London Bridge between theory and practice: a glimpse at drug and alcohol treatment services in UK

15 December 2016

In mid-November, a group of us from the Czech NGO SANANIM (Jan Audrlicky, David Pesek and Tomas Vejrich) with the help of EHRN participated in a study tour to Lambeth Drug and Alcohol Treatment Consortium and alcohol and substance misuse center Blenheim in London. We would like share with you a little of what we have seen: exciting and inspirational things, which social workers and community of people who use drug manage to achieve despite difficulties and problems.

A visit to the Lorraine Hewitt House, community treatment and detox center, which is a part of the Lambeth Consortium, was a true eye-opener. The main goal of the House is to set a contact with clients and help them change their chaotic pattern of behavior related to drug abuse. Beside regular needle exchange, OST and HIV and hepatitis testing services, the House also helps to develop coping strategies for people who use drugs and provides a wide range of social services, such as support for families and carers, sexual health clinic as well as legal, benefits, and housing assistance. Clients at the House can be referred to detoxification and support recovery centers, where they can be involved in a broad spectrum of individual and group activities. Social workers, doctors, and counseling specialists are available for one-on-one or group sessions, stimulant relapse prevention activities, cognitive behavior therapy, mindfulness, and other practical courses.

On average, the amount of newly admitted clients is 4 per day. The caseload for each employee at the center is 50 clients. Those on OST program can choose between methadone and buprenorphine.

One more stop of our visit was the Consortium’s aftercare center Harbour, which provides support to the clients for ongoing recovery from drug use. Dawn Brecken, a representative of the Center, explained to us that Harbour is structured on a recovery and rehabilitation model rather than on a strict abstinence system.

The Harbour makes available for its clients individual consultations with social workers that prepare treatment plans for each client and conduct support and therapy activities. The employees and volunteers at the center organize a variety of group programs: relapse prevention, SMART recovery, women’s group, reading club, art therapy, and yoga. All group activities are open to all clients with one condition – participants cannot be under the influence of drugs during group activities. The clients at the center can get information about available training courses, volunteering possibilities, leisure activities, and employment.

Despite such a high level of organization and various services for clients, the Harbour is unable to accommodate all clients’ requests, related to social integration. One of the biggest problems is accommodation. For socially vulnerable people living in the London area there is a 3-step model of accommodation:  the 1st level is a hostel, the 2nd level is a shared house, and the 3rd level – a private flat. All these social lodgings are taken. Moreover, people who use drugs are not a priority social group on the list of potential tenants – in case of vacancy accommodation is given to the old, people with motoric disabilities and other disadvantaged groups. Therefore, despite all attempts, people who use drugs wait in line for a very, very long time.

A few other things that we observed during our study tour are worth mentioning. A good connection exists between science and practice in the provision of services for people who use drugs: new approaches in health services and social care system are being implemented at the centers. The people enrolled in the programs are motived to rehabilitate, quite a number of them return to the centers as volunteers to help the new clients. To sum it all up – well-coordinated work of the employees and its effects on the life of the community is a true inspiration.   

The study tour to UK and the information and inspirations we have received was very important for one more reason. Currently, the reform of psychiatric care is taking place in the Czech Republic, and in this context, SANANIM is preparing a project to evaluate the efficiency and cost-effectiveness of a new approach in the system of care for people who use drugs. Our organization will also lobby for the interests of drug users as an eligible group for social housing and the establishment of multi-stage housing system for this group. 

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