Recovery from drug dependence in West Yorkshire: reclaiming traditional ‘place-based’ identities

and the implications for maximising recovery capital

potential?

Stephen Parkin (University of Manchester)

Society for the Study of Addiction Annual Symposium

York 5-6 November 2015

Background

1. A mixed methods study (2012-2013)2. Recovery from opiate and/or crack cocaine

dependence in (West Yorkshire)3. Commissioned by a ‘Public Health Unit’4. Conducted by researchers at the University of

Huddersfield (School of Human and Health Sciences)

5. Focus upon two towns within West Yorkshire6. Final Report delivered in March 2014

A Tale of Two (former) Mill TownsWoolford

Pop: c.160,000Industrial heritage

Structured life based around textiles and mills

(eg conjugal / gender roles)Work-based ‘shift’ systemBenefits from Immigration

Characterised by rise and decline in industrial fortunes

1980s Recession(Heroin footprint (1980s))

Ramfield

Pop: c.80,000Industrial heritage

Structured life based around textiles and mills

(eg conjugal / gender roles)Work-based ‘shift’ systemBenefits from Immigration

Characterised by rise and decline in industrial fortunes

1980s Recession(Heroin footprint (1980s))

A distinct social, economic and cultural history that is recognisable to local people

Qualitative Component of Mixed Methods Study

• 2 sites: Woolford and Ramfield• 41 respondents (20 + 21) accessing treatment service• Semi structured interview• Guided by topics within ACMD (2012) report on

‘Recovery Potential’• 13 domains that may influence/impede recovery

(carers and families; communications including stigma and media; criminal justice; education and training; employment and volunteering; housing; natural recovery; personal finance (including benefits); health and wellbeing; recovery communities; social care; local communities and ‘substance misuse treatment services’)

Respondent Profile

Field Male Female CohortCurrent Injector 7 (17) 3 (7) 10 (24)Heroin (main drug IDU) 23 (56) 10 (24) 33 (80)1st IDU (average age) 17 years old 17.5 years old 17 years old1st IDU (range) 13-28 years old 15-21 years old 13-28 years oldInjecting Career (average) 17 years 15 years 16 yearsTreatment (current) 25 (61) 12 (29) 37 (90)Methadone 20 (49) 11 (27) 31 (76)Subutex 5 (12) 1 (2) 6 (14)Methadone (mean daily mg) 48.5 46.5 47.5Methadone (range mg) 0-95 13-75 0-95Subutex (mean daily mg) 8.35 15.2 11.8Subutex (range mg) 2.8-16 15.2 2.8-16Ever Overdose (indoors) 15 (36) 2 (5) 17 (41)Ever Overdose (outdoors) 5 (12) 3 (7) 8 (19)

Field Male Female CohortGender 28 (68) 13 (32) 41 (100)Age (range) 27-53 years old 24-51 years old 24-53 years oldAge (average) 36.5 years old 34 years old 35 years oldWhite (British) 25 (61) 11 (27) 36 (89)Local 27 (66) 10 (24) 37 (90)Unemployed 25 (61) 13 (32) 38 (93)Ever L.A. Care 6 (15) 5 (12) 11 (27)Ever Homeless 22 (54) 9 (22) 31 (76)Ever Prison (DRO*) 23 (56) 7 (17) 30 (73)Ever Sex Work Missing 4 (10) 4 (10)Current Sex Work Missing 3 (7) 3 (7)Sex Work (range) Missing 1-17 years 1-17 yearsSex Work (average) Missing 4.5 years 4.5 years

Socio-demographic information

Drug use: past and curre

nt

Key Socio-demographic Info

1. Age range = 24 – 53 years old (born 1960-90)2. Average Age = 35 years old (born 1980)3. Local to Town = 37 / 41 = 90%4. ‘Never Worked’ = 1 / 41 = 2%5. First drug use = 1980s/1990s6. Average Injecting career = 16 years (1998)

Age of 1st Injecting Episode = 17 years old 1st Injecting Episode = 13-28 years old

‘Recovery Potential’ of Cohort:Selected Qualitative Summaries

1. Families2. Employment3. Training4. Local Communities5. Recovery Motivation

Recovery Potential: Families

1. Relationships with parental family members typically dysfunctional, problematic and estranged

2. Respondents typically did not involve extended family in their recovery

3. Positive family experiences relate to participation by and contact with maternal kin.

4. Traditional gender roles recognised and valued

Recovery Potential: Employment1. A wide range of work-related experience, skills and

vocational qualifications were noted throughout the cohort. These abilities were associated with events and experiences before and after developing dependence to particular drugs

2. Many male respondents expressed an interest in a return to former manual work (manufacturing, construction, production)

3. Women expressed interest in developing ‘caring’ roles (childcare, social care)

Recovery Potential: Training

1. Negative opinion related to lack of vocational relevance, academic disadvantage or because of conviction records

2. Positive views were noted in the widespread enthusiasm for various courses perceived useful to respondents (but unavailable at present)

3. Positive views were also associated with courses that provided structured activity into daily lives

4. Respondents viewed opportunities for ‘education and training’ as either completely negative or entirely positive

Recovery Potential: Local Communities 1. Lack of community participation related to

avoiding social contact with other people (including contact with other drug users) in areas typically associated with community/class-based cohesion

2. Participants expressed a desire to relocate (from Ramfield to Woolford or vice versa) to assist with recovery.

3. Detached from - yet participant within - familiar environments for recovery

Recovery : Motivation1. Child protection and safety2. Employment

3. Maintaining/restoring relationships with significant others4. To obtain housing / accommodation

5. Drug Rehabilitation Requirement6. Acquiring altruistic role as paid/unpaid employment7. Emulation of positive role models8. To develop vocational skills9. Restoration of health10. Physical appearance

Recovery: Interpretation of Motivations

1. Gender role association2. Employment Record (locally)3. Restoration of former community ties4. To facilitate continued residence in local

area

5. Indicative of class-based motivations

Collated EvidenceAge

Family BackgroundFamily (Dis) Connections

Work Experience (‘culture’)Modest Aspiration / Ambition

Recovery Motives

Against a backdrop of the social, cultural and economic history of

Woolford and Ramfield

Concluding Hypothesis1. Indicate collective recovery identities that are

entrenched in a shared socio-cultural history of provincial towns

2. that have been disrupted / fractured by personal and national histories /events

3. Not so much a ‘spoiled’ identity – but a specific ‘class-based’ identity that has been ‘lost’ and seeking reclamation?

1. Many structural comparisons can be made to seminal sociological study of kin, kinship and kindred in London’s East End (Young and Willmott 1957).

‘Place-based’ Recovery

Work Experience

Family

Community

Funnel representsWoolford and

Ramfield (as ‘cultural settings’

that may inform, impedeand/or influence

recovery potential )

Ramfield W

oolfo

rd

‘Local culture’

Recovery Potential is physical and social.

BUT ….

Recovery Potential may also relate to the inter-relationship between

Gender, Genealogy and Geography.

Implications: 1

Recovery has to be socially relevant for ‘older’ service users

Implications: 2

A devolved recovery agenda?1. that emulates European ‘city-based’ policy2. specific to provincial settings (towns vs cities)3. targets specific age groups (older service

users)4. with programmes that are socially,

economically and culturally relevant

Implications: 3

Provincial relevance to reflect:Shared collective (historic / cultural / class) histories

With focus upon:‘3G recovery’ (geography, gender and genealogy)as much as social and physical recovery

(eg: re-connecting with economic and social past)

Acknowledgements

Mr. Tony Cooke Kirklees Public HealthLifeline Dr. John StephensonDr. Andrew NewtonMr. Geoff Hinds University of Huddersfield

Mr. Steve LuiMs. Fiona Trotter