THERAPEUTIC COMMUNITIES CALL FOR MORE ICE BEDS AS PART OF A COORDINATED APPROACH
The Australasian Therapeutic Communities Association (ATCA) has welcomed a recent statement by Senator the Hon Fiona Nash, Assistant Minister for Health, which noted results of the historic 2014 Victorian tri-partisan inquiry into the supply and use of methamphetamine, which includes the crystalised form of the drug, known more popularly as Ice.
As Senator Nash notes, “A recent review of 30 publications reporting on 16 studies found positive outcomes for therapeutic communities …including reduced substance use, and criminal involvement, increased rates of employment…residential rehabilitation is indeed an important part of a suite of evidence based treatments available.”
Therapeutic Communities (TCs) in Australia, in line with their counterparts internationally, have been successfully treating meth/amphetamine dependence for many years, and in the past 12 months have increasingly responded to the call for help from those who have become dependent on Ice.
Associate Professor Lynne Magor-Blatch, Executive Officer of the ATCA, said today, “Therapeutic Communities have been working effectively with complex clients and changing drug use presentations since they were first established in Australia more than 40 years ago. Methamphetamine, and the use of Ice in particular, has resulted in a range of acute harms that have not been seen with other drug presentations.”
There are no pharmacological alternatives to treatment in the same way there is for opiate addiction.
The ATCA represents therapeutic communities working across Australia and New Zealand, and all have reported significant increases in numbers of people seeking help.
“All our members have had the opportunity to talk with members of the Ice Taskforce during the period of consultation, and have provided valuable information on the range of complex behaviours and psychological issues that they are dealing with on a daily basis. People seeking residential treatment are not recreational users, they have complex mental health and behavioural issues and are generally those who have come into contact with the law or are involved in considerable personal and family disruption”.
While the association believes strongly in the need to provide a range of services across the treatment spectrum, the reported recommendation to support day treatment and outclient services at the expense of residential TC programs has raised concerns.
“It needs to be acknowledged that clients presenting for treatment for Ice addiction are generally polysubstance users who have been involved in substance misuse and abuse over a number of years.
They are also experiencing a range of health, interpersonal, social and mental health issues which have brought them to this point – and a “quick fix” will not solve this issue long term”, Dr Magor-Blatch added.
The association stresses that the treatment or recovery journey is often a long one, and that people will typically have a number of attempts at a variety of treatment-types before succeeding. Substance use has similar relapse rates to other chronic conditions.
“Unfortunately we too often credit the last treatment attempt with being the successful one, without understanding that it is the culmination of treatments that have produced the successful outcome. Social and psychological factors also play a huge role in this – as people mature and other aspects of their lives become more important, drugs may lose their appeal. Perhaps it appears that the short-term two to four session intervention at the end has been the successful intervention – but it is likely that it has worked because of many previous attempts, including residential treatment.”
The Victorian Government has recently announced the investment of $18 million to expand drug treatment and rehabilitation services, but the majority of the funds are being poured into day programs, which are unlikely to assist those with the greatest need. Meantime, Odyssey House in Victoria, one of the largest TCs in Australia, reports being inundated by the number of people who are desperately seeking help.
Odyssey House is one of the ATCA’s 43 members, and provides two therapeutic communities. They can accommodate 100 people across their facilities. Members of the ATCA provide 53 TC programs in Australia, working with adults, young people and families. Six of the TCs accept parents with children, three are in custodial settings and three are youth-specific (from 14 years of age). ATCA members provide residential services for more than 9,000 people annually, as well as over 20,000 people in outpatient support programs. Recent research showed 63% of clients in treatment had a primary substance dependency on Ice, although this number increases to more than 80% for youth-specific programs.
“The picture provided by Odyssey House in Victoria is mirrored across Australia. Our larger agencies such as Odyssey in New South Wales, the WHOS programs in New South Wales and Queensland, the Salvation Army Recovery Centres across the east coast, Cyrenian House in Perth, along with all our smaller agencies are experiencing a huge increase in demand, and without funding to increase bed numbers, people will be unable to get the help they need. This pushes people in two directions – either to look for help in the private sector or overseas, or to continue to use the drugs that are destroying their lives and the communities around them.”
Often those who are unable to secure a place in government or non-government residential service and do not have private health insurance, are forced to self-fund their own treatment. More often than not this places a huge burden on working families to come up with considerable funds – sometimes $20,000 – $30,000 to secure a safe treatment place for their loved one. More must be done to assist not only the users but to relieve the financial burden on families poorly equipped to cope with this financial burden.
The ATCA is concerned that the Ice Taskforce will also step back from a commitment to residential services and emphasizes the need to provide funds to help those most in need. This does not negate the need for education and early intervention and short-term interventions, but more fully supports a comprehensive approach to the drug problem.
“There has been a huge emphasis on the violence and aggressive behaviours which we often see associated with this drug. Our member services in New Zealand have been working with methamphetamine users for a long time, and the coordinated approach we have seen there between health and justice is one from which we can learn”.
A key message here, is the need to build infrastructure, increase bed numbers in residential services as well as other community-based responses, so that they can take referrals from and work together with the justice system to provide a managed and synchronized response.