IT’S more than 30 years since Phyllis Corish – who had just lost her 29-year-old brother and 34-year-old sister to drugs within weeks of each other – walked into the newly opened Rialto Community Drug Team in Dublin looking for help.
Heroin flooded the Irish capital back in the eighties. Hotspots – including the housing schemes of Fatima Mansions where Phyllis lived and nearby Dolphin House – were both served by Rialto’s community team. The kingpin behind the flow of drugs, Larry Dunne, was brought up less than a 10-minute walk away.
Spiralling inflation and high unemployment across the city made people susceptible to heroin’s dark draw. By the time tragedy struck Phyllis’s family, people had been dying for years, while others contracted HIV from infected needles.
Dealers had set up shop in the area’s housing estates. Mothers were burying their children. Authorities seemed absent and angry, and desperate parents turned vigilante. They started trying to physically march dealers out of the community. “We lost a whole generation,” says Corish.
It was during this crisis that the Rialto Community Drug Team – the first of its kind – opened its doors. It was the centre’s founder Tony MacCarthaigh who first examined the needs of local people, and highlighted what was wanted. The aim of the neighbourhood-based service that emerged was simple – to support the whole community on a journey to wellness.
That meant supporting the whole family, including parents, children and siblings, as well as the person struggling with drug use. That is not the case in many services in Ireland and Scotland, where the person in drug treatment is the primary focus, their family excluded.
Yet according to charities and support organisations, the evidence shows involving the family not only helps support their wellbeing and breaks cycles of trauma from being imposed on children – it can also help the person in drug treatment to recover.
In Ireland, that family-inclusive approach is now written into drug strategies. The “whole family approach” is also Scottish Government policy, along with a commitment to improve holistic family support, with a budget of £3.5 million for alcohol and drug partnerships and a further £3m provided by the Children and Families Fund. Several charities run family programmes.
The aim of this strategy is to tackle the ripples of harm to families and loved ones caused by Scotland’s well-documented drug crisis. Between January 2019 and the end of 2023, more than 6000 people have died, an average of almost 24 people every week. But families too are impacted, not just by grief but by the struggle to support their loved ones.
Research from 2018 suggested 35% of people who died from drug overdoses were the mothers and fathers of children under 16. In 2021, parental substance use was identified as a concern for 15% of children on the child protection register, though figures are not clear about how many were taken into care as a result.
The impact of drug deaths on parents and other family members is not measured, according to Sandra Holmes. She has supported her own family through addiction and runs the Midlothian Family Support Group to help parents and other relatives deal with the trauma involved.
And despite current policies, strategies and funding, not enough is changing, she insists. The charity Scottish Families Affected By Alcohol And Drugs agrees, claiming there is a “patchwork picture of provision, of which many family members are left out”.
In response, Holmes set up Families Campaign For Change. The group is mostly made up of mothers calling for drug reform, better treatment options for their loved ones, and for families to be included in support services.
Holmes is adamant that integrated services that include families are the answer. “Families are very often on the frontline,” she explains. “We’ve been through it all, from seeing our loved ones going through psychosis, to dealing with their drug debts and sitting up all night waiting for a knock at the door.
“But yet families are all too often rejected from services or we see our family members turned away and are powerless to do anything about it.”
So when group member Stephanie Morrison reported back from a visit to Dublin about a community-led service that put families at its heart, she wanted to hear more.
Walking into the Rialto Community Drug Team felt different to the many other services she has been in, says Morrison, who supported her adult son through his struggles with substance use.
She knows there are plenty of challenges here too. But as she heard about its family support workers, the collaborative working with the drug workers and the therapeutic family service on offer, she wondered if a similar approach could work in Scotland.
“I was kept at arm’s length by services in Scotland for a long time,” says Morrison. “We’ve got to the stage where I try to step back. But I’ll always remember the resistance and the devastating impact it had on all of us. I feel sure there’s a better way.”
Now she and Holmes have brought members of their campaign group to Dublin to find out more. They are joined by Caroline Butler, who lost her son to drugs in 2001, and Agnes Donnachie, who runs the Families In The Know support group in Inverclyde.
Also here from Scotland are former homeless support worker Susan Grant, whose own friends and family have been affected by drugs, and Elizabeth – as we’ve agreed to call her to protect her identity – a former heroin user with a family member in the group. The Ferret has joined them to see what they’ll find.
We’re met in the drop-in area by workers and support staff, including Phyllis Corish, who is preparing to take waiting clients through for an acupuncture session.
When Corish pushed open the door of the red-brick church-turned-community centre three decades before, it was a very different place from it is now. “It was one room filled with smoke, half the people were off their heads and ambulances were being called for people all the time,” she says.
She was drawn towards a group of mothers, sewing a quilt commemorating their dead. One had lost five of her children to drugs. As a machinist, she saw her calling. “I could help with that,” she told them.
She didn’t manage to see founder Tony MacCarthaigh but she found a different kind of support – other women who recognised her pain and wrapped themselves around each other. Before long, she had quit her well-paid job and started working with the drug team. “I thought, well, maybe I can’t help my brother and sister but maybe I can help someone here,” she says. “Watching the transformations in people has been amazing.”
There are 13 programmes now running here including drug counselling, but families are still at the heart of this service. Rialto team leader Alan Cleere warns against the illusion that things are perfect. “It’s far from that,” he says. Ireland is also struggling with the impacts of drugs in its communities, particularly cocaine and crack, with drug violence and intimidation hitting headlines.
The nearby Dolphin House is rundown – it’s mouldy, damp, boarded-up, vacant flats have attracted drug dealers and violence. Conditions are so bad that a residents’ group has written to the Irish Human Rights and Equality Commission to initiate an enquiry under the Human Rights Act.
The drug death rate is the highest in the EU, with more than one person dying every day. It’s lower than Scotland’s, however, despite a comparable population of a little more than five million.
Community drugs teams are still funded by the government, but only on an annual basis, and, says Cleere, can feel marginalised. He is clear too about the strengths of the community-based approach: “It came from the grassroots up, from a community coming together saying: ‘This is what we need’.
“There was a recognition that addiction shouldn’t be a criminal issue as it was considered in the day – but that a service needs to look at employment, at housing and at family support.”
The community-led approach in Ireland was a public health one, aimed at tackling HIV. A report by former Irish Labour Party politician Pat Rabbitte led to the foundation of local drug task forces, which supported the work of the community-based teams. The need for action-focused political attention after investigative journalist Veronica Guerin was murdered in a contract killing believed to have been ordered by a South Dublin-based drug cartel.
Family support worker Anne Walsh, who joined the Rialto team in 2007, is also well aware of the challenges facing it. But she can attest to the importance of the all-family approach.
From the start, there was practical family support offered to people struggling with their drug use, helping them at home or getting children to school. There was a “granny minders group” for grandparents acting as replacement parents to their grandchildren and, of course, the quilt group.
The family support service Anne now runs is more formalised than it once was, offering one-to-one support for family members – very often parents – while their sons and daughters use the team’s other services and see one of the drug workers. “We’re working together to help the whole family,” she says.
Problems endured by the families she supports can be brutal, with some facing threats and violence due to drug debts. “The crisis that’s happening for family members, and how families are torn apart, is not being captured by the Irish government,” she explains.
“Families have left the country because of drug intimidation, had their flats petrol bombed, [have been] shot at through windows because of drug debts that started small but have quadrupled with interest.”
Others are struggling to maintain relationships, keep kids in the family home or set down agreements needed to help everyone in the household stay safe and sane. She helps parents set boundaries that make supporting an adult child struggling with addiction feel possible, and advocates at meetings with lawyers or housing departments or supports them at court.
But there is one thing that all the people she sees have in common. “I can guarantee that the first thing they say is: ‘I had nowhere else to go’,” she explains. The extent of the challenge is clear when we meet with some of the women being supported, who’ve asked that we change their names to protect their adult children.
Patricia’s now 28-year-old son, her youngest, was “the model child” growing up, she tells the group. “He was very soft, very sensitive.” When he developed a drug problem as an adult, Patricia initially went into complete denial. “I didn’t want to see it,” she admits.
But after he was hospitalised, she called the helpline in Ireland and begged for someone to speak to. The stigma was too great to raise it with friends and family, she explains. The Scottish mothers nod knowingly.
She’s been seeing Anne ever since as well as coming for regular complementary therapies including acupuncture and massage. Her son sees the service’s drug worker. It’s given her a different perspective.
“I was running around trying to know where he was all the time so I could protect him,” she explains. “He was owing money for drugs and he would give the dealers my number and I was repaying these loans.”
Anne asked her to reflect. What would she say to a friend if she heard what they were doing to help and the toll it was taking on them? It helped her protect her own wellbeing and provide stronger support for her son. “Often other people don’t get it,” she says. “But they do here.”
Others chime in, sharing stories of both the hardships and the strides they have taken to regain control over their lives. “I started to come back to life,” shares one, who admits she’s also started dating someone new. The other women cheer and whoop.
Holmes speaks on behalf of the Scottish contingent listening. “It’s so good that you’re being supported, you know, loved, instead of being shunned by services as an interfering mother. Because that’s how we can feel at home. The system is not set up like this.”
But it’s the Rialto Community Drug Team’s services for families with children under 18 that really make the Families for Change campaign sit up. FamilyWorks is a therapeutic approach, pioneered by former primary school teachers-cum-family therapists Joy Winterbotham and Nicola Crocker, which looks to work with the whole family at the same time.
“Addiction is just a symptom of pain and hurt and ache, but it’s one that’s forgotten,” Winterbotham says. Ireland, she stresses, has not been good at recognising the issue at a systemic level. But she’s trying to change things. “I was seeing families as a therapist in a very disadvantaged area in Dublin,” she explains. “And a parent would say: ‘I’ve got a problem with my child’. My response was: ‘Sorry, if you want to see me, the whole family has to be involved, and please bring as many members of your family as you can’. That’s how I work.”
She brought in fellow therapist Crocker to work with her simultaneously and took the proposal to work differently to Alan Cleere at the Rialto Community Drug Team. Anne Walsh identified six families to start the process and can attest to the benefits.
Its results can be dramatic. We meet Barbara, a former alcoholic, who Walsh supported through her court battle to have her child returned to her care. “My daughter was really traumatised,” says Barbara. She had been with three different families in care and had changed social workers countless times. The two took part in FamilyWorks for a year and a half.
“They never missed a week,” says Walsh quietly from the sidelines. Sometimes they were together, sometimes separate with one therapist working with Barbara on parenting, the other doing play therapy with her daughter. “I start to feel like a normal person again, a normal mother again,” Barbara says. “I feel like my life is just a miracle.”
Sometimes it’s just about helping families hold on. When Deirdre’s oldest son got involved with drugs, she had a new baby. By the time that baby was seven years old, things were untenable. FamilyWorks, which she attends with her younger child and once reluctant husband, has been transformative.
At the moment, her oldest son is not well enough to come. “He’s been in and out of hospital, he lost the power in his legs from doing [nitrous oxide, known as ‘laughing gas’] balloons. There’s been suicidal thoughts, mad psychosis and the like. But the family therapy … I feel like it has saved my life,” she says.
The way Sandra Holmes sees it, that new lease of life will positively impact Deirdre’s son too. Though it’s not always available, she managed to get support when her family member was in rehab. Holmes said that though it took her loved one many years to find a way to recover, it meant she was able to support them throughout in a way she says would otherwise not have been possible. “When we do manage to get family support, there’s that relief – you can be honest about what’s going on and you are understood,” she says. She believes that’s pivotal. “In my experience, it becomes a parallel path to recovery – for you and for the family member who’s [in] addiction.”
Families Campaign for Change has so far presented its findings to the Scottish Drug Forum and intends to use its learning to push politicians to commit to improvements.
But back at the Rialto Drug Team, Phyllis Corish is preparing a new quilt for the family support group’s 30th anniversary memorial this month – it’s the longest-running group of its kind in Ireland.
The list of those who the families have lost is too long to read out in full now. They will instead read a list of 31 names lost by members of the group this year. Everyone here knows that there’s so much more needed to tackle this crisis. But here, families are a critical part of that. “And that,” says Corish, “will continue.”
