Having worked in addiction for ten years in various guises, I have found that this field has consistently challenged, surprised and taught me over time.
Certain aspects of working in addiction are useful, indeed important, to consider, for anyone planning to embark on a placement, volunteer role or new job in this arena.
Dealing with loss
It seems obvious, given the statistics, that those routinely consuming large amounts of drugs and/or alcohol are at risk of death. However, when I first began working in a residential rehabilitation service, getting to know the personalities, aspirations, progress – the real lives – of the residents and spending time with them on a daily basis, it was difficult to imagine any of them succumbing to their addictions.
But, within two years, several clients whom I had gotten to know well were suddenly found dead after they were discharged, despite successful completion of the programme.
Men and women in their 20s and 30s, found alone in public toilets, empty flats and local parks. It was a very hard thing to get used to, as is the cynicism such tragedy is often met with in the public domain. It is something that will almost inevitably occur in your professional journey – supervision and the support of peers are essential at such times.
I learned that it is important to gain a balance between examining such situations for anything that could be improved upon, from a professional perspective, and accepting that despite our best intentions as practitioners, impulsive, high risk behaviour and relapse are unfortunately highly prevalent in the addictive cycle.
The impact of addiction on identity
It quickly became apparent to me that addiction ravages not only bodies and minds, but the individual’s sense and knowledge of themselves. Clients who had been engaged in active addiction for prolonged periods were often unable to identify ostensibly simple things such as a favourite colour, food, song or place.
Daily experience had become a repetitive blur, such that these details fell from memory and importance or were never established in the first instance.
Emotions became difficult to recognise, explain and manage. Moral leanings, personal boundaries, whether behaviours and styles are truly natural, or performative and survival based – all of this can become difficult to determine for those who have been affected by addiction for a long time.
A hugely important, and satisfying, part of therapeutic work is helping clients rebuild their sense of who they are and their connection to themselves. Recovery is only partly about detoxifying from the substance at hand.
There is always a reason
Upon disclosing that I worked in addiction, I was sometimes met with stern responses such as ‘Why would they even take those kinds of drugs? They are well aware of the risks’. Often as they sipped a beer, made their way to a bar, or interjected with a story of last weekend’s adventures in a nightclub. People engage with dangerous substances on a regular basis, at times seemingly unaware that they are doing so. Those who ‘casually’ consume sometimes do so for the same reasons as those who consume to an addictive level: simply to cope.
The notion that addiction is often a maladaptive response to trauma is, fortunately, becomingly increasingly well understood in both literature and public policy. It has been estimated that around two- thirds of those seeking treatment for alcohol and substance misuse issues have experienced a traumatic life event.
On a societal level, understanding and addressing the causal and maintaining factors in addiction and helping people work through these is far more conducive to change than punitive and judgemental responses.
I did not know to what degree people could change until I began working in addiction. I witnessed people go from shouting and demanding to asking and talking, from thinking only of themselves to reaching out to family whom they had hurt, to not being able to look me even fleetingly in eye to standing up and delivering a seminar to a room full of peers.
Addiction is extremely challenging to navigate and overcome and of course not all are able to do so long term. But the subtle to sizeable changes and achievements I witnessed people making over time were truly astonishing, undoubtedly a favourite aspect of the role.
I have the sense that the field is daunting, even unappealing, for many. However, I would encourage practitioners interested in building resilience, awareness of societal issues and intersectionality, who have a strong sense of empathy and compassion and who enjoy a fast pace, to consider a venture into this fascinating area.