September 2015 |
drinkanddrugsnews
| 13
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I WAS RECENTLY DISCUSSING
the increase in
use of prescription opioids in the UK and
the US with Alex, an American doctor, who
specialises in pain treatment, and was
shocked to learn of the negative
consequences of Drug Enforcement
Administration (DEA) restrictions.
He told me about his patient John, who
had returned from Iraq in 2013 in ‘a very bad
way. He had lost both legs and part of his left
hand, as well as having internal injuries and
severe depression. John was very determined
and progressed well in rehab, became mobile
and his mood began to lift. But the thing that
didn’t really improve was his pain – until we
hit on hydrocodone. With his pain under
control, John was able to continue his
rehabilitation, start a part-time job and even
began to play football.’
Then Alex told me the regulations
around hydrocodone had changed – and so
did John’s life. He had regulated his own
intake, but always within the parameters of
the prescription. His pharmacist was now
nervous of the new regulations and wanted
John to go to another pharmacy. This
unsettled John and he again became
suicidal.
Alex explained that it is now much
harder for him to prescribe opioids, leading
to a dramatic reduction in his ability to
provide appropriate care for patients in
pain. Add to this the increasing restrictions
on pharmacies in certain states – in some
areas DEA agents have visited pharmacies
to review the quantity of opioids being
dispensed.
The DEA say they are ‘simply enforcing
the law, taking bad people off the street
and, essentially, trying to interrupt the
supply of illegal prescriptions,’ but take no
responsibility for the effect on people who
need these medications.
So what’s happening in the UK?
Prescription opioid dependence is a growing
problem here and best-practice management
is not well defined. In 2013, 757 people died
with a prescription opioid in their blood
stream, almost the same number as for
heroin and illicit morphine (765) and more
than for methadone (429). It is critical that
we understand this problem and avoid
falling into the trap that the US has set for
the people caught up in this situation.
Dr Chris Ford is clinical director of IDHDP,
. Full version at
Dr Chris Ford
finds that in the US, new restrictions have had negative
consequences for patients in pain
Too scared to prescribe
‘It is critical
that we
understand
this
problem
and avoid
falling into
the trap
that the US
has set...’
from our foreign correspondent
I HAVE BEEN
EMPLOYED
in the
substance misuse
field for many years
and I have always
been struck by how
often bereavement
has been the
precursor to a
period of active
addiction to drugs
or alcohol. Two
years ago, I was propelled into the nightmare
world of bereavement and was given insight
into how personal loss and society’s reaction
to such loss leaves an individual so vulnerable.
I have never had a family to speak of and
for 20 years, I lived with my soulmate Michael.
On 9 March 2013, I returned from work in the
evening and found him unconscious on the
sitting room floor. By 10 o’clock that night he
was dead.
In an instant my life had changed
completely and I had been tossed into a world
of complete isolation. It felt as if the world
was embarrassed by my grief and turned its
back on me.
When I eventually returned to work,
emotionally drained, I was stung by most
people’s reactions. It was clear that most of my
colleagues wanted not only to ignore Michael’s
death, but to wish away his very existence.
We must ask ourselves why we have
reached such a state in society where we are
unable to engage in each other’s pain and
provide comfort to those in distress. If we
cannot address this, then many others will
mistakenly seek comfort in the oblivion of
drugs or alcohol.
Michael’s death and people’s reaction to it
have changed me. For the first time in my life
outside of work, I am quite reclusive. I worry
that I am a nuisance to other people.
There are signs of hope. I am impressed
by how so many people in the recovery
community are committed to creating
meaningful communities where we engage
with each other in a supportive and
nurturing way.
In the meantime, I take some comfort in
the fact that I have not succumbed to
addiction and hope that I can be more
effective in supporting others for whom
profound loss has been the cause of their drug
or alcohol issues.
John Rossington is manager at Big Life
Pathways Drug and Alcohol Service
Cause
and
effeCt
Last issue, we reported on a set of guidelines about supporting those bereaved through drug and alcohol
related death.
John Rossington
looks at how a personal loss can in turn lead to addiction
Personal
loss and
society’s
reaction to
such loss
leaves an
individual
vulnerable.
first person
