I have never liked the idea of Residential Rehabilitation. I never understood the ideas behind the different models of Residential Therapeutic Communities. I had never heard about residential rehabilitation until 1984 when I was interviewing young heroin users in the North of England. I knew a lot about drugs and had been using them myself since my first encounter with benzodiazepines in 1969 at the age of 12. One of my closest friends from primary school died from a barbiturate overdose in his early twenties. Until 1995, I had known many people who had died from drugs (barbiturates and opioids) but I had never seen anyone ‘recover’ from ‘addiction’ (Substance Use Disorder).
In September 1985 I was employed as the manager of one of the first Community Drugs Teams in Trafford, Greater Manchester. Lifeline was started in 1971 by Rowdy Yates and a small group of ‘addicts’ and a supportive doctor called Eugenie Cheesman. Rowdy was, and is, an inspiration to me. He is one of my, very few, drug sector heroes and he remains a good friend (I hope). However, I never understood the fixation on sending people away from the North West of England to residential rehabilitation. Some of the rationale included getting the ‘client’ away from ‘triggers’ in the places where their problems had originated. I never understood this because by then I had started to develop my own alcohol problem. As I sat watching TV during one of my countless DIY detoxes from alcohol I had to sit through alcohol adverts. I had to walk past pubs shivering and knowing that I had the money to go in order a large brandy and port and a pint of stout (my favorite morning tipple).
I could never understand why ‘addicts’ had to be sent away, out of area, to residential rehabilitation whilst ‘alcoholics’ like me (I never admitted this till 1995) were sent to the local psychiatric hospital (the notorious ‘Ward 15’ in Bury) for a detox and then sent home. What happened in those residential therapeutic communities seemed to me like some bizarre therapeutic cabaret. Chairs and benches seemed to be essential props. There were benches to sit on if you had been naughty and chairs to talk to if you wanted to vent at a loved one who had died or done you harm. You could impersonate fruit and walk round with a placard saying ‘I am a liar’ and ‘I am a thief’.
I never understood what all this had to do with recovering from a heroin habit you had picked up on a council estate in Bury. It wasn’t just me either. In 1985 a friend from Bury (who I had used drugs with) was in court for a string of offences committed to get the money to buy heroin. He passed through Lifeline’s Induction Programme and went to residential rehabilitation centre as an alternative to prison. From memory he was there about 9 months. When he came out went for a pint and he told me all about it. He said it was a laugh and, once he realized he couldn’t head butt the counselors ‘in group’ he did OK. After a couple of pints he said “right great to see you, I’m off to score some ugly dust (heroin)”.
Variations on this scenario played out over the years and I came to regard residential rehabilitation as a bit of a joke. There is the possibility that my perspective has always been tainted by the fact that I have always lived in Bury (apart from a brief exile in Bradford) and mix with people I grew up with on an almost daily basis. When I first sought help for my own alcohol problem it never even occurred to me to go anywhere other than 12 step mutual aid. Unlike my negative experience of people from Bury going away to these residential rehabilitation centres, I knew some real alcoholics (who I had drank with) who had stopped drinking by going to Alcoholics Anonymous (AA). Residential rehabilitation if discussed was dismissed as a joke but AA was treated with a degree of respect because people had seen the change in people like ‘Terry from Bury’.
Fast forward to 7th September 2018 and I am sat in the audience at the recovery conference and I hear David Best talking about building recovery communities by connecting people to hope. He seems to say, or I choose to hear him say, that sending people out of area to residential treatment is harmful because it doesn’t add to the local therapeutic landscape. I get excited and start to tweet. In the haste to tell the world that one of our leading, bone fide academics on recovery is presenting evidence that says ‘keep it local’ I fear I may have over egged the pudding. If I have, I want to publicly apologize to David Best for misquoting him. However, I do want to state, for the record, that I certainly think that if people do need residential detoxification and residential rehabilitation they should stay as near to home as they can.
We do recover and we can get well where we got sick. When we are ‘recovered’ or ‘in recovery’ and walk through our local shopping centres, people who know us, who drank and used with us but are stuck in the madness see us and they can connect to hope. They can’t do this if they are recovering 250 miles away on the recovery Riviera. Finally, I want to dedicate this rant to ‘Terry from Bury’ who planted a seed of hope in me that grew roots and 23 years later sprouted and gave me a life beyond my wildest dreams. The photo is of the author in 1981.