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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
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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