Responding to the Risks Associated With the Relapse of Recovering Staff Members Within Addiction Services

Abstract

Practitioners working within addiction services who are recovering from their own addiction issues contribute positively to the strength of service interventions, but their recovery also poses risks, particularly those associated with the possibility of relapse. Little has been published on this issue despite its significant impact on the relapsing practitioners, their clients and colleagues, and the services themselves. This “point-of-view” article divides the various impacts of a practitioner's relapse into four phases and examines how services might develop early and late response strategies. It argues that formal monitoring processes can assist in both preventing and responding to the harms associated with these relapses.

RÉSUMÉ

Article d’opinion: Interventions relatives aux risques liés à la rechute des membres du personnel des services de traitement des dépendances en voie de réadaptation

Les médecins qui travaillent au sein des services de traitement des dépendances et qui sont eux-mêmes en train de se rétablir d’une dépendance, contribuent positivement à l’efficacité du service d’intervention. Toutefois, leur processus de rétablissement est menacé notamment en raison de la possibilité d’une rechute. Très peu de documents ont été publiés à ce sujet, et ce, malgré les répercussions considérables sur les médecins récidivistes, les clients et les collègues ainsi que sur les services eux-mêmes. Cet article d’opinion divise les impacts variés de la rechute d’un médecin en quatre phases et examine comment les services pourraient préparer des stratégies d’intervention rapides et tardives. L’article fait valoir le point de vue que les processus de surveillance officiels peuvent aider à la fois à prévenir les torts associés à ces rechutes et à intervenir pour redresser ces torts.

RESUMEN

Punto de Vista: Respuesta a los Riesgos Asociados con la Recaida en la Recuperacion de los Miembros del Personal Dentro de los Services para la Adiccion

Profesionales que trabajan en servicios que combaten la adiccion, quienes ellos mismos se estan recuperando de problemas de adiccion, contribuyen positivamente al nivel de las intervenciones ofrecidas por dichos servicios, pero su propia recuperacion puede verse comprometida, y son particularmente mas propensos a las recaidas. Se ha publicado poco al respecto, a pesar de que dichos servicios pueden influenciar en forma significativa en la recaida del professional, en sus clientes, sus colegas y en los servicios mismos que ellos ofrecen. Este articulo presenta el punto de vista del autor, divide el impacto de la recaida del professional en cuatro fases, y examina como se pueden desarrollar servicios que ofrezcan strategias de respuesta pronta y otras a largo plazo. El articulo argumenta que un monitoreo formal puede ayudar no solo en la prevencion de una recaida, sino tambien en como responder y minimizar los posibles danos a los cuales las recaidas son asociadas.

Keywords :

• addiction
• addiction practitioners
• recovery
• relapse prevention
• workforce development

THE AUTHORS

Peter Adams, PhD, was trained initially as a clinical psychologist and has practiced in hospital, community, and private practice settings for over 13 years. Through his practice he developed specialist expertise in addictive behavior, violence, and public health interventions for dangerous consumptions. He has been employed by the Auckland Faculty of Medical and Health Sciences since 1991, during which time he has led a number of initiatives in alcohol-related and drug-use(r)-related studies. These include development and coordination of alcohol and drug teaching in the undergraduate medical curriculum, initiation of postgraduate teaching programs for addiction specialists, and development of brief intervention projects in primary care. He supervises a range of alcohol and drug Ph.D. projects and in 2001 formed the Centre for Gambling Studies, which he now directs and which conducts research on the health impacts of gambling. His current research interests include family impacts of addictions, brief interventions, recovery processes, and public health approaches to gambling. He is currently employed as the head of the section of Social and Community Health within the School of Population Health at the University of Auckland.

Helen Warren has a PhD in medical sociology on the topic of dual diagnosis and is a registered comprehensive nurse, with a certificate in addictions counseling, diploma in management (health services), and a master of arts (sociology). She has worked as a clinician and manager in alcohol and drug user treatment settings for 25 years. She is currently employed as an academic at the University of Auckland, coordinating the postgraduate teaching in alcohol and drug studies (including supervision of Ph.D. and master's students). Her research interests are dual diagnosis, critiquing “recovery” as a concept, and supporting capacity building among the Tangata Whenua and Pacific communities.