In my previous article i discussed the frustration of being autistic in a recovery service that was not designed for people like myself, in this article i intend to go into a bit more detail.
There is a problem with substance misuse recovery services. Many if not all of these services do not take into account the autistic individuals who may need to use them in order to find recovery. This presents a unique challenge to autistic addicts who may be seeking recovery from drug and alcohol addiction. I was under treatment with drug and alcohol services for approximately three years, in that time i came a long way, but appointments were an extremely challenging aspect of my recovery for a number of reasons.
Waiting rooms can be horrible for autistic people, but waiting rooms in substance misuse services are especially uncomfortable. The lighting is often bright and fluorescent, beaming down on you and hurting your eyes. You are surrounded by people in crisis, some of whom want to talk to you as they pass the time until their appointment, some people may be extremely distressed, and as such may be making a lot of loud noise. Straight away this waiting room is sensory hell for autistic individuals. How is an autistic person supposed to find recovery when walking through the door of such a building is enough to drive them back to the drink and drugs that they are trying to get away from?
The appointment itself if also problematic. For those with executive function issues, keeping the appointment may be a challenge in itself, my appointment reminders were often on small business cards that i was handed at the end of my previous appointment, and was expected to use as a reminder. Once you overcome this issue, and the previously mentioned challenges of the waiting room, there were the mechanics of the appointment itself. For me, these appointments usually meant sitting in a one to one environment, directly across from a key worker (who most likely has not had specific training in dealing with neurodivergent individuals), in a windowless room, with white walls and the aforementioned lighting from hell. In this environment you are then expected to discuss deeply emotional issues, and take note of your key workers advice. If you are on opioid replacement therapy, you may also need to discuss doseages of methadone or buprenorphine (subutex), something which can literally be a matter of life or death for some addicts.
As any autistic person can tell you, this is somewhat of a hostile environment if you are on the spectrum, so what can be done to make this environment more friendly?
Quiet spaces in waiting areas are important, giving people somewhere to escape to if the noise of a waiting area gets too much. Sensory friendly lighting is also important as the standard lighting may cause physical pain to an autistic individual. To help with executive function issues, appointment reminders should come in multiple forms. A reminder can be given in writing at the appointment, a letter sent to the persons homes or ‘care of’ address, and a telephone reminder given the day before or the day of the appointment.
Once in the appointment, peer support is vital. Having a peer who understands your needs as an autistic individual may aid communication, taking some of the pressure off of the one to one environment. Rooms with natural or sensory friendly lighting may make the experience less like sensory torture, this could also be aided by making walls colour that dont glare in the lighting. Finally everything said in the appointment should be provided in writing for future reference, many autistic people struggle with retaining huge amounts of spoken information at once.
If these sorts of changes are made, the environment for an autistic adult becomes considerably less hostile. Autistic addicts need to be recognised as a unique demographic with their own unique set of needs. Until this is done, autistic addicts will continue to struggle through recovery.
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