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Issue 2: June 2015

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Do entrenched drug users still get high from Drugs or Alcohol?

In the course of providing training to substance misuse professionals, there is a persistent question, or more accurately, a statement that is made by participants. This question or statement asserts that drug and alcohol users who are dependent no longer enjoy their drug use, but instead require it in order to cope, because it’s a lifelong habit or because their body requires it.

At Janus, however, we believe that every time someone consumes a substance, they are striving for a high, a buzz or pleasure. We believe that professionals have helped to generate a myth that states that drug users no longer experience a high, rather they require the drug to maintain their equilibrium or to stay ‘normal’.  Yet the reason someone uses substances is not to remain in the same state of mind. From a pharmacological viewpoint, it is described as the affect of a substance on an organism.  In this case we are referring to the affect of a substance on the human being.  Service users recognise this fact, however in order to protect their drug use it may be convenient for them to say – I no longer enjoy the affect of drugs and alcohol, I use it because I need it. 

The question we need to ask ourselves is why we would believe that a service user is no longer experiencing a high from their substance use, when the nature of drug and alcohol use is to change the physical, emotional and behavioural experience. How can we therefore work effectively if we accept the service user’s assertion that serves to detract us from the very issue that brought them into the service?

Please click here to see the video on Resonance Factor.

The great existential miseries of life come when too many days stack up where we are conforming and posing while doing things we have no passion for. Personal freedom means we are being fully ourselves and striving for things that bring us joy and meaning. The opposite is a life slave to conformity and boredom.

- Brendon Burchard

Drugs and Poverty
According to Professor Carl Hart (Columbia University), the “War on Drugs” that was implemented by the US government in the 1970s was simultaneously praised and criticised by various groups. One of the stronger criticisms claimed that the war on drugs actually became a war on black people. The assumption therefore was that the black community, who to a great extent belonged to a less privileged class in US society, were targeted because of economic status and associated assumptions that members of the poor black community were more likely to use drugs and engage in crime.

Read more

Politics and Policy on Drug Misuse - The New Government

This is an interesting time in politics following the recently re-elected Conservative government. Will there continue to be a focus on abstinence with the aim of getting the substance user back in to work? Will we see the introduction of comprehensive random drug testing in prisons? Will there be a continued focus on more for less, reduced funding for health and social services and the continuing challenge of striving for ‘efficiency’? Read More

Well being: Alkaline Diet

Alkaline diet (also known as the alkaline ash diet, alkaline acid diet, acid ash diet, and the acid alkaline diet) describes a group of loosely related diets based on the belief that certain foods can affect the acidity and pH of bodily fluids, including the urine or blood, and can therefore be used to treat or prevent diseases.

This diet has advocated for avoiding meat, poultry, cheese, and grains in order to make the urine more alkaline (higher pH), changing the environment of the urine to prevent recurrent urinary tract infections and kidney stones.
Read More

New Website now live

The new Janus Solutions website has now gone live. Please visit us to find out more about our work, as well as the latest news and events.

Social Enterprise and The Social Value Act    

“Social enterprise is an approach, a way of trading through adopting a set of principles that include having a clear social and/or environmental mission, generating the majority of your income through trade and reinvesting the majority of your profits to further the social mission”. Social Enterprise UK

On 31 January 2013 The Public Services (Social Value) Act 2012 was passed fully into force, requiring public bodies to consider how the services they commission might improve economic, social and environmental well-being.
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Relapse Prevention

This is a term that can at times be misleading.  It has been used for many years, but is it being used in the right context within current services?

Relapse - to go back to 
Prevention - to deter, to stop from 
It is important to use language with or, in the company of the service user, that is empowering, but also engages with their present circumstances. Relapse prevention seems to imply an intervention that is put in place to avoid the act of relapse.  That sounds positive, but is it appropriate to use if the service user is still using drugs or alcohol?
Read more

Support for drug using parents – is it adequate?

How many problematic drug and alcohol users have children?  How often as professionals do we discuss the appropriateness of services for parents, and in truth often men are exempt from that discussion, and the burden of responsibility predominantly falls on the mother, the woman. There are many views and opinions about parents who develop a problematic relationship with drugs and alcohol:

  • Why can’t they stop?

  • They only care about themselves

  • They are selfish

  • What kind of person would put drugs before their children…

  Read More

The colour of addiction: Blue or White? 
The British Medical Association states that - Alcohol and drug use increases the risk of problems in the workplace such as absenteeism, presenteeism, low productivity and inappropriate behaviour.  It can impair a person’s performance at work through poor decision making and impaired reaction times causing lost productivity, inferior goods or services, errors and accidents. 
It is evident that individuals in employment are more likely to drink frequently compared to those who are unemployed.   The British Medical Association goes on to stress -  Individuals in managerial and professional occupations are likely to drink more frequently than those in routine and manual occupations.
Read More

Unsung Hero - David Seale

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.

Janus is privileged to honour David Seale, who has been delivering high quality work in the drug and alcohol field for 30+ years.  He has seen many changes over the years and has helped many workers to develop their skills.  Here are 2 testimonials from previous colleagues:

"I've known Dave for the last 12 years. What I've learnt from him? I learnt that the drop in area was a place to engage clients that when they were making toast and tea they had less barriers up and that because of that you could make some great interventions especially with people who had been labeled ‘complex’ or hard to reach.  Dave taught me to never give up on someone and if something wasn't working with a client then to change the way I was working as it said more about me than them. He always encouraged me to ask questions to improve my understanding and knowledge which would enhance my practice;  and to challenge the behaviour and not the person whether that was a client or a professional.   He taught me it was okay to make mistakes......,as long as you have the courage to own them.  He gave me constant support in improving my practice so that I could then use those skills and knowledge to make a positive difference in the lives of as many drug users as possible and therefore continue a mission that he had started 30 years before. These few sentences don't really capture what Dave has taught me.   Whatever I learnt there are times when I'm stuck with a problem at work, I find myself asking “what would Dave do?” I believe that's the highest tribute I could pay to the man."

- Andy West, Drug Worker  

"As a non-ex-user with no formal training in the substance misuse field, working at Phoenix’s psycho-dynamic therapeutic community was at times overwhelming and certainly there was much to learn.  Dave helped me to believe that I had something to offer and the potential to make a difference. I am now in to my 27th year working in the substance misuse field having worked throughout the four tiers and within various settings. The foundation for my now strong self belief and ongoing skills set is a direct result of those early years working alongside Dave learning from “the Wizard” as he was affectionately known, he made the complicated uncomplicated and that was his magic. A one off – no carbon copies!"

- Eric Rodney, Drugs Worker 

If you know an unsung hero please send in an acknowledgement.

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Upcoming Events:

Legal Highs Workshop                                       date: 17 Jul. 2015    cost: £120
Resonance Factor Introductory Workshop          date: 18 Sep. 2015   cost: £120
Conference: Substance Misuse In The Community  date: 23 Oct. 2015   cost: £120      

Register and find more workshops and seminars HERE

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READ MORE articles below

Drugs and Poverty continued... In the US the 1970s and 80s saw a decline in many labour intensive industries, resulting in long-term unemployment and subsequent community destabilisation. This led to a new generation who had an uncertain future ahead of them after finishing school. Rather than addressing the real problem of unemployment, the ‘New Right’ government chose to blame the victim. This was exemplified in the classification of young heroin users.  The users from a background of unemployment were perceived to be detrimental to society and prone to crime. However, the group from a working background or ‘middle class’ background were viewed as ‘respectable’ and ‘at risk’ of being drawn into drug addiction (Buchanan and Young 2000).[1]
In reality drug and alcohol misuse accompanies a number of risk factors that include genetics, childhood experiences, psychological factors and mental illness, to name a few. Although those from a lower socio economic background can be considered to be at greater risk of substance misuse, the accompanying risk factors can be found also throughout higher socio economic groups. 
Living in poverty might lead to a life where exposure to drug misuse is high and those who do use drugs or alcohol might do so to their severe detriment. Substance use comes at a considerable financial cost and those without money, and users may have to increase the risks to themselves in order to acquire and use drugs or alcohol to the feed their dependence.  Perhaps those not caught in the poverty trap are simply better able to afford to support their dependence without putting themselves at risk, and thereby maintain a level of functioning eg. work and earning. Poverty might not therefore be the cause of substance misuse, but it can be a significant contributory factor to how that substance use impacts the health and freedom of those who do not have easy access to personal finance to support themselves. 
Social research tends to focus on the poor and creates an over representation of these communities. Perhaps in that case therefore, it can be argued, that both the research and the reported prevalence is potentially biased.

[1]               Shaw, A., Egan, J. and Gillespie, M. (2007): Drugs and poverty: A literature review, Scottish Association of Alcohol and Drug Action
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Politics and Policy continued...  It appears that the one thing we can be sure of is less money for the substance misuse field. With each experience of service re-commissioning, there is a cut to the budget for that service area and a competitive market is formed where service both statutory and voluntary that were previously concerned with service provision are now becoming corporate businesses with an ever increasing gap between what is advertised and what is actually delivered.   

‘Payment by Results’ is the norm with varying percentages of the budget being withheld until after targets are met. The financial pressure of PbR together with the categorical imperative to meet targets in order to qualify for PbR money has changed the focus for many managers and staff who might previously have been more concerned with service provision than meeting targets.

Some positive steps have been undertaken by the new government. Theresa May’s proposed Psychoactive Substances Bill aims at banning all recreational drugs (making individual exceptions for booze, tobacco, caffeine and so on), ending the legal loophole that allowed new and untested drugs to be sold and bought legally. As of Tuesday (9/6/15), a second reading was conducted with the Members of the Lords and a few key decision makers.

So we await with interest the Government plans for the sector and aim to keep you updated.
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Social Enterprise continued... The act states that the authority must consider:

(a) How what is proposed to be procured might improve the economic, social and environmental well-being of the relevant area, and

(b) How, in conducting the process of procurement, it might act with a view to securing that improvement.

The Government’s definition of social value is: “a concept which seeks to maximise the additional benefit that can be created by procuring or commissioning goods and services, above and beyond the benefit of merely the goods and services themselves”.

The Act presents a wonderful opportunity for Social enterprises and the Voluntary Sector to gain leverage when tendering for work/grants to meet the social challenges faced across the UK. The Act means that authorities will now have to consider the social value of the services they commission, and that they can also be held accountable for not doing so. In theory, the Act should support tenders and grant applications from social enterprises and voluntary and community sector providers, who are already providing social value through their services.

The Act was introduced by Chris White MP in 2010, who said: “The aim of the Act is to support community groups, voluntary organisations and social enterprises to win more public sector contracts and to change commissioning structures so that a wider definition of value rather than just financial cost is considered.”

Contact us at Janus Enterprise CIC for a chat and/or more information on how you can have The Social Value Act work for you.

Janus Enterprise CIC is a not-for-profit Community Interest Company established to allow us to direct our Corporate Social Responsibility back to our target beneficiary group: those affected by drugs and alcohol, as well as other socially excluded groups including ex-offenders.
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 Alkaline Diet Continued... The term "alkaline diet" has also been used by alternative medicine practitioners, with the proposal that such diets treat or prevent cancer, heart disease, low energy levels as well as other illnesses.

According to the traditional hypothesis underlying this diet, acid ash is produced by meat, poultry, cheese, fish, eggs, and grains. Alkaline ash is produced by fruits and vegetables, except cranberries, prunes and plums. Since the acid or alkaline ash designation is based on the residue left on combustion rather than the acidity of the food, foods such as citrus fruits that are generally considered acidic are actually considered alkaline producing in this diet.

An alkaline diet emphasises alkaline foods such as whole fruits and vegetables and certain whole grains, which are low in caloric density. Healthy Alkaline Diet Foods involve the ideal balance between acidifying and alkalizing foods.

Our bodies have a number of organs that are adept at neutralising and eliminating excess acid, but there is a limit to how much acid even a healthy body can cope with effectively. The body is capable of maintaining an acid-alkaline balance provided that the organs are functioning properly, that a well-balanced alkaline diet is being consumed, and that other acid-producing factors, such as tobacco use, are avoided.

Alkaline recipe

BREAKFAST: Melon Medley 
Add 1-2 cups each of diced watermelon, cantaloupe and honeydew melon to a bowl. Dig in and enjoy!

LUNCH: Grape Expectations Salad
Salad: 2-4 cups of grapes. 1-2 apples, diced. 1-2 pears, diced. 2 ribs of celery, diced.
Dressing: 1/2 cup dried dates or figs, de-pitted or de-stemmed. Soak in water for 1/2 hour, then blend with water until smooth. Pour the dressing over the salad and enjoy!
Sweet Pea Avocado Delight Dressing: 
Blend ½ cup of cooked sweet pea and 1 avocado with the Juice of ½ of a cucumber. Then, pour this delightful dressing over the salad.

DINNER: Tomacado Veggie Paté
Paté: 1 cup tomatoes, diced. 2 mangoes, diced. 1 small cucumber, julienned or processed into noodles or fine spaghetti. 1/2 large or whole small avocado.
Blend all ingredients in a bowl. Spoon the paté over a bowl of lettuce, kale, spinach or bok choy leaves and enjoy!
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Relapse prevention continued... In services currently, abstinence is often defined as someone who is no longer using their drug of choice, but may still be using other substances, or in other services for the purpose of engagement in a programme, as long as no substances have been consumed on that day.  The message that the service user who continues to use, may take from this is that they are failing because they are not stopping or preventing any drug use. In that context the term ‘relapse prevention’ is ill placed, as the client may continue to feel unsuccessful and hopeless in reducing their use thereby gaining the ideal justification to use and continue using.
In the current climate of drug and alcohol use that involves legal highs and social users, who may only use at weekends,  ‘relapse’ will happen at least every weekend, suggesting that users are actively planning or looking forward to, their relapse all week.
It may not be that the term is outdated, but perhaps it is used in the wrong setting and context.  If a service user is drug free, they are in a position to use the strategies that prevent a relapse occurring.  Part of this intervention focuses on living a life without drugs, and that will entail going through a grieving process for the loss and absence of drugs.  The question that decides whether or not the person is ready for relapse prevention could therefore be “ is it possible to go through a grieving process, if you haven’t yet experienced a loss?”
When the term ‘relapse prevention’ was introduced it was true to its definition, but drug culture and trends and needs of the service user have changed, and most importantly services have changed since then.  In the past and in other aspects of the field, terminology has changed to reflect the current climate, eg.  drug use to drug misuse, and client to service user.  Perhaps it is also time to rename interventions, in order to liberate, encourage and empower the service user in their transition from using to abstinence. 
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Support for Drug Using Parents Continued... But the fact remains that many, if not most men and women who have significant issues with drugs and alcohol, do have children.  The question is, how do services meet the needs of drug using parents and their children. We might see an increase in ‘parenting groups’ in drug services and indeed there is an increase in the communication between drug services and Children’s Services, but how far do these measure go to support the drug using parent and improve the quality of life of their children?

Drug using parents are often suspicious of Children’s Services and fearful that their children will be removed from their care if they are honest about their drug use. Drug services are often unclear about the nature of the information they are obliged to share with Children’s Services and struggle between meeting Safeguarding obligations and maintained the trust and confidence of the client in treatment.

In a time where community care funding for abstinence based treatment is in decline and family rehabilitation units are few, those who might be recommended for such a provision must meet a strict criteria and the plan must be agreed with Children’s Services who are expected to pay for the child or children. Decisions can change based on funding availability, timing, identifying a suitable school placement for the children and of course, the parent’s drug use. Such a placement therefore becomes the exception in many areas.

So what remains for drug using parents? Can existing services facing annual budget cuts and facing re-tender ever 3-5 years, be expected to provide even more for less. The provision of a family worker is often at the cost of a drug worker post and can have such a wide remit and expectation that it is unreasonable to meet. But the provision of a family worker suggests that the drug service is serious about the issue and attempts to make some provision.

With the number of drug using parents accessing services this is clearly not enough. A reluctance to share information about one’s children continues to be common, with fear and mistrust about what might happen being cited by service users. Working relationships between drug services and Children’s Services are variable and not without issue as each service strives to meet it’s own safeguarding obligations whilst also maintaining engagement with the family. Therapeutic placements for families are rare and are unlikely to increase with continued cuts to funding in social care. So where does this leave the drug using parent?

What is your experience? Does your service/area make provisions for parents? Do you have a protocol for information sharing that allows for your client to remain engaged with the service? Does your service have a parenting programme and if so how effective is it? Is it time limited with the expectation that parents will learn all they need to in a 12 week programme? Does your service fund parents to attend external parenting groups or specialist services.

We’d like to hear your views and your experience.

Janus provides a specialist programme for parents, please visit us online to find out more.

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The Colour of Addiction continued... What does that mean to organisations?  Organisations need to be proactive in addressing this through:

  • Policies

  • Strategies

  • Treatment options for employees

Organisations often struggle with getting the right balance between protecting the reputation of the organisation and providing the correct level of support to employees through policies and services. Where alcohol is the most common problematic substance in the workplace followed by other such as cocaine, could employers face a greater problem with the rising popularity of legal highs? At which point then does the organisation recognise that a proactive approach is required?
What is your experience, as either an employer or an employee? If you work in drug services, does your organisation have a policy and if so, how effective is it?
Janus provides a bespoke service for private clients, please visit us online to find out more. 
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