Archive | Suicide RSS feed for this section

Life, Death and Other Things

10 May

‘You might think that the biggest killer of people aged between 15 and 45 in the UK would be road traffic accidents or maybe one of the many cancers we’re reliably told will affect 1 in 3 of us, but it isn’t. The biggest killer of young people in this first world nation is suicide……’

Suicide outnumbers road traffic deaths by 2:1. The latest statistics put the total number at over 6,000 per year; that’s almost one every hour. So, the question is why? What do such a large number of otherwise healthy young people in the prime of their lives find so unbearable that ending it becomes a viable option?

From a personal perspective there is a big difference between life and living. Life is the mechanical process of converting food and Oxygen to the sustain a heartbeat. Living is gaining satisfaction and enjoyment whilst doing so. In the global model of living which we are forced to accept inequality has never been greater, the basic requirements for taking part can become all consuming, leaving many people simply treading water and trying to plug holes in the dam behind which the necessities for life continually pile up leading to the feeling that living is a secondary concern. This is not to say that all downward spirals are caused by what equates to financial stress; rich people are profoundly unhappy too, but for what may actually be the same thing, albeit caused by different circumstances.

On a planet with 7bn other people it is surprisingly easy to feel alone. The family unit or the need to belong and feel needed, wanted and above all loved is another contributory factor. This is where unhappiness doesn’t care how much wealth you have but there is undoubtedly a disproportionate number of economically strained people making up the suicide statistics. The more time you spend plugging the holes in the dam, the easier it is to begin the downward spiral of loneliness and feelings of helplessness and worthlessness.

Despite the narrative that we recognise and care about people who may be well on the way down the path to ending their pain, there is very little professional help available. I’ll guarantee the paperwork and time spent evaluating and exonerating professionals of any blame in the aftermath of a suicide far out ways the amount generated preventing it whilst they were still living.

Although everything I have just written may be factual, it’s typical of my personality to attemp to rationalise and quantify but when all is said and done it is my own internal battle with suicidal thoughts that I intended to write about. The flippant remarks and often quoted misnomer that someone who is suicidal acts completely normally and “nobody would have imagined that they would do such a thing”, is a somewhat annoying cop out. Making the choice to take your own life doesn’t happen in a moment of desperation or madness, it is a considered act in many cases. I can only speak for myself but I go around in circles considering method, guilt and a whole host of emotions and rationale.

I have asked for help but nothing ever happens. Over time I have become more isolated, unhappy and desperate to escape the overwhelming feeling of impending doom. It feels like every concerted effort I make to change things fails. The failures mount up and as they do the chronic (untreated) depression makes the basics hard to maintain. I am consumed by guilt at the thought of hurting people and it is that, and only that that has kept me alive. But I don’t know how much more I can take. I don’t see any light at the end of the tunnel, or for that matter, a tunnel. This isn’t a cry for help; God knows I’ve cried and cried for help but none has been forthcoming. I have posted many times about this and doubtless I’ll be labelled as the boy who cried wolf. Truth be told, I’m distracting myself from thinking because I’m afraid where it might lead. Death doesn’t scare me and the rationalisation that I could never have to face anymore pain is an appealing prospect but for now I’ll just keep plugging holes until the dam inevitably overflows……

Advertisements

The Right to Choose……

1 Apr

‘Regular readers will doubtless know my feelings on the right to self-determination when it comes to assisted suicide.  Well, yet again, another terminally ill man has to suffer the indignity and stress of fighting the British Courts on top of being in an unimaginable position……’

The case of Noel Conway, 67, from Shrewsbury, who was diagnosed with motor neurone disease more than two years ago and fears being “entombed” in his own body as his ability to move declines, is the latest to reach the High Court.  He is not expected to survive beyond the next 12 months.

image

Noel Conway

It is  completely understandable that people in Noel’s position fear the indignity, pain, inability to communicate and all of the unimaginable horrors that come towards the end of life as the disease progresses.  To have the added distress of having to fight a court battle, when all he is requesting a peaceful death when the disease becomes intolerable, seems cruel and totally unecessary.  We have the medicines required to bring about this ending painlessly when the time comes.

The legal arguments against assisted suicide always seem to come back to the same thing; that relatives will ‘push’ a terminally ill person to prematurely end their lives for some spurious reason, or that the person feels they will become a burden as the disease progresses.  It has been demonstrated in countries which allow assisted suicide that with the right checks and balances in place this is almost impossible.   I know of no instances where relatives or carers have been prosecuted in such situations.  In independent polls a large majority agree that it should be an option.

There are options available to some, but only if their condition and financial status allow.  Dignitas, Switzerland, are one organisation that can arrange a peaceful death for sufferers of incurable, degenerative diseases, however, the cost involved (approximately £10,000) is prohibitive for some.  For others, their condition makes travel impossible, denying access to the service.

image

Established 1998

The unfortunate inability of our courts to legalise assisted suicide has led to despairing people taking things into their own hands which can cause more suffering or, in the worst case scenario, a prosecution.

Death is not something to be feared.  The idea that your place in Heaven will be lost is  nothing more than the remnants of outdated superstition.  When you are dead you are effectively in the same ‘place’ you were before you were born; and anyway, surely a loving ‘god’ will understand your need to end your pain.

It is time we removed the superstition and hysteria from the argument and listened to common sense, ended the anguish and suffering of those people who find themselves in the unfortunate position of having an intolerable illness and placed assisted suicide on the statute books.  It is a sick irony that we don’t allow animals to sufifer but our fellow brothers and sisters are allowed to suffer…….

img_2730-1

Trapped……

6 Jun

‘I can ramble on endlessly about politics, religion, science, inequality, war and a hundred other things but the subject I find hardest to express is my own struggle with chronic depression and anxiety, predominantly because I can’t find the words and believe that only another sufferer can really understand……’

Depression has the outward appearance of ‘normality’. It doesn’t come with a plaster cast, visible scars or crutches; it is an invisible, insidious disease. This does not diminish its impact which can be just as debilitating as any physical illness……

Head_04I cannot tell you when I first became depressed, or why, but I live in what feels like a pinball machine being bounced from one crisis to another, all having an accumulative effect over my entire life and illness. Therein lies one of the problems with chronic depression because from an observer’s point of view they usually ask the same questions; why are you so unhappy and what would make you happy; both of which I can’t answer. I can tell you how it manifests but I cannot emphasise enough that this is after suffering for over 30 years. One distressing event in your life is usually surmountable; it’s when years of seemingly endless distress continues that the problem reaches epic scales.

Head_03Days vary; some are better than others but always with an underlying presence. One of depression’s most cruel and insidious effects are on sleep, or the lack of it. No matter what I try I find it impossible to establish a reasonable sleep pattern (even with prescription sleeping tablets). Chronic Insomnia on its own is known to dramatically affect your mood and your ability to concentrate. Added to an already deeply engrained depression insomnia becomes a double edged sword. When all you would rather do is sleep to escape the misery, insomnia puts the dampers on. So, not only can you not sleep but the time drags along making five minutes feel like an hour. I also suffer from sleep paralysis; a situation which occurs both when you fall asleep and wake up. It may only last for seconds and is a state of semi-consciousness where you are aware of not being fully asleep but cannot move. If combined with a nightmare or post-traumatic stress disorder it is truly terrifying fighting to escape to consciousness.

I have become so ill I contemplate suicide almost daily. It seems like the only way to escape from the prison inside your head. It also has a profound effect on your ability to function ‘normally’. I don’t eat properly, I get no exercise, I rarely leave my room and fear of the outside world can be paralysing. It’s not a secret amongst people who know me that I self-medicate, which is not uncommon, and is usually partly as a result of the medical establishment failing to deal with problems quickly and with the right choice of treatment; which is woefully inadequate. The upshot of the inadequate treatment of mental health issues is years of torment as you scream for help which never comes……

Early and appropriate intervention is fundamental for curing any illness; however, your overworkedHead_Pills_01 GP will simply reach for the prescription pad. There are dozens of anti-depressants and finding the one which may help you can take months. More often than not, once you’ve tried them and they don’t work you either continue to take whichever ‘lucky dip’ pills you’ve ended up on (usually the cheapest, not the best), or just give up altogether. Someone suffering from serious chronic depression is unlikely to enthusiastically keep returning to their GP to ask to try something new. The second and probably most important thing someone with depression needs is therapy. But this is a major problem; first of all you will wait months for an assessment. Then, if you’re lucky, you may be offered counselling; in my case four sessions. Four sessions with somebody you may not be comfortable to disclose your innermost traumatic childhood experiences with, and four hours is not sufficient to scratch the surface of 30 years of dysfunctional living, addiction, obsessive compulsive behaviours and despair. All of the time that passes so slowly only makes your situation worse and it becomes incredibly difficult to ever recover……

Head_01Although friends try to help nothing they say has much effect. The most annoying thing I’ve heard a hundred times is, “If you’ve reached rock bottom things can only get better”. Meant in good faith and from non-medical people the sentiment is appreciated but things do continue to get worse. Maybe there is a ‘rock bottom’ but for me things just get worse.

From my point of view the future isn’t something I look forward too. I see my situation as unchanging and a future in which things only appear more bleak the further away I dare to contemplate. I’m isolated, stuck in a challenging domestic situation, I feel I have no prospects of ever reaching the ‘aspirational’ trappings of success and feel that nothing will change, and I will become old, poor and lonely. In truth this will not happen because I will exercise the only control I feel I have left and which is guaranteed to end my daily inner distress; suicide. This isn’t a threat or a ‘cry for help’, it is a simple solution and when my choice will not affect the person I love, I will proceed with a sense of relief……

If there is any possibility that I can be ‘cured’ or at least feel that things were to improve, then I may re-evaluate my future but in the absence of long term, specialist intervention, I cannot envisage that future……

DT_Triangle_Banner

Psychotropic Snake Oil……

7 May

‘The Income of the pharmaceutical industry is huge. Much of that income comes from the drugs used to treat mental health. The chances are that at some point in your life you may be prescribed one of these drugs. If you thought that psychiatric medicine is based on sound scientific principles, think again and read on……’

 

Diagnosing Mental Health Illness……dsm5

Unlike any other area of medicine, mental health cannot be diagnosed through a blood, urine or any other scientific test. It is based on the way in which you answer the doctor’s questions and upon the way you are feeling. This is of course subjective. The range of human emotions is wide and covers the elation of child birth through to the sadness of bereavement and everything in between. In many cases there are multiple choice questionnaires, which can be found online. They contain questions such as “I feel sad”, with answers ranging from; not very often, once or twice each month, twice per week and every other day. Try one for yourself online and even if you are perfectly contented with your life you may discover that you have depression, anxiety or even bi-polar disorder (The pharmaceutical industry are often behind ‘self diagnosis’ websites in order to prompt a visit to the GP). The only other element in the diagnosis is the Diagnostic and Statistical Manual of Mental Health (DSM), which categorises and matches your ‘symptoms’ with a known mental health disorder. With each new edition of the DSM come new diagnoses. In the DSM I, published in the 1950s, there were 106. The latest edition, DSM V, lists over 300……

 

Once you have a Diagnosis……

Before the 1950s talking therapies were the main way of treating mild to moderate mental health illness. More severe conditions such as Psychosis usually led to hospitalisation, possibly Electro-Convulsive Therapy and even surgical Lobotomy. Contemporary treatments usually involve the prescription of Psychotropic drugs. These fall into many categories but all are thought to affect Neurotransmitters, the main ones being Serotonin and Noradrenalin, although no one really knows how or why they work.

So, supposing you have suffered the bereavement of a long term partner and are feeling down, a little lost and have difficulty concentrating and sleeping. Then you are feeling what humans have felt since time immemorial, however, your doctor may well tell you that you have depression and, after a 15 or 20 minute consultation, you leave with a prescription for an antidepressant; a powerful psychotropic drug with potentially deadly side effects……

 

pills1Developing and Testing Psychotropic Drugs……

After initial laboratory tests for toxicity etc, human trials begin. They often last a maximum of eight weeks; some only four. They are only tested against a placebo and not any other drug. Providing the side effects are moderate in the test group which consists of carefully chosen, healthy people, they can be approved for public use. At this point the public become the guinea pigs, sometimes with devastating consequences……

 

Antidepressants and Suicide……

There are hundreds of well documented cases of people visiting their GP at a difficult time in their life, being prescribed antidepressants and committing suicide within days of starting their medication; remember these are powerful psychotropic drugs. But surely this would have been noticed in the trials? Not if the results are manipulated by interested parties; namely, the pharmaceutical industry that test them. Altering statistics is easy; when trialling the drug you simply leave out the question “Did this medication make you feel suicidal?” We are so used to answering multiple choice questionnaires that clever questioning can return either positive or negative answers depending on how the question was asked, that is, if it was asked at all. They may not make someone who is in perfect health feel that way but if you have been under stress and have a low mood, as in the example given earlier, they can have a far more powerful effect……

 

A Conflict of Interests……seven-pharma-logos-300x200

Any regular readers of my blog will be well aware of the close relationships that exist between industries, regulators, politics and money. It used to be called corruption; paying for politicians’ VIP days out, lobbying and making large donations to political parties. But it seems laws and ethics only apply to the likes of you and I. The pharmaceutical industries are more than happy to pay huge grants to fund research at universities; the same universities that the Psychiatrists who write favourable papers for medical journals work at. Doctors require patients and patients require diseases; diseases that require drugs to treat them. You get the point……

 

Finally……

There are some people with mental health issues that may benefit from medication, but they should be closely monitored and the cause of their distress identified and dealt with alongside medication. Unfortunately, an NHS with limited resources are not able to deliver a high enough standard of care, especially when it comes to talking therapies, so a large group of people get left on medication to numb the pain; medication whose side effects have never been tested beyond a few weeks and what long term damage they may do is an ongoing trial, one in which you may be taking part……

DT_Triangle_Banner‘I am still awaiting a reply to my letter to the Foreign Secretary but I’ll let you know when I do (see previous post “Correspondence with the Government”)……’

 

Assisted Dying Bill to be put Before Parliament……

17 May

Lord Falconer who served as Lord Chancellor under Tony Blair and chaired the Commission on Assisted Dying proposed bill will again go before Parliament.  Lord Falconer, who tried to and failed to change the law in 2009, believes current legislation is in urgent need of an update. Three quarters of adults in England and Wales support the proposals in the bill, a YouGov poll for Dignity in Dying found earlier this week.

Although Lord Falconer’s attempts to change the current outdated 1961 Suicide Act are admirable, the amendments would not help people like Paul Lamb and the late Tony Nicklinson because the patient would not only need a prognosis that their life expectancy was less than 6 months but then require them to perform the action leading to their death unassisted.  In cases where the patient was physically incapacitated this would not be possible.

As is usual whenever the subject of self determination is discussed groups opposed are the first in the queue to make their opposition known.  One is forced to enquire as to the religious motivation of these people, most of whom are not suffering from a life altering, debilitating and painful condition, or care for someone who does.  Their opinions may be different if they were, God permitting.

Living in the 21st century we have little autonomy.  We are told where we can go, when we can go there and what documentation we will need.  The ‘free’ society in which we live holds details on almost every aspect of our lives and, as the declaration on the endless forms we are obliged to complete informs us, legal action can be taken against us for failure to give accurate information.  The only aspect of our lives which remains under our direct control is the choice to live or die albeit with many obstacles placed in the way and, for those unfortunate enough to have had a physical barrier placed in their way; even that choice is severely restricted.

In a society which no longer needs to invoke divine explanations for apparently mystical events is it not time to put death into context.  Before the evolutionary process which brought about your existence did you spend all of pre-existence contemplating the brief period of consciousness you were about to experience?  In the same way, do you believe you will spend an equal amount of time contemplating your non-existence once it ends?  The time you spend as a sentient being, hard though it is for some people to accept is the total of your conscious experience.

Ironically, in our politically correct society there are legally binding provisions to provide access to public buildings and adaptations to the workplace to accommodate people with disabilities, provisions which do not apply to self determination.

For some people who are unfortunate enough to have been deprived of the fullness of experience enjoyed by the rest of us, returning to the before or progressing to the after is for them a desire that you, I or any other well meaning person is not at liberty to dictate.  Life belongs to you, and you alone.  Should you not wish to take part that is ultimately your decision and should be the first of your rights as a Human Being……

Paul Lamb Continues Tony Nicklinson’s Case in the Court of Appeal……

15 May

‘Brave Paul Lamb and one other person simply known as ‘Martin’ have been given permission to continue the case of Tony Nicklinson who passes away last year shortly after loosing his case.  Tony was seeking immunity from prosecution for any medical professional assisting him to end his life.  Paul, like Tony, due to their medical conditions where not in a position to take this step without help due to the physical restrictions of their respective illnesses……’

Background……

Both Paul and Tony are the latest in a long line of people who feel that their quality of life has been so profoundly affected by their medical conditions that they feel either now, or at some unspecified point in the future, being able to end their lives with dignity and without pain is their right as autonomous human beings.  The premise behind making such a decision is based upon several understandable factors.  First and foremost is the pain many of them are subjected to on a daily basis.  Secondly, the quality of life they have to endure, in that they are not able to perform even the basic everyday tasks without assistance including going to the bathroom, feeding them self, moving around and some cases even communicating with loved ones.

There is also the question of deterioration in medical condition which the courts seem to take no account of.  If deterioration in health was a new factor, they would be faced with challenging the legal decision all over again.

Like so many before them and one fear many to follow, the steadfast judgements of the courts seem to operate within a ‘one size fits all’ methodology with one issue at its core.  That being the potential for abuse of the law and the vulnerabilities  of certain groups within society who, for whatever reason, may be ‘victims’ of a law permitting euthanasia under certain circumstances……

In the Real World……

Whilst the courts have to give consideration to vulnerable groups and any potential abuse of a carte blanche law permitting assisted dying, I feel we are intelligent enough as a society to make a clear distinction between people like Paul and Tony who are clearly capably of making their feeling known and vulnerable groups who may be acting under duress from others.

The law does not have to be ‘black and white’ and courts could employ the services of Doctors and Mental Health Professionals to establish the merits of each case on a one by one basis.  It is not beyond the courts to identify people who are clearly of sound mind to express when they feel their lives hold no quality and dignity, with little chance of improvement, and to humanly grant them their wish to end them, any more so than to recognise when the plaintiff is requesting such an action under duress.

I am not suggesting a change in law that makes possible the indiscriminate euthanasia of ever sick person but a simplified process under which a judgement can be made without causing delay and upset to those involved.

NIMBYism……

It seems that the opposition to a process which allows ill people the right to end their own lives has fallen foul of the nimbyism which is apparent in many other legal matters and works on the principal that individuals and Judges are not capable of reaching rational decisions.  This is clearly not the case.  Our humanity should allow us to accommodate special circumstances especially when people are suffering……

What can you do……?

 

I have written a ‘Living Will’ of ‘Advance Directive’ to give it its proper name.  It’s quite a simple document that lays out what you want to happen in the event that you should be unfortunate enough to be involved in an accident and unable to make your feelings known.  They are quite straight forward and give instructions on resuscitation and artificial life support.  There is space for you to put a statement of your beliefs and allows you to nominate a proxy, to whom you should make your feelings known.  They can act for you if you are unconscious and not able to make your feeling known at the time.

Although an Advance Directive is not ideal if you feel strongly about this issue, it is a good thing to have in place.  Mine can be seen at the bottom of the post but it is important to print out and give copies to those concerned……

And Finally……

Until the brave battles being fought by Paul Lamb and that of Tony Nicklinson set any precedent in law there is little we can do.  I wish Paul, Martin, Jane Tomlinson and the many others fighting for dignity all the best and hope their tenacity pays off……

My Advance Directive……

ADVANCE DIRECTIVE – Blanks Left to Respect Privacy……

THIS LIVING WILL is made on the 12th day of May 2013.

I:  STEPHEN P_____ W_____ of 1, G_____ D_____, B__________ H____, L______, LN4 ___.  Born on:  3rd February 19__

Being of sound mind make this Advance Directive now as to my medical care and treatment directed to my family, my doctors and any other medical personnel, institution or authority in the event that I shall be unable to make my views known at any time.

I DIRECT as follows:

My life shall not be artificially prolonged and no life sustaining treatment shall be administered, if at any time my attending doctor, consultant or surgeon and one independent medical practitioner certify in writing that in their opinion:

 

a) I have a terminal, incurable or irreversible injury, disease or illness; or

b) I am permanently unconscious, comatose, in a persistent vegetative state with no reasonable chance of recovery; and

c) I am no longer able to make decisions regarding my medical treatment.

In the above circumstances I wish to be permitted to die naturally and to only receive such medical treatment as will alleviate any pain or distressing symptoms so as to make me more comfortable even if this has the effect of shortening my life.

EXCEPTING as follows:

If I have elected to end my own life and have taken steps to bring about this, in the event that I am found I wish to be allowed to die with no medical intervention whatsoever.  I believe this is my right as suicide is permitted in law.  The terms of the above directive shall also apply in this circumstance.

APPOINTMENT OF PROXY

I appoint S____ G______ of 11, S___________ H_____, S____ E__, L______, as my proxy to be involved in all decisions about my medical treatment if I am physically or mentally unable to make my views known. The wishes of S____ G______ should be respected at all times and I confirm that she is fully aware of my wishes.

IN WITNESS of which I have set my hand to this my living will on the day month and year first above written.

SIGNED by the above named in our presence and by us in his/hers.

 

Maker of Living Will

 

Signed:                                                 [Person making living will sign here]

 

Proxy

Signed:                                                 [Proxy sign here]

 

First Witness

Signed:                                                 [First Witness sign here]

Name: [Insert first witness name]

Address:          [Insert address of first witness]

Occupation:     [Insert occupation]

Second Witness

Signed:                                                 [Second Witness sign here]

Name: [Insert second witness name]

Address:          [Insert address of second witness]

Occupation:     [Insert occupation]

Human Rights, Morality, Dignity and Public Image……

20 Apr

‘I an returning to a subject which I have covered before and the original articles can be found at the 18 July 2012 entry “Tony Nicklison’s Right to Die” and, 27 August 2012 “Tony Nicklinson – A Fight for Dignity” – Enter “Tony Nicklinson” into the site’s search box to find the articles……’

‘The case of a paralysed man who wants the right to end his own life will be heard in the Court of Appeal next month and public health leaders in Brighton will consider recommendations regarding the treatment of drug addicts within the city.  Although apparently unrelated both of these issues remain unresolved, despite having clear solutions and are being held up by bureaucratic stupidity rather than any real concerns for the people affected……’

What do they have in Common…..?

Real people’s lives; real people, in real situations, that affect real quality of life to them and that of those who care for them.  Not the philosophical or ideological arguments about the morality and rights and wrongs of certain courses of action which bear no relevance to the issues of the individuals bringing the cases.  Whilst considerations have to be given to potential abuses of any changes made to laws there are quite clearly situations that arise and transcend legal, moral and political arguments.  Euthanasia and the treatment of addiction are two instances that have large amounts of scientific, peer reviewed evidence in support of the proposals.  However, instead of consideration of the individuals affected by these cases they are soon overshadowed by the wider arguments which claim the vulnerabilities of some groups in society and the potential for abuse are placed at the forefront of the debates, making the individual’s logical and well demonstrated cases being over ruled by what could be described as the legal professions equivalent of NIMBYism……

 

The Case of Paul Lamb’s Continuation of Tony Nicklinson’s Fight……

Paul Lamb

Paul Lamb

Paul bravely picked up the torch from Tony Nicklinson who died last year from complications related to his illness shortly after loosing the legal bid to allow a doctor to assist in his suicide, with protection from prosecution.  Tony, like Paul, felt that their quality of life was so profoundly affected by their medical conditions they simply wanted the choice to end their lives with dignity at some point in the future when they deemed it appropriate, with the support of their families.  Both incredibly articulate and intelligent men there was no questions that arose surrounding the possibility of outside pressure leading them to make such a brave and considered request.  Suicide is not illegal and those who are able bodied can take steps to bring about the end of their lives should they wish to do so, but due to Paul and Tony’s practical physical restrictions it would almost certainly require a degree of help from another person, whether a family member or doctor leaving them with the possibility of facing charges, including murder.  This is not a situation which Paul and Tony found acceptable, that someone close to them who had may have had to endure the pain of watching their loved ones suffering, may be put through the trauma of facing a public trial.

It is here that the politically correct version of NIMBYism enters the equation.  I completely accept that safeguards would have to considered when granting the sort of requests that Paul and Tony were asking for but, in both cases, even a layman can clearly see that their cases were in no way influenced by external pressures from the families in fact nothing could be further from the reality.  These articulate men were presenting an indisputable case for a member of the medical establishment to assist in what would be a painless act of mercy to end their suffering.  There are no grey areas in the hypothesis and I strongly feel that under such clear and indisputable circumstances a change to the regulations is workable.

I wish Paul every success in his challenge to the current status quo……

The Treatment of Addiction……

Although, these cases appear to unrelated they do share a number of similar institutionalised orthodoxies, which despite years of scientific peer reviewed studies, all of which draw very similar conclusions, they continue to be ignored by the medical services charged with delivering results; again displaying the politically correct NUMBYism that does not affect the people who are either, going through, effected by someone who is going through or as a part of the structure of institutions charged with producing results using a methodology which has been proven to be largely ineffective and they are unwilling to change.  All of this despite the fact that what is considered by science and medicine as the best practice, demonstrated by favourable results within the small scale trials which sometimes take place……

The National Approach to Dealing with Opiate Addiction……

A patient presents with an addiction to Heroin which is the ‘street’ name for Diamorphine Hydrochloride, commonly used in medicine for the management of post operative and severe pain.  The treatment given to all patients is a replacement therapy with either Methadone Hydrochloride or Bupronophine; both are Diamorphine substitutes but lacking in some of the characteristics of Diamorphine and, it is due to this subtle difference that the substitute medication regime fails in the majority of cases to prove effective.

The second contributory factor to the failure of substitute medication’s failure to prove effective is the delivery by whichever agency is charged with its prescribing.  The National Institute for Clinical Excellence list 8 key principals for dealing with Opiate addiction.  One of the first states that ‘the prescription of substitute medication alone does not constitute treatment and should be used with a psycho-social intervention’, or dealing with the psychological reasons for addictive behaviour.  This is simply not done.  The key workers a patient sees have little if any specialist training in dealing with patients physiological needs.

This approach has changed little in since the 1960s, which is when the prescription of Diamorphine was replaced by that of Methadone.  This was not done for the benefit of patients, rather as a result of one rogue doctor who was abusing his position and supplying drugs…….

What Does the Scientific Community Recommend……

 Over the past 30 years the UK Government have commissioned hundreds of studies into the most effective way of delivering the safest, most compliant method for patients and with the maximum harm reduction and every one has recommended the reintroduction of the prescribing of Diamorphine Hydrochloride; the drug to which Heroin addicts are addicted.  These studies show a compliancy of between 92 and 98% whereas with Methadone it is closer to 12%.  The tendency of users to carry on using Heroin on top of their Methadone prescriptions fuels crime, from local level to high end organised crime.  The need to make money to fund the patient’s habit again equates to crime.  The costs to the retail industry, criminal justice system and the cost of locking up offenders at a cost of £30,000 per year is completely false economics, especially as the solution to the problem is simple, advised in the NICE recommendations and falls within the legal framework already in place, it seems crazy to dismiss these scientifically quantified recommendations……

The Effect on the Individual Patient……

The patient is unable to control their drug usage (unless they were prescribed the appropriate substitute) and this leads to the crime, isolation from ‘normal’ life, depression and anxiety and the dangers of exposure to life threatening illnesses such as Hepatitis C and HIV.  There are also many inherent dangers with the 95% of the unknown substances with which the Diamorphine is ‘cut’ by unscrupulous dealers wishing to expand profits.  The damage caused by addiction to Opiates is not the Opiate itself, it is the behaviour associated with continued illicit drug use……

The Solution……

As has been proven by every scientific study into the best way to treat these people is to prescribe the drug to which they are addicted.  This has the effect of ending the destructive behaviour which causes the harm, giving the patient the opportunity to rebuild their lives after which they can be successfully detoxified and continue being a productive member of society.

Why is this not done despite recommendations to our Government that this is the best course of action?  Because of political motives.  Any government taking this approach would face accusations that they are supplying ‘illegal’ drugs to addicts when the truth of the matter is that they are supplying them anyway, albeit under a different name.  The initial cost may increase but the eventual outcomes would be more effective in reducing crime and relapse and, in reintegrating addicts into society.  It is not done for the same reason that people like Paul Lamb and Tony Nicklinson were not given the dignified options they needed; ineffective politicians, ineffective courts and the worry of the damage it might do to their public image and to hell with ‘real’ peoples lives.

There are several countries which have taken this approach including Switzerland, Canada, The Netherlands and Portugal.  All report positive results in both reducing harm to individuals and achieving abstinence……

‘Our political classes, many of whom have never worked or experienced the real world, should be ashamed of themselves for they do not care about individuals, they only care about themselves……

Tony Nicklinson

Tony Nicklinson

 

In memory of  Tony Nicklinson, 4 February 1954 – 22 August 2012……