Moving from primary care to secondary care. Primary care here, in Kent is on an inpatient basis and we have nurses, doctors, housekeepers, chefs, accountants, secretaries. We got sixty-three staff down here. It’s a very high rate of staff per patient, that’s why it’s expensive. But you can’t run that indefinitely, you’ll just run out of money and therefore we must have a facility where you have one-third of the cost because you don’t need the extra staff. They can get their own meals. They can make their own beds. They don’t need all the paraphernalia that we have down here. They can just get on but they still need the support because otherwise they’re going to relapse.
We find that we take people straight out of here one-third relapse. That’s for people who stayed the recommended course of between four to six weeks. People who leave after one week or two tend to have a relapse rate in our figures of about eighty-five per cent. They think, “Oh, yeah got it! That’s fine, wonderful! Yes, thanks. Bye” and they go straight back and hit the source. That is tragic. Turning round the Queen Mary takes time. Turning round an addict takes time.
It is not just the question of seeing the light, and saying, “Oh, yeah, got it!” we need quite a bit of practice before we can actually live independently and do it on a day-to-day basis. It takes about two years to get step one. I’ve admitted that I’m an addict and that my life had become unmanageable. It takes about two years to do that.
Now why don’t we keep people in treatment for two years? Answer, it’s not economic to do so. People will become institutionalized. We’re completely inappropriate. But we know that we’re letting people go from here before they’re ready but that’s not the point. What we‘re trying to do is to get them to the stage where they have sufficient independence, sufficient understanding to be able to move forward into the next phase. Because after secondary care they then got to go and hit the rooms, Alcoholics Anonymous, Narcotics Anonymous, Overeaters Anonymous, whatever as a continuing dependency.
It’s reckoned that four to six weeks here is the equivalent of about two years in Alcoholics Anonymous, Narcotics Anonymous, Overeaters Anonymous. You save about two years of the time it takes to really come to terms of the fact, “I really am an addict and my life has become unmanageable.”
There are people who are able to do it in the rooms. Alcoholics Anonymous reckons that their recovery rate is about thirty per cent. Narcotics Anonymous reckons that their recovery rate is about is about five per cent. It’s not good but it can be done.
Now the recovery rate here for people who stay the full course of four to six weeks is sixty-five per cent. That is not my figures; it’s not from my marketing department. It comes from the University of Kent who do our monitoring, the outcome studies on a continuing basis. So that’s where it’s come from.
I wish that there was a magic bullet but look what it would do if there was. Supposing we had stereotactic surgery and took out the bit that was damaged, one would lose the potential for what that bit actually really did before it got diseased.
Supposing we had a magic pharmaceutical intervention, you could give the new wonder pill and it would sort it. Again, what a wonderful thing except that you would lose what that part of the brain normally does. I want my feelings. Meg gave me a delicious supper last night. It was lovely. We’re sitting out in the garden just having our supper and the cats will run, the dog was chasing the cats, and the birds were in the trees and there was a bat. It’s a lovely, lovely evening. I want that.
I’ve spent three and a half hours yesterday afternoon writing a medical report, I have got better things to do on a Saturday afternoon. It was a beautiful day but I had no choice. I had to get it done sometime. So I chose to go to my hammock and lie there with my Dictaphone. So I got half of a good day. I got a physical good day even though I had a mental wrong day. Then after that I had a lovely supper and on we went.
I want to be able to feel the negative and the positive. I want to have all of that. But if I tried to fast I lose the whole lot. If I try just to grab it in primary care and then not really bothered about second care and not bothered at all about the fellowships, I won’t get any of it. I won’t get any of it. I can’t run away from my addiction. My addiction goes with me. My name is Robert and I am an addict. I am an addict.
I haven’t used addictive substances and processes for twenty-one years but I am still an addict. I’m still short sighted. It’s a no big deal. I’m short sighted I do the things I need to do and put on my specs. I survived. I can function. I see my addiction in exactly that same way.
Now the purpose of going from primary to secondary is to become progressively less dependent, more autonomous. There is a time when we need to move on because otherwise we become simply part of the dependency culture. We become simply, you know, another number, another cog in a wheel. That’s not what I want for myself or for anybody else.
I want to graduate it step-by-step process of becoming less dependent as what is capable of becoming and then moving on to be interdependent with others. I will never be on the island by myself. I need to be interdependent with other addicts, otherwise I don’t get well.