Addiction Today: "SUCCESSFULLY LEAVING TREATMENT?"

Sending patients to providers of full recovery is seen as a last resort by most commissioners. What does this mean in personal cost? Learn about five patients admitted recently into one rehab, moving from methadone services which had been paid to treat them for years - and no doubt ticked on the discredited NTA Top form as "successfully leaving treatment" from tier 2/3.

Case 1: Female alcohol dependent.
Was admitted having been detoxed by local hospital over xmas period, presented as yellow and very anxious, within hours was taken to [local] General Hospital vomiting blood. Had transfusion and tests and was released to our care 4-5 days later. Was re-admitted to [local] hospital three days later having had some serious fits; there she remains while they undertake tests.

Case 2: Male Drug Dependent.
Admitted drug free having detoxed prior. Five days later admitted to hospital with numb limbs and poor reflexes – diagnosed stroke! Still in [local] hospital receiving tests for cause (currently day 5).

Case 3: Male alcohol dependent.
Admitted to service for detox, was brought to [us] by member of care management team – not his care manager. On arrival was extremely shaky, pale, sweaty and exhibited symptoms of extreme pain. Advised that he had fallen badly two days prior. We took him to [local] hospital for emergency treatment and x-rays. Had broken arm and clavicle, ignored in the tier 2/3 service, was strapped and returned to us for admission.

Case 4: Female Drug Dependent.
Came for assessment and on arrival was vomiting blood which she stated had been ongoing for several weeks. During referral there had been no mention of physical health concerns!!

Case 5: received this morning.
"This is an example of the referrals we receive on a daily basis and the vulnerability, chaotic drug/alcohol use, physical health and risk management issues," the provider said.
22yr old female using heroin (being injected by someone else), crack, alcohol & 75mls methadone. Born with holes in her heart which could require further treatment. Referrer unsure of mental health diagnosis but has previously been sectioned three times a year for two years. Served a prison sentence for stabbing her sister. Has a conviction for criminal damage with fire setting – set fire to an empty council house.

Addiction Today need not comment on the 'treatment' received before rehab. What the researchers and NDTMS do not show readers is how much patients must suffer before they are allowed to enter a rehab, nor how much harm rehabs must undo compared to lesser services.

It is the quality provider, not the tier 2/3 ones, which are exluded from Payment by Results consultations, excluded from expert groups. The quality provider of full recovery in this case study is not even invited to NTA regional meetings of providers.

Whatever happened to "first do no harm"?

Providers of full recovery are experts. If David Cameron wants drug-free recovery to replace these scenarios, he must ensure that the Labour-appointed Sir-Humphrey-wannabes change their spots.