the sector i was once passionate about, recently made redundant and disillusioned at current service provision across most of the UK. Having traveled a lot for work i have been fortunate to see some fantastic practice in some areas, however the very nature of commissioning has led to a postcode lottery and dramatic variance in recovery ‘choices’. One thing i have learned in my time working in the sector is that there is no one size fits all approach to recovery, and my view is that recovery should be self directed and defined by the individual. Complete abstinence can be seen as a barrier to entering treatment, and perpetuate the shame following a lapse/relapse. The term recovery itself has become somewhat of an abstract cliche, and people in early recovery are often paraded out to prove a service’s outcomes and to add value to the service’s ever dwindling pot of money, as cuts continue to bite, with very little ongoing support. Volunteers are now finding themselves increasingly on the front line.

“It is an historical fact that practically all groupings of men and women tend to become more dogmatic; their beliefs and practices harden and sometimes freeze. This is a natural and almost inevitable process…. But dogma also has its liabilities. Simply because we have convictions that work well for us, it becomes very easy to assume that we have all the truth….This isn’t good dogma; it’s very bad dogma. It could be especially destructive for us of AA to indulge in this sort of thing”. ( Bill Wilson, 1965/1988, p. 333)

Disclaimer, as i know there is an almost tribal response to perceived criticism of ones ‘recovery pathway’ so I will say, i have spent time with various recovery programmes and fellowships over the years, i have sponsored ‘addicts’, chaired and facilitated meetings and repeated many of the dogmatic well rehearsed mantras. I have also bitten my tongue on a number of occasions in order to be diplomatic and not rock the recovery boat, however in my view services and commissioners should and can do better. The statistics are quite clearly showing that the existing model(s) are not working for many.

Dogma has had a stranglehold on treatment for people who use substances since treatment was conceived for ‘treating’ the feckless, right through the temperance movement and into the dominant philosophy of recent times being the 12 step approach, and abstinence being the “only way”. This is manifest still today in funding streams and also in rehabs, as well as local service providers.

As such it is good to see the rise of the moderation/ mindful drinking movement with Club soda putting on mindful drinking festivals (pre corona) and engaging people from across the spectrum, and hopefully more will follow suit and consider new models and ways to build community and a society that does not need to rely on substances or treatment in the way we currently do. Invariably we use substances for Fear or fun, both are short term rewards, but extremely gratifying. Our reliance on substances as an emotional crutch means may of us are floating through life like a carrier bag in the wind. The way out of my addiction was finding a purpose i was passionate about. I will be eternally grateful to my mentors that gave me the opportunity to make it happen, and will continue to support others in defining their own recovery goals without judgement or dogma.

Giving back is an important turning point in many peoples recovery journey (After mentoring i created a small community group to support individuals in my own community with the limited knowledge and resources we had at the time) however the biggest factor in me sustaining my own recovery was challenging my own limiting beliefs and feeling empowered enough to pursue my own personal growth, until then I was just ‘white knuckling it’ and going through the motions.

Change needn’t be difficult, only resistance to it is (to paraphrase the Buddha). Find something or someone that inspires you to be the best version of yourself and apply yourself wholeheartedly, you don’t need to have all the answers. There is no quick fix, and those that are pave a road to ruin. The future is yours. The future is now. 💜

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