Cure without support `a recipe for revolving door'

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 £1 put into effective treatment of addicts, an average of £3 would be saved to the public purse in the form of savings on anti-crime measures.