Drink and Drugs News DDN April 2020 (1) | Page 10

LETTERS AND COMMENT ‘I feel too scared to talk about where I get my treatment or with whom because although it is crap, it is all that’s available in my area.’ BEING HUMAN I agree completely with Dr Chris Ford (DDN, Dec/Jan, page 24) that ‘harm reduction is not just a list of practical strategies like NSP and DCRs, essential as they are, but it is a set of principles and a movement for social justice’. I have been in treatment on and off for about 15 years. In the early days I was treated well and felt cared for. But for the last eight years or so, this has been completely eroded. I now feel like a bad person and nobody listens to me. The workers think they know best for me and I have almost no input into MY treatment. It’s completely demoralising and I don’t know how I can continue. I feel too scared to talk about where I get my treatment or with whom because although it is crap, it is all that’s available in my area and I can’t manage without methadone. In the last five years I have had nearly a dozen key workers, most as bad as the last one, but no chance of ever forming a relationship. Most think I should come off methadone and have no idea of the evidence around OST and certainly don’t like me telling them of it. I was threatened with enforced detox last year for being aggressive after I explained the evidence! Also, in the past years the drug service has been run by three different charities, all seemingly with different ways of working, so there is no chance of getting to know how they work. I don’t know how to manage in this environment. My asks are not great: A note from the frontline Marcus Wolf sends a plea from the pharmacy queue T he current international health crisis is enough to worry even those with the most stable of existences. Please, imagine the worry for those reliant on substitute prescribing where all face-to-face contact has stopped and we are now hoping that our scripts will be where they are supposed to be when they are meant to be there. The indication from many services, including mine, is that everyone will be on a fortnightly pick-up to minimise the contact with others – for a traditionally health-vulnerable group and to help support our currently understaffed and overwhelmed 10 • DRINK AND DRUGS NEWS • APRIL 2020 pharmacists. But this doesn’t seem to be working in practice. I’m on a buprenorphine script and so is my partner. We are fortunate to have worked our way up to the ‘stable’ end of the spectrum, yet I am still collecting three times per week and my partner is collecting weekly. We have spent over three hours waiting outside the pharmacy over the past two days surrounded by anxious, worried and angry people awaiting similar scripts, as well as vulnerable older people trying to collect their regular medication and ill people seeking advice. My wife had a telephone appointment on Monday with the drug service. Great… on time for once and went well, other than being told that her script may not be at the chemist, as despite being hand delivered a whole batch had gone missing after being given to a locum pharmacist. She said, ‘fine, I’ll call and see if it’s there’ and was told, ‘oh, no, don’t do that, they’re too busy for phone calls, just go in tomorrow, then come to us if it’s not there.’ I’d missed my Monday pick-up at the pharmacy, which is the ‘go-to chemist’ for all supervised scripts and anything coming out of the nearby drug service. Unfortunately we had decided to go later to ease the burden; they had closed at 6pm instead of 11pm without any warning and notice, so Tuesday it is for both of us. We wait in a huge 1. Treat me like a human being with the same care and compassion as anyone else. 2. Don’t judge me because I use drugs and allow me to decide on my treatment. Thank you. Name and address supplied CASE FOR COMPASSION Chris Ford argues that we need to ‘regain our care and compassion’. Of course, Chris is completely correct because that is the right thing we should do as care and health practitioners. However, there is evidence to suggest that a compassionate approach – what has also been called ‘intelligent kindness’ – can itself improve patient outcomes, and this is surely another sound reason for being kind. In a randomised controlled trial of ‘compassionate care’ for the homeless in an emergency department back in 1995, frequent attenders received either ‘usual care’ or a compassionate care ‘package’. The outcomes included fewer queue that snakes down a narrow path on a busy part of the highroad. We are there nearly an hour and a half. The general public are having to walk on the road to get round us all, a mix of people waiting for controlled drug scripts and general pick-ups. We go in, as a household, and my wife’s script isn’t there. We go to the drug service, get sent back after another 45 minutes, they have the script, but they don’t have the medication for her. I get mine and we are told come back tomorrow. Tomorrow is now today, and after asking the best time to come we return at 5pm. We err on the side of caution and head there for 4pm expecting the queue to be shorter. We are stood at the same bag of rubbish and then pass the same scattered clinical waste as the day before. An hour on we are getting closer to the door. During that hour we encounter shouters, criers, the vulnerable and the anxious. As we get closer to closing time the WWW.DRINKANDDRUGSNEWS.COM