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WORKING IT OUT
10 |
drinkanddrugsnews
| March 2013
Be the change |
Service user conference 2013
www.drinkanddrugsnews.com
DOCTOR’S ORDERS
The right to treatment
workshop heard fromGPs and service users on
how to make sure you get the best and most appropriate treatment
‘GPs will tell you what you need when it’s you who knows what you need,’ stated one
delegate in the morning’s
The right to treatment
workshop. ‘I realise that ten-minute
space means a lot of pressure, but it also means that sometimes GPs will not get the
whole story.’
GPs could either be ‘helpers or fascist pigs’ said workshop chair Dr Chris Ford.
‘We’re like the rest of society. We’ve done a lot of education over the last 20 years, but
there’s still an enormous amount to do.’
Delegates stressed the importance of getting the right – rather than ‘one size fits
all’ – treatment, to which she replied that it was always ‘the person’ who should be
deciding their treatment. ‘It’s about treating people as a person, rather than a drug.’
‘It’s about having a dialogue, deciding on the best course of action, and going along
with that,’ commented one delegate. ‘When I first went into treatment I thought I was
involved in the decision-making, but it became apparent that I wasn’t as involved as I
should have been,’ stated another. ‘Recovery has been pegged as a destination rather
than a journey.’
Much of the terminology in treatment could also be derogatory, added Ford. ‘You’re
defining people by one small part of their personality – why should they be defined by
one element of themselves?’ SMMGP clinical lead Steve Brinksman, however, stressed
that ‘when I say to people, “you’re hypertensive” or “you’re diabetic”, it’s shorthand. So
if I say, “you’re a drug user”, sometimes there’s a difference between language being
used judgementally and to define a particular meaning. In medicine it can sometimes
get really complicated.’
‘As a nurse I worked with someone who had a glioma, but because he’s a drug user
the GP said all his symptoms were down to that,’ said one participant. ‘You may be a
drug user, but you’ve got a body as well.’ Time pressures could be a problem here,
stressed another – ‘you only get about five minutes – you’re allowed one problem at a
time’, while a third stated that there could sometimes be an attitude of ‘you’ve
brought it on yourself’.
The situation had undoubtedly improved, however, said Francis Cook of the
National User Network (NUN). ‘Things have changed, and we’ve come a long way –
particularly in A&E. You now how have A&Es linked up to recovery communities. In the
’80s there was no universal drug treatment of any kind.’
Many medical professionals still had an aversion to being challenged, however.
‘Two weeks ago I saw my addiction psychiatrist,’ a delegate commented. ‘I went along
armed with some information and was called a “cocky addict”.’
There was a ‘massive need for retraining’, both for consultants and drug workers,
said another participant. ‘I pick up my methadone every two weeks and I’m supposed
to see my doctor every two weeks,’ stated a third. ‘But I haven’t seen him in four
months – my script is just left there for me to pick up.’
‘At the moment it seems to be about getting people out of services, and making
services as unfriendly and untenable as possible,’ said Alliance CEO Ken Stringer. ‘It all
comes down to a fundamental right to respect and empowering people to have that
dialogue with a doctor about their own needs, rather than box-ticking.’ The rationale
of some commissioners was to get people out of treatment, he continued. ‘They say
it’s the national strategy – it isn’t. Because, really, there is no national strategy.’
One delegate however commented that she had been given ‘no encouragement
whatsoever’ to come off methadone. ‘I had to do that myself,’ she said. ‘If you want to
come off methadone you should be supported, but to coerce and force people off is
wrong,’ replied Stringer. ‘But we also work with people who want to be drug-free, and
their provider won’t let them have that.’
‘You should be able to choose to come off it 65 times if you want to,’ said Ford. ‘It
should be all about choice. Recovery is becoming synonymous with abstinence, and that’s
dangerous.’ A good idea might be stop using the word ‘treatment’ when it came to
methadone, suggested one delegate. ‘We should use the word “tool”. It’s only a tiny part.’
It was important to ‘work together to stop people demonising life-saving medications,
when it’s really about ineffective treatment,’ added ex-Alliance CEO Daren Garratt.
Service user involvement had brought about great change, said Cook. ‘But the
focus is starting to go off that, I think, as is the money. It’s getting harder.’ Service users
needed to strive to make sure their voices were heard in the localism agenda,
including citing the NICE guidelines, he stressed. ‘Groups are critical to the whole
Four lively workshops saw delegates debate healthcare, user groups, media
and enterprise. Additional photography by Kerry Stewart