Tuesday 27th September 2016

Martin is a Substance Misuse Practitioner working within the NHS community mental health services for 10 years. He is also a trained integrative counsellor and supervisor of counsellors, previously involved I the Talking Therapies network within the Trust’s alcohol and Drugs Directorate. Whilst working as a practitioner he has developed a keen interest in the link between mental health and substance misuse.

The opening of the meeting began with discussion to the growing percentage of substance users found within the UK. This issue has been recognised by the government with more substances available to users than in previous times and not always obvious in the risk they pose. Whilst substance misuse is something that would be difficult to cease entirely, there are methods/ techniques that are continuously proposed to provide a degree of maintenance in handling and aiding substance users.

Martin detailed various substances found today:

  • Alcohol and unit measurements (3 units= 250ml, 10 units= 1 bottle of wine)
  • Cannabis- in its various forms (stronger than in 60’s and 70’s and often linked to mental health issues)
  • Heroin (Injected to create a ‘rush’ or ‘euphoria’ or smoked for a quicker impact)
  • Stimulants such as cocaine or crack cocaine, recently starting to be found mixed with heroin
  • Amphetamine (speed, whizz, billy) which can be bombed or injected, potentially blocking the veins.
  • Methamphetamine (crystal meth)
  • Prescription drugs including ones such as Benzodiazepine which can be addictive

It was discussed how ‘legal highs’ have now become illegal yet there is a conscious issue as users are left addicted. Martin explained how drugs and substance manufacturers are constantly trying to manoeuvre around law enforcement by creating exotic names for existing products whilst creating newer psychoactive substances. It was considered how to a certain degree, trends have a part to play and so production see brightly coloured packages brought out to attract sales and boost popularity. From this the signs and symptoms of substance users were explored:

Change in behaviour, Anxiety, Aggression, Sweating/shaking, Body Odours, Fidgety/ restless/sleepy, Exceptionally emotive or emotional, Paranoid/ delusional

Martin continued by asking the attendees, ‘What does a substance user looks like?’.

It was advised that as counsellors one considers whom they are working with, the client, substance or both. From this, also for consideration was the clients sense of identity and perceptions whilst the counsellor should also be mindful of theirs. For example, are there any judgements or perceptions being formed that may detriment the therapeutic relationship? What is the agenda, therefore, of both parties? It was discussed how the client must always feel they have the enablement to choose to stop their usage and to explore what it may feel like should they decide to, or not. Such discussions in the therapy room may cause the initial contracting between parties to be re-visited several times depending on the details disclosed, which can be helpful when being mindful of keeping the client aware of boundaries. Martin emphasised how the client should be encouraged to remain honest in sessions and useful questions such as ‘What is going on with you right now?’, may serve if discussions become stuck or in need of direction.

Martin explained how for alcohol and substance users, there has been a cycle of change identified. This is not a fixed process and one may find themselves at various stages of:

Pre-contemplation, Contemplation, Action to change, Maintenance, Lapse/ Relapse, Maintaining recovery

The final parts of the meeting provided avenues so that the group could search for those offering help to users:

  • Local 12 step programmes
  • SMART recovery groups
  • Self-help groups
  • Harbour project for carers in Bolton
  • Groups for veterans
  • Alcohol and Drug recovery programmes such as A.A and N.A for narcotics.

This presentation centred around a discussion on drugs and alcohol abuse and the influence found within a therapeutic setting. Various misconceptions were explored that are found within the wider community, looking at how these could potentially influence the therapeutic relationship if not considered. It was discussed how drugs and alcohol impact on everyday life, not only for the individual using such substances, but for all involved and around them.

Chmaine Robinson