Your Interview: Mike Pattinson, director of operations for the CRI (From The Argus)

Your Interview: Mike Pattinson, director of operations for the CRI

7:50pm Wednesday 13th March 2013 in News

The news that Brighton and Hove may finally be winning the war on drugs was met with surprise last week. One man involved in the ongoing battle perhaps more than anyone else is Mike Pattinson. As director of operations for the Crime Reduction Initiatives (CRI), he has spent the last two decades helping drug users get clean. Here he answers your questions.

Sue B, on email: Drug abuse is often linked to mental health problems and is also a lifestyle/culture as well as an addiction.

How do you help people break that pattern – it may mean somebody losing all their friends – as well as finding safe and suitable housing in a city with such a shortage of housing?

Isn’t more money and resources a big part of the answer, yet support services are facing cuts.

Mike Pattinson (MP): Sue is certainly right that the factors that lead someone in problematic drug and alcohol use are many and varied.

Crucially, recovery also often requires radical changes to someone’s life that may involve changing friendship networks and looking for new ways to fill your time productively.

There is though a blossoming network of peer support groups in Brighton and across Sussex that ensure people are genuinely not left alone in either their addiction or their recovery.

Long-term recovery does involve things like stable housing, employment, supportive friendship networks etc – however my view and that of CRI and our partners is that we can’t wait for the housing market to improve, or for there to be an economic boom before we try and help people get into treatment and get into recovery.

It is also true of course that misusing drugs and alcohol does not help someone’s chances of sustaining employment or accommodation.

Sam Forrest, Hove: How has the street price of drugs in the city changed over the last five years and what has driven any changes?

MP: In my experience, which I think is borne out through national surveys – the price of drugs has tended to remain fairly static for many years.

People still tend to buy “£10 bags” for instance. What changes significantly is the strengths and purity of the drugs they are taking.

And this is affected by many factors – including police and UKBA enforcement action, levels of opium or coca production in the exporting countries like Afghanistan or some southern and central American states.

So any response to the drug problems must be seen in the context of the international situation.

Alice Johnson, Brighton: What percentage of drugs users in the city are non-functioning addicts and what percentage are people who simply use drugs on a regular but recreational basis?

MP: Interesting question – it is important to remember that the people we and our partners like Sussex Partnership NHS Trust and BHT work with are those in or on the edges of treatment.

By definition therefore they recognise that there is a problem, or their families do or agencies are already in contact with them. Across the city each year somewhere in the region of 2,000 people are in or pass through our treatment services and we do know that the patterns of use that people are presenting with are changing.

We are, for instance, seeing huge increases in the numbers of people accessing Cannabis Cessation services and have opened up new clinics for Novel Psychoactive Substance (legal highs) users and those injecting body-enhancing substances like steroids.

We are also delivering discrete services within the Lesbian, Gay, Bisexual and Transgendered communities and supporting the council’s family interventions.

What is obviously not known is the number of people in the city who would class themselves as recreational users but do desire or require any treatment intervention.

Our responsibility to these groups I think is to keep providing considered and factual information about the potential effects of and harms associated with the broad spectrum of drugs available and the accessibility of support should it ever be required.

John Phillips, Patcham: How readily available are psychoactive substances to young teenagers and how worried as a parent should I be if my children started experimenting with them?

MP: Novel Psychoactive Substances (NPSs) – or legal highs – are becoming more and more widely available in Brighton and across Sussex.

An international report published this week describes one new NPS coming to market almost every week.

There are a range of interventions that try to address this – ranging from school education, specialist young people’s treatment services in Brighton, East and West Sussex and things like FRANK, the national drugs helpline.

The concerns predominantly are that the potential long-term effects of these substances are unknown and of course no substance is ever 100% ‘safe’.

There are also risks to young people when under the influence from these substances which tend to be disinhibitors – so young people may find themselves in dangerous situations.

So I think as adults and parents we need to be concerned but not over-react. We should talk to our children about what’s going on at school or college and ask them about the drug education they receive etc.

Teenagers particularly may be unwilling to speak openly with you as their parent so trying to make sure there are other ‘trusted adults’ in their lives to whom they could speak is also helpful.

We know historically that alarmist ‘just say no’ messages don’t work and it is probably a fact now that most young people will get their drug information and misinformation from their friends and the internet.

It’s also worth remembering of course that the vast majority of young people will not use drugs. It’s also worth checking out what their school’s policies are around substances and what support may be available to parents. CRI also deliver the parent support service PATCHED.

Martha Collins, Burgess Hill: Can heroin users treated by methadone ever truly kick the habit?

MP: Most definitely – but only when seen as part of a recovery journey rather than a solution in itself.

Methadone is an opiate substitute medication – it helps stabilise the service users when used appropriately and removes the need to use illicit heroin.

Methadone treatment though needs to work alongside psychological therapies, counselling and peer support to actually deliver sustainable recovery.

CRI and our partners in both the treatment and homelessness sectors have worked to develop a seamless and joined up pathway of support for people to try and maximise their opportunities for full and sustainable recovery.

Irrespective of whether we think the military metaphor is appropriate, the city remains awash with drugs, drug dealers, some of whom being respectable business people, desperate addicts, many resorting to criminal activities, to obtain the funds required for the drug habits, victims of the illegal drug economy.

Zeta Function from the web: Is Brighton and Hove really winning the war on drugs?

MP: CRI has always thought that the language of a ‘war on drugs’ is deeply unhelpful and puts the needs of the user and the community at the heart of our approach rather than the drug.

Within Brighton I see an unprecedented level of co-operation between commissioners, treatment providers, the police and those in recovery to try and resolve what are really complex issues.

We are also working to try and establish a culture of recovery within the city rather than one of addiction – as was seen last summer with the biggest celebration of recovery in the UK – an event planned and delivered by former service users. What we do know is that: l The numbers of people leaving treatment drug free are increasing year on year and Brighton is now one of the top performing areas in the country for its recovery rates from opiates.

• The speed of access to treatment is now a matter of days.
• The range of specialist treatment options is much broader – whether it is those provided by CRI, women only services via OASIS, 12 Step Residential treatment at BHT or young people’s treatment through RU-OK.
• The numbers of people dying of drug related deaths has fallen by 60% since 2009. We also know that nationally the numbers of people in treatment is declining and that the age of people in treatment is increasing as fewer young people are being drawn into using drugs like heroin and crack cocaine.

So we are certainly making progress – but I am not sure it is a “war” that can ever be fully won.

George Smith from the web: Isn’t it right that drug use isn’t any better, they just have a drug to counteract overdoses?

MP: Absolutely not – and that would do a great disservice to the many people in our agencies and our partners who have helped to transform the city’s approach to treatment, addiction and recovery.

Numbers of people leaving the treatment system are increasing year on year – and Brighton is now one of the top performing areas in the country for its opiate recovery rates.

What CRI and our partners have also done locally is ensure that naloxone – which can be used as emergency medication to reverse the effects of an overdose – is much more widely available particularly within those cohorts of clients who have traditionally been most vulnerable to drug related deaths, including homeless men and women and people leaving prisons.

Peter Charlton: Should I ever speak to a drug user on the street?

MP: Well I’m not sure I’d encourage you to start randomly talking to people you don’t know – that might seem a bit odd.

Drug users also don’t all look the same or carry a badge saying they are drug users. People with drug and alcohol problems come from all walks of life and I suspect that in reality you have probably talked to many people with drug or alcohol problems on many occasions without realising it.

If you want to get involved in services that work to support drug users, there are numerous opportunities to do voluntary work.

Nicholas Dunn-Coleman: If teaching and practise of mindfulness meditation was widely introduced in schools, it would produce general benefits and more specifically help interfere with the temptation on the part of some people to see drugs as a way to relax. If the basic guidelines of cognitive behavioural therapy were referred to often within the body of teaching in schools that would have benefits too. Does Mike Pattinson agree with my points?

MP: Another interesting question Nicholas – certainly we ‘teach’ mindfulness within our treatment services as a way of supporting relaxation and resisting the urges to act impulsively and it is very well received by many of our clients.

Some of the skills involved in cognitive behavioural therapies are also embedded within many of our treatment interventions – giving people the opportunities to identify high risk situations and plan how to and practice avoiding them for example.

I think the question of where and how it might fit into a school curriculum is a slightly different matter and not one I feel qualified to comment on.

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