A brief overview of a one-to-one detoxification service was explained to clients from the Independence Initiative; including information regarding client’s inability to mix with other clients while undergoing detoxification and that all interventions would take place within the client’s own room. Following this, clients were asked if they or others that they know would be interested in a one to one detoxification service, 18 (90.0%) of the sample from the Independence Initiative said they would be interested in a one-to-one detoxification service and two (10.0%) clients said that they would not be interested.
Respondents were then encouraged to explain what they believed the most important benefits of a one-to-one detoxification program would be. The over riding theme to come to the fore from this question was the lack of ‘interaction’ with other drug users.
“Safer not mixing with others. Others talk about drugs.
Not being bullied or called a grass for wanting to talk to staff”.
“This would help people who can’t talk to others who are easily led and very suspicious. People will blossom in this program. Get treated like humans. It would be safe and secure”.
“Having the chance to do it and not to mix with others. This would have really suited me”.
The next theme to emerge was ‘security’. In that respondents would feel safe in an environment to detoxify in.
“Get drug free in a safe place”.
“Safe environment. Get reassurance.”
“Staff are there (feel secure), you would be OK”.
Clients from the Independence Initiative were then asked to explain any disadvantages they perceived in engaging with a one to one detoxification service. While seven clients thought that there would be no disadvantages the most predominant theme was
‘isolation’.
“Might be lonely, but would be better that other detoxifications”.
“Feeling alone-No one to talk to.”
“Sometimes you need people around, isolation is hard. Should mix at times (maybe for 1 hour)”.
“You need others around you who have gone through the same experience as you”.
As previously mentioned, two clients from the Independence Initiative said that they would not be interested in a one-to-one detoxification service. Both clients did feel that there would not be any benefits to this particular type of approach, although they did express their thoughts with regards to disadvantages for establishing a one-to-one detoxification service. Set out below is the responses given
“Too restricted. Very controlling. Too hard and giving the person (client) no trust. Trust is important, given no choice”.
“You need others around you who have gone through the same experience as you.”
Respondents were encouraged to think about what would be the most important element if a one to one detoxification were being established. There were three main themes to emerge from this particular question, the first was again a ‘safe environment’, second was ‘understanding staff’ and the third was ‘activities to occupy the mind’
“Safe base”.
“Good aftercare. Stay safe.”
“Keep your mind occupied. Non-stressful environment, anything to relax, nice surrounding. Keep safe”.
“Security, need to feel safe. Television in room. Padded room - as in a room to go were you can be alone”.
“Good staff support and trust. Treated as an individual”.
“Trained Staff that will challenge you. Support with family”.
“That staff checks up on you and you are not on your own so much. Make sure everyone is on the same level and you don’t bump into other drug users just coming in to the service.”
“Music, books and TV. Keep happy and safe.”
“Radio-Music (CD’s). Access to garden and fresh air, that is calming.
Pastel colours, soft lighting, no hospital or prison reminders, look homely and easily cleanable. Games (scrabble, connect 4 and one player games.”
“Might heighten feelings of being alone, that would need to be considered and the person kept occupied. Mind needs to be occupied. Nights might be a problem (need TV), and might need someone to talk to”.
“Occupy your mind-lots of time to think so you need stuff to do (Playstation and games). A structured program”.
Whilst clients did understand the mechanics of a one to one detoxification service, four individuals mentioned that they would still need to interact with others or with family members.
“Care and support. Need to talk to other addicts and share your experience. That way you find out you’re not alone. Maybe while doing a one-to-one detoxification clients could spend 1 hour with others under the supervision of staff.”
“Contact with my wife to see if the kids were OK. Not to see the wife, just to speak to her on the phone.”
“Privacy is needed, but sometimes you need to talk to your family, maybe be allowed one phone call.”
The contradiction in client responses regarding the benefits and the disadvantages of entering into a one-to-one detoxification service may be explained in terms of client’s preconceived ideas from previous detoxification experiences. For example, most clients that indicated they would not wish to be involved with other clients whilst
undergoing a one-to-one detoxification also said that they would need some contact with ‘others’ or with ‘family members/partners’. Therefore, as a number of clients from the Independence Initiative had negative experiences of detoxification, especially in a prison setting, the idea of a one-to-one detoxification service may seem a little daunting. However, more positive than negative responses were gathered from respondents and the feasibility of this particular type of model of detoxification as an alternative to current detoxification provision does seem possible, but as highlighted by the Independence Initiative, may be more suited to specific client groups. This is because the one-to-one approach is believed to be particularly suitable for individuals that are perceived as being vulnerable such as those prone to peer pressure, or those who are at a disadvantage in a group setting.
Thus to summarise, in all 20 individuals from the Independence Initiative participated in this study, the majority of who lived alone in rented accommodation. Most clients had also engaged in drug use in the prior four weeks to being interviewed and all had been through various kinds of detoxification services including in-patient, community, prison and unsupported. The positive aspects of clients experiences in detoxification was that they were able to identify with other drug users going through the withdrawal process and that they received support from a variety of service providers such as the Independence Initiative and Gateway. Clients negative perceptions of their experiences of detoxification tended to stem from what they referred to as unhelpful or uncaring staff and this was true for both inpatient and community detoxification experiences. The majority of clients from this sample had experienced detoxification in a prison setting. This client group felt that they were constrained and isolated during withdrawal from drugs, which may have had an impact on their responses
when asked about the disadvantages of establishing a one-to-one detoxification service.
The overwhelming majority of clients from the Independence Initiative were interested in the prospect of a one-to-one detoxification service being established and cited the main benefit of this type of approach as the lack of interaction with other drug users. The disadvantages of this particular type of detoxification were also addressed and clients claimed that they might feel lonely, which is inconsistent with their previous responses of wanting to be alone whilst detoxing. The most important elements of establishing a one-to-one detoxification service from the clients perspective was a safe environment from which they could detoxification from, friendly and helpful staff and activities to occupy the mind.