CURE WITHOUT SUPPORT RECIPE FOR RELAPSE

Drug treatment centred on methadone maintenance was "social control and
then abandonment", an addiction lecturer told yesterday's conference.

Ms Jane Wilson, researcher in addiction and mental health at the University
of Stirling in Scotland, said health professionals working with drug
addicts should be sensitive to the likelihood of a background of childhood
trauma and psychological problems.

Returning a detoxified addict to the environment in which they formed their
addiction, without recognising that they would need support and possibly
psychological treatment, was a recipe for the "revolving-door" syndrome,
she said, where the addict might relapse over and over again.

Describing a European study, based at Red Towers drug treatment unit in
Scotland, into "dual diagnosis" (a substance use disorder co-existing with
one or more psychiatric disorders) and its impact on treatment outcomes, Ms
Wilson said data showed that between 60 and 80 per cent of clients had one
or more co-existing psychiatric disorders.

These disorders could be caused by numerous factors, including alcoholism
in the family, emotional neglect, sexual abuse, physical abuse, the
negative impact of poverty and bullying, i.e. childhood trauma.

"Like other victims, abused children experience significant psychological
distress and dysfunction," she said. "Unlike adults, they are traumatised
during the most critical period of their lives when assumptions about self,
others and the world are formed . . . and coping and social skills are
first acquired," said Ms Wilson.

Drugs served the survivor in numerous ways, she said. Describing addiction
to drugs as a form of "self-medication", she said they created some level
of well-being, released inhibitions against the expression of painful
emotions and created social groups that had few demands.

The Red Tower study confirmed the relationship between child maltreatment,
substance misuse, increased levels of psychological distress and more
severe problems in adulthood, she said.

"These issues have considerable implications for policy, planning and
resource allocation," she concluded, adding that for every pounds 1 put
into effective treatment of addicts, an average of pounds 3 would be saved
to the public purse in the form of savings on anti-crime measures.