EP11 Mark Moody, Chief Executive, Change Grow Live

[00:00:02] Chris Langley: Hi, welcome to the Addiction Recovery Place, the podcast championing addiction treatment specialists around the world. I'm very pleased to introduce today's guest, Mark Moody. Mark is the Chief Executive of Change Grow Live, a national charity based over the United Kingdom. Change Grow Live has grown from a tiny volunteer led organization back in 1977, offering accommodation, support to people leaving prisons to a national charity, helping tens of thousands of people change the directions of their lives, grow as a person, and live life to its full potential. Change Grow Live supports people who are using drugs, alcohol and smoking, and they help people with housing and employment.

Welcome to Addiction Recovery Place Podcast. Mark, it's great to have you join us today.

[00:00:46] Mark Moody: Thanks for having me.

[00:00:47] Chris Langley: Now, I really appreciate your time. I know you're incredibly busy. So, we'll get started with a, with a pretty straightforward question. So tell us about your career working in addiction treatment services in the UK and how you became CEO of Change Grow Live.

[00:01:01] Mark Moody: Eh, okay so I was doing a completely, I went to university kind of late, tried to become a rock star, didn't really, work out. Moved down to London, was working in media, I suppose, as it was at that time. Really hated it. Volunteered in a needle exchange at the weekend, because I felt like I wanted to do something like that.

I came from a town that was, fairly blighted by heroin in the sort of 80s and 90s. Loved doing that. Volunteered a couple of years. Got a job somewhere else. Pitched up at Change Go Live as a frontline worker. It was under a different name at the time, but I pitched up in, September the 9th, September the 9th, 2000, employee number 86, I think.

so my 

payroll number's, 86, and, you 

know, I was a frontline worker for a while. Then I was a Team Leader for a while. Then I was a, Project Manager for a while, then I was a Service Manager, then I was an Area Manager, maybe a Deputy Director, a Director, an Executive Director, Head of Operations, Chief Executive.

That about 24 years and, 

and I failed a lot more interviews than I passed, by the way, people always forget about the disappointments. So, yeah, just did one job as well as I could, then got the next job and, yeah, and here we are.

[00:02:34] Chris Langley: Wow. So you've really rose through the ranks and now you're CEO of a big national charity. I mean, you've long, a lot of experience with being a CEO. Obviously with, you know, I used to, I used to work for one of Mark's charities in London when that the privilege of working there.

So, so yeah, that's quite a long, history there, Mark, so, your charity, Change Grow Live, supports many people who are experiencing addictions to drugs and alcohol, as well as many other problems. Tell us about some of the services and the geographical areas where your teams are located in your services.

[00:03:09] Mark Moody: Okay, so I mean, really north from the very south of England right up into Scotland these days. I'm Scottish, it might not be obvious to Americans, I don't know, 

but I'm

Scottish. But, for a long time we were just in England. We did some work in Wales for a little bit. We've got a little bit of stuff in Scotland.

A lot ofwhat we do, as you say is Drug and alcohol support services, the full range of things from kind of 

psychosocial, including psychiatry and psychologists and counselling and all that kind of stuff, and the medical side of things with substitute prescribing. Alongside that, we do work in prisons again, often around drugs and alcohol, some of it around just people reintegrating into society.

Do quite a lot, well, a bit of work on domestic violence, proportionally, not as much as when you worked for us, do some work to get people back into, employment, do quite a lot of homelessness, work as well. So it's not really a single issue charity, but I think all of the harms that we try to do something about are, are connected, and, probably cluster around drugs and alcohol, homelessness, involvement in the criminal justice system, that kind of thing.

[00:04:28] Chris Langley: Yeah. So the real hard core work that needs to be done, obviously. So it's very, very wide ranging.

[00:04:35] Mark Moody: Yeah, I've got about five and a half thousand people working for us these days, and about 2,000 volunteers provide services to maybe 150,000 people, formal services to 150,000 people.

[00:04:49] Chris Langley: 150,000 clients on you're taking care of. Wow.

That's very impressive. In the United Kingdom, when I was working there, the main drugs of choice mark were heroin and crack cocaine. have you seen any shifts in the prevalent drugs of choice at all? Have you seen any changes at all over the last, I don't know, 10 years

[00:05:10] Mark Moody: Well, we have, we have. I 

mean, for a long time, heroin and crack, to a slightly lesser, but still particularly in the south of the country, a very substantial extent were the big things. In the last few years, a huge growth in powder cocaine, which has got purer and cheaper. And so we're seeing that right across the country, including in places like Scotland where you really just didn't see it

at all, back, back in the day. And while we've had some, instances of things like fentanyl appearing, it's tended to be mixed in with what was being sold as heroin rather than people knowingly buying fentanyl with, with predictably tragic circumstances.

[00:06:00] Chris Langley: Yes, 

[00:06:02] Mark Moody: Fentanyl has never really taken off in a huge way over here, and 

nor has methamphetamine, which we see very little of.

but actually, the thing that's worrying us now is a new class of drugs called nitazines, which again are a synthetic. Opioid drug,

yet more dangerous than fentanyl if such a thing

is possible. And with the reduction of poppy production in Afghanistan and the reduction in the availability of 

natural heroin, for want of 

a better word, we do fear that that's something that's coming to us that may give us a similar experience to that that's happened in the States.

[00:06:48] Chris Langley: Oh, very much so. Yeah, we're definitely seeing a shift in drug use, with fentanyl being so prolific. I mean,

finding it's not just found in opioids, but in cocaine. And I interviewed someone the other day that said that it's even in cannabis.

[00:07:03] Mark Moody: and indeed it can crop up in all kinds of places. Also in the UK, I think the availability of all kinds of what we would call bathtub chemicals on the internet. Which are, it's a pill, it says it's something, it's not necessarily that, but, particular things that either are or are claiming to be benzodiazepines, so things like diazepam, tamazepam, that kind of stuff.

Diners, basically. 

[00:07:33] Chris Langley: Yeah,

[00:07:37] Mark Moody: And often with drug related deaths, you've got a cocktail of, of these things, involved.

[00:07:47] Chris Langley: It's a very tricky situation. I mean, are you able to test for these new substances that you find in your test to keeping up with this?

[00:07:55] Mark Moody: Keeping up with, it's 

good. I think we're catching up 

with them. So, things, things appear, you find out it's there, you find a way to test for it, you try and provide all the testing you can. I don't think testing's anywhere, not just Change Grow Live, but anywhere in the country, I think testing's at the levels that we would want it to be.

I think there are some, trust issues for people. I mean, we're talking about illegal drugs, so you know, people trusting you to help them test the drugs and stay safe as, as a thing too, but we're certainly doing our level best to 

try and, and keep people safe. Cause I mean, you know, for lots of people, stopping using drugs is the ultimate goal.

For me, you only get to make a choice like that if you're not dead. So, that's kinda goal number one for us. And beyond that is the way the person's gonna take their own life, making sure they retain that choice is the thing.

[00:08:56] Chris Langley: It must be quite a shock if you're able to test for fentanyl and then you're telling the person they've tested positive for fentanyl and then, you know, they're like, what am I using here? I mean, it could be a real it could be quite a shock to someone that they put their life literally at a much bigger risk than, I'm not trying to downplay heroin use

at all, but 

[00:09:16] Mark Moody: Yeah, yeah. 

[00:09:17] Chris Langley: this is another league of drugs that we're talking about here.

[00:09:21] Mark Moody: I think the thing, perhaps, when people are buying fentanyl, and they know what it is they're, 

they're treating it with, respect is the word I want to use. It's the right, the right word, but it's the word I've got. But when you're buying what you think is heroin, or, or any of those other things that you mentioned, have fentanyl in it, and particularly if it's been improperly cut so that there's

hotspots, within, in the mix.

So one of it is 

heroin and another has enough fentanyl to kill you in it. The risk management of such a thing is, it's really difficult. And if you're not expecting at all, it's It's very near impossible, yeah?

[00:10:04] Chris Langley: Mm-Hmm. I remember when I was working over there, Mark, there, there was the, the Anthrax scare as well around about 2005 six. And I don't think they had the experience that over here. So when I'm speaking to people about the, the Anthrax thing and they like,

[00:10:17] Mark Moody: No, 

I mean, there were a few tragedies. It wasn't a,

it didn't turn into the huge 

catastrophe that we thought it was going to. Drug contamination is a very real risk when things are in the hands of criminals. 

anything can happen, right?

[00:10:41] Chris Langley: Absolutely. Absolutely. so Change Grow, Live. So you, you work in the criminal justice system. So is, my background was working in the drugs intervention programme. I mean, is that still active? Are you still working in police cells and the Carrot teams and still in prisons?

[00:10:57] Mark Moody: We've got different names for things. 

We do substantially, all the same things. I think it was the drug intervention program, then it was the criminal justice intervention teams, I can't remember. Carrot worker. I can't remember quite what it stood for, but we still have people working in prisons. We still have people going into police stations.

Actually, my first job working for 

Change Grow Live was, was going into police stations and talking to people and trying to get to the root of their offending behavior, which was all often because we're trying to get money for, for drugs. So we, We still do all that stuff. I 

think the difference from when I started is that the level of service that there is to plug people into and how quickly they can get that service.

Is rather better than it was, 24 years ago, although it peaks and troughs depending on the funding that's available to, to do things. I think if someone's been working in the field for 10 years, they probably think, think things have got tougher. If you've been working in it for 30 years, you probably think things have got better.

but theres you know, there's never enough help. Really, problem is always larger than the resources available to provide a solution and that's quite a tough thing. 

[00:12:14] Chris Langley: Yeah, I found it incredibly rewarding work, work in the, in the police station. So I did enjoy

doing that.

[00:12:20] Mark Moody: I'd

[00:12:20] Chris Langley: I really did. It was quite a quite a privilege to do that work.

[00:12:25] Mark Moody: say a much more enjoyable job than being a Chief Executive on a day to day basis. You get to see people. You get to meet people,

[00:12:32] Chris Langley: Yeah.

[00:12:33] Mark Moody: See them getting well and, and turning their lives around and that's really rewarding. So I try to meet as many people who use the services as possible just to remind me that all that, Fairly boring stuff.

that I have to do 

actually has a point to it you know?

[00:12:48] Chris Langley: Yeah, I remember very well Mark. So, In the United States, there are different rules and laws for providing medication as a treatment, such as methadone and suboxone, especially state by state. I'm finding it very different stories about how people can, can access, medication as a treatment. Can you tell us what prescription services Change Grow Live has available and what's the process to access them and how long does it take someone to receive a script on average?

[00:13:17] Mark Moody: Okay. So, I suppose,one of the big differences between the, UK and the States is that the kind of principle of the National Health Service where treatments free at the point of need. And although we are not, an NHS organization in itself, we do

deliver within that framework. So all of our services are free and are ultimately the vast majority of them paid for with, with government money. There's a full range of prescribing available. So there's a fair bit of, methadone and buprenorphine is the other big option

we don't probably, use as much of the, because I can't remember the name for it. You can tell we don't use as much of it. The, the, the buprenorphine with the blocker, alongside it, it is there. There's also in recent times, some injectable forms of buprenorphine that are used, which are long acting for perhaps for people who are less able to come in, regularly or pick up at pharmacies.

We are working towards same day prescribing for everybody that comes into our services. So you turn up, you get assessed, you get prescribed. I think we're up to nearly 50 percent of the people that come into Change Grow Live, get same days of prescribing. It's a massive, focus for us to shorten the amount of time it takes for people to get a prescription, as quickly as possible.

I think historically, there was an idea that you needed to demonstrate your motivation to change to, be provided with a prescription. We feel that if you say, I'm in a bit of trouble and I need some help, you're motivated. And, the difference, I guess, from, your my days and the rest of Ferro is, right, I'm going to help you, but it's going to take about six weeks.

[00:15:19] Chris Langley: Yep. 

[00:15:21] Mark Moody: and that six weeks we lost a lot of people. 

So, I think when people reach out for help, trying to get them help as quickly as we possibly can is a major focus for us.

[00:15:34] Chris Langley: I mean, the fact that you've got someone there coming to your service that shows enough to, to say these, these,

[00:15:40] Mark Moody: It's good enough for me. It's good enough 

for me. And I think, I think one of the other things, and I don't know how this works in the States, but we will have people that we prescribe to who will, use, illegal drugs on top. in the UK, the standards are that that tends to suggest that the prescription needs to be increased.

Rather than reduced or stopped. So, probably do that rather carefully. That would tend to be our approach. We don't want to take a punitive approach. People may have lived a particular lifestyle for quite a long length of time. You don't expect people to turn that around, immediately. So, having some consideration for that, I think, is also 

really important. 

[00:16:29] Chris Langley: definitely, definitely. over here in the United States, addiction services are set up very differently from the UK Can you explain TUPE and the service bidding process that organizations have to go through? 

[00:16:42] Mark Moody: Okay, so, is it's a funny thing. As I say, it works within the kind of framework of NHS services, but different services, including the NHS itself, the National Health Service as an organisation, various different charities, and indeed the private sector, can bid for contracts to deliver a service in a particular area and you will be judged on what you say you can do with the available money.

And should you win one of those contracts, something that Change Grow Live has been pretty good at, you inherit the staff of the previous organization. TUPE stands for the, Oh my goodness. This is terrible.

[00:17:34] Chris Langley: Sorry mark, it's okay

[00:17:36] Mark Moody: Transfer of undertaking of employment.

[00:17:41] Chris Langley: that's it

[00:17:42] Mark Moody: Which means, 

[00:17:42] Chris Langley: completely

[00:17:43] Mark Moody: which means, which means that basically, your job on the terms that you were employed, is protected up to a point.

If there's less money available to deliver the service than there was previously, it can lead to people losing their jobs. Again, that means that they will be paid the redundancy money on the terms of their previous employer. I think most of the people who work in this sector, regardless of who they work for, have entered the sector.

with good intentions. 

But the cultures that develop in different places and deliver services in slightly different ways are quite different. So it can take a little while for a new service that's got a new provider that might have slightly different policies, procedures, even ethos. To, buy into that and deliver something with the level of consistency.

So that's, the downside is there is, there can be a bit of disruption. And over the last few years we've seen the length of these contracts get longer. And actually, right now, there are changes where the recommissioning of services, rather than happening every three years, it used to be every five years as it is now, is likely to only take place if it's felt that the services, is underperforming, which I think everyone thinks is a, is a good change.

But, but the fact that you don't just get the contract and keep it forever, unless you do a decent job does keep, does keep organizations honest. I think, you know, when you know that if you don't do a great job, You'll get it taken away from you. I don't like, I don't like to think that we need that. I want to do a good job because I want to do a 

good job.

Nobody's Nobody's coming to this line of work to get rich I don't think, but Not in the, not in the Not in the UK 

anyway 

[00:19:36] Chris Langley: no, 

yeah,

[00:19:38] Mark Moody: But I think it's public money that's being spent having some accountability to show that you're spending that money as well as you can I think is important.

probably been something that's driven, improvements in drug and alcohol services in particular. over, over the last, 20 or so years.

[00:19:57] Chris Langley: Definitely. Well, thank you very much for explaining that to me. That's great Mark. So your organization's involvement in assisting families affected by divestment Domestic violence is very much needed. When did the, when did the organization start focusing on this in the community?

And have you, did you observe a surge in demand in these services, especially during the COVID-19 lockdowns or post that

[00:20:23] Mark Moody: As I say, our, our relative involvement in, in, delivery of domestic violence services compared to when you worked with us, Chris, is probably less. The organization has grown enormously and the number of services that are dedicated to domestic violence services that we run is actually very small.

We've tended to think, working in partnership with other organizations where that's a particular specialism has been a better way to take that, to take that forward. So, you know, an example would be an organization like, like, like Women's Aid. Not, not to say that it's only women that, that suffer domestic violence, 

but predominantly that is what we, come across during the COVID, experience.

yeah, we did, we did notice that there was a surge in, in domestic violence. People, I suppose cabin fever is kind of an American term, isn't it? And I think where, where relationships are bad, where there were pre existing problems and people were, were stuck with each other and couldn't get away from each other 

for, for, for months on end at 

times, these, kind of things can tend to come to head.

So yes, we did, we did see that there was, more of this kind of thing happening. And obviously the delivery of all of our services during the pandemic was tremendously,

tremendously difficult. 

[00:21:46] Chris Langley: mm-Hmm. 

[00:21:49] Mark Moody: iIt's, it's an area where I think as we've grown. We've realized that to provide a uniform, standard of service, we are better to partner with people of the same kind of national footprint as we do doing that.

As we do during the drug and alcohol stuff. So a wee bit more partnership stuff, although we do still have some dedicated delivery, which is high quality stuff, but, increasingly we're, we're bearing down on more,

[00:22:23] Chris Langley: Okay.

[00:22:23] Mark Moody: drugs, alcohol, homelessness, and

work in the criminal justice environment, people who suffer 

[00:22:30] Chris Langley: Yeah. Thanks for to me. Mark. I just wanted to touch base on that. So what are the future plans for Change Grow Love with service deliverability and what are the new services you're about to provide to communities in the UK? Have you got any other, any, any plans for, for what's kind of, you

[00:22:46] Mark Moody: it's always about being as good as you possibly can be, and I think that the desire to be as good as we possibly could be was the thing that drove the growth of the organisation, rather than a desire necessarily to grow a great big thing. If I were to have a choice between being fabulous, but smaller, or huge, but a bit average or worse.

I, I think fabulous, but smaller. So I think our, our biggest focus is to make sure that the limited resources that are available are spent in the best possible way, make the services we've got as good as we possibly can. 

If we end up delivering more services in more places and helping more people, that's great, but it's got to be a side effect of focusing on excellence and, delivering, you know, with compassion to 

people who are having a really, really hard time.

I think sometimes for a lot of people who enter our services, It's maybe the only, I was going to say the only service that treats them with a degree of humanity. Sometimes it might be the only people that treat them with a degree of humanity. So I think getting right what we've got is more important to me than launching anything new or fancy.

Continually trying to make sure that we respond to the changes. So things like testing strips and all that kind of stuff, responding to new drug harms. Making sure that we get the balance between harm reduction and recovery or, or, or whatever, right, yeah. generally if you do a really good job, the organization might grow by happenstance.

but I think you've got to get that it's a charity, it's not 

a business. It's a charity that's business like because we need to 

spend every every pound,

to its greatest effect, but it's a charity first and business like second, not a business that happens to be 

a charity. 

[00:24:57] Chris Langley: Absolutely. Absolutely. Last last couple of questions, Mark. So where can people find you online?

. 

[00:25:09] Mark Moody: www.changegrowlive.org. It's amazing, it's a bit like my own phone number, I don't know what that is either. No, I do know what my own phone number is. I don't know what my house phone number is, I do know my mobile phone number because I've had the same mobile phone number for the last 24 years.

But, if you put Change Grow Live into the website, it should come up, it should come up pretty, pretty swiftly. We will be revamping our website this year, actually, because it's,

we were kind of busy over the whole pandemic experience, and then clear up after that, and technology moves on. you can find what you want there, but it could, it 

could use a wee bit of a, a spring clean, I think, to, come up to standard.

yeah, but if you need us in the UK and if you get a hold of us and it happens that it's not us that delivers, services in the area where you live, we will try and connect you to the people, that do, because, you know, I really for this organization a long time. It's really important to me, but it's not as important to me as making sure that people get the services that require whoever it's the daughter says.

[00:26:24] Chris Langley: Perfect. Perfect. So last question, Mark. Have I missed anything at all that you'd like to mention to our audience?

[00:26:31] Mark Moody: Do you know, I don't dunno because I dunno 

your audience, but what, what I would say, if any of your audience are interested in any of this, I do know it. My own email addresses mark.moody@cj.org.uk. I know that.

So any questions they would like to have asked me, I'd be very happy for people to contact me.

I'm fascinated by the differences between the two countries, all sorts of differences, between the two countries. and I just think, I think maybe the fentanyl, I don't know if the fentanyl crisis or the opioid crisis in the States has had this effect, but I think one of the things I'd hope might have happened a lot of people who wouldn't have been thought of as stereotypical drug users got drawn into a way of life, but possibly wouldn't previously have been by the not overprescribing of opiate medications and so forth.

And I think that demonstrates that these things can happen to just about anybody. And once you've realized that these things can happen to just about anybody, I'd hope that the compassion that we have for the people that we meet that might have these problems could go up just to be tick. I'm not a religious person, but I do like the phrase, "there, but for the grace of God go I", because I think there's a huge amount of truth in it.

You know, life's a series of circumstances and dumb luck or dumb mischance. so, I think I'd just like to say that that's kind of what I'm looking for from people is to, to just think about the folk that are suffering through these things as, as human beings who are. People's kids, 

maybe people's parents, brothers and sisters, It's happened to a whole lot of people that were, yeah, that weren't deserving of the way their lives turned out.

Absolutely. It's 

only just before 

[00:28:40] Chris Langley: I couldn't have thought of a better way to end this, this, interview today. Thank you so much for joining me today. I really appreciate your time. And, 

[00:28:47] Mark Moody: me again. 

[00:28:48] Chris Langley: yeah, it was a real, and obviously it was a real privilege to work, to work with you before back in the UK. And, I'm really glad we had this conversation today and thank you much indeed.

Really appreciate it.

[00:28:58] Mark Moody: I do hope your viewers can understand my accent. I've been trying tremendously hard to speak English, rather than how I normally sound.

[00:29:07] Chris Langley: I have the same too. I'm not, I'm not Scottish, but I still have the same issue myself. So I got called Old English the other day. So

[00:29:14] Mark Moody: Yeah, yeah, absolutely. Well, thanks for having me, Chris. 

Thank you Mark 

Do, do, do, do, do.