Frontline addiction services: P addicts curable if society will make the commitment

Recently the Herald has drawn attention to the damage methamphetamines cause to people and society. The stories told have been traumatic accounts of woe and self-destruction.

The P problem is frightening but those who work in addiction treatment say the situation is not hopeless.

Methamphetamines are a major concern for alcohol and drug treatment providers and the costs to society of this and other drug abuse are extremely high. They include poor health, family violence, random aggression, chronic welfare dependency, lost productivity, and criminal behaviour.

After long-term use people who abuse methamphetamines can develop a stereotyped behaviour, including paranoia and aggression. Those unwilling to seek treatment often turn up in the workload of police, criminal justice and medical emergency departments.

Many addicts come to alcohol and drug services with major problems after chronic bingeing on methamphetamines, often in combination with other drugs and alcohol. In many cases they wait until the consequences of their use have become so severe that they feel backed into a corner.

So what are we to do? Treatment of methamphetamine addiction is no different from the treatment of any other addiction. Commitment to change, support from family and peers, and therapeutic interventions based on good evidence are the key ingredients to a successful outcome.

Helping addicts become drug-free is only the first step, however. They also need support in staying drug free.

Recovery demands substantial changes in lifestyle, taking personal responsibility and learning to deal with life on life's terms. A range of treatment interventions can assist people to make these changes. For some this may include a period in a residential therapeutic community where, for 24 hours a day, they are in an environment that helps them take more responsibility.

For others, regular counselling, positive peer support, help from their families and churches, and sometimes pharmacological interventions assist them in recovery.

Active participation by the addict and his or her family is essential. Research shows long-term successful recovery includes: Being free of illegal drug use, replacing drug use and illegal activities with pro-social activities. Also real accountability for behaviour to a person who has knowledge about the process of recovery (for example to a Narcotics Anonymous sponsor, alcohol and drug counsellor, probation officer, priest, police officer, general practitioner or elder). And the development of a spiritual or ethical outlook on life.

Research also tells us that no single form of therapy is successful in all cases. However, ease of access to treatment and a compassionate and engaging style of interacting by the professional are essential no matter what approach is taken. Addressing a range of immediate needs and developing a clear plan on how they will be further addressed are more effective in the early stages of engagement than in-depth soul-searching for the "causes of addiction".

In the real world there is no instant miracle cure for addiction and for many the process of recovery will be a story of disappointments and successes, particularly in the first year.

Abstinence can be difficult to maintain initially, but a harm minimisation approach may achieve important steps towards it. Avoiding becoming infected by Aids or hepatitis, for example, is an important achievement, particularly for the addict's children and family.

Finding appropriate housing, improving childcare, and disengaging from criminal activities all contribute to a foundation of recovery.

Waging war on those who import and manufacture methamphetamines may make some impact. Waging war on addicts and their families won't.

The "war on drugs' approach only serves to marginalise and demonise those afflicted with addiction and often decreases their chances for rehabilitation.

Around 1100 professionals work in the alcohol and drug sector in New Zealand, including nurses, medical officers, psychiatrists, counsellors, cultural workers and psychologists.

Around 10 per cent of those seeking help through alcohol and drug services have problems with methamphetamines (75 per cent of cases are alcohol related). Better alignment between the criminal justice and alcohol and drug rehabilitation services is required, in particular to target those who are not interested in dealing with their addiction.

Treatment provides an alternative to jail for addicts who want to make the hard calls and stop using. It also is more humane and cost-efficient for the public. Every dollar spent intervening early saves an estimated $5 in healthcare costs down the line.

The Government's stated commitment to addiction treatment and prevention is welcome news and we encourage it to make good on that commitment. Recession or not, the incredible personal and social costs of methamphetamine and other addictions mean this is a problem we cannot afford to ignore.

If you need to find out about alcohol and drug treatment services near you, please call the Alcohol Drug Helpline: 0800 787 797.

The frontline addiction services who contributed to this piece included:

Robert Steenhuisen, manager, Community Alcohol and Drug Services Auckland; Chris Kalin, CEO, Odyssey House; Tim Harding, CEO, Care NZ; Cate Kearney, CEO, Alcohol Drug Helpline; Alcohol Drug Association NZ; Lynette Hutson, national manager, Addictions and Supportive Accommodation; The Salvation Army; Ross Bell, executive director, NZ Drug Foundation.