Mark Gilman, North West NTA Regional Manager 2010 – The Year of Recovery Mark Gilman, North West NTA Regional Manager

40 years and Four Ages of Drug Treatment to get to ROIS – The Final Frontier? 1. Health & Welfare of INDIVIDUAL Addicts (1960s/1970s) 2. PUBLIC Health and Welfare and HIV prevention (1980s/1990s) 3. Crime Reduction and Community Safety (1990s/2000s) 4. The 3 R’s: -Recovery -Reintegration -Regeneration Recovery Oriented Integrated Systems ROIS

Harm Reduction 25 Year Report Card Make Contact  Needle and Syringe Exchanges Maintain Contact Easy Access To Maintenance Medication Programmes Make Positive Lifestyle Changes X Must do better & introduce recovery

Professor Dwayne Simpson (ITEP, RELS) 4 major influences for Recovery Oriented Integrated Systems (ROIS) (access via search engine) Professor Dwayne Simpson (ITEP, RELS) William L. White (Slaying the Dragon) George De Leon (Right Thinking) John McKnight (ABCD)

Boundaries & Hinterlands Commissioned Treatment Recovery Includes AA, NA, CA SMART Natural Recoverees Well Being Body, Mind and Spirit etc

Historical context... Recovery Community Bill W and Dr Bob, AA 1935 Treatment Community 1965?

“A grateful addict/alcoholic” “The Power of Recovery” (Personal communication with Phillip Valentine, Executive Director, CCAR, Connecticut Community for Addiction Recovery) “5 years+ In recovery” “Recovering People” “Long Term Recovery” “Better than well” “A grateful addict/alcoholic” “Model citizens” “Normal People” Potential “Early Recovery” Time

…and the bridge takes you both ways to and fro... Recovery Oriented Integrated Systems (ROIS) bridge the gap… Recovery Community Treatment Community …and the bridge takes you both ways to and fro...

What happens when you introduce a ROIS? Recovery Optimism replaces Treatment Pessimism. Ambitions and Aspirations are raised. Commissioners and Providers learn that substance use disorder is a condition that people recover from. People still suffering with substance use disorders are exposed to the experience, strength and hope of those who have recovered or are recovering. Drug workers see people they have treated get well in the same communities that they got sick. Professionals take their place; “on tap” and not “on top”

Treatment Workforce and Recovery Physician Heal Thyself Treat yourself first You can’t give away something that you haven't got Experience ‘recovery’ for yourself We want people to change their behaviour, will we change ours?

Recovery Spreads out from the Personal to create “Tipping Points” in Society “We are sick and tired of being sick and tired - Are you?”

Recovery Spreads out from the Personal to create Community Anchors “This is a Recovery Community”

ROIS speaks to Local Strategic Partnerships ROIS can produce OUTCOMES that address the “Big Ticket Items” Parents able to care for their children Crime Reduction and Community safety Social Integration (employment and housing) Health Inequalities Prevention of Inter-Generational Transmission of Addiction (and other social problems e.g. teenage parenthood, welfare dependency)

Asset Based Community Development + 14 14

The Future is where recovery meets ABCD Recovery from Drugs + Alcohol Asset Based Community Development

Recovery Community Centers… Are recovery oriented sanctuaries anchored in the hearts of communities Are physical locations where local communities of recovery can be organized Places where Recovery Support Services are delivered and are designed, tailored and delivered by local recovery communities Are fueled by a comprehensive Volunteer Management System – including people in long-term, sustained recovery 16 16

Volunteers Staff

Recovery Community Centers in Connecticut Carlisle? Penrith? Barrow? Workington? Willimantic, New London, Bridgeport, Hartford 18 18

Recovery Coverage using volunteers and 4 recovery centres 1 x CEX + 16 staff £700k Volunteers 4 x Staff 4 x Staff Volunteers Volunteers 4 x Staff 4 x Staff

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Recovery Support Services All-Recovery Groups (NA, CA, AA, SMART etc) Recovery Training Series Family Support Groups Recovery Coaching Recovery Social Events Telephone Recovery Support Recovery-Oriented Employment Services Recovery Housing Projects 21 21

ROIS: Recovery Oriented Integrated System Harm Reduction Services,NX GP Primary Care Psycho Social SDC Employment 3 Single Point of Assessment& Access Mutual Aid Tier 4 IPDetox, Res Rehab T3 - Community Drug Services Substitute Medication Assisted Treatment (e.g. MMT) Housing Prisons (IDTS)

ROIS: Recovery Oriented Integrated System From Independent SPOA Go DIRECT to Detox & Rehab 3 INDEPENDENT Single Point of Assessment& Access Do not have to go via Tier 3 Tier 4 IPDetox, Res Rehab

ROIS & Traditional Ideas of Residential Treatment Community 2-3 weeks In Patient Assisted Withdrawal (In Patient Detox) 6-9 months Residential Rehab Away from Home & “social cues” Dealers etc Back to which Community? Birmingham Liverpool Bristol This is often a full stop. Many successful people don’t return to their home community from traditional rehabs because home is not a ‘recovery friendly environment’

ROIS & More Recent Ideas of Residential Treatment to create recovery friendly environments Community Birmingham Liverpool Bristol Detox: At home In Patient In Prison 12 weeks in Community Based Total Abstinence Recovery Oriented 12 Step Residential Attend abstinence support groups in Community Of Residential Centre “Ambassadors Of Recovery” To addicts Still suffering Attend abstinence support groups in Home Community Become active in abstinence support groups In Home Community Encourage others to follow this path Engage in Therapeutic Employment in Home Community

Measuring the success of Recovery Communities Measuring the success of Recovery Communities? Hit the target but don’t miss the point Recovery is THE point

Chameleons and Caterpillars? Chameleons Change Caterpillars Transform “Recovery? We can do that” “Recovery will be our organising principle”