Tag Archives: Drug Addiction

Addiction, Corruption and Democracy……

12 Sep

The National Health Service is letting down large groups in society because of the Government’s inability to act on the advice of specialist healthcare professionals whilst impeding progress to service improvements with endless committees, reports and commissions.  This is particularly true of Drug and Alcohol services despite a unanimous consensus that the current status quo isn’t working and which has a detrimental effect on communities, businesses and the legal system……

House of Commons Affairs Committee……

As if any further demonstration was needed, after a year long enquiry into drugs and addiction, which reported to the fingers-in-earsCommons Affair Committee earlier this year, Keith Vaz recommended the immediate setting up a special Royal Commission as it was a ‘critical, now or never moment for serious reform’ and should report by 2015.  All he has achieved by making this recommendation is a delay in any action being taken until 2015, or later.  The Prime Minister, David Cameron, dismissed the call when one week earlier his deputy, Nick Clegg, backed the call, telling the BBC that is was time to break the conspiracy of silence in which serving politicians shy away from a proper discussion on drug policy……

The UK Drugs Policy Commission……

The UKPDC was given six years to look into drug and alcohol services.  Its remit has now come to an end.  The full report can be downloaded as a PDF file by clicking here.

In brief the UKDPC conclusions are not that different from many of the reports the Government has commissioned.  They say the way in which we collect and analyse evidence is woefully inadequate and that holds back cost effective policies. They also refer to the systems used in Canada where users are provided with a clean, monitored environment in which to use their drugs.  Their report also highlights the disjointed approach to tackling drug and alcohol problems where the Police, Mental Health Services, Family Services and other agencies don’t work in tandem on the problem……

Burying your Head in the Sand……

Current Policy

Current Policy

Some readers may remember Prof. David Nutt who was the Government’s Chief Advisor on drug policy.  Prof. Nutt proposed alternatives to the ‘standard’ Methadone or Subutex treatments that are use in the UK, advocating instead the use of Dia-Morphine.  This was not the ‘advice’ that the Government wanted to hear, so they sacked Prof. Nutt and found an ‘advisor’ that agreed with their limited vision toward drug treatments……

Drugs Don’t Kill People, Policies Do……

Heroin is the street name for Dia-Morphine, a drug that is used in hospitals every day.  It has a very low impact on the body and is no more dangerous than a Paracetamol.  The damage caused to Heroin addicts is not caused by the drug, rather the lifestyle that goes with it.  Finding the money to pay for it causes crime.  The drug is acquired illicitly and may be contaminated which causes the health issues, as does the cross contamination from sharing equipment.  The illicit nature of the drug means that the user does not know how strong it is, which can lead to overdose.  The list goes on.  If, like Prof. Nutt suggested, it was provided on prescription all of the potential harms are removed or controlled.  But ‘Prescribe Heroin to Heroin addicts’ is not the recommendation the politicians wanted.  It is a political hot potato so it is easier to continue with the status quo, even if that has an impact on the legal system with people being burgled, shoplifting, supporting organised crime and terrorism etc.

So, there is the political answer.  Rather than saving lives, reducing crime and offering what has been proven in all peer reviewed trials to be an effective treatment, MPs want the current situation to continue for fear of unpopularity amongst some ‘Sun’ readers.

The same self serving attitudes are the reason they don’t want to ban cigarette advertising or minimum alcohol pricing; 1, popularity and 2, upsetting their paymasters……

We’re all in this Together……

Only we’re not.  Very few of us earn £80,000 per year, with another £135,000 expenses to cover our first class travel, luxury business lunches and mandatory second homes.  Very few of us have ‘consultancy’ jobs paying £1,500 per hour for 2 hours asqcomp08 week and very few of us are given gifts to go to the Chelsea Flower Show with a champagne lunch thrown in.  And, very few of us have work contract that is completely blank and allows us act as we see fit.  Finally, very few of us get a whole years wages when we loose our jobs and go on to work for some of the ‘friends’ we made when we were in power.

Is it any surprise that the Government are unable to close the tax loopholes that allow billions to go unpaid or that they we able to find billions to bail out the privately held banks that are still returning large payouts to shareholders and multi-million pound remuneration packages for their employees.  I distinctly remember David Cameron state ‘No banker will receive more than £2000 as a bonus’ under his leadership; maybe I imagined it……

Democracy……

The will of the people, no, democracy; an old boy network that act in their own interest and in the interest of companies and people who will be of use to them when they loose their seat, as they inevitably will……

‘If only we were all in it together……’

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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……


Drugs Don’t Kill People – Policies Do……

19 Dec

‘I was waiting in the reception area of the local Addaction clinic and thumbed through some of their leaflets to kill some time and noticed  advice given out only confirms the case for alternative approaches to treatment.’

 

The Leaflet in Question……

The leaflet was titled ‘Heroin – Essential Information about Heroin, What it is, how it is used and its Effects’.  It gives basic information about what Heroin is derived from, how and why people use it, details about how addictive it can be, health hazards, withdrawal and getting help……

A Couple of Pieces of Information Caught my Attention……

First:  Health Hazards – This is verbatim what the leaflet states:

‘Frequent injecting [of Heroin] can lead to a variety of problems; such as Thrombosis and blocked veins.  If you share or borrow injecting equipment (including needles, syringes and spoons), you run the risk of becoming infected with a number of blood borne viruses, such as Hepatitis C or HIV.

It is easy to overdose on Heroin, such as when the drug being used is unusually pure – or when it is being used with other drugs.  Most overdoses occur when the user has been abstinent for some time, and then injected their ‘usual’ dose.  Because it is often mixed with other substances, it is difficult for a user to know how much Heroin they are taking and, therefore, the risk of them overdosing is increased.

The substances mixed into the Heroin can cause health problems themselves, for example; powdered baby milk can thicken in your veins which, in turn, can lead to circulatory problems and even loss of limbs.  Others can cause Heart diseases, blood poisoning and lung disorders.’

Second:  Getting Help – Again, this is verbatim what the leaflet states:

‘If you want to stop you don’t have to do it on your own.  Asking for help from a drug worker is the first positive step you can take.

Addaction’s services are completely free and confidential.  We can help you find substitute medication (such as Methadone or Subutex) and work with you in managing your withdrawal.  Many of our services also have needle exchanges where you can get sterile injecting equipment, and return used equipment.’

Health Hazards……

There is nothing within the information offered which is untrue.  However, they highlight the very issues which an alternative approach to treatment could greatly reduce harm and the very same issues which have been addresses in the numerous consultations undertaken by Professor David Nutt, the former chairman of the Government’s Advisory Council on the Misuse of Drugs, and Professor John Strang the head of the National Treatment Agency at Kings College, London.  Both have advocated the use of Dia-Morphine in the treatment of Heroin addiction and which have been demonstrated to be more effective for compliance, negating the dangers highlighted in Addaction’s literature……

Getting Help……

There is nothing inherently incorrect in the ‘Getting Help’ section.  The services are indeed free and confidential to a point.  With regard to confidentiality, service users are asked to complete a Treatment Outcomes Profile sheet.  In my experience, anecdotally, service users are not aware of the purpose of this form.  It asks a variety of questions regarding a patient’s mood, the amount they have used and even if they have committed any crimes to fund their usage.  However, this form has no bearing on any future treatment nor is it used to evaluate the current treatment.  It is used to collate statistics by the Government.  If a patient was told with whom this information would be shared, they may reconsider their answers and even their willingness to fill in the form.

Another statement which is somewhat disingenuous is that an alternative medication can be found ‘such as Methadone or Subutex’.  Although there are many different medications which can be used, Methadone and Subutex are the only choices offered, even though the clinical guidelines allow for other substitutes; the same substitutes recommended by Professor Nutt, Professor Strang and cited in many other peer reviewed scientific trials……

The Aims of Drug and Alcohol Services……

The aims of drug and alcohol services are to reduce the harm caused to users and attempt to help them achieve abstinence.  The peer reviewed scientific studies referred to above demonstrate that there are much more effective ways of achieving these goals.  However, as I wrote about in ‘The War on Drugs’, it is the political stonewalling of the advice they contain which is causing the most harm to those involved in the war on drugs……

‘I was waiting in the reception area of the local Addaction clinic and thumbed through some of their leaflets to kill some time and noticed  advice given out only confirms the case for alternative approaches to treatment.’

 

The Leaflet in Question……

The leaflet was titled ‘Heroin – Essential Information about Heroin, What it is, how it is used and its Effects’.  It gives basic information about what Heroin is derived from, how and why people use it, details about how addictive it can be, health hazards, withdrawal and getting help……

A Couple of Pieces of Information Caught my Attention……

First:  Health Hazards – This is verbatim what the leaflet states:

‘Frequent injecting [of Heroin] can lead to a variety of problems; such as Thrombosis and blocked veins.  If you share or borrow injecting equipment (including needles, syringes and spoons), you run the risk of becoming infected with a number of blood borne viruses, such as Hepatitis C or HIV.

It is easy to overdose on Heroin, such as when the drug being used is unusually pure – or when it is being used with other drugs.  Most overdoses occur when the user has been abstinent for some time, and then injected their ‘usual’ dose.  Because it is often mixed with other substances, it is difficult for a user to know how much Heroin they are taking and, therefore, the risk of them overdosing is increased.

The substances mixed into the Heroin can cause health problems themselves, for example; powdered baby milk can thicken in your veins which, in turn, can lead to circulatory problems and even loss of limbs.  Others can cause Heart diseases, blood poisoning and lung disorders.’

Second:  Getting Help – Again, this is verbatim what the leaflet states:

‘If you want to stop you don’t have to do it on your own.  Asking for help from a drug worker is the first positive step you can take.

Addaction’s services are completely free and confidential.  We can help you find substitute medication (such as Methadone or Subutex) and work with you in managing your withdrawal.  Many of our services also have needle exchanges where you can get sterile injecting equipment, and return used equipment.’

Health Hazards……

There is nothing within the information offered which is untrue.  However, they highlight the very issues which an alternative approach to treatment could greatly reduce harm and the very same issues which have been addresses in the numerous consultations undertaken by Professor David Nutt, the former chairman of the Government’s Advisory Council on the Misuse of Drugs, and Professor John Strang the head of the National Treatment Agency at Kings College, London.  Both have advocated the use of Dia-Morphine in the treatment of Heroin addiction and which have been demonstrated to be more effective for compliance, negating the dangers highlighted in Addaction’s literature……

Getting Help……

There is nothing inherently incorrect in the ‘Getting Help’ section.  The services are indeed free and confidential to a point.  With regard to confidentiality, service users are asked to complete a Treatment Outcomes Profile sheet.  In my experience, anecdotally, service users are not aware of the purpose of this form.  It asks a variety of questions regarding a patient’s mood, the amount they have used and even if they have committed any crimes to fund their usage.  However, this form has no bearing on any future treatment nor is it used to evaluate the current treatment.  It is used to collate statistics by the Government.  If a patient was told with whom this information would be shared, they may reconsider their answers and even their willingness to fill in the form.

Another statement which is somewhat disingenuous is that an alternative medication can be found ‘such as Methadone or Subutex’.  Although there are many different medications which can be used, Methadone and Subutex are the only choices offered, even though the clinical guidelines allow for other substitutes; the same substitutes recommended by Professor Nutt, Professor Strang and cited in many other peer reviewed scientific trials……

The Aims of Drug and Alcohol Services……

The aims of drug and alcohol services are to reduce the harm caused to users and attempt to help them achieve abstinence.  The peer reviewed scientific studies referred to above demonstrate that there are much more effective ways of achieving these goals.  However, as I wrote about in ‘The War on Drugs’, it is the political stonewalling of the advice they contain which is causing the most harm to those involved in the war on drugs……

The War on Drugs……

18 Dec

‘As the subject of tackling substance misuse and addiction has been raised again within the hallowed walls of Westminster, I felt now was a good time to look again at the issues which affect us all as citizens and tax payers’

 

Fighting a Loosing Battle……

 

As a society we are loosing the ‘war on drugs’.  We have been consistently loosing the ‘war on drugs’ since the 1960’s.  The affect on drug users, their families, the criminal justice system, the National Health Service and society in general is measurably damaging.  But, we are not loosing the war due to lack of ‘ammunition’ as it were, rather, the policies and approaches to dealing with the problem, which despite the advice given to government by the professionals specialising in addiction, have remained largely the unchained……Drugs and drug paraphernalia

 

Statistics in Isolation…….

 

The statistical data pertaining to drug misuse and the affects on society as a whole is disjointed and taken in isolation.  The criminal justice system can offer statistics relating to the number of crimes linked to drug use.  The commercial sector can provide figures for theft of goods and increased security costs.  The NHS can provide statistics for the costs of secondary treatment provided as a result of damage to health caused as a result of drug misuse.  What is not available are statistics of the causal effects of how one is linked to any of the others……

 

The Origins of Democracy …..

 

The word democracy is derived from ancient Greek:  ‘Demos’ meaning ‘the people’ and ‘Kratos’ meaning ‘power’.  The literal interpretation of ‘Democracy’ is the power of the people.  In ancient Greece this was seen as the fundamental way in which parliament operated; upon the power of the people……

 

Democracy in Practice……

 

Our democracy is far cry from its original meaning but it shouldn’t be.  The power, or opinions of the people, should still be exercised by governments they elect.  Furthermore, as it would be impossible to canvas the people on all issues of policy, we entrust the ‘will of the people’ to acknowledged experts in their fields and cross party select committees.  One only has to look at the House of Lords which, for all of its shortcomings, have some highly respected specialists chosen to add an unbiased and independent voice to political debates.  For example, Lord Robert Winston was chosen for his intimate knowledge on Embryonic Stem Cell research and reproductive medical issues.

 

There are however, some notable exceptions.  We have recently seen the complete disregard for the recommendations made by Lord Justice Leveson into the future regulation of the press.

 

Another hot potato is that of the recommendations made by those specialist charged advising the Government on substance misuse and addiction.  Professor David Nut is a specialist in Psychiatry, Neuropsychopharmacology and

Professor David Nutt

Professor David Nutt

addiction.  Professor Nutt was the Government’s chief drug advisor until he submitted advice which was not dissimilar to hundreds of other peer reviewed scientific studies into the treatment of substance misuse and addiction, recommending a radical change into the way in which services are delivered.  As Professor Nutt’s recommendations were diametrically opposed to the current legislative framework the Home Secretary asked for his resignation as the chair of the Advisory Council on the Misuse of Drugs.  The Home Secretary then appointed a chairperson who agreed wholeheartedly with current doctrine.  The potential benefits to all of society were stopped in their tracks by ‘democracy’……

 

‘In future blogs I will set out the ‘radical’ proposals put forward by Professor Nutt and site the numerous peer reviewed scientific studies which demonstrate a much more effective approach to dealing with substance misuse issues to the benefit to all parties affected.  Surprisingly, none of these suggestions require and change to legislation and are in fact laid down in the guidelines as the recommended course of action.’

 

 

Drug Treatment Failing Patients……

26 Jul

There exists a large number of patients for whom drug treatment is failing to deliver results, both in terms of achieving abstinence and reducing the harm being caused to the individual and the wider community.  The statistics published by the National Drug Treatment Monitoring System (NDTMS) are not only inherently difficult to understand due to the way in which groups are subdivided but also offer no insight into the damage caused to the individuals within certain groups by the ineffective treatment they receive.  The statistics focus mainly on the numbers of patients engaging with services and those discharged or who leave.  Little, if any, consideration is given and no solution proposed for the group who have been in treatment for extended periods of time or to the damaging effect it is having on them.  The recent reorganisation of services and the different agencies engaged to deliver them will only further complicate the reporting of the results.

 

The NDTMS statistics for 2010 – 2011 show a total of 39,725 patients who have engaged in treatment and been in receipt of prescribed medication for over 4 years.  This represents more than 25% of the total for whom treatment is demonstrably ineffective.

 

How this Failure is Affecting Those Involved…..?

 

The impact on individuals, their families and the community can be wide reaching and devastating for all affected.  The impact on the health of the patients can be irreversible.  Patients may be placed at risk of overdose or contracting Hepatitis C, HIV and other infections from using unsterilised equipment.  They are also at risk from the agents used by unscrupulous dealers to ‘cut’ drugs in order to increase weight and therefore profits.  Users sometimes re-use equipment through lack of access to clean ‘works’.  Many users experience weight loss as a result of having insufficient funds to maintain a healthy diet.  The general ill health of users can result in a suppressed immune system leaving them susceptible to infections.  The social impact of long term drug use can have many consequences for the patient, their families and wider society.  Maintaining stable housing can prove difficult leaving some users homeless, making access to General Practitioners difficult, which invariably leads to further deterioration in mental and physical health.  Criminality often results as users turn to crime to fund their habits and family relationships breakdown making it hard for users to maintain contact with their children.  Overall, the failure of drug and alcohol services to properly address these issues with the tools at their disposal is having a hugely detrimental effect on the physical and mental health of patients, many of who feel despondent, badly let down and in some cases suicidal.  Addiction is a disease and given the right treatment can be successfully addressed.

 

The Failing Model…..

 

The guidelines for the treatment of opiate addiction are clearly set out.  Once a patient is referred to drug and alcohol services an assessment is carried out.  The ‘first-line’ treatment is by using psycho-social intervention, usually delivered by a key worker, with the substitute prescribing of either Methadone or Buprenorphine given at an optimised dosage in an attempt to reach abstinence from the use of illicit drugs.  Statistically, this appears to work in 75% of cases.  However, in the remaining 25% of cases where the patient does not respond a more structured form of psycho-social intervention may be required, especially when co-morbidity is a factor.  Along side this, a clearly defined prescribing regime is set out in the guidelines.  This involves the prescribing of Dia-Morphine under close monitoring of the prescribing doctor.  In practice this does not happen despite the clear failing of prior interventions.  As provisions for this are clearly laid down in the guidelines, one has to ask the question why these are not followed.

 

Evidence Based Medicine……

 

In numerous peer reviewed scientific studies, the prescribing of Dia-Morphine to treatment resistant users, has proven to be between 88-94% effective.  In conclusion to one of the largest studies published in the British Medical Journal (Van Der Brink – Volume 327 – August 2008) sited by 207 doctors, Dr. Van Der Brink states “Supervised co-prescription of heroin is feasible, more effective, and probably as safe as methadone alone in reducing the many physical, mental, and social problems of treatment resistant heroin addicts.”  The RIOTT trials undertaken by Professor Strang at the Institute of Psychiatry produced similar results.

 

Given that evidence proves the effectiveness of prescribing an alternative to Methadone or Buprenorphine and, that the guidelines allow for this course of action, one has to ask why this approach is not being used by the agencies tasked with helping people who have been unable to tackle their problems using the ‘first-line’ interventions.  It appears prima facia that a structural hierarchy does exist, contrary to the principals issued by the NTA and NICE which state that decisions regarding treatment should be taken on an individual basis.  In practice this does not happen as can be demonstrated statistically.

 

The Solution……

 

To mount an effective challenge to the structural hierarchy will take more than one individuals effort.  To do this we will be collecting questionnaires from long term treatment users who have experienced the same treatment and offered nothing other than the status quo.  The defence that the treatment is not offered on the grounds of cost does not stand up in light of the fact that length of the existing treatment can be shown to be more expensive.  As studies have shown the treatment is no more inherently dangerous than current treatment and, proves effective therein negating the mental and social damage being caused by the status quo.

 

We need to compile enough first hand experiences of service users to show the ineffectiveness of the treatments currently being offered and demonstrate the stonewalling of requests for other established treatments.  We will then be able to demonstrate the second rate treatment we receive and the failure of services to follow their own guidelines, through a petition to the European Court of Human Rights if necessary……

So Much for the Specialist……

8 Jul

I have tried in vain to convey the main reason for my Herion addiction to the clinician (Dr. Dickhead – see previous posts) which is anxiety.  I have also tried to explain that, whilst negating the physical redrawals from Dia-Morphine, Methadone is of no benefit in controlling the anxiety.  Still, this has fallen on deaf ears, despite my Key Worker agreeing this is the case.  In the 3 years I have engaged with Drug & Alcohol services, I have screened clear for Dia-Morphine only once &  that was to comply with my ex-employers demands to facilitate my return to work & keep my job.  At no time during the endless mettings with my Doctor & Key Worker have either offered any constructive proposal to deal with the underlying problems or, given any useful advice as to how to move forward.  A pretty poor show seeing as they are supposed to be the trained, experiened & specislist withing their field……

My GP prescribes Diazepam which does control my anxiety.  However, Dr Dickhead has written to my GP to ‘suggest‘ that he reduces my presciption for Diazepam & Mirtazapine.  At the same time trying to increase the Methadone prescription by 25%.  The reason for this is not entirely clear, although it would appear it is intentded to curtail my use of Dia-Morphine.  History dictates that this will not work as is has done on numerous occasions.  If one where to look at it from a cinical angle, if the final statistics show an overall drop in prescribed medication will appear as if they are making progress, which I can assure you they are not……

My proposal to change my presription to Dia-Morphine, which is within the remit of  Dr Dickhead & indeed advocated as part of the process of dealing with long term addiction &  yeilds published, well documented results in terms of the phsco-social benefits & in doing so limits the financial and social degridation caused by my need to continue using Herion.

I do not feel as if any detailed assesment of my mental and physical health has been undertaken and that no solution has been found.  They simply stumble along with the status quo happy in the knowledge that, as the statistics show, there is an ever increasing ‘need’ for Drug & Alcohol Services and with it comes their job security……

I have looked at the European Convention on Equality & Human Rights Act 1998 and feel that the service is in breach of several sections.  Namely, a patients right to ‘dignity in treatment’, the patients right to be ‘involved in the decision making process’ and the patients right to given ‘all’ available data pertaining to their treatment.  It is my intention to mount a challenge to the decision making process in the courts, once I have found out the best way to acheive this……

Meanwhile, the ongoing sustitute prescribing & substitute precribing alone continues.  This runs contrary to the the second of the ‘Eight Key Principals’ laid down in the guidelines which states; “Subbstitue prescribing does NOT constitue treatment without Pysco-Social interventions along side ‘……

And on we go……

Let Down by the NHS……

19 Jun

You’re probably bored of hearing about it by now but I’m at crisis point.

I was first referred to Drug & Alcohol services about 17 years ago.  Since then I’ve had the same repetitive cycle of ‘treatment’.  This has basically consisted of substitute medication and that’s about it.

The very first principal stated in their own guidelines says substitute prescribing does not constitute treatment on its own and that that Psycho-social interventions are crucial in tackling ongoing drug dependency.

Well here we are 17 years later and my life has been reduced to a pitiful existence of misery, loneliness, depression and thoughts of suicide because I am not able to control my addiction.  This has had profound implications for me and those people I cherish the most.  I’m not surprised that they’ve had enough of me; given the same set of circumstances I’d have had enough of me too.

I am now so desperate that the option of ending my own life is ever present and very real.

I’m not looking for sympathy and I know it may be a case of ‘you’ve made your own bed’.  This does not however excuse the pathetic treatment I have received at the hands of the ‘specialists’.  As with everything in life it comes down to the size of your wallet.  If I had the means I’d take them to court to prove their inadequacies I probably wouldn’t have to as I could have afforded the proper care needed to deal with my issues.

I’m blurting out these regular updates so that when I can’t take it any more, there’ll be a record of how I felt, how I was treated and what wasn’t done to help.

Consider it to be a kind of 21st century suicide note.

Spare me the final indignity of sycophantic bullshit of ‘what a nice bloke he was’ at my funeral.  I don’t want anyone there.  Just burn me and forget me because that’s what happened while I was still here……