Unhooked thinking

Mental Health Nursing,  Sep 2006  by Byrne, Chris

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Having been out of mental health for four years, Chris Byrne, who formerly worked in substance abuse, found the inaugural 'Unhooked thinking' conference on the nature of addiction a real revelation. But four years on, are treatments for substance misuse merely 'sticking plasters over society's wounds?'

This event, for someone who left mental health nursing four years ago (and whose last post was in substance misuse), was a real revelation. A real attempt to gather many of the English speaking world's experts on 'addiction' (the use of this word was also hotly debated) and break the subject down to its basic components.

The venue was the historic Assembly Rooms in Bath and the hospitality was great.

Academics at the cutting edge of research who presented their work included: Professors Jim Orford and Stanton Peele. The style of this conference was quite unique in that debate (frequently on stage with audience involvement) was often the focus of the activity.

A highlight of the conference was the first two evenings' edutainment, in the form of a film around the topic of substance misuse. Julien Temple conducted a short question and answer session after a screening of his film Pandaemonium.

I went to a breakout session on ecopsychology and addiction - which argues that in many ways addiction is a by-product of industrial capitalism. The writer Ralph Metzner has argued that several forms of psychopathology (including autism, post-traumatic stress disorder, amnesia, and addiction) each capture a distinct component of the modern alienation from nature. Another speaker told of the explosion of addiction in colonised societies.

This conference was a stab in the dark, in that it was an attempt to look at the nature of addiction, rather than treatment or targets. A breath of fresh air for many!

Service users were in attendance, and some of the speakers seemed to be unable to explain their ideas for the layperson.

It seems to be that we are beginning to comprehend that both our current understanding and 'treatment' of substance misuse are limited. Former Birmingham prison doctor and psychiatrist Theodore Dalrymple (aka Anthony Daniels) has recently published Romancing opiates: Pharmacological lies and the addiction bureaucracy, in which he demolishes the medical model of substance misuse in the context of his description of a dominant Western liberal ideology. This has tended to minimise the responsibility of individuals for their own actions and to undermine traditional values, thus contributing to the formation within rich countries of a vast underclass afflicted by endemic violence, criminality and sexual promiscuity.

Congratulations to conference director William Pryor and colleagues for a brave attempt to get a (non-medicine) ball rolling. I came away with my belief reinforced that a lot of substance misuse 'treatment' is merely 'sticking plasters on society's wounds'.

The conference also begged the question as to whether or not the growth industry of substance misuse treatment should have its own nursing qualification, or a unique generic qualification for workers. This is especially important, as in my experience there was little or no formal training in substance misuse beyond a placement on my nursing course and 'on the job' training. This could also help reduce the time lag between research and practice.

Chris Byrne is a former specialist nurse in substance misuse

Copyright Community Psychiatric Nurses Association Sep 2006
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