Saturday, December 18, 2010

Drug Addiction, When Is Intervention Really Justified?

A quick update on my MMT campaign before posting.   Most Government MPs that the information was forwarded to, did have the courtesy to at least acknowledge receipt of campaign material.   The exception being Hon Tony Ryall National Minister of Health, Ruth Dyson spokesperson Labour Party, Keven Hague spokesperson Green Party, and Russel Norman National Minister of Health & Well Being.   These MPs not responding at all indicates their level of respect and integrity for others views and concerns.   All that responded though stated Hon Dr Jonathan Coleman held the portfolio for Alcohol & Drugs so he would be addressing the issues raised in my MMT campaign.

Hon Dr Jonathan Colemans letter regarding my MMT campaign was received 26th November.   His response however was disappointing.   The letter read like a transcript that had been written for him promoting the value and benefits of using Methadone.   His attitude towards my views and concerns was somewhat arrogant and belittling, and he failed to really address any of the issues I'd raised.   His views were definite on the treatment programme and Methadone.   Quotes such as:   Some people may never withdraw from Methadone but live happy, productive lives.   The guidelines emphasise that long-term treatment is common for many medical conditions, and should be seen as a cost-effective way of prolonging and improving the quality of life, rather than as a treatment failure.   And it's 4.2 percent of people that voluntarily withdraw from opioid substitution treatment a year, not 2 percent as you stated.   He acknowledged therapeutic residential facilities have enabled many people to gain control over substance use.   However, such programmes are not useful, recommended, or cost-efective for everyone with substance use problems, so that aspect of my campaign was addressed but completely disregarded.   I have forwarded a letter back to Hon Dr Coleman responding to his response.

Lain Lees-Galloway, Labour Party spokesperson on Alcohol & Drugs did send an encouraging response though.   Stating:   I am aware you are not alone in your concerns regarding the MMT programme and that there are various opinions in the community as well as amongst treatment professionals about the way Methadone should be administered.   He was interested to know what response I'd received from the Government Ministers I had written to.   Copies of Hon Dr Colemans letter of response to the MMT campaign and my letter of reply dated 1st December was forwarded to Me Lees-Galloway for his interest.

I did also receive a very encouraging response from Mr Robert Steenhuisen, Regional Manager, Community Alcohol & Drug Services Auckland.   He addressed at length my concerns regarding Methadone and the treatment programme, and he did so with empathy and understanding.   He welcomed my comments and views and had pasted my information on to his staff.   An invitation was extended to have a meeting with him at CADS Auckland to further discuss the issues I'd raised, which I will endeavour to do early next year.

There has been no response received as yet to my MMT campaign from Media, or District Health Boards, except from Garry Smith, chief executive Auckland DHB, whom asked Mr Steenhuisen to respond on his behalf.   I assumed from Mr Steenhuisens letter that CADS personal are not permitted to respond unless it is approved by their area DHB, so that may be the reason for lack of response from Community Alcohol & Drug Services nationally.   Readers will be updated further down the track on MMT campaign.   Now to my posting and I will try and keep this one as short as possible.

Our first visit to Shane in Waikato hospital and my appointment with the hospital doctor was on the Wednesday, the day of his final surgery.   I was expecting to be greeted by a stressed, edgy Shane knowing his addiction and injury status.   But this wasn't the case in fact he was in a really buoyant mood and looked remarkably well considering all he'd been through over recent days.   Shane did speak of his pain and discomfort but said the pain medication 'Tramadol', plus his Methadone and sleeping sedative was helping to minimize this.   His good mood was apparently due to having his first cigarette this day since his admittance to Thames hospital the previous Thursday night and also this three ward companions.   Shane was confined to his hospital bed with his leg in traction for elevation until until his final surgery was completed at 10am that morning.   Even though he'd been on daily nicotine patches to ease his cigarette craving, he stated, they hadn't helped much and he was hanging out for fresh air and a smoke.   As soon as Shane had recovered from the anaesthetic the nurse located a wheelchair and one of the men from his ward took him outside for a cigarette.   Obviously, he'd been a good patient and room mate, or otherwise the staff nurse and his ward companion wouldn't have been so helpful and obliging.

I was so thankful of his buoyant mood and attitude because we'd decided that on this visit Shane would be forewarned to some degree about my rehabilitation plans, thus allowing him time to hopefully accept the changes before being discharged.   Which the doctor had indicated would be on the Friday.   Although necessary, it was a task I wasn't looking forward to especially knowing how protective he was of his drugged lifestyle.   However, Shane listened intently as I calmly and briefly explained that I'd be responsible for his Methadone and medications upon his return home.   Even though he accepted the news with dismay, it was very clear he understood why.   Choosing to omit telling Shane though, of the extreme measures I'd taken for that responsibility was intentional, knowing how sensitive the issue of my authority, especially for his Methadone, would be.   Privacy and lots of diplomacy, I knew, were going to be required to fully explain this news.   Therefore, this would be done on his discharge from hospital.   Overall I thought the visit and discussion went quite well, considering the bombshell I'd dropped.

Although Shane seemed reluctant to talk about the accident, it was obvious by his comments that he'd reflected enough to know how lucky he'd been to have survived it with only leg injuries.   Maybe the experience had frightened him, I hoped so.

The authority paperwork, requiring my signature and identification had been faxed through from CADS to the Methadone dispensing pharmacist in Thames.   All paperwork had been duly signed, verified and was ready to commence upon Shane's discharge.

Although I did feel confident and eager about rehabilitating Shane, there were moments of doubt and also this instinctual gut feeling of apprehension that was constantly churning within me about it.   I'd done all the research so I knew there were more negatives than positives regarding forced rehabilitation, and that's what I was basically doing.   Did Shane want it? Yes, deep down I think he did.   I'm sure most of those that are addicted loath and hate what drugs have done to them, I knew Shane did.   He always referred to himself as a 'scumbag' drug addict.   He'd witnessed what normal life was like for others around him and what they had accomplished, especially his two siblings.   Just simple things like husbands, wives and families while his life had stood still, and had done so for twenty odd years now, all because of drugs.   He had so much potential, and that's what was so heartbreaking for me about his addiction.   Shane did have the desire and loath of his drug lifestyle, but I think he honestly feared normal life as well.   Anyway, at what point or stage in a persons addiction is intervention really justified?   Do we wait until they are dead? Or maybe laying in hospital in a comotose state?   For days now I had grappled with my decision about taking control of Shane's life/addiction, but the answer was always the same, do it now because later just might be to late.   Those in life that have never failed, have never tried to succeed.

I would like to wish all my readers a very Merry Christmas and a happy festive season.

Saturday, December 11, 2010

Harsh Decisions, Will The Means Justify The End?

Sorry my postings are a bit long, it's difficult to keep to my story short with so much to explain.

For years I'd watched with a heavy heart Shane's decline into the hell hole of drug addiction without really knowing what to do about it.   I'd witnessed his torment and guilt and listened to his promises, but still didn't know what to do about it.   I just kept hoping and praying year after year that one day Shane would find the strength to finally cast his demons out, but alas that hadn't happened.   A mother's hopes and dreams can't be foiled that easy though, hence the reason why I never once in those years considered abandoning Shane's battle with drugs.

In all honesty though, he had continued to withdraw down his daily dose of Methadone, so he was making an effort to cast his demons out.   However in doing so, had been with the ever increasing risk that his abuse of other substances deployed.   My concern now was would the means justify the end.   This was a  dilemma I feared and one that I was in constant turmoil about, and worsened of course by the fact that I had no control over what the end may be for Shane.

But that fateful night of his accident proved my worst fears, that the means doesn't always justify the end.   I also determined at this point that intervention was required to allow Shane to be safely rehabilitated off drugs.   My intent was to gain authority to uplift and administer Shane's Methadone and medications, removing the temptation would help solve his drug abuse problem and hopefully keep him safe.   I would attempt to rehabilitate him myself in the home enviroment, but professional rehabilitation facilities would be investigated if difficulties arose.   So his accident although upsetting was to turn my dilemma into opportunity, it's success however, was an unknown entity.

I realized to do this would mean, basically, taking control of every part of Shane's life, especially the Methadone, which he was very protective of.   Contolling someone's life might sound harsh and drastic, and it is.   But an addicted person doesn't have control over their lives anyway, the addiction does.   So, really, I was only taking control of the addiction, not the person.   As a persons addiction progresses so does the risk and irresponsibility attached to it, and I didn't need research to verify this,  it was a pattern I'd witnessed, always watching, waiting and wondering, what to do about it.   I knew in my heart Shane never had a death wish, so I definitely wasn't prepared to accept death for him on any level, but certainly not by drugs anyway.

It's time to stop wondering, I told myself, just do whatever it takes now.   At least, gaining authority for Shane's Methadone and medications would give me some control over the abuse.   I thought, if he doesn't abuse then his mind will become clearer, and, in time he will see how good it feels to not be so drugged up.   Yes, it was being fanciful to think this, but feasible enough to believe it.

Well, it was the morning after Shane's accident and, even without sleep I felt invigorated.   Some huge decisions had been made overnight and I was eager to get the authority process underway, and have my rehabilitation plan established ready for Shane's discharge from hospital in a weeks time.   Contact was made daily with Waikato hospital for udates on Shane's medical status.   Shane had two trips to theatre, one on his first day in hospital, the Friday and again on the Sunday, to clean the leg wound.   After the last wound cleansing on the Sunday an open plaster cast was put on the leg.   The following Wednesday, Shane had his last trip to theatre to stitch the leg wound and pin the breaks in his ankle, then a more permanent plaster cast was applied, his leg remained in this cast for six weeks.   So his leg had suffered quite serious, significant injuries, which did reinforce the decisions I'd made and the reasons for them.

The first stage of my plan was contacting Shane's CADS caseworker in Manukau City, firstly, to inform him of Shane's accident and injuries, also of his serious abuse of other substances and the Methadone.   All of which had been responsible for the events that had lead to his accident and near death the previous night.   Secondly, to inform him of my intention to gain authority to uplift and administer Shane's Methadone, to hopefully end his abuse, hence, keep him safe.

I hadn't had a lot of contact of recent years with Community Alcohol & Drug Services regarding Shane and the Methadone.   However, my past contacts with them about my concerns hadn't been all that satisfying due to their obligation to protect Shane's privacy.   Therefore, I knew how this request for authority might be viewed.   But this time, I was staunch in my belief that, privacy issue or not, my concerns were justified and  weren't going to be flogged off.   I was determined to battle whomever I had to within the service to gain authority for Shane's Methadone, and that was that.

But, surprise, surprise, this time I received a courteous, understanding response.   Shane's CADS caseworker listened intently as I explained the accident, injuries and Shane's drug abuse.   He understood that my intent for authority was out of desperation and despair to help Shane.   To my great relief, no privacy issues were quoted this time.   And my concerns were immediately acknowledged and accepted as serious by Shane's caseworker.   He also agreed, under the circumstances, my request for authority of the Methadone wasn't unreasonable, and gave assurances it would be taken up urgently with the CADS medical practitioner/Director.   The CADS protocol to gain approval required Shane's injury status and blood results being verified and confirmed with Waikato hospital.   Final approval for authority was granted later that same day by the CADS medical practitioner/Director.

I was also informed by the caseworker of Shane's blood test results that were taken on admittance to Thames hospital, and they confirmed abnormally high amounts of 'Benzodiazepines' in his system.   Which confirmed my concerns and I'm sure aided my approval for authority over the Methadone.   Shane's drugged state was obvious on admittance anyway, but I feared a drug overdose may occur if severe pain relief was administered.   So as a precautionary measure I'd spoken with the attending doctor re: Shane's addiction, drug abuse and Methadone.   Doctors are naturally cautious, especially with the obvious so it was stupid of me to assume bloods wouldn't be taken before pain relief was administered, all the same the doctor was respectful of my concerns.   Hence, Shane had a very painful, uncomfortable night, but did receive his dose of Methadone and strong pain relief on arrival at Waikato hospital the next morning.   But I'm more than certain all those 'Benzo's' in his system would've helped ease his pain anyway.

Shane's caseworker was extremely knowledgeable about addictions inn general, and explained some of the problems that can be experienced when withdrawing off Methadone.   Which most I'd experienced first hand dealing with Shane, but he was such a nice man that I extended him the courtesy of listening anyway.  He did explain the rehabilitation process, and that it can be slow and difficult outside the professional arena of a residential centre.   However, I was informed that Shane's transfer to CADS Thames had been completed, and Shane's new caseworker would be working closely with myself and Shane with the rehabilitation and withdrawal off the Methadone process.

Stage two of the plan was contacting Shane's general practitioner to inform her of what had befallen Shane and why, and to make her aware Shane will abuse any medications prescribed, and for that reason it was my intent to gain authority over all his medications upon his discharge from hospital.   The doctor only required Shane's approval for me to be given this auhtority.   I didn't foresee a problem gaining that, once his situation was realized upon discharge from hospital.

Stage three was making an appointment with the doctor in charge of Shane's care at Waikato hospital.   With whom I discussed the drug abuse, why and how Shane's accident happened, his injury convalenscence, our concerns for his safety, and of my request for authority over all his prescriptions upon his discharge from hospital.    My authority request was granted without hesitation.   I did realize the approvals for authority from CADS and the doctor at Waikato hospital were only granted due to the circumstances of Shane's accident and his drug addiction problem.   All concerned were aware that my intention for authority was, firstly, to try and keep Shane safe and, secondly, to attempt rehabilitation.

The last phase of my plan included contacting residential rehabilitation facilities within the Auckland region, for professional advice on Shane's addiction, rehabilitation methods, and also the criteria regarding entry into their treatment facilities.   This inquiry was a back up measure, just in case I needed it.

I'd been extremely busy organizing my plan, but I'd also fought all day with my conscience about the right and wrongs of the decision for authority, and what I was about to do but, in the end decided it was my only option to minimize Shane's drug abuse.

Shane had abused over a long period of time so to regain control of the addiction he now needed to be stabilized.   Removing control would accomplish this, as it would remove the temptation for further abuse.   With these 'authorities for control' and the extra knowledge I'd acquired through research, I was hopeful, and quietly confident, of reclaiming my son's life and soul back from the evil and darkness that addiction had shrouded him with for many years now.

Although quietly confident, I was slightly nervous though about having to explain to Shane the contacts I'd made and the measures I'd taken since he'd been in hospital.   I fully expected him to question everything I'd done, especially my authority over his Methadone with some distaste and anger.   But, after many years of waiting, I now had the opportunity to finally crack Shane's addiction.   Even the anticipation of small disagreements and problems on his return home from hospital, couldn't faze the positivity flowing within me about this.

The first stage of Shane's rehabilitation plan was his convalescence, and it was important not to just strengthen his body, but his mind and soul as well.   Love and respect would restore Shane's dignity and self worth, but pride in his life, and the value of it, wouldn't be so easy to restore.   This addiction journey had been a difficult one for all concerned, but as I'd grown older the journey was becoming more difficult for me, so I knew this had to be my final battle.

Rehabilitating Shane wasn't the challenge, but removing the addictions that had plagued him for years was.   Shane had multiple addictions now, so each addiction, including the Methadone, would have to be dealt with separately.   I felt two years to achieve this goal was being realistic.   The proverb 'you can conquer anything with faith, love, courage, and strength,' I hoped, was true.

Monday, November 29, 2010

The Devil On One Shoulder An Angel On The Other

In the September of 2006 my husband and I relocated as planned to Te Mata, a lovely coastal settlement about 25 kilometres out of Thames.   Shane's employment problems were semi resolved so he remained in Pukekohe.   Without onsite drug testing available the allegations of drug use in the workplace couldn't really be established and I think Shane used this to his advantage.   But his work performance and quality of spray painting may have been his saviour as well.   Although no further action was being taken Shane said all the fuss had created a bit of tension between himself and certain members of staff, including management.   However, he was confident this would remedy itself in time and assured us that him and his job would be fine, so to go and enjoy our retirement.   I wasn't surprised by this employment outcome at all really knowing how clever and masterful Shane was at manipulating people and situations.   Not, usually, with a destructive intention in mind, but just to dig himself out of the holes his drug addiction constantly created for him.   His cunning never seem to desert him if his back was against the wall.   This move and our retirement had been anticipated for so long though that nothing could faze me, not even Shane's work drama's.

Oure home at Te Mata was situated in a small quiet clue-de-sac one street off the main coast road.   It was an elevated site so had amazing sea views over the firth of Thames from the front, and the rear of the property backed onto native bush and trees which was abundant with bird life.   The Tui and Wood Pigeons soon became our two most favorite birds of enjoyment.   We'd sit on our large back deck area and soak up the splendour of this wonderful place, and agreed that this was definitely like living in paradise.   We sold the alloy boat we'd owned for years and had replaced it with a slightly larger, fibreglass, cabin boat, in anticipation of all the family fishing trips to come.   Our retirement dream was shaping up well and, for the first time in many years, my husband and I were enjoying a life free of stress.   We quickly learned that the secret to relaxation was being retired beach-bums.

There were some days that Shane and how he was doing in Pukekohe was still foremost in my thoughts, but these days became less frequent as the weeks went by.   Having the distance between us and the lovely beach lifestyle also helped, and didn't allow me to remain negative or worry for to long though.   What will be, will be I continued to tell myself.   My contact with Shane was sparse, but not so with my daughter and eldest son living in Pukekohe, and they allayed my concerns as well in those early weeks.   However, Shane's life began to unravel about the November with another vehicle accident, and my concerns for him were resurrected.   Apparently there were road works in Pukekohe and Shane had failed to see the warning signage one evening when returning from work.   Shane's excuse for the accident was that the road work signs hadn't been placed in the correct position!!!!!   He wasn't injured but the vehicle did suffer extensive suspension damage and was uninsured, so once again he sold the car to the auto wreckers for parts in lieu of the towing fee.   Fortunately, Shane didn't have expensive tastes when it came to purchasing vehicles.   Transport to his employment was still viable through a co-worker who also resided in Pukekohe, so I guess that was something he could be thankful of.   I'd always had some concerns about Shane driving under the influence of drugs anyway.   But studies of recent years have also concluded that Methadone taken in high doses can impair driving ability, and that's without anything else being in the system so this accident and Shane not having a vehicle was almost a blessing in disguise for me.

Well, our lives in paradise were definitely in for a change because as the year 2006 was coming to an end, so was Shane's employment.   Shane said management had never really accepted the outcome of the work place drug use issue, so making him reduntant due to a slowing of the market was just their way of getting rid of him.

So it was January 2007 that Shane moved in with us at Te Mata.   Enrollment with the pharmacy in Thames was immediate, but until a Thames CADS caseworker was allocated his treatment case file remained with Manukau City.   Shane was always congenial and compromising, so he wasn't difficult to live with but his drug abuse was emotionally disruptive and this issue was adressed with Shane upon arrival.   For this reason it was reiterated to him that, from this point on, I personally, wouldn't tolerate any form of abuse where his Methadone or other substances was concerned.   Shane's reassurance that I needn't worry, that he wouldn't muck up anymore, was only semi comforting and, I guess, part of me did remain ever hopeful that this time he really meant what he said.   Shane was also instructed upon moving in that a serious, concerted effort to withdraw off Methadone was now expected, which he agreed to do, as soon as he was allocated a caseworker in Thames.   The last 3 months had been a time of contemplation regarding Shane's drug addiction and my options.   I decided my support for Shane in his bid for drug freedom would continue, but with a different, more resolute approach.

Well, my new approach worked in the interim but slowly that crumbled as Shane's 'topping-up' spiralled out of control again.   Confrontations between myself and Shane regarding his drug abuse with the Methadone were many, his sorrow, guilt and promises though always spurned me on.   One night in April 2007 after one such confrontation, Shane, packed his bags and left, it was about 7pm so it was dusk.   He had a large canvas army type back pack on and was carrying a smaller pack.   Walking with all this weight on, and in an extremely drug induced state was dangerous, but I was still reeling from our confrontation, so the stongest emotion I was feeling at that time was anger and frustration, not protection.   However, I reassured myself that Shane would be safe enough to walk the 2 kilometres to Tapu, he'd hold up in the reserve there, reflect on his actions and return home.

About 10pm that night a vehicle stopped at our gate, I went out to investigate and saw Shane slowly making his way up the driveway, he was hobbling, in terrible pain, and his clothing was saturated.   Questioning Shane about what had happened was met with some confusion.   The only thing he seemed to be sure about was that he had a bloody sore leg, and foot.   Once inside I could see the damage and injury, his foot and ankle was extremely swollen and going black, but it wasn't until he took his wet jeans off that the full extent of his leg injuries became apparent.   He had this huge, open gash, it was deep, right down his shin bone, from just beneath his knee down to his foot, and it was the same leg as his ankle injury.   Hence, the Thames Accident & Emergancy department was immediately contacted to prepare for our arrival.

The trip into Thames from our home takes approx. 25 minutes, this gave me time to establish how Shane had obtained his injuries.   Shane stated he sat in the Tapu reserve for a while, he wasn't sure how long he was there for, but it was dark when he decided to continue walking into Thames.   He remembered walking some distance on the coast road and the next thing he was in the sea, almost drowning.   He realized his foot was jammed between rocks and his back pack was weighing him down in the water.   He took his pack off, but had to yank and pull really hard to free his jammed foot to get himself out of the water.   Once out of the water he then tried climbing back up the steep rock face to the road.   Feeling his way up the sharp rock face in the darkness of night was difficult, and he fell, three times back into the water.   Shane said he knew he'd hurt his foot bad and was terrified he wasn't going to get back up on the road until morning.   He said that fear must have created an adrenaline rush and, with determination, his forth attempt to climb up to the road was successful.   Once up on the road he hobbled only a short distance when two nice, young guys picked him up and brought him home.

Shane's account of the event left me feeling flabbergasted and speechless.   The stretch of road that Shane fell off, is very narrow, windy and it drops off some 25mtrs onto a rocky foreshore, and at high tide it is very deep water all along there.   If Shane had fallen a different way and hit his head on the rocks, he would've been knocked out.   If that had been the case, then there is no doubt, in my mind, he would've drowned.   Once again anger filled me at his stupidity and disregard for life.   Frankly, I think he fell off the road because he dropped off to sleep while walking due to all the drugs in his system.

Shane's leg injuries were serious, and he was admitted into Thames hospital that night and transferred to Waikato hospital the next morning for surgery and specialist treatment for the leg wound.   Shane required 3 surgical procedures and spent 1 week in Waikato hospital.

It was 1.30am when my husband and I finally left the Thames hospital that night.   The night was dark and calm, and driving along the coast road was quite spooky.   We realized approaching Tapu, in the darkness of night, just how treacherous this section of the coast road is.   My husband stopped the car and turned the lights off, then the darkness of night time and the road was just horrifying.   Shocked and in disbelief I remarked to my husband.   "What the hell was Shane thinking, attempting to walk this road at night?   He's just dam lucky, with the injuries he sutained, that he even managed to climb back up the rock face onto the road, but even luckier then that he didn't get hit by a car.  You know, somebody up there, or whatever, was really looking after Shane tonight".  

That night though, I vowed Shane's demon's weren't going to invade him much longer.   I would get him clean of drugs myself one way or another by taking over his life, well, the addiction anyway.   So this accident was the turning point that changed the boundaries of Shane's battle for drug freedom.

To fear the unknown is to be fearful of life itself and, at my age and in my lifestime, I thought I'd experienced all the unknowns in life.   But the following year to come, dealing with Shane's final drug addiction battle, was testament to how truly fearful the unknown can be.

Sunday, November 21, 2010

Retirement Brings Lifestyle Changes For All

Sorry about this posting being late, had to catch up on all the tasks I've put on hold of recent weeks with Blog and Campaign. Nothing constructive to report as yet re: Campaign. Now on with posting.

Shane's whole family, not just me had accepted and embraced his drug addiction from day one, and he was loved heaps regardless of it, even when overly drug induced.   That's not saying we accepted his drug abuse, in fact it concerned and saddened us because of the risks involved but we understood it was part of his addiction, therefore we didn't love him any less for it.   Also the addiction hadn't altered or effected Shane's personality or nature, he was always caring, obliging, and respectful of us and others, so it wasn't difficult to overlook his addictive flaws and love him anyway.   And that's the reason why his dad and I and his family had stuck by him all these years and never cast him out, because Shane was a nice, genuine guy, he wasn't an 'asshole' type person.   Another reason was that Shane had nobody else in his life but us.   That was mainly because Shane didn't trust a lot of people regarding his addiction, he felt they may judge or ridicule him for it.   He knew we accepted him for what he was, so he felt safe and comfortable with us.   Also the less people in his life meant fewer apologies he had to make for what his addiction may cause.

We were well into 2006 and although Shane was still employed, he was encountering work related problems so his employment at this stage was on very shaky ground.   Apparently Shane and two other co-workers had been questioned about drug use in the work place.  I didn't know the other two lads but it didn't surprise me about management being suspicious of Shane.   He could be quite remiss regarding his drug abuse anyway, but of late it was the cocky attitude about it that I knew was enventually going to be his downfall.   I guess the more you offend and get away with it, the more confident and cocky you get.   I'd also quizzed him on occasions myself about using at work because of his drugged demeanour and his excuses for it were always the same.   Paint thinners, lack of sleep or simply just not feeling well.   The lack of sleep reason was semi acceptable because Shane did suffer from insomnia, but that was due to his drug taking anyway.   It wasn't the Methadone though as that tended to make him blobby, it was all the other drugs like 'speed' and medications he used that kept him awake.

The reasons given for managements suspicions and him being questioned were so typical of a Shane excuse, but as usual almost believable.   Shane attends the pharmacy twice a week to pick up his take home doses of Methadone and he is required to consume that days dose of Methadone in the pharmacy.   So Shane was at the pharmacy and one of his co-workers had witnessed him consumming his dose of Methadone.  Shane said at that point, he had no alternative but to acknowledge being on the programme when approached by this person, whom had promised him confidentiality, but obviously he hadn't.   Because it wasn't long after this incident that Shane was accused of drug use in the workplace and questioned.   He did accept that trusting another co-worker about The Methadone programme was a foolish mistake, in fact a real bad slip up for him.

Shane had vehemently denied the accusations when questioned of drug use in the workplace and having any knowledge to The Methadone programme.   He told management that it was just a spiteful rumour and workplace gossip, in other words 'hearsay'.   Shane was very clever and cunning when it came to his drugs, so I knew that management could question him for hours about his drug use or demeanour and they still wouldn't get the truth or right answers.   He'd cleverly spin his web of deceit and rely on their gullibility and possible lack of drug knowledge.

My husband and I had retired in the May and were relocating back over to the Thames coast in the September to pursue our old coastal lifestyle.   It was a move we'd yearned for since leaving Te Puru in 2003.   Because of his employment commitment Shane was planning on staying behind in Pukekohe, but with this work related problem cropping up that plan could change.   Although I was excited about our relocation to the coast I was also apprehensive about leaving Shane behind in Pukekohe to live on his own.   That might sound smothering or being over protective of me, but it was the risks that Shane's drug abuse presented that was concerning me, especially if he'd used excessively.   But he had two siblings and their families living in and around Pukekohe, so that eased my concerns a little.

Shane never really understood why his drug addiction effected us so much, he used to tell us constantly it was his problem, not ours.   And as much as he loved us, I think at times, he felt belittled and angry with our involvement, especially mine.   So I convinced myself that maybe it was a good thing to leave him behind in Pukekohe.   It would give Shane the opportunity to once again take responsibility for his own life, and hopefully redeem his self worth.   What will be, will be I told myself.   Shane must walk out of the darkness of drug addiction soon.

Sunday, November 7, 2010

Insurance Drama Ends Our Coastal Lifestyle

Shane's pre-hunting drug abusing binge had left me feeling frazzled and intolerant.   I so desperately wanted to believe his promises of 'never going to do it again', but because Shane's an addict I couldn't.   Shane's intentions and words were always sincere, it was the addict within him that wasn't.   However, time spent alone while the men were hunting was good therapy, and that drama was as usual past tense by the time they returned.

Another drama though was fast looming up in the back round for my husband and I, which usually tends to put Shane's drug addiction drama's into perspective.

The weather bomb in 2002 that hit the coastline and surrounding areas of Thames had left 100's of properties severely flood damaged.   All insurance companies had without a doubt met their obligations to policy holders, and had repaired or rebuilt all properties affected by the floods.   However, the financial cost of the flood repairs to insurance companies had been huge.   Hence, insurance companies were now reluctant to renew insurance policies in 2003 on properties that had been affected.   So we waited with abated breath for our insurance renewal notification to arrive, which was due in the April.   And like most in the community, our insurance policy was renewed but flood insurance for the property was being excluded.

Our property and area in Te Puru had never been flooded prior to that night in 2002, but do we stay and take a chance that we would never get flooded again, or not?   It was a dilemma that most property owners in the community and surrounding areas were all effectively faced with, not just us.   The weather experts deeming the flood of 2002 to be a 100 year event, was of no consolation at all.   "These so called weather experts" I said to my husband, "get the weather forecast wrong most days, nobody can be that sure, and predict what the forces of nature will do".      I still had in my possession the paper work that the flood damage had cost our insurance company, it was over 100 thousand dollars.   This figure was for rebuilding the interior of our home, the replacement cost of damaged contents, and the motel accommodation for 4 months.   So it was understandable why the insurance companies weren't prepared to risk having such claims as this repeated.   However, understanding it didn't solve our dilemma.

Complete insurance cover is required on properties by any lending institution you have a mortgage with, so informing our bank about the insurance dilemma wasn't an option.   Refinancing to lift our home for flood protection wasn't an option for us either.   A builders report stated that the top storey of the house had a flat, not cabled roof so the house couldn't be safely lifted.   The prospect of selling our home was upsetting, but frankly, we weren't prepared to stay and take the risk of possibly flooding again without having insurance cover.   The property was reluctantly marketed in May and it sold in the July, and we relocated back to Pukekohe.   The property sold quickly as buyers were flocking to these coastal locations for bargins.   Unfortunately, as picture perfect as our property was, the flood reflected the figure it sold for.   It was a sad, sad day for us and our family.   They had all worked so hard, coming over for weeks helping us re-landscape our section after the flood, especially our daughter and her husband.

But luck happen to smile on us with our next property purchase in Pukekohe.   It was a 12 year old home, so reasonably new for us, and the property was in a good area of Pukekohe within walking distance to the township.   The property had previously been rented out, so it did require a bit of TLC here and there, but nothing major or expensive.   Shane had to once again transfer his CADS file back to Manukau City, and be enrolled back with the pharmacy in Pukekohe for his Methadone.

Shane was still abusing other substances and meds, but so far he was keeping his abuse somewhat under control.   His abuse did still piss me off though, and this was periodically vented to him.   So it was obvious my tolerance level and understanding was waning a little with Shane and his drug addiction.   But we'd had a lot thrown our way in the last year, with the flood, and then having to sell our lovely sea-side property because of it.   Knowing there were 2 new grandbabies due in the September of 2003, and in June the following year, helped put a silver lining to my cloud of doom and gloom.

I truly believe good people have good things happen, but I guess, to keep us all grounded we've got to experience the bad stuff, to help us appreciate the good in life when we do get it.   My life would be almost perfect if I could just get Shane to beat his drug addiction.   Having him drug free would be a dream come true for me.   It had been 10 years that Shane had been on The Methadone program, and my dream still seemed to be a long way off yet.

However, in March of 2004 Shane did gain employment.   The firm specialized in making large, expensive wooden gates.   The position was for an experienced spray-painter, skills that Shane had, and drug testing wasn't a prerequisite for applicants.   Methadone being an Opiate based drug may be detected in work place drug testing, so testing was usually a barrier for Shane.   I had hoped that Shane gaining this position was a good sign of better things to come, but it wasn't.   Working or not, Shane still abused other substances, and this was obvious by the state he arrived home from work in.   Shane used to blame his demeanour on the paint thinners etc he was working with.   But I'd been involved with his drug abuse for to long to be sucked in by that excuse.   Even though Shane was a good worker and a skilled spray-painter, I didn't foresee him holding this employment position very long term.   Shane knew drugs had created problems in his life, but he still never saw himself as the addict we did.   I don't know how he didn't see what we saw, it was obvious that Shane didn't look in a mirror on his drugged up days.   Sunglasses work a treat though.   The eyes are a dead give away for an active addict, but with sunglasses on they aren't visible, so Shane used to wear them a lot, sunny or otherwise.

My dedication and determination to Shane's drug addiction had never wavered, it was not knowing how to help him end his addiction that had always been my stumbling block.   Over the years I'd gained adequate knowledge of the addiction itself, and The Methadone program.   But I lacked understanding and information on what avenues were available to procure an end to drug addiction.   But all that changed with the investment of a computer.   Having this new technology certainly did increase my knowledge but also my fears.   It became apparent then that Shane drug abuse with the Methadone could  have serious consequences, so would he live to end his addiction.   This new information altered my thoughts, dreams and journey of Shane's addiction.

Saturday, November 6, 2010

An Update

To date three letters of acknowledgement to my MMT Campaign have been received from those it was forwarded to.   The wheels of progress turn very slowly when dealing with persons of higher authority and Government Officials.   Readers will be kept informed of the campaigns future progress.

This is an answer to a question that was forwarded to me:    The privacy of campaign supporters emails will be respected.   The Hon. Jonathan Coleman, the Ass. Minister of Health, NZ Government will be the only person besides myself that will be privy to supporters names and addresses.   So continue to support this campaign with confidence, your privacy will always be respected.   The old saying ' it takes a village to raise a child', applies also to those trying to make changes within that village.   One person alone cannot effect changes, but lot's of people together can.

Individules entering into The Methadone Maintenance Treatment program are flawed and vulnerable persons due to their drug addiction.   If a treatment program is going to operate for them with flaws, and without conscience, then it allows failure without justification.   I have had brief contact with other participants whom have been on The Methadone program long term, and their experiences with Methadone regarding their drug addiction are the same as Shane's.    Indications are, that only about 20% of participants using Methadone deem it as a successful treatment option for their drug addiction.    Personal experiences and views of The Methadone Maintenance program from other participants, ex-participants and, or their families would be welcome and appreciated.    You can remain anonymous by contacting me privately by email.

I will be loading a normal posting on blog tomorrow.

Saturday, October 30, 2010

MMT Program Campaign Proposals

This posting is my completed campaign for proposed changes to The Methadone Maintenance Treatment program. 

I am not pro or anti Methadone, I acknowledge The Methadone Maintenance Treatment program does have a place and purpose in our society for persons with drug addictions.   However, I am very uncomfortable and concerned with certain aspects of The Methadone Maintenance programs current operating format.   The existing program format must be restructured to put more emphasis on achieving an end result for the participant, not just maintenance.   Participants shouldn't have to, or be permitted to exist on this program for years.   These participants, just end up 'Methadone Junkies' who see no way out of the program, and without a timeframe, plan, or encouragement, why most stay on it for many years.

Addiction research and studies confirm that Methadone is highly addictive and one of the hardest drugs to withdraw from, with body tolerance to Methadone being higher and cravings stronger than Heroin.   Addiction professionals also confirm this is the reason why participants tend to 'Poly-abuse' or 'Top-up' with other substances while attempting to reduce their daily dose of Methadone.   Apparently it is quite common, and why drug abuse within this treatment program is a major problem.   To give drug addicts a more highly addictive drug than the one they were probably using, begs questioning, and why the treatment, maintenance and dependency of Methadone needs to be seriously investigated.

The Methadone mixture was originally mixed with a syrup so it couldn't be injected, but the mixture was altered and the sryup was removed towards the end of the 1990's.   The Methadone mixture could, and was used by most participants intravenously from then on.   Addiction professionals within The Methadone Maintenance program acknowledges the mixture being changed did promote the intravenous use of Methadone.   Participants on, and entering this program are mainly intravenous drug users, so why have a treatment program that almost encourages the addict to continue with their intravenous habit, also begs questioning.   A Methadone mixture that cannot be used intravenously urgently needs to be investigated and introduced back into this treatment program.

Very random urine and periodic blood testing should be a perquisite of The Methadone Maintenance
 program.   This would help to solve the drug abuse problem that widely exists with participants on the program.   Urine only detects some substances, whereas blood testing could detect all substances in the system.   It is necessary that the drug testing be very random, as addicts are knowledgeable enough to work their drug abuse around the testing that presently operates.   It is simply not random enough and allows too many loopholes.   The current guidelines, I believe, also need to be more rigid and participants held accountable for their actions.   The privilege of participants having take home doses of Methadone is one area of accountability that seriously needs to be reviewed.

Most addicts entering The Methadone Maintenance program are burdened with psychological problems, they suffer low self esteem, and have self worth issues, which are not professionally addressed at all within this treatment program.   All these psychological issues become a bigger burden and are accentuated with becoming addicted to Methadone.   I think that addiction professionals within this treatment program has lost sight of the fact that drug addiction is a mental and spiritual problem, as well as a physical problem.   In other words, you cannot heal the body without healing the mind as well.   Community Alcohol & Drug Services caseworkers are the only link these program participants have, and very few of these caseworkers are qualified addiction counsellors.   So regular professional counselling for participants must become a top priority within this treatment program.

I propose a time frame of 3 - 5 years be introduced for all participants to withdraw off Methadone and exit the program.   In that time, with regular therapy, constructive support and encouragement, partial Methadone withdrawal could be safely achieved under the current guidelines.   The final and tricky withdrawal phase of 3 - 6 months could be safely accomplished within a residential rehabilitation facility.

If the Opioid Substitution Practice Guidelines were changed to accommodate all these new measures, then all, including participants already on the program, would have to abide by them.

Admittedly an increase in funding would be required in the first 2 - 3 years to intially phase these new measures in - especially for the extra residential rehabilitation facilities, the cost of blood testing, and professional counsellors.   The long term monetary savings of funds allocated to Addiction Services, with not having participants on The Methadone Maintenance Treatment program for years, would be extremely beneficial and worthwhile, making this a very practical, sustainable solution.

I am aware of what the view point will be towards my proposals and suggestions from professionals within Addiction Services.   I am also knowledgeable enough to realise some years ago, when the program originally started, that timeframes for participants were attempted and weren't successful, with addicts having to enter back into The Methadone Maintenance program.

T say " it's been tried and it doesn't work" is a cop out to me, that was some years ago.   I know what is required and how difficult it is for participants to withdraw from Methadone, and any attempt will never be successful without a new approach.   The Methadone Maintenance program has been operating for some thirty years or so.   It has become bigger, with more persons entering, but certainly not better, or even worthwhile anymore.   A huge amount of Government health funding goes towards this particular treatment program.   So for future benefits The Methadone Maintenance program must be streamlined for success, not just sustainability.

I don't have a crystal ball in front of me, I just know from my own experience with Shane on this Methadone Maintenance program for 14 years, that this treatment program and the services that exist around it, or lack of them, seriously require attention.

The Methadone Maintenance Treatment program operates world wide.   However, programs in other countries are structured and operated differently to the MMT program in New Zealand.   With funding and duration of treatment for overseas program being the major difference to our MMT program here in New Zealand.

Government Health Officials and Addiction professionals attend world wide Drug Addiction Treatment conferences annually.   One would assume then with all this new knowledge and expertise that firstly, the MMT program in New Zealand would have improved after 30 years, and secondly, that the success rate for complete Methadone withdrawal would be higher than the 2% figure quoted in 2007/08.

The Methadone Maintenance program funding figure for 2008/09 was $13.6 million dollars, with approximately 4600 persons enrolled nationally in the program that same year.   The funding that keeps this treatment program operating, is in reality taxpayers money, that is something none of us should loose sight of.


                                                     End Of Campaign

Shane's 14 years on The Methadone Maintenance program, his drug abuse, and drug addiction was summarized into 2 pages and included with this campaign.   The following list is to whom the campaign has been forwarded out to.

                                                        Members Of Parliment

Mr John Key -  Prime Minister                                   
Mr Bill English -    Deputy Prime Minister
Hon Tony Ryall -  Minister of Health                          
Hon Jonathan Coleman -  Ass Minister of Health
Mr Russel Norman -  Minister Health/well being         
Ms Tariana Turia -  Ass Minister of Health
Ms Heather Roy - Ass Minister of Health                   
Ms Ruth Dyson - Spokesperson.  Labout Party      
Mr Lian Galloway - Spokesperson. Labour Party       
Mr Keven Hague - Spokesperson. Green Party
Ms Sue Kedgley -  Spokesperson. Green Party          
Mr Phil Goff - Opp. Leader Labour Party
Ms Annette King -  Opp. Deputy Leader. Labour Party

                                                      District Health Boards

Mr Brian Rousseau -  chief executive.  Southern DHB
Mr John Peters -  chief executive.   Nelson/Marlborough  DHB
Mr David Meates  -  chief executive.  Canterbury  DHB
Dr Kevin Snee  -  chief executive.   Hawkes Bay  DHB
Mr Craig Climo  -  chief executive.   Waikato  DHB
Mr Phil Cammish  -  chief executive.  Bay of Plenty  DHB
Mr Garry Smith  -  chief executive.   Auckland  DHB
Mr Dave Davies  -  chief executive.  Waitemata  DHB

                                      Community Alcohol & Drug Services

Dr Murray Hunt  -  Medical Director  CADS  Hamilton
Mr Robert Steenhuisen  -  Regional Manager  CADS  Auckland
MS Clarissa Brodrick  -  Manager  CADS  Auckland
Mr Louis Miller  -  Manager of Alcohol & Drug Services.  Blenheim
Dr Alfred Dell'Ario  -  Clinical Director of Alcohol & Drug Services.  Canterbury
The Manager.   CADS  Wellington
Mr Rob Warriner -  chief executive.  Walsh Trust
Mr Tim Harding  - chief executive.   Care NZ


Mr Paul Holmes  -  TV and Radio Host
Mr Leighton Smith  -   Radio Host
Ms Bernadette Courtney  -  editor.  The Dominion Post Newspaper
Mr Andrew Holden  -  editor.   The Christchurch Press
Mr Tim Murphy  -  editor.    The New Zealand Herald  -  weekday edition
Mr David Hastings  -  deputy editor.   The New Zealand Herald  - weekday edition
Mr Bryce Johns  -  editor.  The New Zealand Herald  -  Sunday edition
Mr Jonathan Milne  -  deputy editor.   The New Zealand Herald  -  Sunday edition

Hopefully there maybe a reasonably positive response to my Methadone Maintenance Program campaign this time around.   I do need readers and followers of my blog to get behind this campaign, especially those in New Zealand.    Persons wishing to support my campaign can do so through my email address.
 I will be loading a normal posting on my blog in few days time.


Monday, October 25, 2010

Valium & Methadone Binge

My husband, Shane and eldest son were very keen hunters, and every year around April they all went on their annual hunting trip.   For the past 5 years they had flown in and out of the Ureweras by helicopter from a base in Rotorua for their 5 days of hunting.   The men camped in the bush and stalked deer and wild pigs.   This hunting trip was booked and planned months ahead, and it was something all three men looked forward to and really enjoyed.   Shane even had to apply to CADS weeks prior to this trip for the extra take home doses of Methadone to take with him.   Guns and hunting safety were always a top priority, and my husband had brought both boys up to appreciate this rule, so it was the one time of the year that for 5 days Shane remained in control and didn't abuse his Methadone or other drugs.

The 2003 hunting trip was upon us and the men were departing early hours of the Saturday morning.   It was arranged that our eldest son would head over to Te Puru on the Friday to sort and assemble all the hunting and camping gear ready for departure.   We arrived home from our work in Pukekohe that Friday night about 6.30pm to find our eldest frustrated and upset over the state Shane was in.   He said Shane was drugged up to the eyeballs, and he'd been like that since his arrival early that afternoon.   Our eldest had managed to establish that Shane had purchased Valium tablets from an acquaintance while in Thames that morning collecting his Methadone.   However, he was unsure how many Shane had purchased or taken.   In that moment all the excitement of the hunting trip was lost.

Shane being a bit drugged up wasn't unusual under normal circumstances, but it certainly was prior to a hunting trip, so at first I thought maybe my eldest was being over dramatic about the situation.   But, hell no he wasn't dramatizing at all, and barging into Shane's bedroom confirmed this.   Shane was indeed extremely drugged, in fact it's the worst drugged induced state in 9 years I'd ever seen him in.   Shane was sitting on his bed with this horrible vacant, dazed look about him.   A syringe and 2 empty dose bottles of Methadone were found, which I immediately disposed of, but no valium tablets were located in his bedroom.   His kit for hunting had been packed days before but that was all unpacked, and there were cloths strewn all round his bedroom.

I was livid, absolutely furious with him, not because of the hunting trip, but because he'd blatantly risked his life by abusing all that in one day.   You see, Shane would've drunk Fridays dose of Methadone at the pharmacy, then he'd been given 5 days supply of Methadone to take hunting.   It was obvious that out of this supply Shane had also shot-up another 2 doses of Methadone that day, plus whatever Valium pills he'd acquired as well.   Honestly I felt like slapping him, but he was that drugged up he probably wouldn't have felt it anyway.   It's just unbelievable, and never ceases to amaze me how a drug addict's body copes with all those drugs in the system, and all in one day.   However, that's how most addict's do unintentionally overdose, because they are always prepared to push the limits of what, and how much they've taken on previous occasions, and that's what's really frightening about loving a drug addict, never knowing if that one day of over indulgence, is going to be that one time to many.

All we could do at that time was to get Shane a bit mobile and keep him occupied, hoping that the effect's of the drugs would eventually wear off.   By 11pm that night Shane's drugged stupor had slightly improved, well, at least he was coherant and conversant.   Up to this point I'd contained my anger, but all this fury and fear welled up inside me and I exploded, ripping into him about his over indulgence that day, saying  " how dare you put yourself at risk like that, you're a bloody asshole Shane.  What if dad and I had come home and found you dead, you never think about that do you? with you're  bloody drug taking."   The barrage continued and I told him I knew about the Valium tablets he'd brought, and that he'd also shot-up an extra 2 doses of his Methadone as well.   Shane admitted to purchasing 10 Valium tablets, but he had no recollection of using the extra Methadone.   The usual apologies, sorrow and guilt followed and Shane promised to sort his 'shit' out and not to abuse like that again.   "You better sort you're 'shit' out Shane I said, or else, cause I'm not going to keep doing this drug stuff with you year after year".   Famous last words of mine, and one's that were to be repeated many, many more times over the next few years.   But there was one day I really did mean it.

There are a large group of drugs which in medical terms, are referred to as Benzodiazepines.   Some of the most commonly abused are:  Valium, Diazepam, Temazepam and Lorazepams.   The opiate based prescription medications that are abused and highly sought after by addict's are:  Morphine and Tramadol.   All these pills are listed as controlled drugs, therefore prescription only medications.   Naturally, failure to obtain any prescription drug via a general practitioner, the addict can purchase some of these medications through drug dealers.   Prescription medications are usually abused because they are easier to obtain than illegal, intravenous drugs and a lot less expensive.   Therefore, prescription medications are inclined to be seriously abused by Methadone participants for 'topping-up' due to their availability and cost.   Anyone of these drugs, if overly abused with Methadone, alcohol or other intravenous drugs, can have serious consequences.

My husband and eldest insisted on Shane still being included in on the hunting trip, it takes a day to set up their camp site so they wouldn't be going hunting until the Sunday, and they felt Shane would be fine by then.   Thank god for that, because incidents and row's with Shane used to leave me feeling quite emotionally drained, so putting some space between us was always good medicine for me.   The hunters returned 5 days later, this time minus a deer or pig, but never the less, fun and male bonding was had by all.   Shane went on this hunting trip with 2 doses of Methadone down remember, which meant he had to go 2 seperate days in the bush without his Methadone.   But even this didn't dampen his enthusiasm, my husband stated that although Shane appeared unwell on these days, he never once grumbled or complained about it, he just got on with the hunting schedule.

This fearful over indulgence incident in 2003 was just the tip of the ice-berg, drug binging sessions and Shane putting himself at risk became a nightmare.   But in 2004-05 I invested in a computer and this changed my perspective of Shane's drug addiction and how I dealt with the abuse.   My campaign re: The Methadone Maintenance program is ready to be forwarded out.   I will put my completed campaign format on as an extra posting in a few days time, so my readers are aware of what has been sent out.

Sunday, October 17, 2010

All Good Things Come To An End

In mid 97 Shane moved out of our flat and into his own rural accommodation on the outskirts of Pukekohe.   The flat on the property was always intended as a seperate living space for my husband and I, which Shane was aware of, hence why this move after eighteen months took place.   Shane's earnings were moderately high because of the shift work, but his expenditure which was presumably on drugs reflected this, so I hoped that this move with paying more rent may help to at least curb his drug abuse.

Shane's addiction had remained the same, some weeks were reasonably good, and others weren't, depending on whatever drug or pill he was using to top up with.   The more I tried to understand Shane's drug addiction, the more it grated on me.   He'd had this drugged look or appearance almost since being on the program, and that I'd semi adjusted to, but not the 'nodding-off' or 'blobbing' part of of his drugged behaviour.   Shane could 'nod-off' while eating a meal, rolling a smoke or in conversation, it was brief and only lasted a few seconds, then he'd come to and carry on eating his meal or whatever like nothing had happened.   Shane was totally unware he'd 'nodded-off', but it was really quite bizaar and distrubing to witness.   I'd questioned this part of Shane's behaviour at our meeting with CADS, but this question was also brushed off without explanation.

To keep some form of normality in life you have to try and ignore some of what goes on with a drug addicted loved one, or you'd go 'nuts' if you didn't.   But there were times that Shane's drug abuse and drug habits really did piss me off, and that was usually acknowledged and most times vented to Shane.   I'd got to the impatient, irritable stage of Shane's addiction and treatment, and I used to hound him about the program and his withdrawal rate off the Methadone.   So at this point, I think Shane and I were more than ready to put some space between us, well, for a while anyway.

Shane's visits to us were quite frequent, and in the first year or so of his move he seemed to be managing ok.   I still prodded him on visits about his treatment progress and Methadone withdrawal, but got very little information from him in return.   The break of not having Shane's addiction constantly in my life was good and it revitalized my spirit and emotional well being.   Our break though came to an abrupt end in late 99, Shane had a car accident going to his afternoon shift.   He lost control of his vehicle swerving to miss a goat on the road that had broken loose.   Thankfully, he wasn't badly injured and no other vehicle was involved, but his car was a write off and he'd let the car insurance lapse.   Shane couldn't get transport to work from his rural accommodation, so he moved into the flat with my husband and I, and signed his rural rental over to a friend.   There was plenty of room in the main house but Shane didn't want to encroach on our daughter and family.   The car accident was just the start, there was more upheaval to come as in early 2000 Shane also lost his job.

However, Shane wasn't terminated, he was deemed mentally unfit for work by his CADS doctor, and this wasn't a surprise to those around Shane.   Apparently, on two previous occasions Shane's demeanour at work had been questioned, and he'd also taken an extended lunch break without authority for a caseworker appointment.   Shane disclosed his recent entry into The Methadone program at a meeting with management and severe restrictions were imposed on him to retain his job.   Shane was searched, urine tested and examined by on-site medical staff before commencing his work duties, which was understandable from an employers perspective, but it was embarrassing and it became mentally stressful for Shane.   Up to this point, drugged or otherwise, Shane's work record of nearly 5 years was clean, and he was known to be a diligent, safe, hard worker.   His drug addiction had escalated though over that 5 years, so I guess Shane was lucky to have retained his job that long.   Fortunately for us, his stress levels did slowly abate with not having to deal with the pressure of his employment.   So with that chapter of employment closed, I wondered what the next chapter or phase of Shane's addiction might bring.

My saving grace in times of turmoil were my grandchildren, Shane's usually was drugs, but this time there was a lady in the back round showing interest in Shane.   Shane however, was very wary about relationships with his addiction.   He'd stated way back in 94 that drugs had ruined the few relationships he'd attempted to have, which he said was fortunate because he certainly didn't want, or plan to put his 'shitty' drugged life on a wife and kids.   At times I felt sad that Shane only had the love of his family in his life, and not the love of a good woman.   Which was a shame because he was a really nice, respectful guy, whom had good values in life, and he was wonderfully patient and loving with his little neices and nephew, so there was no doubt he would make an excellent father as well.   Even so, I was thankful that I didn't have the added burden and worry of a wife and grandchildren regarding Shane's drug addiction.

In mid 2000 our daughter and her husband brought our share of the proerty out, and my husband and I relocated to Te Puru, a lovely sea-side settlement along the coast of Thames.   Te Puru was only 1 hours travelling distance to Pukekohe, so we both retained our employment obligations in Pukekohe with our move.   Shane stayed and resided with our eldest son in Pukekohe, and he eventually did acknowledge this ladies intentions, and after much discussions with her regarding his addiction, they attempted a relationship and Shane moved into her home.   However, the relationship only lasted about 1 year, so Shane's reluctance and intincts about love and addiction proved to be correct, and love and women while addicted was never to be approached by Shane again.  

In May 2000 Shane moved in with us at Te Puru, his case file was transferred to the Thames CADS clnic, and he was enrolled with a Thames pharmacy for his Methadone.   Shane's abuse of other substances with the Methadone had always been a worry, but from here on, his drug abuse went to another level, it was to become very dangerous and destructive.   But on the 21st of June 2002 and within weeks of Shane's arrival a huge weather bomb hit along the Thames coast line and surrounding areas, and our property along with hundreds of others was completely destroyed by the flood that followed.   Many homes including ours were deemed uninhabitable, and we lived in a motel with Shane for 4 months while our home was being repaired.   The intial first 2 weeks after the flood my husband and I were very fragile, and Shane was to be our saviour at that time.   He showed empathy and understanding of our feelings, and it was his positive and helpful attitude that kept us grounded in those early weeks.   So Shane can certainly step up and be relied upon when needed.   His drug addiction at that time became secondary to our own problems and flood dilemma.

I soon established the reason for Shane's pattern of Methadone withdrawal and why it had fluctuated over the years, with the rate decreasing then increasing.   Negative urines are a sign of drug abuse and a participants instability, and CADS deem this to be because their daily dose of Methadone is to low.   The participant is notified of negative urine results, at this point a meeting with their CADS caseworker and CADS doctor is initiated, and the participant is ecouraged to increase their daily dose of Methadone.   The participants Methadone take-home privilege is also revoked for 2 - 3 weeks upon a negative urine result.

The Methadone programs protocol for withdrawal certainly requires reviewing.   Drug abuse is a major problem with withdrawal, however, participants withdrawing off Methadone shouldn't be permitted or encouraged to increase their dose.   A proposal will be forwarded with my campaign suggesting a time frame of 3 - 5 years be introduced for all participants to withdraw off Methadone and exit the program.   In that time, with regular therapy, constructive support and encouragement, partial Methadone withdrawal could be safely achieved under the present guidelines.   The final and tricky withdrawal phase of 3 - 6 months could be safely accomplished within a residential rehabilitation facility.

I do appreciate the comments that have come through so far from followers regards my postings.   If my story about Shane's drug addiction and Methadone helps just one person then telling it has been worthwhile.   I am hoping to have my campaign and proposals regarding The Methadone Maintenance program ready to be forwarded to the NZ Government, Addiction Professionals and the appropriate District Health Board Officials in the very near future.  I will keep you posted on the progress of my campaign further down the track.  See you all next week with another posting.

Friday, October 8, 2010

No Change, But Still Employed

This update is being posted earlier than usual, as I'm going to be away for a few days.

In 96 we moved to Pukekohe, a suburb about 15kms away and brought a large 5 bedroom property with our daughter and her husband.   The property also had a roomy one bedroom self contained detached flat on it, which we decided to rent to Shane.   This living arrangement gave him independence and responsibility for his own life.   Shane worked rotating weekly shifts of day, afternoon and nights, with 3 days off in between these shifts.   So with my part time job, there were days when he was afternoon and nights that I didn't see him.   But his addiction status and abuse of other substances hadn't changed, that was for sure.   He lived and breathed Methadone and the program, in fact his whole life revolved around it.   Ther were times we all worried, and wondered about his employment.   But he was still employed, so we guessed he must be ok at work.

Shane tended to be slightly worse on Methadone pick-up days, and maybe using an extra dose of Methadone was our explanation, and injecting his Methadone dose was also strongly suspected.   I did question Shane about his take home doses, and also if he was using the Methadone intravenously.   Of course, he denied both scenario's, especially using the Methadone intravenously, curtly informing me the Methadone was mixed with a syrup, therefore, it couldn't be injected.   No matter how hard I tried, gaining any sort of admission from Shane about anything was never accomplished, he always had an answer, just not an honest one.

Addiction had taught Shane, like most addicts to be very skilled and clever at manipulating situations and people, me included, this ability is a valuable survival technique to them, and one they never loose touch with.   Discussions with Shane at the time of disclosure allowed me some insight into the mind and life of an addict.   Shane stated then that all addicts do hold themselves responsible for being addicts, but none ever contemplate losing control when they originally start using drugs.   That an addict will do whatever it takes in their quest for drugs - they will lie, cheat, deceive and even steal from family and friends.   Shane wasn't proud having to admit these traits, it's just how it has to be to satisfy the craving for drugs, that's all.   So acknowledging and recognizing some of these traits in my addict son wasn't difficult, but actually accepting them was, and I didn't for sometime.

However, Shane didn't ever steal from us, and he always paid his flat rent etc on time.   Even the years he resided with us in our home and was on the unemployment benefit, he fronted up with his board every week, so Shane did retain some pride in himself by paying his way.   But knowing and even understanding all this didn't help, emotions can still run deep when dealing with an addicted loved one, anger, and frustration being two of them.   You soon learn to pick your battles and move on, or you wouldn't survive emotionally.   Having the gift of four beautiful grandchildren, and two of them at that time living on the same property was a wonderful distraction for me, and they did ease the stress of Shane addiction.

Inquiries at the time did reveal Shane was correct about the mixture, however, the Methadone mixture was altered towards the end of the 90's, and it could and was used intravenously by all, not just Shane on the program from that time on, that I did verify.   The Methadone mixture being alterted, I presumed to be a cost effective issue, maybe the syrup became to expensive.   Using the Methadone intravenously instead of orally was preferred by participants because it prompted a faster, more effective solution for uncomfortable withdrawal symptoms.   It kind of defeats the purpose though, of a 'harm reduction' treatment program, HIV and Hepatitis C, needle sharing and all that.   Oh! I forgot, of course they do have needle exchange programs operating, but not through out NZ, only in some larger centres of NZ, but the cost of a syringe is only $3.00 at a pharmacy.   Addiction professionals within The Methadone Maintenance program acknowledges the mixture being changed did promote the intavenous use of Methadone.   Participants on, and entering this program are mainly intavenous drug users, so why have a treatment program that almost encourages the addict to continue their intavenous habit, begs questioning as well.

Shane's CADS caseworker appointments were 3 monthly, and his urine testing was done in conjunction with this visit at the clnic.   This was the only time for years that Shane attended a CADS clinic, and he received notification of appointment about 2 weeks in advance, so I guess that could be presumed random.   There was a 2-3 year period though that Shane went to a Diagnostic laboratory, not the CADS clnic for urine testing.   I don't really know why, Shane didn't eleborate when asked.

Shane had various CADS caseworkers over the years, and very few of them, in fact only 2 were certified addiction counsellors, so Shane received very little if any psychological counselling over that 14 years on the program.   Most addicts entering The Methadone Maintenance program are burdened with psychological problems, they suffer low self esteem, and have self worth issues, which aren't professionally addressed at all within this treatment program.   All these psychological issues become a bigger burden, and are accentuated with becoming addicted to Methadone.   I think this treatment program has lost sight of the fact that addiction is a mental and spiritual problem, as well as a physical problem.   In other words, you can't heal the body without healing the mind as well.   So professional counselling for participants must become a top priority within this treatment program, and this is another aspect of my campaign.

In a future posting I will put forward a detailed plan outlining how these changes and new measures to The Methadone Maintenance programs NZ operation can be financially achieved, and also with only a minimal short term increase to the present Government funding schedule   The priority and importance of this campaign will be to indicate that the programs present format and it's operational services do need restructuring to premote a safer, higher success rate for participants in treatment.   This treatment programs future long term goal has to be improved to encourage and promote abstinence not just maintenance.

Thought I would give you all a break and make this posting a bit shorter.   Catch you all next week with an update.

Monday, October 4, 2010

Drug Abuse. Ignorance Is Bliss

Shane wasn't gainfully employed when he entered The Methadone Maintenance program.   This was probably just as well, as for the first month on the program he was required to attend the Auckland city CADS clinic daily to consume his dose of Methadone.   This was an 80km round trip from Papakura, where we resided.   I don't know how other new entrants work that around a job unless they live and work in the city.   Then after this month Shane was assigned a CADS caseworker in Papatoetoe, and he was enrolled with a pharmacy in Papakura to consume his daily dose of Methadone.   After a probationary period of 3 months, Shane was then progressed onto what's called Methadone pick-ups, or take home doses.   Now, this stage meant Shane only had to attend the pharmacy 3 days a week to consume his Methadone, and the pharmacist distributed the extra doses of Methadone for Shane to take home.   Shane was to consume these doses at home on the days not attending the pharmacy.

Even though the information stated Methadone had proven to be a very effective treatment for drug addiction, Shane taking it was a dilemma I mentally fought with for sometime.   Shane positivity reigned supreme though in those early months, and he even obtained employment, which boosted his morale even further.   His progress and the program were frequently discussed, and at this stage his goal seemed achievable.   However, all that started to change about 1 1/2 years into the program.   Shane became aloof and a bit sullen, and he wasn't as conversant about his progress, just stating he was sorting it out.   At times his demeanour and erratic behaviour indicated to us all there was some form of drug use going on other than Methadone.   But knowing he was being urine tested and he still had the privilege of take home doses of Methadone made our observations and concerns somewhat puzzling.

Shane was obviously experiencing problems within his treatment, but it was difficult to know exactly what to do about it.   After much contemplation, contacting Shane's caseworker about our concerns was decided.   But I was informed due to the privacy act, Shane's treatment couldn't really be discussed.   However, she assured me that random urine tests was done on a regular basis, and no illecit drug use had been detected regarding Shane.   She felt our confusion and concerns were possibly due to our lack of knowledge and understanding of Methadone and the program, so an appointment was made with CADS clinic Papatoetoe, which my husband, daughter and myself attended.   Although we were treated with respect, the two professionals handling our meeting were definite in their views of the program and the drug Methadone.   They completely dismissed our concerns of possible drug use and Shane being different on Methadone.   These caseworkers felt we were all reading to much into Shane's behaviour and such because he was on Methadone, that was their theory and answer to our concerns.   I left the clinic that day distraught, angry and totally peeved that I'd been treated like an over dramatic mother, whom didn't know her son, drugs or their affects.   So early on in treatment Community Alcohol & Drug services were made aware of Shane's possible drug abuse problem on the program.   With Shane's assurances and, now CADS we had no alternative other than to accept the program and move on with our own lives.

I loved Shane to bits regardless of his addiction, but my emotional journey from that point on with him, as a mother, constantly altered and, it was a cross I found difficult to bear sometimes.   From day one, Shane was always loving, respectful and very appreciative of our love and support, so he definitely was worth the effort.   The sadness, anger, frustration and fear that swept in and out of my life with his addiction though, did periodically test my strengths and challenge my spirit, but never deterred my hopes, dreams and aspirations of one day having my son drug free.

The program protocol does require all pariticipants on the program to be closely monitored with random urine tests for illicit drug use, and to have regular appointments with their CADS caseworker.   The take home doses of Methadone are a privilege, and the CADS caseworkers have the power to revoke or review this privilege at any time, if a participants progress becomes unstable or he/she has any negative urine results.   Well, Shane's and others drug abuse certainly validates that this part of  The Methadone Maintenance program protocol definitely requires attention and changes.   My campaign proposal and approach to the drug abuse problem that exists within the program is as follows:

Why do program participants abuse drugs, and why don't they get kicked off the program if they do? is probably what your are all thinking.   Well firstly, addiction research and studies do confirm the addictive nature of Methadone, and addiction professionals also confirm this is the reason why participants tend to 'poly-abuse' or 'top-up' with other substances while attempting to reduce their daily dose of Methadone, apparently it's quite common, and obviously quite acceptable within the program.   To give addicts a more highly addictive drug than the drug they were probably using, begs questioning anyway.   To help combat the drug abuse problem  in the program, recommended changes to The Methadone Maintenance program protocol are:    Very random urine and blood testing should be a perquisite of the program.   This would help solve some of the drug abuse that widely exists on the program.   Urine only detects some substances, whereas blood testing would detect all substances in the system.   It is necessary the drug testing be very random, as addicts are knowledgeable enough to work their abuse around the testing that presently exists.   It's simply not random enough and allows to many loopholes.   The current guidelines, I believe, need to be more rigid and paricipants held accountable for their actions.   If the Opioid Substitution Treatment Guidelines were changed to accommodate these measures then all, including the participants already on the program, would have to abide by them.

Now, why they don't get removed from the program is:    It has been established that immediate Methadone withdrawal can have serious consequences.   So removing a participant from the program would require them to be admitted into a detoxification unit or rehabilitation facility to safely withdraw off the Methadone.   We simply don't have enough Addiction rehabilitation and detoxification centres operating in NZ, and only a few of these centres cater for Methadone withdrawal.   This is a funding issue and another aspect of my camaign, which I will address at a later date.   Some participants daily dosage of Methadone are well over 100mgs, the recommended safe withdrawal rate is 2 - 5mgs weekly, however, if in a safe enviroment maybe 10mgs weekly, even so, withdrawing down from that amount would require sometime in rehabilitation.   So the program has no alternative other than to keep feeding them their Methadone, and  why once in, it takes a long time to get out.

Shane's abuse of other drugs may not have become so destructive, and life threatening, if The Methadone Maintenance program had these measures, with consequences already in place.   This isn't the first campaign that I have attempted to put forward for changes within The Methadone Maintenance program, two other campaigns to the NZ Government and health Officials over the years have failed to achieve a satisfactory result.

Shane, like all on the program has to take some responsibility for his addiction escalating over the years, but I certainly hold this program and it's operating services responsible as well.   Persons entering this program are usually at a desperate stage in their addiction, and this program offers them a drug they don't have to source themselves, and the bonus is, it's free.   Now, maybe I'm being cynical but, believe me, this is exactly how most addicts see this program.   They also all accept, once on the program, there is really no way off it.   The term 'liquid handcuffs' is used to describe their daily dose of Methadone, because that's what it feels like to them.

I do read and really appreciate your comments, and will always endeavour to answer questions, either through a posting or directly.   A comment regarding cost of Shane's treatment is:     The funding figure obtained for The Methadone Maintenance program 2008-2009 was $13.6 million, with 4600 persons enrolled that year in the program.   That's what this program is costing the NZ Government, or you the taxpayer.   Individual costs are:   Approximately $5000 for program, and $2200 pharmacy dispensing costs per year.   Shane's 14 years on the program equates to approx. $100.000, a lot of money for a treatment that doesn't really solve drug addiction.  
Oops!! sorry done it again, this posting bit longer than aticipated. Will continue on next week.

Drug Abuse. Ignorance Is Bliss.

Drug Abuse. Ignorance Is Bliss.

Drug Abuse. Ignorance Is Bliss.

Sunday, September 26, 2010

Confusion. "What's Methadone"

Well, it's been a week since my first posting.   The task this last week has been to get my blog out into the cyber community, a task that was quite daunting, considering my only moderate computer skills.   Hopefully, I have achieved this and I can now concentrate on updating my blog.

The Methadone Maintenance Program,  "what's that, is it the name of a rehab centre"?  I asked.   Shane didn't answer, I guess he'd had enough talking by then, but the literature we were given to read was self explanatory:

The Methadone Maintenance program in New Zealand is a Government funded outpatient program operated from clinics by Community Alcohol & Drug Services, (CADS) in short.   Methadone is a synthetic Opiate based drug made purely for this program worldwide.   It is an oral drug administered daily to addicts to help stabilize their Opiate addiction.   It was first established in NZ in 1975, and it was originally introduced as a 'harm reduction program', to help contain the transmission of HIV and Hepatitis C, which can develop through needle sharing, and also to decrease the criminal activity that supports illicit drug use.   The process of eligibility into The Methadone program entails interviews with a CADS clinic doctor, regarding drug addiction history.   New entrants are then blood tested to verify drug use and also of any possible health risks he/she may have.   This evaluation for entry is very important as it allows the clinic doctor to prescribe the correct daily dose of Methadone each patient requires for their addiction.

The material wasn't very imformative about the drug Methadone itself, or the length of time treatment was for.   Shane was still taking drugs, albeit legal, on this program.   I think all in the family were struggling, like myself, to understand how replacing one drug for another was beneficial for a persons addiction.   But Shane was very positive and optimistic that Methadone would stabilize his addiction, and then he would withdraw off Methadone and exit the program.   Shane entered The Methadone Maintenance program in August 1994, and his goal then was to be off the program in 2 years.

Well, that goal and time frame back in 1994 never happened, and it wasn't that Shane didn't try to make it happen, but Methadone just made it difficult to achieve.   Methadone is actually more addictive than Heroin and harder to withdraw from.   Shane realised this once he started to withdraw down his daily dose of Methadone, and that's when his abuse of other drugs began.   The more he attempted to cut his Methadone dose down, the more he abused other drugs.   It became a vicious cycle of addiction.

Methadone treatment for drug addiction is a fallacy, and certainly not a treatment option I would recommend to others.   Methadone didn't help, it only compounded Shane's addiction.   Shane looked like and became  more of an addict on Methadone than he did on Heroin.    This is because, body tolerance to Methadone is higher than with Heroin, which also makes the Methadone detoxification process a lot longer than Heroin.   So in hindsight, swapping Heroin for Methadone wasn't the best solution for Shane.   The drug Methadone was to bring more destruction to Shane's life than any other drug he'd ever used.   Also, unbeknown to Shane, when entering this Methadone program in 1994, it was to lead to a fourteen year burden that would slowly destroy his body, mind and soul.   This fourteen year journey was to engulf his whole family with such sadness, having to witness Shane's despair, his many failed attempts to come off Methadone, and his addiction spiral out of control.   All he wanted was to be clean, all I wanted was to have my precious son back.

In 2004 and in desperation to help Shane, I commenced research to increase my knowledge regarding addiction, drugs and substances, and The Methadone Maintenance program.   The weeks and weeks of effort and computer technology rewarded me with an abundance of information, especially regarding The Methadone Maintenance program and the drug Methadone.   This knowledge did give me some understanding to the escalation of Shane's addiction while on The Methadone program.   But this insight also made the dream of Shane being drug free seem almost unobtainable.   It was a pity that the addictive nature of Methadone, and it's difficult withdrawal process wasn't fully explained in The Methadone Maintenance program information booklet.

I am not pro or anti Methadone, I acknowledge The Methadone program does have a purpose and place in our society for persons with addiction.   However, the whole program must be restructured to put more emphasis on achieving an end result for the participant, not just maintenance.   Participants shouldn't have to, or be permitted to exist on this program for years.   These participants, as Shane's reference to himself, just end up 'Methadone Junkies', who see no way out of the program, and without a time frame, plan, or encouragement, why most stay on it for years.   I am only referring to The Methadone Maintenance program operating in New Zealand.   Other countries Methadone programs may operate differently to ours her in NZ.

This is the first part of a campaign I propose to forward to the appropriate members of parliament within our NZ Government.   The focus and goal of my campaign will be to instruct fundamental restructuring of the entire Methadone Maintenance program and the services that operate around it.   This program must be streamlined for success, not just sustainability.   I will roll out more aspects of my campaign in furture posts.

I do apologise for the length of this post and hope I haven't bored you all to bits.   I intend to continue sharing Shane's fourteen years on The Methadone Maintenance program, and his journey through addiction hell, so keep tuning into my blog for updates.