I’ve had a bit of a problem recently… it involves moving different coloured gems from the wrong place to the right place until the picture looks as it should. In the past week I’ve done that 127 times, often when I should be doing something else; washing up, cooking for the family and even going to sleep.
This morning I played as I walked my dogs. I barely looked at them, and it was the moment that another dog-walker drew my attention to the fact that one of them was being sick that I knew something had to change.
For a brief while, I had an addiction that was causing me to neglect my dependent pets.
This is but a small example of how the human brain craves reward, comfort and distraction and the potential costs of those cravings, negligible by the standards of the people we support.
When you compound those needs with a traumatic event or childhood, memories so painful that any alternative is better than living with them, or a mental health condition from which solace must be found by any means, the shift from use to problematic use is not hard to imagine.
It is important to note that for over a decade, addiction has been medically recognised as an illness. Opiate and alcohol addictions are both treated with medicines, but unlike a bacterial infection medicine alone cannot treat it.
For a long time COMAD (co-occurring mental health and alcohol or drug use) was a barrier to accessing holistic treatment, you couldn’t get support with mental health issues while you were using, and you couldn’t get treatment for the addiction while you had mental health issues, leaving a patient in a purgatory limbo state of needing support but not being able to access it.
Thankfully, this landscape is beginning to change. Under the “No Wrong Door” framework, the system is actively dismantling that purgatory. Mental health and substance misuse services now have a mandated, joint responsibility to treat the individual as a whole.
The outdated expectation that someone must be entirely sober before they can receive psychological help is being phased out. It means people are finally starting to receive simultaneous, compassionate care rather than being bounced between closed doors.
Yet, even as treatment models improve, a pervasive myth remains: the assumption that having a severe addiction automatically unlocks the door to a home. The reality is that there is no magic housing.
The pathway from the street to a safe bed is a gruelling administrative labyrinth. A person must first prove their vulnerability, undergo a rigorous Care Act assessment, and secure a funded social care package before housing is even placed on the table.
Due to the high number of people needing help and the limited resources available, the thresholds for passing these assessments are high. It means that there are very vulnerable people left stranded.
Which is exactly the value of our substance use service “The Bridge”, by meeting people where they are on their journey, using a harm minimisation methodology, having a deep understanding of Social Care and the Care Act and being able to work across wellbeing and housing concurrently. We are one of the only safe places of support for those who fall short of the thresholds.
Consider this the next time you see a rough sleeper in the grip of addiction: what has led that person to the place where the life they’re living now is preferable? It almost certainly isn’t an active choice.
And if you want to make a difference in their life, start with compassion, recognise this is a person who is struggling, smile and nod a greeting. To make a practical difference, mention The Bridge at KCAH or sign-up to make a regular donation, your support will keep our drop-in service open and our outreach teams on the street.
