Substance (ab)use

Using 'substances' - drugs and/or alcohol (or both) -  to cope with adversity in life may be counterproductive in the long run; and even in the short and medium term, if it stands in the way of individuals accessing the support they need to get on in life. But unless we can recognise the short-term appeal, it is very hard to engage any 'user', to work with them to find another path.

There is a widespread view that the PIEs approach, and the specifics of the PIEs 2.0 framework, are applicable to service to meet the needs of this user group. Anna Tickle's account of the Nottingham Rough Sleepers Drug and Alcohol Service demonstrates the application of the whole systems and 'PIE of pathways' themes, and the 'good practice' paper from the Wallich shows an example in a more specific service setting.

Nevertheless it would be very helpful to have further discussions, and more examples of what works, including in other settings such as treatment units and across the services spectrum, in general needs housing.

Featured: 'PIE: Where is the substance?' : PIElink forum presentation with Anna Tickle of Nottingham University, video recording

'PIE : Where is the substance?' forum presentation slides : HERE

On thinking differently

it can be hard to see the individual through the lens of moralistic affront and rejection from those who see drug use as self-inflicted damage. It may then be helpful to address the moral arguments first. In one of the audio pieces here, Hannah Pickard argues that it is simply not right to compare substance use by someone in pain from recreational use by someone just wanting to have a good time

Another professor of ethics, Zoey Lavallee, goes still further.  In the first paper she argues that in trying to understand the behaviour, we overstate the importance of the biochemistry or the neuroscience of addiction; and in this piece from Aeon she argues that a focus on the craving that we associate with addiction may make it hard to recognise all the other emotions - ansd social circumstances - that may lie behind it.

In practice

Although we can identify several consistent themes in the activities of addiction (and post addiction) support responding to these issues typically involves a combination of many of them. But to help find the issues closest to where your services is at, here therefore they are/will be identified by letter as key themes of each item   So far the key practice issues emerging are:

• working with short timescale thinking;
• the value of peer support and support communities;
• the strengths model, and positive activity; and
• whole systems ('PIE of pathways' )work, closing up the gaps in services which those at risk are more likely to fall through.

 

 

Pretreatment and the core skills of engagement : HERE

'Recovery housing' in the US and the UK : HERE

A PIE of pathways : HERE

Whole systems evaluation : HERE

The Clubhouse model : HERE

Designing, engaging, thinking differently : HERE

 

Case studies, ideas and practice examples

Building recovery communities : HERE

Up mountains: recovery and the crafting of manageable challenges : HERE

Prison or the Priory - the work of One25 : HERE

Women's Hour on Women, exclusion and addiction (audio) : HERE

Supporting sex workers with poly-drug use (video) : HERE

Elastic tolerance in action at St George's crypt (audio) : HERE

Steve Robertson on The Big Issue as a 'psychologically informed business environment'  (audio): HERE

Manageable Chunks of Time - Potter Street Time Bank : HERE

Housing retention in Single-Site Housing First for Chronically Homeless Individuals with severe alcohol problems :  COMING NEXT

Supporting Harm Reduction Through Peer Support : HERE

Ambitious for Recovery - Tackling drug and alcohol addiction in the UK : HERE

Good practice in Abstinence-Based Housing Schemes : HERE

 

Insights

The Dynamics of Domestic Abuse and Drug and Alcohol Dependency : HERE

The phenomenology of craving and the explanatory over-each of neuroscience : HERE

Understanding drug addiction (audio)  : HERE

Turning Point Scotland's comment on Trauma Informed practice in PIEs and other alcohol and drugs work : HERE

 

Personal stories

'One day at a time' - Paul's journey : HERE

Gerry Dickson on Groundswell’s Homeless Health Peer Advocacy : HERE