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MEDIA SAVVY
WHO’S BEEN SAYINGWHAT..?
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October 2012 |
drinkanddrugsnews
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There are many things I love about being a GP
but
above all I value the long-term relationships I have
with my patients. The other night while doing a
routine surgery session, I recognised the name of a
man on my list who was booked in to have a
minor cyst removed.
Dave and his partner Sarah had been using
heroin for a number of years when they first
joined our practice a while ago now, because they
had heard we treated substance misuse in primary
care. In fact at the time they joined us we had the
slightly bizarre situation that the practice was only
accepting new patients if they used heroin!
They engaged well in treatment and both managed to stop using heroin on
top of their script, and that was as far as it went for a couple of years. They had
a daughter who was about eight at the time when Dave and Sarah came in to
see me together one day. They had decided that they wanted to be not only
heroin free but also off prescribed opiates. We discussed the various options
and it was obvious that they felt a residential rehab programme incorporating a
detoxification was the right way forward. Sarah’s mother lived locally and
would provide childcare, so through our primary care based key worker all the
paperwork was done and a place was arranged for them.
They had a date to go in and all was in place, scripts cancelled, no further
appointments with the drug worker or me till they returned. Two weeks later
Sarah came in for an emergency appointment. She had been unable to cope
with being apart from her daughter and had discharged herself, although
Dave had decided to stay. She was still determined to become opiate free but
had realised that what she thought was the right option to pursue this goal
would not work for her. We restarted her methadone prescription and devised
a slow reduction programme. She found this worked for her and was proud of
her ability to cope with both caring for her daughter and reducing her
prescribed medication.
Dave found the support offered by the rehab facility invaluable and stayed
for the full six months. By the time he returned Sarah was on 8mls of
methadone daily and a month later she had stopped all prescribed opiates.
The family remain patients on our list and Dave and Sarah remain drug free.
Dave has been promoted at work and their daughter does her GCSEs this year.
For me the joy of treating people in primary care is that not only could we find
an option that suited each of them, but also unless patients move away, I will
in all probability see them again.
Recovery happens in primary care, sometimes with patients who stay with
us, sometimes with those who go away to other treatment systems. We should
be proud of these patients – as I am of Dave and Sarah – and yet accept each
person is different.
We’re equally as proud of the progress that Dave’s brother, who remains on
a methadone prescription, has made. Rehab didn’t work for him and he felt
safer with a longer term prescription. I haven’t given up on regularly discussing
options for change with him, but he doesn’t feel ready yet; that is his decision
to make, not mine. If he decides it’s time for a change again, I and the rest of
the practice will help him, but till then we will keep him as safe as we can.
Steve Brinksman is a GP in Birmingham and clinical lead of SMMGP.
www.smmgp.org.uk. He is also the RCGP regional lead in substance misuse for
the West Midlands.
Post-its from Practice
The three Rs
It’s all about the right treatment, at the right
place, and the right time, says
Dr Steve Brinksman
As for Jeremy Hunt’s promotion to Health Secretary, all you can really dowith
that bombshell is borrow from the late Sidney Vicious, and indeed the even
later Eddie Cochran, and mutter an awed, ‘Wow. That’s somethin’ else.’
Matthew Norman,
Independent
, 5 September
As Jeremy Hunt has not proved to be a particularly adept minister, and such
plaudits as he might try to claim have been overshadowed by the BSkyB
fiasco, the question is why he should be put in charge of a huge and
unfamiliar department. There he will have to push though complex and
controversial reforms introduced by his predecessor Andrew Lansley, who,
whatever his shortcomings, had at least studied the NHS for seven years. It’s
all mystifying…Nominister in recent times has behaved so badly in office and
survived, and I am including in that judgment several New Labour scoundrels.
Stephen Glover,
Daily Mail
, 5 September
Drug addicts are selling NHS methadone to buy the heroin it’s meant to
wean them off. Hundreds have died taking methadone sold by addicts in
a taxpayer-funded cycle of misery. Victims include angel-faced Danielle
Scott, 17, who was fed the heroin substitute by a dealer who got gallons
of it on prescription.
Daily Record
news story, 4 September
Successive governments knew that when they poked at the nasty little
methadone problem, the stench would be overwhelming. This is a story of
short-termism, apathy and concealing the truth of what has been a
strategic blunder. In every war there are profiteers, and the war against
addiction is no different. Chemists, doctors and drug companies got fat as
the addicts got skinny.
Annie Brown,
Daily Record
, 7 September
Breaking the link between benefits and living standards would be no less
than breaking the link with decency. In hard times the values of a civilised
society must ensure the most vulnerable families are protected.
Alison Garnham,
Guardian
, 18 September
Prohibition is a relatively recent social experiment, an extremely
dangerous failure, and should be dismantled as soon as possible.
Howard Marks,
Guardian
, 1 September
The 40-year publicity campaign for dope, provided gratis by dozens of rock
stars (who can flourish however stupid they are), has been so effective that
13-year-olds who smoke it do not even think it is a drug. And untold
numbers of criminal parasites make a tidy living by running chains of
hydroponic cannabis farms in the attics of suburban houses. In fact, it is
one of Britain’s few agricultural success stories of modern times.
Peter Hitchens,
Mail on Sunday
, 2 September
Music festival casualties rub cheek by jowl with middle class girls who have
ditched their smart clothing and opted for car boot sale chic in order to
catch the eye of edgy musicians. These girls who will have friends, fathers,
brothers – boyfriends even – in the armed forces and so inevitably will be
or have already served in Afghanistan declare themselves ‘starstruck’ by
these heroin addict music ‘stars’. Heroin addiction helps fund the Taliban.
It helps fund people who kill and maim our troops.
Annabelle Fuller,
Daily Mail
, 11 September