Clean, in body and soul

The Core Trust in London treats drug and alcohol addiction using a unique holistic approach - and it works. Hester Lacey reports
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There is an almost palpable air of calm about the row of tiny cottages that house the Core Trust. It is in the heart of central London, just off the busy thoroughfare of Lisson Grove in Marylebone, but inside even the heavy traffic can't be heard. Core is a pioneer in the field of addiction treatment: uniquely, it relies totally on holistic therapies. Attempting to tackle long-term dependence on substances such as heroin, alcohol and cocaine with remedies like counselling, acupuncture and yoga might seem like treating pneumonia with a couple of aspirin: but it works. Over 62 per cent of Core's clients remain addiction free after completing the programme: this compares very favourably with other more conventional methods.

At nine o'clock in the morning the centre is almost eerily tranquil; the day starts with an hour-long session of yoga or qi gong. Between 10 and 11, all clients, known as "students", settle down for ear acupuncture; five fine needles are inserted in each ear. This is supposed to soothe cravings and agitation, and have a profound calming influence: when I tried it, I yawned sleepily through the rest of the morning. Mugs of herbal tea containing a mixture that aids detoxification are handed out. At 11, a communal breakfast of porridge is served. The rest of the day is filled with one-to-one and group counselling, plus art therapy, meditation, dream analysis and creative writing workshops.

The holistic approach takes time. Conventional detox programmes are usually considered complete in anywhere between three days and three weeks; some Core students spend well over a year attending the sessions. Commitment is expected: students come to the centre five days per week throughout their treatment. The centre is the only one in London to open seven days a week.

Jason Wright is the director of the Core Trust; he is an analytical psychotherapist who has been involved with the project for the past six years. The centre's approach, he explains, is a mixture of ancient eastern and modern western: while its physical therapies are rooted in the Orient, its approach to counselling is Jungian. The Core philosophy is that body and mind are interlinked and healing the one involves working on the other. This combination, he says, "helps people to change at the depth they need to, so they won't have to go back to using".

"What we are engaged in here is healing," he says. "Jungian theory provides a full view of the psyche and body as a complete being. Acupuncture is a 5,000-year-old tradition that combines body and soul. These are the two pillars of what we do. It's a synthesis, providing an environment where people can begin to address what has been destructive in their lives and find creative ways of living with themselves."

The Core system was devised 10 years ago, by the trust's founders, Carol Wolf and musician Jackie Leven. They were fighting heroin addiction at the time. "Our doctor said he didn't think any of the current programmes would suit us, so why didn't we devise our own," recalls Leven. Westminster Council was sufficiently impressed to offer them premises, and the late Princess of Wales presented them with a prize for their innovative work. Over the past decade, some of their ideas have been taken up by mainstream clinics and even the NHS - several other addiction programmes now offer acupuncture.

The idiosyncratic Core approach set out to combine breaking addiction with spiritual growth. "Core will never be the right treatment for everyone," says Jackie Leven. "But if you have an intelligent, enquiring mind and a bit of spark you would be attracted to the course. It's very, very tough to complete. We had a predilection towards believing in this kind of treatment and spiritual growth and if you don't have that you would find it unsuccessful."

Those that do find Core successful praise its approach highly. Sarah's problems with cocaine, cannabis, Ecstasy and alcohol landed her in court. Friends recommended Core. "I had always been interested in holistic medicine and I liked the fact that you had to do your own stuff as well," she says. "It's not a case of 'We'll give you this, you'll do this and you'll be better'. There is something very comforting about Core; there is a real calmness about it. My counsellor was brilliant. I was quite difficult and she was so patient." She spent a year and a half at Core and has been clean for two and a half years now. "I don't think I'd have got the same results anywhere else," she says.

Core students can be referred to the clinic by their doctor or by the courts, or they can refer themselves. Initially they take part in ear acupuncture and group work; the full programme of complementary therapies and psychotherapy doesn't start until they are substance-free. During this time the student is expected to come to terms with the underlying causes of their addiction. The long-term detox runs in blocks of three months and costs pounds 200 for the first block and pounds 140 for subsequent blocks. There is then an aftercare programme, which prepares them to cope afterwards and further develop the changes they have made. This costs pounds 90 for three months.

Core treats around 300 people a year, most in their twenties and thirties, and can take about 30 students at a time - but at the moment they are running at below full capacity and several staff have recently been made redundant. This, says Carolyn McDonald, the centre manager, is because the trust simply doesn't have enough money. Most clients are able to get public funding for six months of the course, but no one is asked to leave until their treatment is complete, which usually takes considerably longer. "We'll make up the rest but it gets harder and harder," says McDonald. "People think a lot of money is coming into the addiction treatment sector, but a lot of agencies have closed down and the existing ones are reducing their capacity. People who are at the point where they are about to give up may not get help because they are not classed as being in danger of immediate health risk."

It costs around pounds 160,000 a year to provide the full Core service. This year, due to a restructuring exercise, one of the centre's main grants from London Boroughs Grants was reduced by half. Next year they will be getting no money at all from that source, and will be relying more heavily than ever on private donors and the efforts of volunteers. The staff at Core are waiting anxiously to hear how the Government's much-publicised war on drugs will translate into cash for those on the front line.

Sean, who is a heroin addict, only had funding for six months of treatment; it ran out several months ago. "It was restricted to six months, but they don't kick you out," he says. "For heroin addiction, you can do a 12-step programme, you can take methadone, which is horrible stuff and kills more people than heroin, you can try various kinds of ad-hoc counselling but I don't think these would work for me. There should be more places like this - I've come across a lot of recovery modules, but nothing like this." Core's approach might be alternative, but, says Sean, "there are no alternatives to Core. It is unique."

The Core Trust, Lisson Cottages, 35a Lisson Grove, London NW1 6UD, tel 0171 258 3031

THE COCAINE AND SPEED ADDICT

Katrina was addicted to cocaine and speed when she went to Core; she now works there as a volunteer. Like Sean, she had tried other avenues. "I'd been to one of the anonymous groups, but I never stopped using," she says. She came into Core every day for over a year. "I had a lot of problems at home, I had small children and I had a few relapses. But seeing people at different stages of the treatment really helped me. At one meeting, one girl said she hadn't used for a year and I was amazed. Then when I left, people were like that about me!"

One of the key factors in the treatment's success, she says, was that the course is not residential; she had to live in the environment where she had been using drugs. "You have to go home at the end of the day and at first I hated it. That's what a lot of people find very difficult but it's how you learn to cope - not by being cocooned away in a rehab centre for a while and then having to go straight back to your normal way of life." Her counsellor, a former addict, helped her to uncover what she refers to as "a lot of very difficult, emotionally shaky stuff".

"You start slowly and learn it's all right to have feelings and learn to express them," she says. "And the acupuncture balances us physically: it helps restore the physical damage the drugs have done." She says that not only has she learned to cope with her own problems with strategies that don't involve drugs, but that her relationship with her own children has improved. "I feel I would not be who I am without the help Core has given me," she says. "People come off drugs, and they are still really lost as to how to cope, I've seen it. Being here has given me a lot more than just being off drugs. I've gained knowledge and wisdom."

THE HEROIN ADDICT

Sean, who is tackling his heroin addiction, has been at Core for eight months and expects to be there for another three or four. A veteran of more conventional treatments, he believes this time will be different. "I've already reached several turning points here," he says. "I've done a 12-step rehab before and the differences were huge. Twelve-step is very confrontational and there's no leeway: either you take it on board completely or you don't, and I didn't. It's like a recovery production line: you rush through and it's way too much to take in. Here, there is a very accepting vibe, it is very individualistic, there's an absence of rules and regulations."

This does not mean that Core therapy is an easy experience. "Here, you do it at your own pace, but for a place that has so little confrontation it tends to go very deep very quickly, it encourages you to engage." He believes that the acupuncture and reflexology he has had are just as important as the intensive counselling. "The acupuncture in particular has been hugely important. It really does cure me on a physical and emotional level - the two are very much connected."

Like other Core students, he feels that remaining in the community is an essential part of the therapy. "If you are locked away in rehab, you can cope within those specific surroundings. But you can only function within the context of the place. The transition to the outside world is overwhelming."

He has relapsed a couple of times, but is still making progress - Core differs from other centres in that a relapse doesn't automatically mean expulsion from the programme. "Here, you can make mistakes and they don't disown you," he says. "They don't collude if you are using, but if you genuinely want to stay substance-free they will help you."

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