Hard News by Russell Brown

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Hard News: Splore 2019 – Please Don't F*ck This Up, Part 1: Treatment and Health

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  • andin,

    the healthcare industry – because it’s still very white and very abolitionist, when it gets up to the high level. I think we need to mature, because there’s a whole lot of people being taught about harm reduction at university level, then they get into the industry, and it’s captured by 12 Steps. Absolutely captured.

    alcohol. It’s still the most pervasive, damaging thing in our society.

    Theres money to be made in addiction on both sides of whatever screen is erected there to keep the cash rolling in. Can I just scream...MOTHERFUCKERS!

    raglan • Since Mar 2007 • 1868 posts Report Reply

  • steven crawford,

    Because pretty much all there is, if you are clinically addicted to drugs or alcohol, is 12 Steps, is some flavour of an abstinence-based programme. Those programmes work for a lot of people, but why don’t they work for everyone?

    There is the methadone program, and most community mental health service providers will only suggest total abstinence as a last resort.

    Abstinence is a specific type of solution for addicts (alcoholics are addicts).

    What David didn’t bother to mention is that most of the government funded treatment programs – the residential treatment centres/therapeutic community’s have been down graded or decommissioned. They mostly operated on the Hazelden
    model. Hazelden is over and above the 12 step program from the 1930s. There is plenty of scientific research gone into it. Davids argument for not putting funding back into that isn’t strong.

    For Pacific Island or Maori whanau, removing someone from their family – saying that their old life was the bad thing, and that they must change and have this new family now – becomes really problematic.

    That would be a bad thing, but that’s not what happens in proper government funded residential treatment centres. If thats happening, pull the funding please. Whats more likely to happen in a well managed public TC, Hazelden based and adapted to contemporary New Zealand, is that successfully treated Polynesian people will return to their own community’s as them selves, rather than drunkards, trying to be all gangster. I know some of this stuff from my day job around Waitangarua.

    Speaking as an individual, if you read the preamble to actually signing on to the program, if you don’t agree to attend NA and live by all their precepts, they won’t take you in. So that means that if you’re not willing to have a spiritual awakening, then you’re not getting in. And they might dance around the problem by saying, you can say that your spirituality is this pen or that chair or whatever.

    For practical reasons, expensive residential treatment centres that house a broad spectrum of vulnerable and potentially volatile people, can’t afford to fuck around with fat heads.

    I don’t know if anyone knows what tapa wha is, the four po, the four pillars of your health: your community health or spiritual health, your family health, your body health, and your mental health.

    I know what that is, Ive seen it applied in an addiction treatment - tekanga context. I just wouldn’t describe it quite like that.

    It’s hard to argue about these things with a man who has an honorarium. But It would be nice if David was will to be challenged on some of this.

    Atlantis • Since Nov 2006 • 4163 posts Report Reply

  • Russell Brown,

    For practical reasons, expensive residential treatment centres that house a broad spectrum of vulnerable and potentially volatile people, can’t afford to fuck around with fat heads.

    That’s not really what it’s about though. It means that the only way to enter a judicial process and stay out of jail is to formally declare a spiritual belief. I think that’s a bit of a problem.

    It’s hard to argue about these things with a man who has an honorarium. But It would be nice if David was will to be challenged on some of this.

    I’m happy to see if he wants to respond. But I would point out that he’s someone who works every day at the sharp end of this, both independently and with Waipareira. And he’s not the only person I’ve spoken to about the dominance of the 12 Steps model in treatment.

    Auckland • Since Nov 2006 • 22724 posts Report Reply

  • steven crawford, in reply to Russell Brown,

    That’s not really what it’s about though. It means that the only way to enter a judicial process and stay out of jail is to formally declare a spiritual belief. I think that’s a bit of a problem.

    What they are asking for a willingness to at least consider they have an actual problem. They do not ask people to declare A spiritual belief. They want an assurance of the openness to a paradigm shift.

    I suppose we might be talking about two or three different things here, and I might be missing something. If we are talking about the drug courts offering rehab rather than punishment for drug possession, then fair enough, semantics about God a bit of a deal breaker. But what I’ve seen are people who are up on very serious drug -__related__ charges being remanded to treatment centres. People who have done things like burgling chemist shops or driving with ridicules blood alcohol levels while having small children the car. I’m not trying to be intentionally patronising here, but addiction is a life threatening mental illness. And almost no properly sick addict wants to abstain from what’s keeping them sick. So thats why series people who run residential treatment programs don’t fart about experiment with things like moderation. Thats what lifestyle resorts do.

    Yes it would be nice if David could take a break, and translate into Pakeha what exactly what hard reduction means to a recidivist drunk driver or more importantly, they’er children.

    Disclaimer: Im not religiøs and I don’t follow any 12 step doctrine.

    Atlantis • Since Nov 2006 • 4163 posts Report Reply

  • Neil,

    People who have done things like burgling chemist shops or driving with ridicules blood alcohol levels while having small children the car.

    I think I see your point. Perphaps this is about identifying and dealing with different personality types and addiction.

    Some people respond well to addiction services that cater for people wanting to change and who have the ability to change and in the meantime don’t pose a risk to others.

    But there’s people who aren’t like that the may require some form of stricter regime.

    Since Nov 2016 • 331 posts Report Reply

  • steven crawford, in reply to Neil,

    I think I see your point. Perphaps this is about identifying and dealing with different personality types and addiction.

    I was making a distinction between the way the courts dealt with addiction related crimes historically and the current drug court trial. I have to confess to shooting off at the mouth before thinking enough about who comes up in frond of the drug court. I realise that most people who are in front of that court on possession charges, may not require an abstinence program.

    For those who do require residential treatment : they will need for there to be an actual facility to go to. And that facility needs to be appropriately staffed with professionals who understand what addiction really is.

    There are people that substitute street heroin for the methadone. Thats harm reduction. There are people who used versos medications complicate they’er drinking. I remember back in the day it was called Antabuse. Thats a form of calm reduction. There are people among us who have court imposed machines they blow into in order the get the car started.

    And thats OK. Whatever. When one single person is successfully treated thru and abstinence program such as the now decommissioned Hanmer springs TC, they can have a catatonic affect on the local community’s. They can really piss people off by not continuing to behave like the village idiot. So that require wraparound support. Thats when David comes in. He’s not unduly judgemental and authoritative.

    How Hazelden treatment centres essentially work, is they introduce the experience of self help mutual help. This can set of whats loosely referred to as a ‘spiritual awaking’. Let me translate that into Pakeha. It is an awakening to feeling useful and valuable to other people. Proper residential rehab centres like the now decommissioned NSAD houses would have a turn around of about two or three coming in and about the same graduating. I seen the glow on those people who greet the new entrants after only there first or second week, and its profound.

    I spent a year in and empty rehab building after it had been decommissioned and least out to the then department of justice during the mid 1990s. I was essentially the fly on the wall as the resource consents process was worked thru. The local community didn’t like the idea that the place would house criminals, but that same middle class community embraced and interacted with it as when it was seen as a sort of hospital. A hospital for people with tattoos on their faces. And that pllor of support and understanding had a healing affect,

    I had lots of time on my hands so I worked my way thru there video collecting and some of the books. One thing that stuck with me is what I read in one of the more academic Hazelden books. It talked about how taking an alcoholic off the street and giving them a new suit isn’t going to work. Hazelden philosophy is that people should not be taken out of there culture and fitted into an ideal different one. The TC nearly gives the addict the ability to choose to work towards a long term sobriety and cultural improvement ( such as maybe handing in the gang patch).

    There are more specialised treatment centres in New Zealand, who deal with difficult personality disorders. Odyssey house was one of those doing the 1990s, David might be able to clue us in a bit more about that.


    PS: Im dyslexic. If you find spelling mistakes, you already understood what I meant:)

    Atlantis • Since Nov 2006 • 4163 posts Report Reply

  • Emma Hart,

    I think it might help just for reference to list what the twelve steps are, because I think AA and NA have sort of entered pop culture from a US perspective without us really realising how religious it is:

    Here are the 12 Steps as defined by Alcoholics Anonymous:

    We admitted we were powerless over alcohol–that our lives had become unmanageable.
    Came to believe that a Power greater than ourselves could restore us to sanity.
    Made a decision to turn our will and our lives over to the care of God as we understood Him.
    Made a searching and fearless moral inventory of ourselves.
    Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
    Were entirely ready to have God remove all these defects of character
    Humbly asked Him to remove our shortcomings
    Made a list of persons we had harmed, and became willing to make amends to them all.
    Made direct amends to such people wherever possible, except when to do so would injure them or others.
    Continued to take personal inventory and when we were wrong promptly admitted it.
    Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
    Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.

    I have a dear friend who accompanied her alcoholic then-spouse to an AA meeting (I'm not sure how legit that is, but she did), and they both, as atheists, found it really alienating. That's not the problem. The problem is that there wasn't really anything else available.

    Christchurch • Since Nov 2006 • 4650 posts Report Reply

  • steven crawford, in reply to Emma Hart,

    The big stumbling block for these organisations is that they are not organised . I understand there is a desire to take the word God out of the literature, but every member has to agree. I understand there is a motion on the table, and its been getting debated for a few years.

    https://www.na.org/?ID=bulletins-bull19&ID=bulletins-bull19

    So, probably not a silly idea to pump some cash into the professional treatment centres, just to be on the safe side.

    Atlantis • Since Nov 2006 • 4163 posts Report Reply

  • steven crawford,

    In addition to the above link, I have to say, I can’t think of any outfit more secular in its intent.

    Atlantis • Since Nov 2006 • 4163 posts Report Reply

  • andin, in reply to steven crawford,

    more secular in its intent.

    A big but tho. They still suffer from seeing whatever it is they think cures addictions as being/owing something to some “force” external to the individual, and needing to put that in their framework. Is that what agencies have to do when trying to get funding? That blows big time. Flexibility is key not rigid procedures, The person can do that themselves (with help) later when they get back to life.

    IMO it is a person directly experiencing that “other worldlyness’ themselves via psychedelics which is going to give them the strength/ability whatever to move away from an addiction even with therapists whoever being intrusive.

    Drug therapy works it seems far better than whatever external thing it is one is supposed to rely on.
    On a side note I remember seeing previously solid surfaces start to undulate, take on 3D perspectives while on acid I thought it was the coolest thing ever. I suppose some might find it frightening tho’ not me ;-)

    raglan • Since Mar 2007 • 1868 posts Report Reply

  • steven crawford, in reply to andin,

    A big but tho. They still suffer from seeing whatever it is they think cures addictions as being/owing something to some “force” external to the individual, and needing to put that in their framework.

    Seen as how I’m not a member of NA and don’t attend the meetings, I have limited knowledge of what they collectively think keeps them well. I’m guessing its primarily the not taking addictive drugs.

    Atlantis • Since Nov 2006 • 4163 posts Report Reply

  • Russell Brown, in reply to Emma Hart,

    That’s not the problem. The problem is that there wasn’t really anything else available.

    Yeah, that’s the problem. Maia Szalavitz is pretty compelling on this – pointing out that 12 Steps does alienate people and doesn’t have a better success rate than other therapies. She actually thinks it should be separate from treatment, available for people who find it of benefit.

    Beth Macy’s book Dopesick also identifies the ubiquity of 12 Steps-style abstinence therapy as a problem in America’s opioid epidemic. It fails a lot of people, but it’s generally all there is – particularly in circumstances where people are sent to treatment through a court process. Same problem here. If you want to take the opportunity offered by the AOD Court, you have to embrace 12 Steps, or you're barred.

    Auckland • Since Nov 2006 • 22724 posts Report Reply

  • steven crawford,

    IMO it is a person directly experiencing that “other worldlyness’ themselves via psychedelics which is going to give them the strength/ability whatever to move away from an addiction even with therapists whoever being intrusive.

    Funny you should say that. I had a friend a few years back who tryed giving up his methadone and took a bunch of magic mushrooms. He ended up in the psych unit in Auckland. He’s dead now, overdosed on morphine.

    Atlantis • Since Nov 2006 • 4163 posts Report Reply

  • andin,

    Sorry to hear that.He was going it alone Im guessing Self medicating, self diagnosing, if it was years ago in NZ would have had to have been

    raglan • Since Mar 2007 • 1868 posts Report Reply

  • steven crawford, in reply to Russell Brown,

    She actually thinks it should be separate from treatment, available for people who find it of benefit.

    Yes but we went and shut most of the treatment programs down, and not because they incorporated the 12 steps as a part. All thats left now is mostly the 12 step people to do it as volunteers, It’s lucky some of them got trained of sorts, thru Hazelden, to behave with at least some ethical standards.

    Its well and good for people like Maia Szalavitz to make dissing arguments like Cognitive behavioural therapy is as good or better, we don’t have enough of those practitioners to go around.

    There are other alternatives to the 12 steps. I have seen good Marae based models which work well, but they are also going to alienate a bunch of people.

    James K Baxter started something called Flash, up Holloway road for the lunatic fringe, but it didn’t quite get well of the ground.

    Atlantis • Since Nov 2006 • 4163 posts Report Reply

  • steven crawford, in reply to andin,

    Sorry to hear that.He was going it alone Im guessing Self medicating, self diagnosing, if it was years ago in NZ would have had to have been

    It was about 24 years ago. A keen outdoors man with a collection of hunting equipment in urban Greylynn. His dad raced over and removed all that during the Psychedelic meltdown.

    Atlantis • Since Nov 2006 • 4163 posts Report Reply

  • steven crawford,

    So the “don’t fuck it up panel” has moved on to legalising cannabis. And making comparisons with Abortion law reforms in Ireland.

    I’m still trying to understand what it is that fucks me off the most about the token talk about harm reduction.

    This from David:

    For Pacific Island or Maori whanau, removing someone from their family – saying that their old life was the bad thing, and that they must change and have this new family now – becomes really problematic.

    David, do you have any idea that Christianity is prominent in Pacific Island communities? If so, why did you just type cast them to fit your view that your method of dealing with addiction is modern and cool and like you’re self, lots of people are Atheists.



    I was working with a polynesian man recently, who is now on a 12 step program. He says his sister found him going into cardiac arrest and rushed him to hospital. This was as a result of being assaulted by the local patched gang members he had been working for. Less than a week after he left the hospital he was back among the very people who had put him in hospital. He’s has now been a year clean, and is no longer vulnerable to being beaten to death. He got him self to that place himself, with the support of his pairs alone, not you!

    Because you did a little bit of academic study, and a bit of internship, and maybe some work around the outskirts of the 12 step programs and now make a living out your addiction job, doesn’t automatically make you an expert.

    I get it that the 80 plus year old 12 step programs are at odds with grooving Green party panel talks. I understand you are an atheist, but for fucks sake. Get think about the messages you’re are putting out there as a health professional!

    I don’t expect a reply.

    Atlantis • Since Nov 2006 • 4163 posts Report Reply

  • Sacha, in reply to steven crawford,

    Because you did a little bit of academic study, and a bit of internship, and maybe some work around the outskirts of the 12 step programs and now make a living out your addiction job, doesn’t automatically make you an expert.

    You are making a lot of assumptions there. Unlikely to help the conversation.

    Ak • Since May 2008 • 19661 posts Report Reply

  • steven crawford, in reply to Sacha,

    There isn't a conversation, just a bunch of assumptions. David is welcome to speak for himself here. He didn't seem to have a problem when there was none to call some of his bullshit.

    Atlantis • Since Nov 2006 • 4163 posts Report Reply

  • Neil, in reply to steven crawford,

    Because you did a little bit of academic study, and a bit of internship, and maybe some work around the outskirts of the 12 step programs and now make a living out your addiction job, doesn’t automatically make you an expert.

    Possibly you’re more familiar with the real hard edge of addiction – something most people don’t see.

    There’s some very difficult decisions to be made with drugs that don’t sit easily with the classic harm minimisation model.

    The other side of the coin to harm minimisation is risk management. How to deal with people who pose a risk, a serious risk, to themselves and others. It’s going to take some form of coercion and secure residential settings.

    Since Nov 2016 • 331 posts Report Reply

  • steven crawford, in reply to Neil,

    Imagine if the doctor stood up and said that abstaining from smoking cigarets is for religious wankers.

    Atlantis • Since Nov 2006 • 4163 posts Report Reply

  • andin, in reply to steven crawford,

    David, do you have any idea that Christianity is prominent in Pacific Island communities?

    And alcoholism was virtually unknown in all indigenous cultures in that region until western style liquor was bought to that part of the world and tribal structures were undermined/destroyed. The purveyors of god werent far behind ever willing to fill that vacuum. And it changes again as children are raised away from their islands.
    <dry> Ain’t civilization grand! </dry>

    raglan • Since Mar 2007 • 1868 posts Report Reply

  • steven crawford, in reply to andin,

    And alcoholism was virtually unknown in all indigenous cultures in that region until western style liquor was bought to that part of the world and tribal structures were undermined/destroyed.

    It wasn’t so long ago that the common belief in western society’s was that alcoholism was genetic. Then came the peculiar idea in New Zealand that sophisticated society’s like France don’t have significant alcohol addiction problems.

    Atlantis • Since Nov 2006 • 4163 posts Report Reply

  • andin, in reply to steven crawford,

    Those Mediterranean countries virtually run on alcohol that addiction line is blurred to a fuzz. But at least they have a midday siesta to sober them up so they can drink long into the night.

    raglan • Since Mar 2007 • 1868 posts Report Reply

  • steven crawford, in reply to andin,

    We scoff, but they feed it to their children, which makes them double hard and able to drink properly.

    Atlantis • Since Nov 2006 • 4163 posts Report Reply

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