RAISING THE
STANDARD
Drug and alcohol treatment and
its relationship to wellbeing
This Report
With this report we are marking the start of an ongoing project to understand how a better understanding of
mental wellbeing might influence the effectiveness of treatment for drug and alcohol addiction.
When we talk about treatment we include prescribed, psychological and social interventions that are used to
help people recover from their dependencies.
This is very much the start of the journey. We have undertaken some initial surveys to help shape our thinking
and give us some areas for further investigation.
We will continue to publish our findings as we progress.
As an organisation, we believe in working in partnership with others and would, therefore, welcome anyone
interested in collaborating on this project to contact us to look at how we might pool resources to advance
our aims.
Dr Ian Guinan and Dr John Richmond
About Delphi Medical
Delphi Medical is a leading independent provider of drug and alcohol clinical treatment in the UK.
We work both in community and prison-based services and focus on helping our patients to achieve and
sustain abstinence.
As an organisation we place a significant emphasis on innovation and working in partnership with other
like-minded organisations.
Wellbeing and Treatment
Increasingly we have been looking at issues relating to addiction, treatment and wellbeing.
We believe feelings of wellbeing are crucial to successful treatment for drug and alcohol addiction.
As a result, we are undertaking surveys to assess and track feelings of wellbeing before, during and
after treatment.
By better understanding how treatment affects wellbeing, we think, it may be possible to achieve the following:
• Understand what aspects of wellbeing are most critical in achieving sustained abstinence and therefore
focus treatment to become more effective.
• Provide early warning of patients for whom treatment is not being effective at improving wellbeing,
therefore prompting a change of approach to increase chances of success.
• Create strategies for maintaining wellbeing after treatment to help patients achieve sustained
abstinence in the long term.
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Drug and alcohol treatment and its relationship to wellbeing
www.delphimedical.co.uk
Initial Findings
Our initial work on understanding the relationship between wellbeing and treatment has been to conduct
surveys amongst three sample groups:
• A male prison population of 40 people currently receiving treatment for addiction.
• A mixed gender group of 54 people from a community user forum (a mixture of people abstinent, in
treatment or post-treatment and their families and carers).
• A mixed gender group drawn from a representative sample of 200 UK adults.
Each group was provided the same questionnaire. Our questionnaire uses WEMWBS (The Warwick-Edinburgh
Mental Well-being Scale) to measure mental wellbeing. WEMWBS was created by mental wellbeing experts,
and is often used by scientists and psychologists.
The WEMWBS questionnaire for measuring mental wellbeing was developed by researchers at Warwick and
Edinburgh Universities (see Tennant R, Hiller L, Fishwick R, Platt P, Joseph S, Weich S, Parkinson J, Secker J,
Stewart-Brown S (2007) The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): development and UK
validation, Health and Quality of Life Outcome; 5:63 doi:101186/1477-7252-5-63).
The Questionnaire
Our questionnaire contains14 statements, for which respondents were asked to choose from 5 responses that
best described their state of mind over the last 2 weeks.
The statements were:
1. I’ve been feeling optimistic about the future
2. I’ve been feeling useful
3. I’ve been feeling relaxed
4. I’ve been feeling interested in other people
5. I’ve had energy to spare
6. I’ve been dealing with problems well
7. I’ve been thinking clearly
8. I’ve been feeling good about myself
9. I’ve been feeling close to other people
10. I’ve been feeling confident
11. I’ve been able to make up my own mind about things
12. I’ve been feeling loved
13. I’ve been interested in new things
14. I’ve been feeling cheerful
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Drug and alcohol treatment and its relationship to wellbeing
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The five possible responses to each question are allocated a points value as follows:
a) None of the time (1point)
b) Rarely (2 points)
c) Some of the time (3 points
d) Often (4 points)
e) All of the time (5 points)
The results were then assessed for the overall scores and also the responses on the individual questions.
These scores were compared between groups to look for trends and patterns.
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Drug and alcohol treatment and its relationship to wellbeing
www.delphimedical.co.uk
Our initial findings
and observations
1. Addiction and prison unsurprisingly is associated with
a negative effect on wellbeing
Average totals for each sample group
49
48
47
46
45
44
43
42
41
40
39
General Population
User Forum
Prison Group
The wellbeing questionnaire is suggestive of the negative impact prison and previous addictions have
on people.
However, what provides hope is how close the scores are for the User Forum group and the general population.
It indicates that successful treatment and improved personal circumstances can have a significant effect on
restoring feelings of wellbeing.
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Drug and alcohol treatment and its relationship to wellbeing
www.delphimedical.co.uk
2. Treatment seems to work specifically on social
wellbeing
4.5
4
General Pop
User Forum
3.5
3
2.5
Q14 Cheerful
Q13 New Things
Q12 Loved
Q10 Confident
Q9 Feeling Close
Q8 Feeling Good
Q7 Clearly
Q6 Problems
Q5 Energy
Q4 Interested
Q3 Relaxed
Q2 Useful
Q1 Optimistic
2
When analysing the scores for the general population it is those aspects of wellbeing related to social
interactions that seem to be boosted by a positive experience of recovery.
Our user group sample performed well against the general population for feeling close to other people, feeling
loved and feeling interested in other people.
It also appears that being in recovery boosts a sense of hope for the future with levels of optimism also higher
than in the general population.
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Drug and alcohol treatment and its relationship to wellbeing
www.delphimedical.co.uk
3. The wellbeing of women seems to be particularly
boosted by treatment
4.5
4
Women
User Forum Women
3.5
3
2.5
Q14 Cheerful
Q13 New Things
Q12 Loved
Q10 Confident
Q9 Feeling Close
Q8 Feeling Good
Q7 Clearly
Q6 Problems
Q5 Energy
Q4 Interested
Q3 Relaxed
Q2 Useful
Q1 Optimistic
2
4.5
4
Men
User Forum Men
3.5
3
2.5
Q14 Cheerful
Q13 New Things
Q12 Loved
Q10 Confident
Q9 Feeling Close
Q8 Feeling Good
Q7 Clearly
Q6 Problems
Q5 Energy
Q4 Interested
Q3 Relaxed
Q2 Useful
Q1 Optimistic
2
Interestingly,, when looking at gender differences, women in our User Group had higher wellbeing scores than
those in the general population.
The situation is reversed for the men in our sample groups.
It seems that recovery from dependence may be more effective at boosting women’s wellbeing than for men.
There is scope for investigating these gender differences further to understand whether men would benefit
from greater emphasis on treatment designed to boost wellbeing. Also to sense-check whether the increased
wellbeing of women going through recovery translates in a high propensity to achieve sustained abstinence.
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Drug and alcohol treatment and its relationship to wellbeing
www.delphimedical.co.uk
4. The wellbeing of younger people may be more
adversely affected by drug and alcohol addiction
52
50
48
General Population
LUF Age
46
Prison Age
44
42
40
18–29
30–39
40–49
A low feeling of wellbeing seems to be a more significant issue amongst younger people than it is for
older groups.
It may be that the natural optimism, sociability, energy and confidence of younger people are undermined by
the effects of addiction.
There is potential for further study to see if this means that re-establishing ‘normal’ levels of wellbeing is a
harder task amongst younger patients, therefore inhibiting the effectiveness of treatment.
Conversely it may be that younger patients find it easier to ‘bounce back’, with their sense of wellbeing having
greater natural resilience.
Both these possibilities will be investigated through further study.
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Drug and alcohol treatment and its relationship to wellbeing
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What Next?
Our use of wellbeing surveys is going to be extended across all our treatment services over the next 3 months.
We will continue to collate the results and analyse the trends and patterns that we find.
We will continue to seek out other organisations willing to partner with us on studying the relationship between
wellbeing and initiatives designed to increase the effectiveness of treatment.
There are a number of early hypotheses that we will be seeking to test. These are:
• Successful treatment has a significant effect on increasing wellbeing.
• There is a correlation between increasing wellbeing and sustained abstinence.
• Successful treatment is particularly effective at boosting specific aspects of wellbeing.
• There is a correlation between increasing specific aspects of wellbeing and successful sustained
abstinence.
• There is a gender difference in how treatment impacts on wellbeing.
• There is an age difference in wellbeing that has an impact on the effectiveness of treatment.
We will report again in six months-time to help share insights and advise on any lessons for using wellbeing to
increase the effectiveness of treatment.
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Drug and alcohol treatment and its relationship to wellbeing
www.delphimedical.co.uk