Drink and Drugs News DDN September 2019 | Page 13

/DDNMagazine @DDNMagazine www.drinkanddrugsnews.com Have your say on issues that count: www.drinkanddrugsnews.com CliniCal eye MEDIA SAVVY The news, and the skews, in the national media Crumbling under pressure What are we doing to support nurses’ health, asks Ishbel Straker IT WAS WITH GREAT SADNESS THAT THE KEYS TO CITY ROADS DETOX UNIT WERE HUNG UP FOR THE FINAL TIME EARLIER THIS YEAR – a service with a legacy of over 40 years of supporting drug and alcohol users to reach their goals. A staff team of exceptionally passionate people who genuinely had a heart for their clients and who steered them towards success at every opportunity, a team who had embraced changes where others may have crumbled under the pressure of ‘this is how it has always been done’ and did everything in their power to uplift this service in the face of political adversity. I was interested to see in the August issue of the Nursing Standard an article discussing the NHS England data of almost 7,000 full-time equivalent days sick leave because of drug and alcohol issues. The majority of these issues were related to alcohol, with staff using it as a coping mechanism to manage stress and anxiety. The solution wasn’t clear, other than staff needing more support in some form. This data was between Oct 2017 and Nov 2018 and I have neither seen nor heard a whisper of a measurable response. I have watched staff crumble under pressure throughout my career and it is never a surprise when a substance is brought into the mix. I have seen colleagues become mentally unwell and I have attended funerals of those who have committed suicide, yet the approach seems to never change and surprise is a first response. With the closure of City Roads and one less place in the country to support such people, I find myself trepidatious about what NHS England may have up their sleeve and would like those reading this from varying organisations to consider how they support their staff – not just with treatment, but to have the confidence to come forward. Ishbel Straker is a clinical director, registered mental health nurse, independent nurse prescriber and board member of IntNSA Letter StrIKIngABALAnCe Steve Rolles makes some valid points in his response to my letter (DDN, July/August, page 12), and I’m encouraged by the fact that he says many issues around legal regulation are tricky, that challenges exist, balances need to be struck, and that there’s ‘no perfect answer’. I’ve always been in favour of decriminalisation, and I’m open to hearing a well-argued case for legalisation and regulation as well. What antagonises me is the unquestioning certainty of much that’s written on this subject by many media commentators – ‘war on drugs’ bad, legalisation good – as if it were some magic bullet that would miraculously end www.drinkanddrugsnews.com all drug harms and put the world’s organised crime groups out of business overnight. So it’s nice to hear something a bit more nuanced (and it goes without saying that Transform know considerably more about this subject than your average columnist). He’s also right to say that mephedrone’s popularity had a lot to do with MDMA shortages, although evidence does suggest that a significant proportion of its users were people who hadn’t really taken many drugs before and did so because it was legal. One of my points he doesn’t address, though, is the question of the US – a massive increase in legal opioid prescribing, coupled with a massive increase in opioid-related deaths. Molly Cochrane, by email ‘The uncomfortable truth might be that we, the electorate, are responsible.’ THE INCREASE IN DRUG-RELATED DEATHS hasn’t suddenly happened, deaths have been rising significantly for years. There has been ample opportunity to think about how to reverse this horrendous trend. And unusually, we know how to do it. The evidence has been collected and made available to ministers… So if it’s not a lack of evidence, something else must be holding back politicians from tackling the rise in drug-related mortality. It’s seductively simple to point out the failings of politicians on this issue. But they instinctively follow public opinion rather than shape it. So the uncomfortable truth might be that we, the electorate, are responsible. Ian Hamilton, Independent , 15 August FEW EXPERTS consider that criminalising vulnerable and marginalised people who inject drugs is an appropriate response. The UK government should stop politicking about being ‘tough on drugs’ and act urgently to stop the harm to which its policy contributes. Decriminalisation of personal drug use allows interventions such as safer injecting rooms and drug testing where appropriate. It also enables gathering of evidence. What is already clear is that moralising about perceived intrinsic wrongs in taking drugs and blaming or punishing patients for having drug use disorders are not effective or ethical ways to reduce harm. Richard Hurley, BMJ , 8 August MOST ADDICTION SERVICES are not properly connected to wider health and care teams, so people are bounced between addiction and mental health services or fall between the gaps in both. It’s not uncommon for a patient to be excluded from mental health services due to having drug or alcohol use disorder but not be able to access addiction services because they have an untreated mental illness. This represents a lost opportunity to improve outcomes for patients, reduce the harm to individuals and their families, as well as a staggering waste of limited resources. Julia Sinclair, BMJ , 23 August AS THE SICKLY-SWEET STENCH OF MARIJUANA spreads ever further across the once-civilised Western world, there is one universal result. There are more crazy people. Some of them are dangerous. Many of them are crazy because they have fried their brains with skunk. Some are crazier still because baffled doctors have added to the cocktail with various poorly understood prescription drugs. But the chances that you will meet such a person grow daily, as our leaders refuse to enforce the laws against marijuana possession. They will grow still more if they are stupid enough to bow to the billionaire campaign to legalise this poison. Peter Hitchens, Mail on Sunday , 11 August September 2019 | drinkanddrugsnews | 13