Addiction: Helping break the cycle

As one of the Alcohol, Tobacco and Other Drug Service's outreach clinical treatment officers, Ms Rushe spends her days working through the cycle of substance dependency and journey of recovery with her clients in the North West.

The physiological and psychological factors involved with a person's use of a drug are differing and individual, making each client a world apart in the field of rehabilitation.

"The challenge with any client is engaging them and to a point making them believe in you and how you can help them," she said.

"We use this idea of strength-based counselling and assessing what the client feels their strengths are, whether that be their work or family relationships for example, and make a treatment plan tailored to them specifically."

Ms Rushe said as their service was voluntary, each client had one reason or another for wanting to quit or lower their use of a substance, ranging from potential job loss to neglecting their children in their dependency.

"You can never tell how long it might take a person to reach their goals, people come to us in such different stages, whether they're in what we call pre-contemplation or they have decided definitively to give up their habit," she said.

And contrary to popular belief, she said relapse wasn't something that occurred someone was feeling down or struggling, but was just as likely to occur when at a high.

"People can reach a certain stage in their reduction where they might feel they don't need help anymore, they're doing well and feeling good, and may relapse, but that's just when they need to come on board and try again, and stay with it even when they're doing well."

She said with such a high level of alcohol and tobacco addiction in the North West, and in a place with such a high importance placed on the social aspect of a night out drinking and smoking, many clients preferred to work on reduction rather than elimination.

"It's about identifying triggers for use and how, in situations of increased stress for example, they may want to use again," she said.

"We work on anticipating how the client might feel at that point, and especially at times like Christmas or anniversaries or when emotions are heightened how they can avoid relapse."

Dependency reduction or recovery encompasses every aspect of life, from family and friends to spirituality, employment, social life and hobbies.

And Ms Rushe said personally, when a client finally took steps to better their life or could see it improving, there was that cliche feeling of job satisfaction.

"Some clients will contemplate rehab but will be hesitant to go due to factors such as what they would need to leave behind to complete the rehabilitation, so we work with them and they will weigh up the positives and negatives before making their decision. When they do decide to take that step, personally I'm very proud and happy for them.

"Other clients might have a goal like reducing to a certain number of cigarettes by Christmas, so we meet and assess that goal every few weeks and work to keep motivation."

Ms Rushe said the rise of synthetic drug use and continuing change in the chemical make-up of substances since she had studied meant user experiences were not uniform and differed for every client, but the perception that it was safer than listed illicit substances was wrong.

"It's not very well-known what each and every synthetic drug is doing to your health, we know there are reports of psychosis, anxiety and paranoia but it's hard to know at this point," she said.

"As with any addiction we go through the process of assessing how it affects the client's life and what they find important, and working with them to identify where they are on the scale of experimental, recreational or dependent use, and what negative impacts are coming from that."

She said at all stages of dependency the effect of drug use intensified emotion and reduced decision making capacity, which led to increased impulsivity and could lead to suicidal ideation and attempt, depending on the individual.

She said with National Drug Action Week coming up, between June 16 and 22, her work focused more specifically around creating awareness of the negative impacts of drug and alcohol, as well as the fact there were many methods of help available.