Addiction does not have to be a life sentence

People still consider Narcotics Anonymous and its sister groups to be a weird cult full of batty people
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The Independent Online

Dougray Scott and Ian Hart give every appearance of being young actors with limitless career choices. So it is surprising to learn that The Lie Is Dead, a new film starring both of them, alongside a generous handful of other well-known faces, took one weekend to film, cost £64 to produce and runs for around 11 minutes.

A grim little slice of social realism, the film chronicles a day in the life of Mick McElroy, a father-of-two from Liverpool who has just returned home after five months on a residential drug rehabilitation programme. Mick approaches his old stamping ground, the deprived estate where he grew up, full of plans for a sober future, and determined to keep himself clean.

Within moments of arriving back home, he learns that his best friend has died of an overdose, that his children still don't want to know him, and that his former wife has set up home with the local heroin dealer. Another close friend, ostensibly on a methadone programme, exhorts him to forget all of his troubles by smoking a little smack with him. It dawns on Mick that after all the difficulty he's had in getting clean, the real battle - to stay clean - is only just beginning.

For a simple film, The Lie Is Dead carries a complex message. Made by John McKeown, a freelance drug counselling consultant, and Illy, it's appearance coincides with the opening of a daycare, abstinence-based rehabilitation programme in the city, run by Sharp (Self-Help Addiction Rehabilitation Programme). The film promotes the idea that addiction is an affliction that can be beaten, and not just medicated.

If the narrative of The Lie Is Dead seems to be suggesting the very opposite - that addiction can be so ingrained in certain lifestyles that it is impossible to escape from - that is because this film is not designed to educate drug users, but instead is aimed squarely at educating and provoking the various people and agencies who concern themselves with drug counselling and rehabilitation.

For astonishingly, most of these professionals are of the opinion that Mick's situation is not a tenable one. In cities like Liverpool, where The Lie Is Dead is set, the belief in abstinence as a credible method of tackling drug addiction is virtually non-existent. Up and down Britain, drug treatment professionals, in a counsel of despair, are of the opinion that maintenance programmes, based usually on methadone treatment, and sometimes on treatment by prescription of a patient's drug of choice, are the only way forward.

Those with a hazy idea that abstinence programmes are available to all through the informal network of Narcotics Anonymous might be surprised to learn that in Liverpool meetings are poorly attended and far from inspirational to all but the most determined. And while a certain number of places are available to addicts on residential courses in other parts of the country on the NHS, when the the clinic is over there is little or nothing available in the way of aftercare or community support back home.

For someone like the fictional Mick, the idea that a period in rehab can be followed up by regular attendance at 12-step meetings of the kind Narcotics Anonymous organises is hopeful to say the least. The culture of recovery that underpins the organisation worldwide hasn't penetrated to some of the places where it is most needed.

The reasons for this are understandable. The nature of Narcotics Anonymous is that it is an active programme of recovery, where people are encouraged to be discursive in meetings, and talk about their feelings. While this might seems to be entirely in tune with the temper of times, there is a huge distrust in Britain of 12-step programmes. People still consider Narcotics Anonymous and its sister organisations to be a weird cult full of batty people.

Resistance among communities where toughness, straightness and self-reliance still prevail as desirable values, even when the community is full of people drugged up to the eyeballs, is greatest of all. Further, so much has been invested in getting people to understand the insidious nature of addiction, that it is feared that the suggestion that it may not always be insurmountable may result in a loss of public sympathy for those who really cannot break their habit.

McKeown's argument is that abstinence should be an option given to all addicts, and not just for the weeks or months they spend, if they're lucky, on a residential programme. He doesn't rule out other treatments if a drug user cannot manage abstinence, but he believes that decent, sustained support is needed for those who wish to try.

For the middle-class addict, a network of family, financial, and therapeutic support is often available after they leave the safety of the rehab centre. In London and some other parts of the country, a thriving network of daily, even hourly meetings, offers solid additional support, as do sponsors in the organisation who have been involved in abstinence recovery for many years and can offer their experience to newer members.

In many other blighted cities, though, for those returning to the same desperate situation that they absented themselves from to clean up, there is no support at all. Maintenance doses of methadone may help heroin addicts in a limited fashion, but many of those who have freed themselves of drugs completely will say that the thought of such an alternative fills them with revulsion. The truth is that however humane the intentions of maintenance programmes, they remain a way of sedating people, rather than helping them to cure themselves and regain control of their minds and their lives.

John McKeown, himself a Liverpudlian, is fond of recounting an anecdote in which he asked a psychiatrist administering methadone to around 3,000 addicts if he might have any referrals to an abstinence programme. The psychiatrist though for a moment, scratched his beard, and tentatively replied that he might have one or two. The idea that only one or two in 3,000 people can recover from heroin addiction is the "dead lie" in the title of the film, and Sharp is hopeful that it can prove this.

Sharp's alternative treatment is modest. It simply offers 12-step day care, whereby a person on a recovery programme spends several months attending a centre by day, and returning home in the evening and at weekends. While attending the course, they can discuss difficulties at home and with friends and family, as they come up, instead of being confronted by them all at once, when in a vulnerable state.

While attending the course, which is usually paid for by a local authority grant, patients are tested for drugs both at prescribed times and randomly. Amazingly, there are only 30 such places available to addicts in London, and none at all available in Liverpool or any of Britain's other cities.

Sharp's breakthrough is that it is about to gain a presence in Liverpool. Funding has been guaranteed for 12 places for three years. This may not sound like much in a city known to be riven by addiction, but it is a much-needed fillip.

Abstinence programmes, when successful, can grow a network of recovery which will strengthen over the years. Maintenance programmes, on the other hand, maintain not just the user, but the idea that addiction is inescapable. There are plenty of people who can attest that it is not.

If groups like Sharp get the support they deserve, there will be plenty more.

d.orr@independent.co.uk

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