Drugs

Drug addiction is a complex condition which needs specialist support. There is a vicious cycle of addiction that leads people deeper into not coping, becoming more isolated from others and dependent on their drug of choice.

Key aspects of addiction include:

• ­ Feeling out of control and finding it impossible to stop using the drug of choice
• ­ Dependency on the substance, a sense of not managing without it and need for it in order to carry on, even if problems arise as a result
• ­ A process from initial experimentation through occasional then regular use to increasing doses to have the desired effect as the body becomes tolerant
• ­ Risk of harm.  The physical damage caused depends on the drug used however there are also effects on mental and social health. In cases of extreme addiction the need for the substance becomes all consuming, takes priority over relationships and work.  As a result the person is unable to live a normal life. In cases where there is a lack of funds to purchase the drug then criminal activity may develop.

How someone is affected by drug addiction depends on a number of factors including:

• ­ Their mental health prior to taking drugs
• ­ Their life circumstances
• ­ The physical damage caused by the drug
• ­ Genetic predisposition

How drug addiction affects people

The effects of drug addiction are profound.  It can change a person’s perceptions, attitudes and often disrupts personality as well as lifestyle. The experience of addiction disturbs feelings, thought patterns and behaviour.  Common feelings include guilt, shame, anger, boredom, isolation, anxiety, depression, lack of confidence and low self esteem.

Drug addiction can often produce disturbed thought patterns and behaviours including:

• ­ Denying reality
• ­ Obsessing about the drug of choice
• ­ Not taking personal responsibility
• ­ Blaming other
• ­ Expecting others to fix things
• ­ Memory loss
• ­ Reduced concentration
• ­ The desire to escape
• ­ Avoiding other people and responsibility
• ­ Manipulation and controlling others
• ­ Self harming
• ­ Betrayal of others in pursuit of drug
• ­ Deception in order to keep ahead of the consequences

Addaction produce a very helpful leaflet for anyone worried about a family member or friend - Download addiction leaflet.  

Overcoming drug addiction

If you have a drug addiction, the most important thing is to acknowledge there is a problem and to want to overcome it. Motivation is vital to sustain the recovery from addiction so knowing why you want to quit is essential.

In the UK there is a wide range of treatments, support services and sources of advice and it should not be difficult to find the appropriate approach. The first port of call is usually your GP who will make an initial assessment without judgement or criticism. When provided with accurate information about your addiction the GP will find it easier to make the right diagnosis and find the best treatment and support. The ongoing care may be given by the GP themselves, the community drug team or a specialist drug unit, or a combination of these.

Types of Treatment

Advice and counselling

This can range from individual or group counselling as well as advice about safer use, housing, work, benefits etc.

Opiate detoxification (detox)

The aim of detox is to reduce the amount of drug (usually heroin) from the body prior to support to be abstinent. Doses of the drug are reduced until the user is drug free. Usually this is done over a period of a few weeks but sometimes involves abruptly stopping. Detox programmes are available in hospitals but more commonly on a community basis where users remain at home and receive support to deal with withdrawal symptoms and become drug free.

Methadone reduction programmes

Methadone reduction programmes involve prescribing methadone to heroin users to control withdrawal symptoms. The aim is to gradually reduce the quantity prescribed until the user experiences no withdrawal symptoms and is drug free. The degree of reduction and length of time used to achieve abstinence can vary from a few weeks to several months. Motivation is a key to the success of such programmes. Participants regularly review their progress and usually receive therapy and support as part of the programme. Methadone reduction programmes usually take place in community settings.

Methadone maintenance programmes

With methadone reduction programmes the aim is not to eliminate drug use in the short term, but to stabilise the use by prescribing methadone as a substitute for heroin. The idea is to reduce the need for criminal activity and the harm caused by injecting and to stabilise the user with a view to them giving up drug use in the longer term. Programmes are usually delivered in community settings.

Heroin prescribing

Very few doctors in the UK are licensed to prescribe heroin to street users. In the past some doctors have prescribed heroin, on the basis that many heroin users do not like methadone or continue using heroin while on methadone.

Treatment for stimulant drug users

There is not much specialist care and treatment for people who experience problems with use of amphetamine, cocaine or crack cocaine. Legally permissible prescribing of amphetamine is rare and can be risky. Most agencies offer treatment through counselling, possible referral to residential rehabilitation and alternative (not substitute) prescribing of anti-depressants.   The increase in crack use has led to some agencies also offering cognitive behaviour therapy, acupuncture and other alternative therapies.

Services for younger people

Most drug services are only equipped to deal with adult users (over 18 years old). Confusion over legal issues about confidentiality and informing parents has resulted in some agencies refusing to see the younger age range. However, new initiatives have seen development of projects which specifically cater for younger age groups and the appointment of staff at existing agencies to work with young people. 

Professional support for drug addiction

Telephone Help Lines

There are many telephone helplines you can contact to get immediate advice on drug abuse.  See the Helpful resources section for a number of 24 hour and freephone helplines.

Non-specialist young people’s advice and counselling services

These types of services exist in some areas. They do not specialise in drugs but they do specialise in working with young people. Colleges, universities, youth clubs or youth projects sometimes offer similar confidential services for young people.

Hospital based drug services

Hospital based drug services are usually for people who are heavy, long term drug users, particularly injecting heroin users. Many of these services can prescribe substitute drugs, especially to stabilise or bring people off heroin. Treatments vary between different clinics. These services usually require a letter of referral from a GP, social worker, probation officer or local drug service. Hospital beds may be available if needed but there is often a waiting list.

Drug advice and counselling services

Drug advice and counselling services give information and advice and offer counselling and other forms of support to drug users and/or their partners, family or friends. They usually offer simple advice over the phone as well as seeing people by appointment. Services offered vary from area to area in the following ways.

• ­ Some services operate drop in services while others are only by appointment.
• ­ Some may only meet people at the project base while others will meet clients in their homes or elsewhere in the community.
• ­ Some services have their own doctors who can prescribe substitute drugs. This service is mainly for heroin users and usually involves prescribing methadone either on a detoxification basis (reducing dose over a period of time) or sometimes maintenance basis (constant dose over a period of time until people are ready to give up).
• ­ Some services provide syringe and needle exchange facilities.
• ­ Some services work with self help groups and rehabilitation centres.

The services are nearly always confidential - no one else outside their service will know you have been in contact. Until recently few such services have worked with young people under the age of 16. They usually have more experience of working with the 18 plus age range especially those who inject drugs like heroin. This is gradually changing and while some still only see under 16s with parental consent, many are now working with under 16s, without parental consent if necessary.

The names of these services vary. In some areas they are called Community Drug Teams or Drug Advice Services but often they have a name that is specific to the area they operate in.

Residential rehabilitation centres

These are for people with longer term drug problems, usually involving dependency. Users live in them for up to a year in an attempt to kick the habit. Residents must usually be drug free on admission. This means that they usually have to undergo detoxification before entry
If there is no such facility in your area local people may be able to go to centres elsewhere in the country. Costs can be met through benefits although recent changes in Community Care arrangements has produced funding problems for these services. Information about them can be obtained through your local drugs advice service.

Self help groups for drug users, parents and families

These exist in many areas. Your local drugs advice service should be able to tell you what is available. You can also contact one of the following national organisations: Narcotics Anonymous, Adfam, Parents Against Drug Abuse, Families Anonymous.

Needle/ syringe exchange schemes

These are for injecting drug users – whichever drugs they use be it heroin, amphetamine, steroids or other drugs. They aim to ensure that drug injectors do not have to share injecting equipment and to limit the spread of HIV (the virus which leads to AIDS) and other infections such as hepatitis. Schemes may have their own separate building, be based within drug advice projects, act as mobile services which move around different areas or operate from chemist shops or hospitals.

Some schemes include outreach workers who meet users in their homes or on the streets. They are confidential services. Users do not have to give their name. As well as giving out clean injecting equipment they also offer advice, information and access to health services.