SO WHY REHAB? Interview with Garth Popple

Rehabs, where you go and stay for a period of time - anything from a few weeks to several months - have been one of the main treatment choices offered to people who use drugs to make changes to their drug use. Rehabs offer intensive self-reflection and learning away from the usual triggers, responsibilities and stresses.

We Help Ourselves is an innovative service that offers treatment choice including abstinence and opioid substitution stabilisation. Each program includes harm reduction and hepatitis C treatment. WHOS has services in Sydney, Cessnock and Nambour (Queensland). The main site at Rozelle, in Sydney’s Inner West, is set in beautiful grounds and is calm and relaxed. People who go to WHOS describe it as a respectful and loving service that changes lives. To get started, you need to decide which program suits you. Information is available at http://whos. com.au/getting-admitted/ or you can ring ADIS or NUAA for support. You will then need to do an admission assessment by ringing the appropriate service.

UN interviewed WHOS’ Executive Director, Garth Popple about the service. We were also privileged to go into WHOS Rozelle so we could bring to you interviews with WHOS residents about their experience.

UN: You are a rehab service. What does that mean?

GP: We are run as Therapeutic Communities (TC). “We Help Ourselves” (WHOS) sums up the TC model; peers support each other in their goals, while our well-qualified staff direct the programs and offer various health and learning opportunities. We offer stabilisation, harm reduction and abstinence - to attend you need to respect each others peoples treatment goals and live and work alongside each other.

UN: I always thought WHOS was 12-step based.

GP: We do offer access to Narcotics Anonymous (NA) and Alcoholics Anonymous (AA) meetings but only as part of our aftercare. We also offer SMART Recovery. People need access to a peer group after they leave. Isolation is the biggest hurdle. You can take some solid friendships away from your time in a TC. But self-help groups are great for quickly getting a new peer group and learning how to make friends.

UN: So how does it work?

GP: At the Rozelle community we currently have 128 people in separate therapeutic communities (TC). We have men’s and women’s abstinence programs and mixed gender Opiate Substitution Treatment (OST) stabilisation and withdrawal programs. We also have regional TC’s in the Hunter and in Nambour, Queensland.

Programs run for 90 days followed by an optional 4-week commitment stage where people put back into the TC by supporting newer people. We have a day program in Newcastle for people who are on OST and are doing it tough - sleeping rough. It works well and we need more day programs. In Western Sydney we run an assessment and referral service for Nepean Hospital.

UN: People often get to rehab in poor health. How do you help people get their health improved?

GP: As part of a “living skills” program, we focus on selfcare - good food, sleep and an exercise program - and we are linked into Medicare bulk bill services for things like dental and optical. Importantly, we have Liver Clinics in all our TCs. At Rozelle we have on site testing including fibroscans and specialist appointments to make it easy for people to go on hep C treatment. In our regional TCs we have helped grow access to hep C treatment in the local hospitals.

We hold fortnightly overdose training in all the programs that includes how to use naloxone. We also do Infection Control groups where people learn about preventing blood borne viruses, Post Exposure Prophylaxis (PEP) for HIV and the new hep C treatments. We want to make sure that everyone takes something from their time here.

UN: A lot of people have kids and some of the family stuff might be tricky. How do you deal with that?

GP: We have found that family support is really important to getting a successful outcome for people. We have Family Support Workers to get families together. Among other things they offer support for child restoration and parenting courses.

Children can visit their parents in the TCs twice a week and every afternoon parents can Skype their children. We support reunion with parents, siblings and so on. We refer the families of our clients to Family Drug Support.

UN: How do you help people back into the community?

GP: We don’t cotton ball people to start with. We support them to stay connected with the wider community throughout their stay. We also focus on living skills - you can even can earn TAFE certificates while you’re in the TC.

Our Gateway team helps people transition back into the general community. After care is vital in staying committed to a life change.

To support this we have 7 or 8 transition houses in Sydney - around 30 beds - where people can continue to do WHOS training, for example life skills and budgeting; do external courses; perhaps do paid or voluntary work; sort accommodation; get job ready.

UN: You are a secondary Needle and Syringe Program. That sounds contradictory?

GP: In every TC we employ a Harm Reduction Worker who is responsible for ensuring safer injecting supplies and condoms are available and that people leave educated in harm reduction including overdose care.

We offer new injecting equipment when people leave. Fits and condoms are in each bathroom for use by residents. There are three main rules - no drugs, no sex, no violence. I say “don’t break our rules but if you do, do it safely”.

UN: So what’s the “success rate” like?

GP: We find that most people who leave will go in the first 7 to 14 days. It’s not a case of not finishing, it’s a case of never really getting started. Those who make 30 days usually last the program. About 60% complete our OST programs. Around 40% see the abstinence programs through.

We want to make sure that everyone takes something from their time here. There is no pressure when you leave. But we want you to take a safe injecting message and new equipment when you go. I want people to feel there is no shame in leaving, nor is there any shame in coming back, as many times as you need. It’s about doing what is right for you. Use the services, learn what you can, it’s your call - no stigma, no judgement.