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iCAAD London 2019 - Chip Somers - REHAB – DEAD OR ALIVE?

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In this presentation Chip will talk about the parlous state of rehab. How it is possible that we have gotten to the point where we have all these rehabs but you can only really get in to them if you have money? How have we let local councils take over the medical care of addicts and alcoholics? How have we tolerated a system so clearly broken to continue?

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iCAAD London 2019 - Chip Somers - REHAB – DEAD OR ALIVE?

  1. 1. Chip Somers Clinical Advisor, Help Me Stop
  2. 2. Rehab - dead or alive?
  3. 3. Who am I? "Chip Somers is a liar, a charlatan, a confidence trickster and a deceiver. If only some such donkey of a faux therapist would seek recourse in the courts for such descriptions of him. Then we would have the opportunity to prove that he is a man of bad character and evil motivation." Peter Taylor , CLEAR
  4. 4. The 30 Years War
  5. 5. The 30 Years War ABSTINENCE V HARM REDUCTION
  6. 6. WAR!
  7. 7. Strengths and weaknesses of each team
  8. 8. Harm reduction - strengths • Geographically broad • People not alone • Health checks • Signposting • Substitute prescribing • Non- judgmental paraphernalia • Support groups • No pressure on clients to change • (DTTOs)
  9. 9. Harm reduction - weaknesses • Success rate! • People are still dying • Substitute addiction – is methadone ‘normal’ • Positive urines • Contempt prior to investigation • No hope – even on paraphernalia • Overworked staffed – very little time • The most chaotic get suspended – what happens then?
  10. 10. Harm reduction – weaknesses 2 • NTDMS- TOPS forms • What % of clients who want detox/rehab actually get it? • Triple lock doors and lockers • No interaction with family • 1 in 4 have CSA • Sometimes inexperience really shows • How dare clients be judged before they are given the chance • Terminology • NTA
  11. 11. £ 9 million (2010/11) Payment by results!! 36,000 in treatment! Stole the terminology!
  12. 12. Abstinence - rehab – AA/NA: Weaknesses • Only way! • Early insurance funding • £ made people myopic about relapse • Fudged admission criteria • “You will die!” • No relationships for first year • FINE • GOD!!
  13. 13. Abstinence - rehab – AA/NA: Weaknesses 2 • Abusive • “We break you down to build you up” • Attitude to relapse • Anonymity = Secrecy • Predatory behaviour? • Judgmental about relapsers • Individualised plans? • Referral fees • CQC
  14. 14. Abstinence - rehab – AA/NA: Strengths • Rehab is a safe place with no pressure • Doesn’t collude with the problem • Includes family, past issues and Aftercare • Success rate • People are taken out – they move from cost to input • Unlikely to reoffend when successful • Detox – people experience abstinence • Community – lowers shame and isolation
  15. 15. Abstinence - rehab – AA/NA: Strengths 2 • AA, NA etc FREE • Available anywhere in the world • Come and go as you please • Practice ground for social skills • Inspires – provides hope • Fills up time!
  16. 16. Solutions - dreams • Probably discover much more about genetic and brain behaviour • More people need to come out • That services work together “If you treat an individual as he is, he will remain how he is. But if you treat him as if he were what he ought to be and could be, he will become what he ought to be and could be” (Goethe)
  17. 17. Surely it is not beyond our ability to work together, to solve problems together and to bring hope and life to the same group of people we all work with.
  18. 18. #Dayhab @HMSDayhab www.helpmestop.org.uk Rehab inthe real world

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