Local authority social workers are too busy fire-fighting crises in under-resourced social services departments to develop any kind of expertise, a substance misuse expert has warned.
Child protection social workers encountering families with drug and alcohol problems could do “much better” if they were educated around substance misuse issues and had an expert they could call on to guide them through the best way to deal with complex cases involving drug and alcohol misusers.
“Social workers need a bit of guidance, they don’t need someone to do the work for them. But a lack of understanding substance misuse and because it is not fighting a fire, it is low on the funding priority,” said Nigel Radcliffe, an Independent Social Worker, trainer, consultant and expert in substance misuse.
Yet the need for expertise in tackling drug and alcohol misuse is greater than ever with substance misuse being “a bigger problem than ever”, says Radcliffe. Figures show that 250,000 – 300,000 children live with problem drug users and 1.3 million children live with adults with an alcohol problem.
“I became an addict”
Radcliffe himself knows all too well, having experienced both drug and alcohol addictions prior to his career in social work.
“The level of naivety in social workers has increased by the year because they are fire-fighting,” said Radcliffe, “they are dealing with crises and so any development of expertise goes out the window.”
“All the resources have gone,” he added.
Radcliffe originally went to study at Reading University to become a PE teacher. “I fell into addiction instead,” he says plainly. It was 1970 and there was “a colossal amount of drugs” available on campus.
“Everybody was taking drugs across the board, they were freely available - Hallucinogens, cannabis, LSD, magic mushrooms and a lot of amphetamines. There was a big hippy culture at uni and most people rode it out. I was the only one that I know who got into trouble with it.”
Radcliffe explains that even though he was using the same drugs as other students and many of his peers were in fact taking more drugs than him, his behaviour was different. “That is the illness of addiction,” he says.
The defining moment came when other students were settling down for their finals. They stopped going out and taking drugs but Radcliffe continued. He found a different crowd to take drugs with and eventually got kicked out of university largely because of the people he was bringing back to his halls of residence and the fact he was doing very little work. As a result he ended up on the streets of London at 21.
I became psychotic
“In those days there was no such thing as homelessness. There were nice squats or small flats and social security. I was a six foot tall pretty lad in the West End of London, people would say come and stay with me for a while,” says Radcliffe.
He registered with numerous doctors because there was no such thing as computerised records so no one found out and got prescription drugs from each of them. He therefore had a pocket full of prescribed drugs he could sell to his benefit in Piccadilly Circus. Amphetamines (speed) were coming out of the back doors of chemists and were freely available.
“Taking too many amphetamines makes you psychotic and that’s what happened to me,” says Radcliffe. I was taking so much I was completely out of touch with reality. I’d end up in A&E or police stations where people had literally taken me and left me there.”
“Because I was bonkers, people would get me to do stupid, dangerous stuff for a laugh but I was getting in trouble and I knew I could end up in prison. I knew I couldn’t face that so I went into rehab,” he explains.
Radcliffe spent four months at Phoenix House rehab centre in Forest Hill in London. It was very disciplined, military even, and had a strong sense of hierarchy. Plus it was drug free. However, it did not deal with the nature of addiction, Radcliffe says, and as a result four months into the nine month programme, he’d had enough. He did not want to go onto the next step of the programme which was being moved into sheltered accommodation and had nowhere else to go except from home to his parents in Colchester. However, the family were very clear that there were to be no drugs in the house and he needed to get a job.
Living on a knife edge
As a result of his time at Phoenix House and the voluntary work he had undertaken with teenage children during his time there for which he was praised, Radcliffe got a job in social services in Southend in 1977. However, Radcliffe soon descended into alcoholism. “I soon realised that what I couldn’t do on drugs, I could do on alcohol,” he says meaning he could hold down a job while drinking heavily. In fact, as he felt that work was pretty much all he had and was fearful of losing it, he put in four times the efforts of other colleagues and was delivering services that were 10-15 light years ahead of their time. He admits he was “living on a knife edge” for the next 10-11 years with Radcliffe living for the 3-4 hour period in the evening that he allowed himself to drink until unconsciousness.
The turning point came when he met a man in a local running club who was sober and in recovery for alcoholism. Radcliffe felt drawn towards him and they ended up running together. After a particularly heavy weekend, he called his new friend and asked him if he could to the next AA meeting with him. That was August 1988 and Radcliffe has not touched a mood altering substance since.
He made a lot of changes to his life including a new partner and children of his own and trained to be a counsellor. His first job in addiction was at The Priory in 1991 which at that time had two local hospitals: one in North London and one south of the river, and Radcliffe’s job was to set up and run an Addiction Treatment Programme in both. However, in 1993, life in the private sector started to get more difficult with insurance tightening up and Radcliffe’s job became more about selling which he disliked and admits he wasn’t good at. So in 1993 he moved to London Transport to manage and develop their drug and alcohol programme.
“I started off as a counsellor and within a year I was managing a £2m a year unit,” says Radcliffe. The programme was for people who worked for London Transport who had addiction problems and the organisation introduced state of the art testing and assessments as well as working with families before recommending and paying for treatment services. The success rates were staggering with 60% of people clean after five years the most demonstrably successful treatment programme in Europe, says Radcliffe, compared to an estimated success rate of 10% at AA, and he stayed in that job for 20 years.
A fear of abandonment for children
Alongside that work, Radcliffe spent his time developing his own training and consultancy company and carried out work as an Independent Social Worker and substance misuse expert including child protection assessments and although he retired from London Transport in 2012, he maintains his independent work today splitting his time between Cyprus and England.
“Substance misuse is a bigger problem than it ever was,” says Radcliffe, explaining that there is the “additional problem” of legal highs alongside illegal substance misuse and in terms of danger, no one knows what they are taking and it is usually combined with large quantities of alcohol.
Radcliffe highlights the Health Survey in 2005 which found that:
- 30% of children under 16 in the UK live with at least one binge drinking parent
- 8% of children live with parents who are both binge drinkers
- 4% of children are in lone parent families where the lone parent is a binge drinker
- 2% lived with a Class A drug user
- 335,000 were living with a drug dependent user
- 72,000 were living with an injecting drug user
Given these figures were 11 years ago, the likelihood is that they have increased, says Radcliffe. The risk factors depends on the age of the children but there are clear and obvious risk factors including:
- The danger a child is placed in if a parent/parents are unconscious
- The risk of Hepatitis and HIV if needles are left around
- The risk of child abusers being in parental peer group
- The risk of dangerous people being in parental peer group
Social workers can do much better
Having worked with adult children of alcoholics, Radcliffe says there is damage among children of addicts that is taken into adulthood. Firstly there is no security, a fear of abandonment, having been exposed to trauma, a notion that they are not loved or cared for. Secondly, many parents who are addicts are not ‘present’, even if they are there physically and children pick up on that and tend to have one of two responses: the first is that they feel their parent prefers drugs or alcohol to them and therefore there must be something fundamentally wrong with them for the parent to feel that way. The second response is a dangerous response, where children feel that everyone is against them and they will get in there first. Finally, many children of addicts go on to be pathological carers who go through life looking for “lame ducks” and go into the caring profession either health, social work, mental health services to try and “save everyone”.
More than 50 per cent of care proceedings involve children affected by substance misuse and Radcliffe feels that it is essential that local authority social workers are educated and skilled up to cope with this rising trend. Radcliffe is running a training course for WillisPalmer in March – ‘Dealing with substance misuse and addiction for workers in caring and helping professions’ for social workers, lawyers, teachers and counsellors who work with substance misusers on a daily basis.
The course will look at how to work safely and more effectively with drug and alcohol misusers and their families in a statutory or official setting. It will include how to make accurate assessments of the nature and scale of the problem and of the risks posed to vulnerable others, particularly children, how to access credible treatment programmes and how to measure and monitor progress and recovery.
“Good practice comes down to individual practitioners but social workers could do a million times better in practice if they were taught about issues such as using drug testing effectively and carrying out expert assessments,” Radcliffe concluded.