This article is from the source 'guardian' and was first published or seen on . It last changed over 40 days ago and won't be checked again for changes.
You can find the current article at its original source at https://www.theguardian.com/society/2018/oct/17/closing-residential-rehab-increases-suffering-addicts-chandos-house
The article has changed 5 times. There is an RSS feed of changes available.
| Version 1 | Version 2 |
|---|---|
| Closing drug and alcohol rehabs helps no one – I should know | Closing drug and alcohol rehabs helps no one – I should know |
| (21 days later) | |
| Drug and alcohol rehabilitation, like all effective therapy for mental illness, is highly labour-intensive; requiring counsellors who are not just empathetic enough to reach their patients, but also sufficiently authoritative to confront them with the real consequences of their pathological behaviour. In line with the successive waves of addictive illness to wash over our society – from the great heroin influx of the early 1980s to today’s spice and opioid epidemics – there have been successive waves of rehabilitation. Thanks to numerous films and TV shows, most people are familiar with the basics of rehab: total abstinence from drink, drugs and associated behaviour, such as anorexia, bulimia and compulsive shopping; group therapy; a quasi-bootcamp atmosphere, oddly combined with a lot of asexual hugging and affirmation. When I was in rehab in the mid-80s, my counsellor said: “They call us brainwashers here – but we have to wash your brain, because it’s dirty.” | Drug and alcohol rehabilitation, like all effective therapy for mental illness, is highly labour-intensive; requiring counsellors who are not just empathetic enough to reach their patients, but also sufficiently authoritative to confront them with the real consequences of their pathological behaviour. In line with the successive waves of addictive illness to wash over our society – from the great heroin influx of the early 1980s to today’s spice and opioid epidemics – there have been successive waves of rehabilitation. Thanks to numerous films and TV shows, most people are familiar with the basics of rehab: total abstinence from drink, drugs and associated behaviour, such as anorexia, bulimia and compulsive shopping; group therapy; a quasi-bootcamp atmosphere, oddly combined with a lot of asexual hugging and affirmation. When I was in rehab in the mid-80s, my counsellor said: “They call us brainwashers here – but we have to wash your brain, because it’s dirty.” |
| Many are no doubt also familiar with another approach, now termed “harm minimisation”, but originally – rather more accurately – called “maintenance”. Alcoholics are prescribed sedatives such as Valium or alcohol-substitutes such as Heminevrin; opiate addicts are given methadone. Everyone is given bucket-loads of antidepressants. The advantage to commissioners is that it is both cheaper to deliver and easier to sell to potential funders than total abstinence rehab, which can require inpatient treatment for weeks, if not months – and at the very least a fully staffed day programme, with support workers and auxiliary nurses to deal with the physical maladies and social incapacities that are the sequels of long-term substance abuse. | Many are no doubt also familiar with another approach, now termed “harm minimisation”, but originally – rather more accurately – called “maintenance”. Alcoholics are prescribed sedatives such as Valium or alcohol-substitutes such as Heminevrin; opiate addicts are given methadone. Everyone is given bucket-loads of antidepressants. The advantage to commissioners is that it is both cheaper to deliver and easier to sell to potential funders than total abstinence rehab, which can require inpatient treatment for weeks, if not months – and at the very least a fully staffed day programme, with support workers and auxiliary nurses to deal with the physical maladies and social incapacities that are the sequels of long-term substance abuse. |
| In British prisons beset by crippling drug problems, the compulsion to deliver “value for money” in an increasingly neoliberal economy has seen long-term rehabilitation services repurposed as exercises in harm minimisation. Basically, the addicts are now kept on drugs instead of rehabilitated – and it’s the same so‑called “service providers” who are responsible for doing this. | In British prisons beset by crippling drug problems, the compulsion to deliver “value for money” in an increasingly neoliberal economy has seen long-term rehabilitation services repurposed as exercises in harm minimisation. Basically, the addicts are now kept on drugs instead of rehabilitated – and it’s the same so‑called “service providers” who are responsible for doing this. |
| There indeed, but for the grace of a collective conscience, go you – and, very definitely, I | There indeed, but for the grace of a collective conscience, go you – and, very definitely, I |
| Prisons are a giant and pestilential canary in the coal mine of British attitudes towards addictive illness: and their disease has now been carried into wider society by the vector of austerity. With no money to pay for rehab beds, local authorities are reduced to doling out drugs themselves – for what is maintenance, if not competing with illegal drug dealers? The case for rehab is normally focused on the same calculus of cost-benefit that’s led to their downfall. While it’s true that properly rehabilitated addicts and alcoholics often become productive and responsible members of society, it’s by no means always the case. Whereas maintenance programmes can often produce effective results in terms of lower reoffending rates and increased employability. | Prisons are a giant and pestilential canary in the coal mine of British attitudes towards addictive illness: and their disease has now been carried into wider society by the vector of austerity. With no money to pay for rehab beds, local authorities are reduced to doling out drugs themselves – for what is maintenance, if not competing with illegal drug dealers? The case for rehab is normally focused on the same calculus of cost-benefit that’s led to their downfall. While it’s true that properly rehabilitated addicts and alcoholics often become productive and responsible members of society, it’s by no means always the case. Whereas maintenance programmes can often produce effective results in terms of lower reoffending rates and increased employability. |
| We should bemoan the closure of residential rehabs such as Chandos House, the last one in Bristol, which will shut its doors for good next month, because, in line with the theory of progressive taxation, they represent a genuine and effective mechanism through which compassion can operate. Charity largely exists to relieve the rich man of the burden of his conscience, which is why rehab shouldn’t have to be funded by charitable donations. | We should bemoan the closure of residential rehabs such as Chandos House, the last one in Bristol, which will shut its doors for good next month, because, in line with the theory of progressive taxation, they represent a genuine and effective mechanism through which compassion can operate. Charity largely exists to relieve the rich man of the burden of his conscience, which is why rehab shouldn’t have to be funded by charitable donations. |
| Addiction and alcoholism are devastating maladies, and no respecters of person – while what’s most remarkable about them, surely, is that their sufferers present, in an exaggerated form, behaviour we all fall prey to in our consumption-driven lifestyles. That the man or woman lying on the flattened cardboard box next to the cashpoint is an individual just like yourself, with hopes and dreams and tender feelings, is a truth barely acknowledged in our daily lives – but we dismiss the indigent addict and alcoholic at our peril; for there indeed, but for the grace of a collective conscience, go you – and, very definitely, I. | Addiction and alcoholism are devastating maladies, and no respecters of person – while what’s most remarkable about them, surely, is that their sufferers present, in an exaggerated form, behaviour we all fall prey to in our consumption-driven lifestyles. That the man or woman lying on the flattened cardboard box next to the cashpoint is an individual just like yourself, with hopes and dreams and tender feelings, is a truth barely acknowledged in our daily lives – but we dismiss the indigent addict and alcoholic at our peril; for there indeed, but for the grace of a collective conscience, go you – and, very definitely, I. |
| • Will Self is a journalist and author | • Will Self is a journalist and author |
| Drugs | Drugs |
| Alcoholism | Alcoholism |
| Opioids | Opioids |
| Alcohol | Alcohol |
| Mental health | Mental health |
| Health | Health |
| Charities | |
| comment | comment |
| Share on Facebook | Share on Facebook |
| Share on Twitter | Share on Twitter |
| Share via Email | Share via Email |
| Share on LinkedIn | Share on LinkedIn |
| Share on Pinterest | Share on Pinterest |
| Share on Google+ | Share on Google+ |
| Share on WhatsApp | Share on WhatsApp |
| Share on Messenger | Share on Messenger |
| Reuse this content | Reuse this content |