The Elephant in the purple room

Having worked with a number of recovery communities and services across the U.K over the last decade, it still surprises me how reliant we have become on volunteers. Local authority budgets have been drastically cut in recent years and commissioned treatment provider caseloads in many cases are at unmanageable levels, with recovery workers firefighting complex cases or looking for quick discharges of others with varying levels of ‘sobriety’, it is perhaps no wonder that the integration of volunteer roles has gathered pace. I have visited services with volunteers on reception, running groups, mentoring, providing needle exchange services, doing home visits, and many other roles that were previously paid positions. Whilst this is undoubtedly great to see, and there are clear benefits to both the individual and service as a whole when you treat people as assets rather than just ‘service users’, I am frequently met with frustrations from volunteers, some of which i will attempt to articulate here.

The 2015 UK Life in Recovery survey found that those in recovery volunteer for local services at twice the rate of the general public. ‘we only keep what we have, by giving it away’ is the mantra.

Are service providers over reliant on volunteers? Do those volunteers receive the support and training they need and deserve?

We are frequently reminded, as people in recovery that we should be grateful, and how much ‘giving back’ supports our own wellbeing and recovery. These things are indisputable, I frequently do my own gratitude lists and meditations, as well as volunteer where I can, and I certainly wouldn’t have had a career in substance use without volunteer peer mentoring for my local service at the start of my journey. When I got my first paid position for a local treatment provider I had been volunteering for 18 months, had 27p on the electric meter and was under a sanction from the job centre for missing an appointment while volunteering. I was fortunate to have managers that believed in me, and be given the opportunity to create a job position where there wasn’t one before. That afforded me a pathway back into meaningful employment.

The elephant in the room however is the increasing pressure placed on volunteers in early recovery, and the lack of meaningful support received in many cases. Early recovery as defined by William White is anything under 12 months. Sometimes this period is referred to as the pink fluffy cloud of recovery, often this is the best life has ever been, we are substance free and we start to appreciate life and notice the small things. We want to give back and carry the message that we do recover.

We all love to hear success stories, from despair to hope. It gives us a warm feeling that recovery is possible and helps those earlier in their journey to identify. It is undoubtedly why many of us do what we do. Change is a beautiful thing.

Whilst there is undoubtedly lots of value in sharing our story, to celebrate change, inspire hope and promote visible recovery in our communities, I am often left wondering what support or guidance these brave individuals have in doing so, and also what happens when, as in many cases they serve their purpose, eventually lose their spark, or relapse. We all know that aftercare provision in the UK is in many cases woefully inadequate STILL. There is also an inherent stigma to re presenting at a treatment provider for a volunteer after a relapse. After being placed on a pedestal, overcoming those feelings of shame can be a real barrier. Does the organisation have a relapse policy, and is this equitable and supportive?

Services can be very quick to get their new successes to share their story and get them involved with volunteering. (some would say to evidence their services’ efficacy for future commissioning bids and to tick a ‘service user involvement’ box).

With record numbers of drug related deaths, fewer people entering treatment for alcohol use, and fewer successful exits (whatever successful means in reality) according to PHE statistics, the role of a peer worker is now more important than ever, but it should not compromise your personal recovery.

So what support do we really give these volunteer superstars managing receptions, running groups, facilitating access to mutual aid, mentoring, and generally making working life easier for paid staff and services across the UK that receive millions in contracts to provide services.?

Often, in my experience it is nothing more than inhouse or online training around safeguarding, confidentiality and a DBS to tick the boxes for the provider. I recognise that in the postcode lottery of UK service provision there are areas of really good practice with some great training options including accredited courses and regular supervisions, as well as pathways back into employment, however in my experience this is more the exception than the norm.

So whilst I agree that this recent shift towards enabling those in recovery to empower themselves through volunteering is a positive one on the whole, it must also be balanced with adequate resources and support for them, as well as recognition that their individual recovery is paramount. Volunteering should never be detrimental to personal recovery. Volunteers are more than just free labour, and volunteers should be compensated for the time they give freely.

Whether they are called, recovery champions, peer mentors, peer support workers or volunteers the important roles these individuals play deserve more resources, support and respect than is currently given in many areas. Particularly if they are integral to the delivery of a commissioned service. There is no greater resource than time, and these individuals give theirs freely, the least we could do is give them the skills and support they deserve to;

a) fulfil their role responsibilities to the best of their ability b) build their skills for the future c) have proper supervision d) feel like a valued and respected member of the team

Have local services in your area changed their mindset from ‘fixing and treating’ individuals in recent years to a more person centred community asset based approach? Does your local provider actually provide meaningful volunteer opportunities, as well as adequate support, training and a pathway back into employment? I would love to hear of your lived experiences. Feel free to drop me a confidential message to carlozuccaro@hotmail.co.uk.

Recovery what?

September is celebrated as Recovery month in towns and cities worldwide. It is a visible celebration of recovery from addictive behaviours, where people from various pathways connect, share stories, sing, dance and typically walk through their towns and cities in a show of solidarity. The recovery movement hopes to challenge stigma and act as a beacon of hope and inspiration for our communities, showing that we can and do recover.

This year however it comes around amidst a backdrop of record numbers of drug related deaths, rising suicide rates among almost every demographic and increased social isolation due to the pandemic, which will undoubtedly result in a surge of additional mental health and substance use issues. It is more important than ever to shine some light on a subject that is not a particularly endearing societal problem, despite so many families and communities being affected. There is an enduring stigma that pervades addiction and prevents people talking honestly and openly.

A quick bit about my early experience

I am a person in long term recovery from substance use and mental health issues and now a self employed recovery coach and consultant for a couple of peer led recovery services in the UK. Having worked for almost a decade within both NHS and charity services I want to share my experience as a person seeking recovery, working in treatment, and why i think that recovery coaching may be the answer to some of the issues we face.

The first time I ever sought ‘treatment’ was for my opiate habit and I was aged 18. I’d already dropped out of my A’ level studies after too much house partying in the late 90s, and my substance use had escalated onto harder drugs looking for some kind of escape from myself and my environment. I’d never heard of the concept of recovery then. I was living in a small market town in Lincolnshire, my mum was an addict, her bloke was a dealer and hope was something other people had. It was trainspotting without any of the nuanced relationship dynamics or scenic tourism. It was dawn raids, ODs in the kitchen and methadone not milk in the fridge. Shoplifters half price offerings and a who’s robbing who of giro junkies. I took my feelings of shame to the local surgery, broke down in tears to my GP and begged for some relief.

The well meaning but Ill equipped GP gave me some DFs and a few diazepam for which I was grateful (bless him) it was free drugs after all. The intention was there though, in that moment of clarity between giro days I imagined a life free from withdrawal, anxiety and depression, I was going to do it. Well, I did 3 long days on my grandma’s sofa pretending I had the flu before I necked the rest of the yellow tablets and clucked off to score again. I didn’t re-engage meaningfully with treatment again until I was 21 and left town with a methadone script and my first ever period of (MAT) recovery, and all manner of cross addictions (but that’s another story).

What’s new?

These first interactions of mine over 20 years ago with services raise some important points for me to reflect on today as a person in long term recovery.

Firstly a few questions, Can we honestly say that GP’s and front line services across the UK have the resources and knowledge necessary to provide more proactive interventions over 20 years later? Are traditional treatment services appealing and accessible for those new to them? Are waiting lists for accessing ‘treatment’ still in the future with very little in the present to support people during those brief moments of clarity? The best time to initiate change is when a person feels ready, that feeling is fleeting. Are aftercare services post treatment fit for purpose to maintain long term sobriety? I must say that I do see areas of good practice in some places in the UK with thriving well connected recovery communities, but i’m speaking here in general terms of the treatment system.

Secondly, what would it have looked like if I had access to an experienced guide who could advise me of different pathways and connect me to others in recovery, as well as wider community resources. Someone who could share their story of hope and recovery as well as ask tough questions from a place of experience and understanding?

My belief is that Recovery Coaching should be at the heart of every recovery support service and community. So, what is Recovery Coaching?

It is a form of strength-based, person centred support for people in or seeking recovery, and even their family members. It is similar to life or business coaching in that it is a type of partnership where the person seeking recovery self-directs their plan while the coach provides support, guidance and options. Recovery Coaching focuses on achieving goals important to the individual, without stigma, dogma or an agenda. They help people access recovery and the systems needed to support it and add to an individual’s recovery capital. They are not counsellors or therapists and as such are future focussed and goal oriented. They do not diagnose or treat substance use or any mental health issues, but can absolutely help with signposting to professional services that can, as well as offer an unparalleled level of understanding.

Peer based Recovery support

There are a myriad of different names for volunteer roles in the U.K, from mentor to recovery champion and others in between. These are primarily volunteer roles, and typically taken up by those still in treatment or at an early stage of their recovery. I am in no way dismissing these roles, they play a crucial part, and it is in these roles that I also gave back and volunteered at the start of my own journey. Nor am I speaking of the specific roles of a sponsor which again is a great part of a wider community approach.

There are however some distinct differences between existing unpaid roles of ‘peer support’ or ‘recovery champions’ and that of an experienced recovery coach. Not least a period of stable recovery, but also robust ongoing training and guidelines that incorporate values and ethics. The dynamic of the roles is also largely different, and an understanding of these differences can help ensure each role is maximised to its full potential in order to support existing treatment and public services. Support and development of these roles is critical to building a thriving recovery community.

There has been some great work across the pond by our American friends on peer based recovery support services, and their view is largely that we are very much behind the curve. “The history and future of peer-based addiction recovery support services,

There are areas of the U.K that have embraced similar models of peer based recovery support services, including rehabs and community organisations, and some great work has been done broadly by FAVOR UK on this as well as regionally by Red Rose Recovery. While this has been a great step in providing opportunities for employment and resources for people, we also need to be mindful to maintain the fidelity of the Coaching lane so these roles do not become appropriated into clinical, or “go-fer” type roles. Many treatment services over reliance on volunteers has reached new levels, sometimes in a way i have seen to be detrimental to their personal recovery. Whilst giving back is undoubtedly an important part of wellbeing and recovery it must be meaningful, and feature appropriate support and guidance. Once trained our experience and expertise provide us invaluable insight and become our tools to help others. There must also therefore be a pathway for volunteers through meaningful volunteer roles to employment when appropriate.

I am grateful to be working with a very proactive CIC in Grimsby that supports recovery through art and mutual aid. They recognise the importance of bringing some of these concepts to their recovery community to help it become a thriving space for people to get well and re-engage with the wider community. I will be initially delivering 8 sessions of recovery coaching based on the great work of many giants before me including William White, McShin Foundation, CCAR and Favor UK to name but a few, as well as including elements from my own experience and coaching practice. This will form a wider bit of co-produced work from which we aim to establish a number of local coaches and implement systems to support the local community.

When i attended my first recovery walk in Birmingham UK in 2013 the theme was ‘make it happen’ and this is a mantra i have continued to aspire to on my own journey. Recovery is not only possible, it is inevitable when we reconnect with a community and find our purpose.

Hope + Opportunity + Purpose = Recovery 💜

I am also looking to connect with people across the UK who would like to influence their local community to make visible and sustained recovery the new normal.

Contact me; carlo@purplemagpiecoaching.co.uk

If you are in or around Grimsby get in touch.

Dithering dogma…!

As UK pubs reopened to a mixed response, after the last three months of isolation Brits still seemingly still have a thirst on and aren’t too fussed about distancing.

With news articles declaring consumption has risen during lock-down, and some early studies also looking at potential increases it may be a good time to reflect on our choices. It has undoubtedly been a difficult period, particularly for many of our dependent drinkers, and the lure of getting back out there ‘connecting with friends’ or ‘disconnecting from current reality’. I’ve noticed it both on my social media timelines with friends and family’s daytime drinking patterns, and at work with those i support. One of the biggest protective factors for many was connection, and we have long stressed the importance of this as part of the 5 ways to wellbeing. So as social isolation has grown, as seen in Dr Alexanders rat park experiments of the 70s addictive behaviour invariably escalates.

So what is out there now if i want to get help?

There is of course your local treatment provider commissioned by your local authority, who can put you in touch with all local community assets. A quick online search should find the current one, after initially stopping seeing people face to face many are now opening their doors again. I know many people that simply will not engage with these services due to barriers, either real or perceived varying from stigma to a previous bad experience. There are also mutual aid meetings such as 12 step fellowships like AA or NA that are avidly promoted by GP’s and other public services. Some barriers to engaging with these groups can be the perceived ‘GOD issue’, the ‘powerlessness talk’, the ‘drunkalogues’ or just the perceived monotony of perpetual meetings. Alternatively there is SMART; barriers to engagement – over reliance on confusing concepts or acronyms, lack of community, and ‘recovery know it all’s’. You will often hear the phrase within the recovery community “take what you like and leave the rest” and that is generally the way to go. Whatever you decide do it with an open mind and positive intention. There are some excellent parts that make up the whole and can act as helpful recovery capital to support your goals.

So what about the large majority of those over reliant on substances that find the barriers to engaging with treatment providers or mutual aid too much or too stigmatising?

Recent PHE figures [1][2] before the pandemic also showed disturbing trends of fewer alcohol dependent people engaging with treatment services. Over the last few years we have also seen record numbers of drug related deaths across the UK. It is clear something is not working for many, as services have also faced drastic cuts to their commissioned treatment budgets repeatedly in recent years. The sector is asked to do more with less, but at what cost?

Having worked in “recovery services” of various guises over the last 9 years, and as a person who had a serious substance misuse problem/substance use disorder/addict/person in recovery/recovered* (*delete as appropriate today) I now find myself walking away from the sector i was once passionate about, recently made redundant and disillusioned at current service provision across most of the UK. Having traveled a lot for work i have been fortunate to see some fantastic practice in some areas, however the very nature of commissioning has led to a postcode lottery and dramatic variance in recovery ‘choices’. One thing i have learned in my time working in the sector is that there is no one size fits all approach to recovery, and my view is that recovery should be self directed and defined by the individual. Complete abstinence can be seen as a barrier to entering treatment, and perpetuate the shame following a lapse/relapse. The term recovery itself has become somewhat of an abstract cliche, and people in early recovery are often paraded out to prove a service’s outcomes and to add value to the service’s ever dwindling pot of money, as cuts continue to bite, with very little ongoing support. Volunteers are now finding themselves increasingly on the front line.

“It is an historical fact that practically all groupings of men and women tend to become more dogmatic; their beliefs and practices harden and sometimes freeze. This is a natural and almost inevitable process…. But dogma also has its liabilities. Simply because we have convictions that work well for us, it becomes very easy to assume that we have all the truth….This isn’t good dogma; it’s very bad dogma. It could be especially destructive for us of AA to indulge in this sort of thing”. ( Bill Wilson, 1965/1988, p. 333)

Disclaimer, as i know there is an almost tribal response to perceived criticism of ones ‘recovery pathway’ so I will say, i have spent time with various recovery programmes and fellowships over the years, i have sponsored ‘addicts’, chaired and facilitated meetings and repeated many of the dogmatic well rehearsed mantras. I have also bitten my tongue on a number of occasions in order to be diplomatic and not rock the recovery boat, however in my view services and commissioners should and can do better. The statistics are quite clearly showing that the existing model(s) are not working for many.

Dogma has had a stranglehold on treatment for people who use substances since treatment was conceived for ‘treating’ the feckless, right through the temperance movement and into the dominant philosophy of recent times being the 12 step approach, and abstinence being the “only way”. This is manifest still today in funding streams and also in rehabs, as well as local service providers.

As such it is good to see the rise of the moderation/ mindful drinking movement with Club soda putting on mindful drinking festivals (pre corona) and engaging people from across the spectrum, and hopefully more will follow suit and consider new models and ways to build community and a society that does not need to rely on substances or treatment in the way we currently do. Invariably we use substances for Fear or fun, both are short term rewards, but extremely gratifying. Our reliance on substances as an emotional crutch means may of us are floating through life like a carrier bag in the wind. The way out of my addiction was finding a purpose i was passionate about. I will be eternally grateful to my mentors that gave me the opportunity to make it happen, and will continue to support others in defining their own recovery goals without judgement or dogma.

Giving back is an important turning point in many peoples recovery journey (After mentoring i created a small community group to support individuals in my own community with the limited knowledge and resources we had at the time) however the biggest factor in me sustaining my own recovery was challenging my own limiting beliefs and feeling empowered enough to pursue my own personal growth, until then I was just ‘white knuckling it’ and going through the motions.

Change needn’t be difficult, only resistance to it is (to paraphrase the Buddha). Find something or someone that inspires you to be the best version of yourself and apply yourself wholeheartedly, you don’t need to have all the answers. There is no quick fix, and those that are pave a road to ruin. The future is yours. The future is now. 💜

Own your story

Life is very short and anxious for those who forget the past, neglect the present and fear the future

-Seneca–

~MementoMori #AmorFati

This is a blog for posterity, about my personal journey through council estates and reprobates, addiction and living with a physical disability, followed as ever by the haunting spectre of anxiety and fear.

Im well aware i’m joining the majority of 30 somethings blogging about their dull lives for nobody to read, but I guess i’m doing this partly as I value the stoic strategy of journalling and find it somewhat cathartic, but also in the hope that it can perhaps be a flicker of light to someone going through their own period of darkness. We can and do recover.

I write this having just completed my third 10k road race in Grimsby. The only time I remember doing cross country at school, we used to dick off to smoke in ‘the pheaso’, so running has never been a friend, unless you count running from my responsibilities, kinda made acquaintance with that for a while.

10k

This race was also a personal milestone for me, in that it was the first time ive ran in public in a tshirt since being an adult.  I have suffered from depression for many years relating to body issues from my congenitive limb defect, and become very obsessive about covering up my imperfections. This year has been a bit of a transformative one in many ways as i also adjust to being a dad and balancing a difficult workload, while working on myself. Really appreciate everyones support and motivation.

 

As a person in long term recovery part of my personal programme focuses on goal setting, so in order to push myself out of my comfort zone this year I have signed up to run the London marathon in 2020, and have been humbled to be given the opportunity to be raising some money for a charity that is close to my heart.

(justgiving link)

Practising acceptance among other stoic and CBT based strategies have been central to my recovery journey and addressing my own thought patterns and behaviours. Ultimately we have a choice to face our fears and try to be the best version of ourselves given the circumstances within our control.

#uksmartrecovery Has been also been present throughout my journey into recovery, from facilitating meetings as a volunteer with a local service provider to delivering the programme as an employed staff member in the NHS, to now being employed full time as UK SMART Recovery National coordinator for England.

I was probably considered a lost cause, disenfranchised from society and unable to talk about my issues, perpetuated by the shame and stigma around addiction, mental health, and the taboo of disability, part of my healing process after a successful spell in detox has been embracing acceptance and facing life on lifes terms, as the cliche goes.

Having worked in the sector for a number of years i am as ever encouraged by my amazing peers that are supporting recovery communities across the uk in increasingly difficult conditions, amidst record numbers of drug related deaths and government austerity measures.

I would encourage anyone looking to regain some control over their addictive behaviours to use mutual aid as part of their recovery capital. There are many pathways to recovery, but acceptance is required in all. We can and do recover.

The obstacle is the path – Old zen proverb

UK SMART Recovery

Narcotics Anon

Act peer recovery

Thank you for reading. All is love. 🙂

Facebook Detox

[Insert New Year, New Start cliche]

Let me start off with saying i have never set any firm new years resolutions beyond a half-hearted mono-toned mumbling to the cat as the fireworks fizzled out. I do however try to make every day an opportunity to practice small, positive changes towards personal growth, so this decision has just been the next in a series of life choices i have been mindfully reflecting on. I got rid of my TV almost a year ago as i started to be more conscious about how i was spending my time, and my procrastination gremlin had also resurfaced, so amid the white noise of Brexit i felt it was the right time to get rid of that particular negative distraction.

So as a person in recovery from addictions myself, recent articles highlighting similarities between (dopamine) releases and triggers from social media to those of  ‘traditional substances’ like cocaine really made me think about my own use of social media.  [source] [source] [source]

What once seemed a benign and practical way to keep in touch with family and friends, and occasionally sharing funny pictures, has for me, at the very best become a haven for procrastination, my thumb aimlessly scrolling for what must have been some miles daily during any free time. At worst, i had noticed my mood changing depending on certain interactions with social media, and in real life i was often distracted, sometimes even having a flutter of panic if i had left my phone somewhere i could not check it.

What struck home for me particularly as somebody who often bemoans the fact that i don’t have enough time, was a recent report that stated; “as of 2017, daily social media usage of global internet users amounted to 135 minutes per day” [source] I could not believe it. That is almost a part time job.

So what that i waste time on social media, it is hardly an addiction really is it?

 

‘Addiction’ is often characterised as a compulsive behaviour, that in turn has a negative impact on an individuals life. So while i am not shoplifting to pay for my WiFi, or holding people hostage for likes, i have noticed some addictive behaviours creeping in and have made the conscious decision to be more present in my daily life, and limit my use of social media.

“Desires for media may be comparatively harder to resist because of their high availability and also because it feels like it does not ‘cost much’ to engage in these activities, even though one wants to resist.” [source]

So with the knowledge that social media and apps are created specifically to be addictively engaging [source] it is of course on us individually to challenge our compulsive urges of instant gratification and where appropriate use coping strategies. Be mindful of how you are interacting with the world around you and do some honest reflection. Are your current behaviours truly benefiting you and those around you?

Everyone whom i told about my decision to take a break from Facebook made a very similar and somewhat disconcerting face, a mix of shock, and that suspicious face you make when you think someone has farted in a lift.  Their reaction was oddly reminiscent to that of some of my drug using acquaintances when i first told them i was going into rehab.

What that means for me is simply deleting the apps from my phone, nothing more. I am not putting any pressure on myself to delete my accounts, or making any commitment to anyone other than myself. I am taking things ‘one day at a time’. Also just to note i did not do the dramatic ‘i am leaving facebook post’ that you often see before a person typically returns the following day. This is not about others. This is a personal choice.

I am 10 days in, i feel less anxious in general and have read 2 books i have been putting off, including rereading The Power of Now by Eckhart Tolle, which is a great book if you have not read it yet, and started a blog which has been on my to do list for an age. I have also taken more time out to practice mindfulness and CBT techniques which have really helped me calm my overactive brain chatter.

If you are struggling with any type of addictive behaviour, remember you are not alone and there are services and resources that can help.

 

If you want to take the leap, here is a great little TED talk about quitting social media  –

 

Thank you for taking the time to read my blog

Carlo Zuccaro