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Resonance

Newsletter Issue 4: August 2015

Resonance Factor

Addiction

The Resonance Factor avoids terminology such as ‘addiction’, ‘dependency’ and ‘illness’ based on the belief that these terms are unhelpful in the treatment and support of those who use drugs and alcohol problematically. In addition, other approaches to substance misuse are often based on the concept of ‘addiction’ and these too have limited success for many and leave the service user with the belief that their problem is life long and greater than they themselves can often manage.

Read more

Fundraising and Charities

Are some of the “bigger charities” increasingly behaving more like big business? Should the charity sector really be looking to big business' for inspiration, or should they change the approach?

Read More

Stature or Perception

Why is Lord Sewel's Cocaine misuse highlighted? Is it because he had a certain stature? Or could it have been that it went against the general public's perception of a drug user?

Full Article
 

Colour of Incarceration


In the South East of England prisons are filled with predominately black or ethnic minority inmates. But why are these offenders committing these offenses and why are they re-offending ?

Read more

Recovery

How is recovery viewed in the current UK climate? Why is Harm Reduction and controlled misuse not being considered?
Read More

The Age of Cuts

How is one of the best public health services faring against the recent policies of the government aiming at more cuts? And how will this overall reduction in spending affect the drug and alcohol services in the UK?
Read More

Anxiety
What is it like to begin to understand what anxiety is? Where does it come from? And how does it make you feel and behave?
Read More

Organised Crime
There is little doubt about the relationship between Drugs and Organised Crime. But how far is their reach? How can they influence the government and the administration in certain countries in the world?
Read More

 
Workers' Corner


"I like The Resonance Factor, it highlights a broad spectrum of triggers that also involve everyday experiences. I can relate to the retail Therapy aspect. 

I was wondering about Anxiety Provoked situations, ie. Social Situations that our clients experience. Sometimes the feelings can be acknowledged but the overwhelming effect of the feelings can possibly set a trigger to relapse.

I worked with many clients who experienced this issue. Various alternative suggestions were offered, but you know our clients. Instant gratification, need to be fixed, right now. Anyway, I,ll stop chatting rubbish. Look after yourself and don't work too hard"


- Jackie Mulshaw

 
Workers' Corner is a dedicated section for readers to give feedback on the articles in the newsletter, or their experience of working in the field of substance misuse. If you have any suggestions for Janus, or just want to share your* experience, please write to us at news@janussolutions.co.uk with the subject "Workers' Corner".

We look forward to hearing from you!

*The name(s) of contributor(s) would not be mentioned or an alias would be used to maintain confidentiality unless permitted to do so by the contributor(s).

Unsung Hero

Janus would like to acknowledge the contribution of individuals in the caring sector who do great work and long lasting work, however they do not get the accolade offered to more high profiled individuals. These people go about their work in a unassuming way, the reward simply being the work.

Read more

Upcoming Events

Resonance Factor Introductory Workshop
Date: 18 Sep. 2015; Cost: £120


Resonance Factor Seminar
Date: 25 Sep. 2015; Cost: Organisations £49 per person, Individuals
 £20 

Conference: Substance Misuse in the Community
Date: 27 Nov. 2015; Cost: £120      

Register and find more workshops and seminars HERE

Find out about our Accredited Courses HERE

 Addiction – Exploring the Evidence

A significant contribution to the history and development of the concept of addiction, was made by Avram Goldstein (1919 – 2012). As a leading professor of pharmacology and a noted expert of ‘addiction’ he stated, based on decades of animal studies, “If a monkey is provided with a lever, that he can press to self–inject heroin, he establishes a regular pattern of heroin use – a true addiction – that takes priority over the normal activities of life….. Since this behaviour is seen in several other animal species (primarily rats), I have to infer that if heroin were available to everyone, and there were no social pressure of any kind to discourage heroin use, a very large number of people would become heroin addicts" [Goldstein, Avram, “Heroin maintenance: A medical view. A conversation between a physician and a politician.” Journal of Drug Issues. 9. 341 – 347. 1979].

Goldstein established the Pharmacology Department at Stanford University School of Medicine, one of the most influential educational and research establishments in the United States. He was awarded the prestigious Franklin Medal for his contribution to science, and he was elected to the National Academy of Sciences. This non-profit organisation established in 1863 by Abraham Lincoln was created to provide independent advice to the nation regarding science and technology. This organisation was obliged to provide advice to any government department if requested. With such credentials it would be difficult to challenge such an esteemed scientist regarding his ‘scientific’ view on ‘addiction’.

In 1997 he reinforced his position when he wrote: "Every addictive drug used by people is also self-administered by rats and monkeys. If we arrange matters so that when an animal presses a lever, it gets a shot of heroin into a vein, that animal will press the lever repeatedly, to the exclusion of other activities (food, sex, etc.); it will become a heroin addict……”

The Rat Experiment
The rat experiment involved a rat that was administered heroin, and was trained to press a button that administered heroin to the rat through a small needle placed directly into the nuclues accumbens. It was observed that the rat kept pressing the bar to get more heroin because the drug makes the rat feel good. The heroin is positively reinforcing and serves as a reward. In many of these types of experiments the rat may use until they die. This type of ‘scientific’ experiment was seen as evidence that supported the concept of ‘addiction’. Unfortunately many practitioners, theorist, policy makers, strategists and services have accepted the concept of ‘addiction’ without questioning it, and often validating it without questioning the ‘evidence’ that supports it.

In fact, many of these ‘animal tests’ have been discredited some time ago. For example, the work of Bruce K. Alexander, a psychologist and professor in Vancouver who researched the ‘Psychology of Addiction’, examined the ‘animal test’ and raised various questions and concerns. He realized that an otherwise empty cage with a lever in it that administered heroin, and nothing else to choose, was not a robust scientific environment from which to draw factual conclusions.

In response, he designed an alternative investigation into behavior now widely known as the ‘rat park’ experiments. This involved creating an environment for rats that was rich in physical resources, a veritable rat paradise. He created a number of parks with a variety of functions. The outcome of the experiments was that unlike many of the rats and monkeys in Goldstein’s experiments who ultimately overdosed and died, those in Professor Alexander’s experiments showed little or no interest in the heroin, because their environment was a stimulating, nurturing and nourishing and met their needs. Professor Alexander’s research was initially attacked by predominant theorists however, there is now a new interest in his work as more of us question the concept of ‘addiction’ as a life long issue.

Professor Alexander presented a paper to the Canadian Parliament stating: “Most Canadians believe that certain drugs cause catastrophic addictions in people who use them. This conventional belief is reflected in such familiar phrases as "crack cocaine is instantly addictive" or "heroin is so good, don't even try it once". It is also implied in the professional literature that routinely describes certain drugs as "addictive", "dependency producing", or "habit forming". The belief that drugs can induce addiction has shaped drug policy for more than a century.

However, the only actual evidence for the belief in drug-induced addiction comes 1) from the testimonials of some addicted people who believe that exposure to a drug caused them to "lose control" and 2) from some highly technical research on laboratory animals. These bits of evidence have been embellished in the news media to the point where the belief in drug-induced addiction has acquired the status of an obvious truth that requires no further testing. But the widespread acceptance of this belief is a better demonstration of the power of repetition than of the influence of empirical research, because the great bulk of empirical evidence runs against it. Belief in drug-induced addiction may have deep cultural roots as well, since it is a pharmacological version of the belief in "demon possession" that has entranced western culture for centuries [The Myth of Drug-Induced Addiction : Bruce K. Alexander, Department of Psychology, Simon Fraser University, Burnaby, B.C., V5A 1S6]

The Resonance Factor’ offers an alternative approach that explores the substance users relationship with their drug or drugs of choice. To learn more about The Resonance Factor please click on the link below:

http://www.janussolutions.co.uk/the-resonance-factor/

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Fundraising in Charities

Last month Sir Stuart Etherington, Chief Executive of the National Council for Voluntary Organisations (NCVO) was asked by Rob Wilson, the Minister for Civil Society, to conduct a review of fundraising self-regulation in light of recent concern highlighted in the media.

Sir Etherington stated that, “Charities can only do the work they do because of the trust, confidence and overwhelming generosity of the British people. To maintain this trust, charities must work to the highest standards. That trust and those standards must be safeguarded by a simple and effective system of fundraising regulation” and asked to hear views from those within the charity sector on how to best create such a system.


This prompted quite a discussion. One respondent stated that, “As a small charity we value our relationship with supporters too much to take advantage by door stepping or using “Chuggers” or other intrusive methods, however the squeeze on local government funding means we will in the future rely more than ever on regular giving. We need a clear strategy that leads us to supporters that want to help us and to benefit our cause whilst balancing our respect for our supporters privacy”.

Another wrote “Please remember in the review that the problems were caused in the main by the big charities – the vast majority of the sector is made up of smaller charities who do not use the services of professional fund raisers or undertake cold calling but rely on traditional methods of fund raising like collection tins and fun days. The sector is not in crisis (as is often reported) but a small number of the bigger charities – who are increasingly behaving like big businesses – are making it harder for all of us!”

This comment raises an interesting question. Are some of the “bigger charities” increasingly behaving more like big business? There is certainly enough talk among the sector that suggests this question is valid and in need of some serious consideration. With awareness spreading in recent years about the impact of big business, a significant number argue that many big businesses seemingly operate with an utter disregard to their social responsibility, or worse, have a detrimental impact on their local communities and/or the environment at large. That being said, should the charity sector really be looking to ‘big business' for inspiration? Albert Einstein stated that “we cannot solve a problem with the same level of consciousness that created it”. If charities and not-for-profit organisations are genuinely looking to solve problems, we should probably listen to Mr Einstein and look elsewhere for some inspiration moving forward.

Sir Etherington of the NCVO concluded his call to the sector by saying “I wish to be clear that charity fundraising has never been more important. Many charities are in a tight financial position, still dealing with the increased demand for their services, prompted by the economic downturn of recent years. This is why it is particularly crucial that we get fundraising right. We cannot afford to jeopardise charities’ fundraising now or in the future. We must find sustainable solutions that can ensure the public continues to have faith in charities in the long term – that is what I aim to do”.


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 Perception and Stature of a Drug Misuser 

In the news recently, pictures of a member of the House of Lords were splashed across the front pages and screens of the media and TV of him allegedly snorting Cocaine. A public outcry they said. The judgement! The shame! The hypocrisy! It certainly grabbed the public attention. 

This may have been due to the unfulfilled expectations or disappointment of the public who perceived his wealth and privilege, his career in social and environmental issues, and his independent status in the House of Lords and third marriage, as enough! Many of us would be happy with less. The public felt betrayed!

Or could it have been that it went against the general public's perception of a drug user?

If the story is true, can we consider why someone of such standing would jeopardise their whole career, reputation and family, and remain totally unaware of the potential exposure and consequences of his actions. When someone uses drugs they are able to create their own unique world where they can be what, and who they choose, and this is appealing, irrespective of the circumstances of the person’s life, or the possible consequences. The actions are in pursuit of a ‘high’ that they do not experience in their day-to-day lives. The very same as the service users who walk through our doors every day. A life of privilege can become a life in pursuit of the ‘high’ in a relatively short period of time. Perhaps our words to our learned friend should be: Beware m’lawd, your pursuit of the ‘high’!

The video:
https://www.youtube.com/watch?v=VsOfbc1NSbQ

The news:
http://www.thesun.co.uk/sol/homepage/news/6560352/Baron-John-Sewel-drug-binges-with-prostitutes.html

Reactions:

http://www.independent.co.uk/news/uk/politics/the-best-reactions-to-the-lord-sewel-drugs-video-10417738.html

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The incarceration rate of minorities:
Flaw in the system or the people?


Prison conditions and prison populations are topics of debate that generally take place only among those affected or those involved in delivering or commissioning services to those who are incarcerated. Furthermore, the features of the prison population in the UK eg. age, gender, race, class, religion, immigration status, mental health and drug and alcohol use are not topics that we often see debated or highlighted in mainstream media or indeed in the public domain.

Keith Vaz, Chairman of the Home Affairs Committee, re-elected in 2015, stated that up to 75% of those coming into prison were drug users and that around 50% had a problematic relationship with drugs. (Leicester News March 2015).

The issue of drug use in prison continues to present challenges with the increased availability and diversion of prescription drugs and lately ‘legal highs’. The focus is often on detection of drugs through drug testing which is perhaps not the most reliable source of evidence. Drug treatment in prison is available but faces the same challenge in that those completing a programme often struggle to remain drug free as they re-integrate into the larger prison population to continue or complete their sentence. The challenges facing drug users upon release from prison can prove insurmountable for many and therefore the likelihood to return to drug use is high.

Other features of the prison population are that of race and religious beliefs. MP Dianne Abbot recently said that the last Labour government had failed to examine “the consequences of locking up a generation of young black men” adding “there are some prisons in the south east that are now virtually all black…. Many are converting to Islam”. 

View the full article here

The Young Review (2014, Centre for Crime and Social Justice) was commissioned by the government to recommend ways to improve outcomes for young black and Muslim men in the criminal justice system. Pathways into and out of prison were studied in order to better understand the issues faced. View Young Review online here

At the same time we are told that Police forces are up to 28 times more likely to use stop and search powers against black people than white people, and may in fact be in breach of human rights laws (The Guardian 26 June 2012). 

The links between drugs and crime are long established and the prevalence of drug use among young black and Muslim men has to be considered in light of the apparent fact that black people are more likely to be stopped and searched by the police and as a consequence more of them, unlike their white counterparts, may find themselves entering in to the criminal justice system. The question to ask therefore, is what is the role of drug treatment in prisons for those experiencing discrimination and disadvantage even within the criminal justice system itself?

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 What is Recovery?

It is now 5 years since the last Drugs Strategy that focussed on ‘recovery’ as the pursuit of abstinence. Payment by Results continues to drive services also faced with re-commissioning at 3-5 year intervals. There is less money allocated year after year that results in posts being cut, and also cuts to community care funding making access to residential treatment much harder than before. Services are expected to provide abstinence based treatment for their service users often at the same location as all their other services.

So what does this mean for ‘recovery’? In many services, prescribed service users form the majority and those who do not comply with a reduction plan are given ‘treatment breaks’ until they are ready to engage in a meaningful way and identify abstinence as their goal. Together with other drug users, they will be encouraged to engage with the myriad activities and other services provided in order to address their other issues eg. housing, health, relationship and skills building, in order to develop their recovery capital.

Whilst these interventions are welcome and beneficial to those who engage with them, where does that leave the drug use – the primary reason for accessing the service? Whilst service users may be reducing medication so that their records show progress towards the goal, what of their illicit drug use, alcohol use and cannabis use?

For many the thought of being totally abstinent from all drugs including those prescribed, and alcohol, is alien. It is not how many choose to live their lives. For a long term heroin user to quit and be opiate free, their perception of their other drug use is often minimised in the shadow of their greater achievement. For a long term crack user who has quit and now uses cannabis and alcohol, their perception might well be that they are ‘drug free’. For the person who no longer engages in 4 day long chemsex binges, but uses cocaine and alcohol at the weekend, this may be the achievement they are happy with. The common factor here is that the user’s perception and belief is that drugs no longer control their life, in fact they are in control of what they use and their quality of life is improved as a result.

This describes harm reduction of course, a term that appears not to fit into the recovery agenda. However, with the increasing pressure on services to achieve treatment completion for agreed number of service users monthly, the definition of ‘recovery’ will have to be variable and according to the voice of the service user. Where there may also be less emphasis on working with the service user drug use, or realistically providing a drug free environment where abstinence is the norm, the definition of ‘recovery’ stands to become increasingly variable and less related to drug consumption than to functionality.

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Anxiety

Anxiety is a common experience of modern day living and can leave many feeling debilitated to the extent that they do not feel able to function at the usual level. It is generally assumed that anxiety comes from situations that cause stress. Although the stress factor will differ from person to person, the manifestation of anxiety may be experienced similarly.

What is it like to begin to understand what anxiety is, where it comes from and how it makes us feel and behave? Have you ever suffered from anxiety? How do you manage it?

Working with anxiety in the here and now:

Usually, anxiety is rooted in an incident from the past. When the feelings or circumstances of today relate or refer to yesterday, the anxiety is usually ignited. While we work with the past to think about how and when the anxiety started, it isn’t enough to move forward. Dealing with the triggers of today however, will help to harness the feelings associated with anxiety and the past. It is important to have a conversation with yourself about the situation that caused anxiety today, as much as it is important to have a conversation with yourself about your past.

Consider this. What challenge do you fear or face daily? What are you refusing to accept or say out loud? What are you shutting out while fear and anxiety is allowed in?

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 The Age of Cuts

Very recently the Chief Executive Officer at Blenheim CDP – John Jolly - posted a blog, of which he made a prophetic statement:

Unless Service User Groups and a powerful alliance of GP’s, NHS and third sector providers and charities are prepared to fight in the corridors of Whitehall and Westminster, and on the beaches of local authority cuts, I fear that the worlds best treatment system is about to be decimated in 2015/16. I fear for the people we help and I pray that I am wrong. It’s time to stand and fight.”

Prior to this statement in October 2014, Public Health England and the Association of Directors of Public Health published a Joint Review of Drug and Alcohol Commissioning in England and Wales. This review was funded by The Department of Health. There is a general consensus from this review that Authorities will reduce investment in drug and alcohol services and that the picture for 2015 – 16 may be the same or worse. To read more please click on the link below:

http://www.nta.nhs.uk/uploads/review-of-drug-and-alcohol-commissioning-2014.pdf

From a service delivery perspective and a commissioning perspective this raises the question over what the funding situation will look like over the coming years, and the impact of that on service delivery; are we commissioning in the best possible way to deliver the best service to clients, while allowing services the opportunity and time to embed and deliver services without the pressure of achieving outcomes in unrealistic time frames.

Clearly there is a sense that this is a topsy-turvy time, with everybody feeling pushed and pulled by austerity and Whitehall. A sad thing is that Drug Scope: 'a national membership organisation for the drug sector and the UK's leading independent centre of expertise on drugs and drug use', that represented the interests of service users, practitioners, services and organisations through its lobbying of government and being a critical friend with regard to Government policy development and implementation is no longer here as it closed this year. This is / was very much 'the end of an era', and as such who or what will replace the work that they did?

It is the responsibility of all people to keep an eye on the direction of policy because only through that will the best interest of clients, practitioners, services, organisations and the general public be met. What appears clear is that this sector will experience and is experiencing change on a scale that is new!

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Drug Trafficking and Organised Crime

The recent Shawshank Redemption–esque escape of the Mexican Drug Lord Joaquín “El Chapo” Guzmán (The Guardian, 13 July 2015) has brought into surface the might of organised crime and drug trafficking. It can be argued that this incident is only pertinent to Mexico. However, there is little argument about the fact that drug trafficking is most profitable and lucrative trade in organised crime, more than illegal arms trade, human trafficking and other such criminal activities (Barnato and Schlotterbeck, 2013). Even in the UK, organised criminal involvement in the drug trade can be seen in every step, from import to the end product in the hands of the consumer.

According to the National Crime Agency,
1. Annual Heroin import in the UK is 18 – 23 tonnes,
2. Annual cocaine import is between 25-30 tonnes, and
3. Annual demand for cannabis is around 270 tonnes.

NCA believes that international importers and UK wholesalers are becoming more integrated in the supply chain. Some local sellers are now travelling to make their own import arrangements.

When it comes to drug trafficking and organised crime, the trade route of drugs to the UK is truly global. According to NCA, Heroin trading includes countries such as Afghanistan, Pakistan, Iran, the Balkans and the Netherlands. Colombia, Venezuela, Ecuador, Peru, Bolivia and Spain, and cities such as Antwerp and Rotterdam make up the trading route of Cocaine to the UK. And in the trading of Cannabis, Afghanistan, Morocco, some southern African countries, the Caribbean and the Netherlands are part of the supply chain. Once these drugs are in the UK, they are transported to major cities such as London, Liverpool and Birmingham before being distributed nationwide.

Before the drugs reach the end consumer, 'cutting agents', or adulterants, are added to the drug (these include substances that mimic the appearance or effect, or alter the effects in a desired manner). These agents are now integrated in the drug trade, with most of them being imported from China and India. The global trade has forged global strategic alliances, such as the alliance of the Sicilian Mafia with the Chinese organised criminal networks and the Colombian Cartels (Wright, 2013).

The correlation between organised crime relating to drugs and violent crime differs from region to region. Organised crime in certain parts of Latin America, Hong Kong etc. seems to generate more violence and corruption than that in the USA or Japan. It is based on the capacity to corrupt the state, poverty and various social and economic factors in these areas. In some of these areas, state presence is limited or inadquate, resulting in reliance on organised crime that accounts for the livelihood of many (Felbab-Brown, 2012).

The role of organised crime in the economy can be such that it becomes an essential part of it. Criminal organisations have been reinvesting their illicit money in the legal economy for the past few decades. These investments can be done in such a manner that it could be difficult to separate the legal from the illicit, allowing criminal organisations to launder profits, diversify their sources and exercise control over authorities and territories (UNICRI, 2014). Countries such as Guinea Bissau in Africa experienced a rise of foreign exchange reserve of $141 Million in a 5-year period where there was very low level of foreign direct investment and donor assistance. In 2010, a staggering $2.1 billion (equivalent to 3.8% of GDP, or nearly half of Kenya’s total exports) found its way into the Kenyan economy without the government being able to explain its source (Mungai, 2015).

It has been observed that the policies aimed at suppressing drug flow are generally ineffective against organised crime (Felbab-Brown, 2012). High value targeting or eradication of crops (such as in Mexico or Afghanistan) generally lead to violent crime and insurgencies. Some believe that legalising drugs might be an answer to reduce organised crime relating to drug trafficking, and in the process diminish the roles of these cartels and organisations.

Families of drug abuse victims in the UK have recently sent a petition to David Cameron, stating that there needs to be reform in the drug laws. The 'Anyone's Child' campaign is asking for a legal regulation of drugs rather than a ban, with the idea that drugs should be controlled by medical professionals rather than criminals. It also criticises the government's view of criminalising people that might be victims, and also for stopping any discussion on alternative views (Harris, 2015).

Legalisation of drugs, however, might fail in countries where the state presence is limited. In certain Latin American countries, or in countries with a developing economy, legalising wont ensure that the crime groups will be excluded. They might resort to more violence to hold on to the market. Reducing violence associated with organised crime might be more effective, as it will enable to build the confidence of people about the role of the state, even if it fails to substantially reduce the role of the crime groups (Felbab-Brown, 2012).

Social, political and economical factors should be considered before laws and policies are enacted in view of organised crimes. The debate for and against legalisation of drugs need to consider the impact of this underground economy before any conclusion in terms of an effective process can be agreed upon.

References:


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 Unsung Hero: Jackie Mulshaw

Janus is privileged to honour Jackie Mulshaw, who up until her early retirement, delivered high quality work in the drug and alcohol field for 27 years.  She has seen many changes over the years and has helped many workers to develop their skills.  Here are 2 testimonials from former colleagues:

Testimonial 1: Having worked with Jackie M for a number of years at the Caravan, I have always found her supportive, open and accessible towards her colleagues.

Her professional relationship with clients/patients, has never been rigged or inflexible. Where needed, Jackie M will go the extra mile. No thats wrong, she will go the extra 100 or 1000 miles to try and meet the needs of the individual she might be working with. Not to lead them, as a parent would lead or guide a child, but to help them to help/find themselves and their true direction in life.

Jackie M, is the sort of person I always want to work with, because she is a team player and not a 'I know it all maverick'.

Testimonial 2: What Can I say about the lovely Jackie, She has been working in the field of drug and alcohol gaining 30 years of expertise.

Jackie has always enjoyed working with individuals who need support. Jackie not only provides emotional and practical therapeutic  support to clients regarding their dependency /recovery issues but has an amazing wealth of knowledge of street and pharmacteciual drugs that she can identify and plan harm min strategies with her extensive drug knowledge. In addition Jackie has gone above and beyond in her support to individuals  and always takes into consideration the impact of one’s drug use relating to their mental health and physical Health. At The same time always  collaborating with individuals need and wishes whilst drawing together care /treatment /recovery plans to incorporate a holistic approach to treatment.

Above all Jackie would always emphasise the need to have fun in recovery and would offer a myriad of intervention to any service user who just requires on the spot intervention and signpost them to onwards service. In addition she fights for the rights of client to be heard this has made Jackie a popular keyworker and colleague to work with.

We salute you the lovely Jackie!!!!!

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