The importance of networks: we are stronger together

Advances in Dual Diagnosis

ISSN: 1757-0972

Article publication date: 12 August 2014



Hughes, E. (2014), "The importance of networks: we are stronger together", Advances in Dual Diagnosis, Vol. 7 No. 3.



Emerald Group Publishing Limited

The importance of networks: we are stronger together

Article Type: Editorial From: Advances in Dual Diagnosis, Volume 7, Issue 3.

I have written previously about the importance of clinical networks at a local, regional and national level for practitioner and researchers in the field of substance misuse and mental health (Hughes et al., 2012). Often we are working in our organisations in relative isolation and it is incredibly draining to be the one who is always swimming against the tide. It is so helpful and empowering to discuss issues with a group of peers and comforting to hear that we share common struggles. I have recently been at two such networks, PROGRESS the UK National Consortium of Consultant Nurses in Dual Diagnosis ( and the North and North West Regional Dual Diagnosis network. Attendance at both took me out of the office, and the work on my desk stacks up whilst I am away at such meetings. I guess we all reflect on our work priorities, and such meetings are the first to be cut in order to keep control of an ever-increasing workload. However, both meetings were incredibly important in terms of the benefits for me personally, and for my work. I would argue that networks make us more efficient rather than taking up precious time from our core business, and these are the reasons why:

  • Its time and resource efficient to discuss and share practice and research ideas rather than work in isolation. The dual diagnosis community is a very collaborative and generous world and it's great to see people sharing.

  • It's a chance to recharge and get support – it's easy to become disillusioned in a dual diagnosis post, especially when health and social care services are in turmoil (cuts to public budgets, recommissioning and transformation of public services). This has a huge impact on well-being and self-esteem and can engender a feeling of hopelessness. The network is a good way to remind each other of the small steps and progress being made, as well as trying to unpick and creatively respond to challenges.

  • Communication of news and new developments in the field of dual diagnosis. PROGRESS members are engaged at a national level with policy developments and members of PROGRESS are also active in their regional and local networks. This way, information from top down can flow into the local areas, but also (and more importantly) clinicians who attend the network can feed their experiences into the national policy agenda via PROGRESS members.

If you haven’t got a local network, set one up. If you have got a network, please try and attend at least some of them. Provide a clear rationale to your organisation that this is not an added extra but an essential part of your role. The Dual Diagnosis network on Linkedin is a virtual international community and a place to put a call out for advice and support, and to share useful tools and papers relevant to dual diagnosis. Sign up to Linkedin and join the group! We are moving to a global virtual world, it's an exciting time, and social media is proving a powerful tool for sharing information and lobbying about important issues. I urge researchers, practitioners and service users interested in dual diagnosis to come together virtually or face to face. We are stronger together.

This latest issue of Advances in Dual Diagnosis is an eclectic mix of discussion and review papers focusing on relatively new and/or neglected areas of multiple needs.

Ottar Ness and colleagues from Norway have undertaken a literature review to identify “first person” experiences of facilitators and barriers to recovery for dual disorders. They found a paucity of literature in this area. However, they were able to identify that a meaningful everyday life, having a focus on strengths and future orientation, and re-establishing a social life and supportive relationships were key themes in what service users themselves identify as necessary for recovery. However, two themes were identified as barriers to dual recovery: lack of tailored help, and complex systems and uncoordinated services. There is a need to undertake more research into the recovery journeys of people with dual disorders.

Ian Hamilton (University of York, UK) picks up on these challenges in a reflection of development of knowledge of dual disorders over the past 30 years. Whilst he notes that there has been significant achievements have been made in attracting the attention of clinicians, researchers, policy makers and commissioners to this issue. We are still not clear about what treatments are effective, or the optimal ways in which services should be configured.

Charles Place (UK) argues that Alcohol-Related Brain Damage (ARBD) is a neglected problem. There is a consensus in the literature that there is little research and a lack of awareness of this condition. The paper uses case studies from his own experience of working with people with ARBD to describe the difficulties in accessing appropriate assessment and care for this group, and suggests that they are often excluded in a way that is familiar from the experience of the person with “dual diagnosis”.

Duccio Papanti (Italy) has written a fascinating article pulling together what is known about one of the most popular new psychoactive substances (NPS); synthetic cannabimetics known as “Spice”. This drug is particular interest to the dual diagnosis community for its powerful psychoactive effects and potential to trigger and exacerbate psychosis. “Spice” products are used as a legal alternative to cannabis for their very strong THC-like effects. A clear link has been established between Spice use and the experience of psychosis (“Spiceophrenia”). The acute SC intoxication is usually characterized by tachycardia and hypertension; visual and/or auditory hallucinations; agitation and anxiety; nausea/vomiting; and seizures. Service users, carers and workers need to have access to information about the nature and effects (and adverse effects) of Spice and other NPS in order to limit the harm that can arise from use.

Elizabeth Hughes


Hughes, L., Holland, M. and Bell, R. (2012), “The importance of local and regional networks in supporting dual diagnosis in clinical practice”, Advances in Dual Diagnosis, Vol. 5 No. 4, pp. 185-8

Further reading

Progress Consultant Nurses in Dual Diagnosis, “Progress”, available at: (accessed 1 August, 2014)

Linkedin, “Progress”, available at: under “groups” search for “PROGRESS-Dual Diagnosis Network” and request to join (accessed 1 August, 2014)

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