ON THE GROUND: Salvation Army homeless centre, Bristol

Scheme: A detox and rehabilitation unit for poly-drug users, attached to an immediate-entry hostel supported by addiction-recovery programmes, including art therapy and resettlement help

Funding: The detox and rehabilitation unit is funded by a grant from the Bristol Drug Action Team, housing benefit and charitable donations. The Salvation Army covers the costs of some staff and buildings. A 10-day detox programme costs £632 per person

Objectives: To provide a community-based programme for homeless men and women and drug users living in Bristol.

Bristol's good transport links bring in business but also a steady supply of drugs. An easy supply of crack and heroin and the problem of rough sleepers have drawn the Department of Health's attention to the city.

In 2000, the Salvation Army received funding from the department to set up a detox and rehabilitation unit as part of the organisation's Bridge programme attached to the Little George Street hostel.

The unit runs a 10-day in-house detox programme, staffed by three nurses and a part-time GP. Clients are referred through drug agencies, outreach teams, hostels or by just walking in. Heavy drug users are put into a preparation phase for six weeks before starting the detox programme. In the rehabilitation stage, patients can move onto other activities, run through the adjacent Salvation Army hostel, such as art therapy and help with resettlement.

However, not all clients make it to the final stage. "The hardest thing about this job," says Matthew Albury, addiction programme manager, "is seeing a client making the decision to go back to using drugs. Quite often by that stage, they have lost everything."

Albury has been with the Salvation Army's pilot scheme in Bristol from the start. He became involved in the sector by volunteering at a drop-in centre. One of the sharpest memories was of a young streetdrinker who died from exposure. "It took until midday for people to realise he was dead: passers by just thought he was drunk."

The unit places no restriction on the number of times service-users can undergo the cycle of preparation, detox and rehabilitation. A network of workers helping rough sleepers can pick up clients who have dropped out of the programme. The treatment is based on a cycle-of-change model of four stages: using drugs; being aware of the disadvantages of drug use; taking action; and maintenance, where clients keep off drugs and are linked with self-help groups.

The Salvation Army has two other detox units in London and Craighouse, Scotland, with addiction recovery programmes around the country.

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