Feedback on Fi Blair's and Sarah Loeb's talk on "How do I help a colleague, client, friend or relative who has a drugs problem?"

Martin Currie in Saltire Court were kind enough to host this key talk in the OASIS series which addresses some of the most serious social issues we may come across or indeed face in our own lives. The talk was given jointly by Fi Blair and Sarah Loeb, both from Simpson House Drugs Counselling Service, a service with a Lothian-wide remit funded principally by Lothian Health Board and the Church of Scotland.

The speakers started by asking us all to think of something we do or have on a regular basis and on which we think we depend.

• What is our dependency?
• Why do we think we have this dependency and what does it do for us?
• If we had to give up our dependency how would we feel?
• If our dependency became illegal would we continue?

This helped us realise that almost all us have some dependency, though generally it is harmless. So we were already beginning to understand people who have become reliant on drugs...

The next step was to consider phases in the process of change from one type of behaviour to another, this with a view to understanding how drugs counsellors do their work with clients:

• Pre-contemplation, when the client has not yet seen that they have a problem.
• Contemplation, when the client begins to weigh up the situation, but may still identify benefits to them in their behaviour. They may need help to recognise the problem. Motivational interviewing is useful here.
• Decision, a brief period in which the client chooses between realistic change and no change.
• Active Change, when the client is putting into practice their decision to do things differently

• Maintenance, when the client may benefit from support to help resist any temptation or pressure to revert to dependency.
• Lapse, when the client reverts to some aspect of pre-change behaviour. With support, occasional lapses need not result in total relapse.

Next came an explanation of three classes of drugs, each having different effects:

• Downers, which calm people down, examples being Alcohol, Methadone, Dihydrocodeine, Heroin, Cannabis, Diazepam, GHB, Ketamine Special K and Temazepam.
• Head Turn Arounders, which are hallucinogens making people imagine what isn't there, examples being Ecstacy, Cannabis and Magic Mushrooms.
• Uppers, which are stimulants, examples being Ecstacy, Poppers (Amyle Nitrate), Cocaine, Nicotine, Amphetamine (Speed) and Steriods.

Note that Ecstacy and Cannabis belong to more than one class.

How to go about helping people come off drugs? A common model of would-be support but which does not work is the Drama Triangle in which there are three roles:

• Persecutor, assuming a position of superiority with a 'hurt or be hurt' attitude.
• Rescuer, also assuming a position of superiority with a 'need to be needed' attitude.
• Victim, assuming a 'helpless' position.

The recommended model is the Winning Triangle in which again there are three roles:

• Assertive, has firm consistent boundaries.
• Supporter, empowers vulnerable by being supportive and taking a step back.
• Vulnerable, takes responsibility for their own situation.

Our speakers answered some questions and kindly met with a few of us afterwards. Just some of the points that came up:

• taking drugs is often only a presenting problem, i.e. it masks a much deeper issue.
• sometimes it is connected with the clients having been abused in some way in their childhood.
• coming off drugs can be a long haul and requires huge patience and stamina on the part of the client's support group (spouse/partner; family; relatives; even colleagues); one estimate says it takes an average of nine lapses before a person is free of their drugs dependency.
• surprisingly to some of us, coming off heroin can be much easier than coming off some of the so-called less harmful downer drugs.

The talk was inevitably only a a brief introduction to this topic. Fi and Sarah certainly know how to communicate well but our lunchtime was all too short. They, and their Simpson House colleagues, are open to doing a more in-depth seminar for business people, e.g. over a half day.

Fi and Sarah offered us a range of leaflets, including H. M. Prison Edinburgh support work, Group Work for other organisations, Family Support Group and Individual Counselling.

Simpson House offers a free counselling service and opens late on a Tuesday. Contact details:

Simpson House,

52 Queen Street,

Edinburgh EH2 3NS

Tel: 0131 225 6028, 0131 225 1054

Fax:0131 220 0064

Email: staff@simpsonhouse.bosr.org.uk

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