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.

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