Someone face down in the gutter with a can in their hand, or a dubious looking character begging for spare change to fund the next hit. No. It’s the person who passes you in a supermarket aisle, who you chat to at the school gates, who sits opposite you on the commuter train.
Consultant psychiatrist Dr Yasir Abbasi explains why people become addicts, the new generation of psychoactive substances and how addiction services are helping people put their lives back together.
“Historically mankind has always had an interaction with mind altering drugs. Human beings have always found a way to use psychoactive substances from the Stone Age to the present day designer drug era. People turn to substance misuse sometimes to mask difficult emotions or social situations.
“There’s often an underlying mental issue and people drink and take drugs to block it out. Unless we resolve that, the outcomes of treatment interventions are not long lasting. There’s no one thing that can define an addict. People have a vision of someone who can’t function, is on the streets but that’s often not the case. People hold down jobs, they appear fine but below the surface they can be struggling.
“To say it’s a lifestyle choice is a very simplistic way of looking at it. It may start like that but the addiction comes gradually, often without warning. Some people are more likely than others to become addicted, for example people with an impulsive nature.
What happens in your home environment influences your behaviour. As a child whatever you see becomes the norm. You might begin using substances to have a good time, you don’t plan or aim to become an addict but it’s a slippery slope. “It’s almost always other factors that lead to dependence. When you’re facing problems and you don’t know where to turn, the easiest thing is to go back to something that helps you feel better and is available.
“Why is alcohol much more socially acceptable? Alcohol is legal and drugs aren’t. People with drug addiction are
perceived by some as criminals, creating trouble for society where alcoholics hurt only themselves. But nothing could be further than the truth. Criminal behaviour can start because the person becomes addicted, runs out of resources and becomes desperate, but in some ways alcohol is more damaging to society than drugs. Heavy drinking can result in antisocial behaviour, violence or disrupt social and family lives.
BREAKING THE CYCLE
“The way we help people is transforming beyond recognition. In the past we’d send people with a drug or alcohol addiction on a detoxification programme that took away the physical need then send them home. But if you put someone back in the environment that caused the problem, with the same network of people and without any psychological support to motivate them to sustain their recovery, they’re almost bound to relapse. We’d see them again six months later or so for another detox – and so it went on. “Now we take into account that it’s a complex problem, detox is only the beginning and we have to break the cycle. This is an illness and even along the road to recovery there will be problems.
We have to support the person to be able to put their life back together. “The emphasis is on motivating the person to keep going. A big part of succeeding is self realisation – where the person understands the reason why they are drinking or using drugs. That requires skilled people who can work through it with them, to have a frank discussion but not judge or give opinions. “It has to be collaborative. There’s no point in saying to someone ‘do you know this is going to kill you?’ If they could stop, they would. Instead we assess the person, look at the reasons, prescribe medicines but importantly try to help and motivate them to move away from the triggers.
“Staying away from substances takes a lot of motivation. Our drug and alcohol teams work closely with our mental health teams to identify the underlying problems before someone leaves the services.
“Having the help of someone who has walked in their shoes is invaluable. We have a long established recovery volunteer programme in which people who have recovered with our help can give support, based on their own experiences. It’s having someone who can talk about life after addiction, someone they can relate to and trust.
‘“We help someone onto our Recovery College courses which can help with simple things like managing anxiety, or put them in touch with other organisations out there who are experts – we are well served in Liverpool by community services who can support us to support our patients. If someone’s drinking is because of a housing or debt issue, we have to tackle the whole problem otherwise it won’t change.”
WHERE TO GET HELP
FRANK young people’s drug advice website - talktofrank.com
REHABNET national council on seniors drug and alcohol rehab - rehabnet.com