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In 2001 I had the opportunity to develop atherapy service for young people (aged 12to 25) at a holistic drop-in centre called

‘Base 51’ in Nottingham. The service, whichbecame known as ‘Relax@Base’, hadreceived Health Action Zone funding to offerfree Reflexology and IHM to young people,many of whom were homeless and sufferingfrom various stress-related conditions.Therapies were made available one day perweek and my list was always fully booked.

I soon discovered that many of the youngpeople attending the centre had issues withproblematic substance use. One couple inparticular, who were tackling crack cocaineaddiction, were referred to me for treatmentby the GP at ‘Base 51’. Crack cocaine is astimulant that increases adrenaline levels andin turn can generate feelings of anxiety,paranoia, depression and sleeplessness.Having sought support from local drugagencies the couple were soon drug free, butthey both maintain that the 6 weekly IHMtreatments they received really supported andhelped them to beat their problem.

Once ‘Relax@Base’ was under way, I beganto introduce other therapists to the projectover a series of ‘Well Being Days’. This was tobe the start of the Holistic Health Team(HHT), which is now 25 therapists/practi-tioners strong. Collectively, HHT can offer 17different therapies to service providers,including: Shiatsu; Seated AcupressureMassage; Reflexology; Indian Head Massage;Aromatherapy; Hypnotherapy; and Yoga.

In July 2002, Graham Miller, Services Managerat Double Impact Services (DI), approachedHHT. DI supports people recovering fromproblematic drug and alcohol use. Auricularacupuncture had been delivered very success-fully at other drug services over the past fewyears as a support to people in recovery fromsubstance misuse. However, Graham wantedto provide something different and wasresponding to users of the service who wereexpressing an interest in ‘hands-on’ therapies.The reason he had contacted HHT wasbecause someone from ‘Base 51’ had recom-mended our services to him.

The Pilot StudyIn November 2002 a pilot project waslaunched which introduced 5 different therapiesover a 10 week period at DI: IHM; Shiatsu;Aromatherapy (back, neck, shoulders & faceonly); Reflexology; and Reiki. These therapieswere selected on the basis that they wouldpromote natural well being, induce relaxation

and were easily received through clothing (apartfrom Aromatherapy). The area used for thesessions at DI had a partition that offered someprivacy, but obviously it did not lend itself totreatments such as Full Body Massage.

The consultationA health questionnaire was produced inconjunction with monitoring and evaluatingtools.1 These ensured that therapists treatedclients safely and enabled them to assess thebenefits and effects of the treatments.

Contra-indications to treatmentAlongside all the usual health-related concernssurrounding the provision of a complemen-tary treatment, the therapy team attendedtraining sessions at local drug service

providers to learn more about the potentialhealth issues that they may be presented with,including:

• Deep vein thrombosis (DVT) is a blood clotthat forms in a deep leg vein and is a‘standard’ contraindication. It can be causedas a result of poor injecting.

• Infective endocarditis is an infection whichaffects some part of the endocardium (thetissue that lines the inside of the heartchambers). It is a serious infection which canbe life-threatening. It can be caused if clientshave been injecting street drugs such asheroin with needles contaminated withbacteria.

• Skin problems due to poor diet and/orhomelessness

• Dental problems from prolonged use ofopiates/poor diet

• Hepatitis can make clients more prone tobruising

• HIV/AIDS can compromise immunity

• Raised blood pressure due to constrictedblood vessels

• Heart problems from continued stimulantuse

• Respiratory problems due to damaged lungcells from smoking

• Nasal problems from ‘snorting’• Seizures and convulsions from prolonged

stimulant use.

Clients were also presenting with anxiety,sleeplessness, agitation, depression, panicattacks and paranoia as a direct result of theirdrug history.

Assessment The difficulty in collecting data exploring thebenefits and effects of receiving complemen-

Complementary Therapies and

Substance Misuse

“By using relaxation therapies, respiration is decreased, whichwill help to reduce adrenaline levels, thus helping to alleviatecravings, so kicking the habit becomes a lot easier.”2

By Pip Bateman, MICHT, RMN

Pip Bateman has a background inpsychiatric nursing and gainedher first holistic therapy qualification(Reflexology) in 1991. In subsequentyears she has gained qualificationsin Indian Head Massage (IHM),Thai Yoga Massage and Auricular

Acupuncture.

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tary therapies lead the team to adopt ameasuring system, asking for before and after‘scores’.1 The assessment form asked theperson to identify up to 3 main areas oftension that they were experiencing that day,be these physical, psychological or emotional.Each area was then scored before and aftertreatment (1 = Good, 9 = Bad).

Method/DesignSixty half-hour ‘taster’ sessions were madeavailable over a 10 week period, during whichtime 25 people used the service. The numberof treatments accessed were as follows:

Aromatherapy 8Reflexology 9Shiatsu 10Indian head massage 11Reiki 16

Fifty treatment assessment forms werecompleted, of which 3 were spoiled. Eightpeople completed a feedback form at theconclusion of the project.

Results• 83% reported lower tension scores at the

end of treatment • 16% reported the same tension scores

before and after treatment• 1% of the feedback was incomplete• Users of the service also reported that they

had coped with feelings of aggression muchmore effectively after treatment. This hasnow been added to the assessment form.

After the Pilot Study …Three years on and complementary therapiesare now being delivered at DI two days perweek. Feedback is collated at regular intervalsand continues to be positive. Service usersreport the following benefits and effects:

Relaxation 100%Improved concentration 63%Improved sleep patterns 58%Reduced cravings for drugs/alcohol 58%Pain management 53%Anger managed more effectively 53%Help with withdrawal symptoms 37%Boosted appetite 32%Improved memory 32%

When asked how they would describe theirexperience of complementary therapies:

• “They have been a major aid in my alcoholrecovery”

• “It has helped me be more focused”• “Surprisingly effective and relaxing”• “I find these therapies very helpful to my

recovery”• “Feel happy, light and content. Beats taking

drugs. Feel more relaxed and more at easewith myself”

• “I have been feeling ill for over a week. Iforgot I was ill!! Feel much lighter andrelaxed - chilled”

Interestingly, the client group is predominantlymale, but more women have been attractedto the service since therapies have been intro-duced. Other drug services in Nottinghamhave now adopted complementary therapieswithin their services with consistently positiveresults.

Training for TherapistsIn 2003, Pip developed a new community-based course called ‘Healthy Highs’ (withthanks to continued support from DI andNottingham City Crime and DrugsPartnership, in association with PeoplesCollege Nottingham). The course has beendesigned specifically for qualified therapistsand practitioners hoping to work withsubstance misusers. As well as learning aboutdifferent drugs, withdrawal symptoms,contra-indications to treatment and so forth,each student is also required to carry out aminimum of 40 hands-on treatments. HealthyHighs has just finished its first year, duringwhich 8 students delivered over 300 treat-ments within 6 drug service centres inNottingham.

Further ResearchA research study is currently under way todetermine themes and commonalities ofpresenting problems and adaptations to treat-ments using the evidence gathered byHealthy High students. Feedback so farindicates that the following essential oils andreflex points have proved useful:

Ylang Ylang: to benefit anger, impatience andirritability and raise self esteemFrankincense: for relaxation, to ease breathing,encourage stability and curb apprehensionChamomile: to ease restlessnessLavender: a safe oil with analgesic properties,induces relaxation.

Relaxation and solar plexus: to aid restfulsleep, reduce anxiety and agitation and deepenbreathingDiaphragm: to ease chest tension/congestionHeart: to help circulationPituitary and pineal gland: to help stimulate allglands/release of natural endorphins for painrelief/ stimulate serotonin for mood elevationHypothalamus: to help balance emotional stressPancreas: to help regulate blood sugarBladder/kidneys: to assist with detoxification/eliminating toxins and ease fluid retentionLower back/spine: a common area of tensionwhen withdrawing from heroin - stimulating thespinal nerves may be beneficialLungs: to help relax the respiratory system/reduce adrenaline levelsLiver: to help purify the blood and filter wastesIntestines: to help activate absorption ofnutrients and eliminate wasteAdrenals: to help improve energy/moodThyroid: to help balance metabolismBrain: to help the brain function without theneed for drugs or alcohol.

Self-Help TechniquesThe other benefit of being with this clientgroup for a therapy session is the addedbonus of introducing healthier lifestyleoptions. Many clients are now: drinking watermore regularly; putting lavender oil on theirpillow at night or in their baths; eating 5portions of fruit and vegetables each day;using relaxation techniques to help themsleep; massaging their solar plexus hand reflexwhen stressed; and some are attending Yogaand T’ai Chi classes.

References, Research and Further Reading

1 Project 6, Keighley, West Yorkshire – monitoring/evaluationtools

2 The Blenheim Project, 321 Portabella Road, London W105SY “What’s the Crack” for Professionals

• Holistic Health Team: www.holistichealthteam.com

• Double Impact Services: www.doubleimpact.org.uk

• Nottingham City Crime and Drugs Partnership: http://www.nottinghamcity.gov.uk/coun/department/social_services/drugaction/default.asp

• HIT delivers effective interventions on drugs, alcohol,sexual health, community safety and other public healthconcerns: www.hit.org.uk

• National Treatment Agency: www.nta.nhs.uk “Models ofCare” (Chapter 4.7 - Complementary Therapies / Chapter3.1 - Stimulant Users)

• “Street Drugs” by Andrew Tyler : Coronet Books; ISBN 0-340-60975-3

• “The Reflexology Handbook - A Complete Guide” byLaura Norman: Piatkus; ISBN 0-86188-912-6

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