The National Centre in HIV Social Research (NCHSR) undertook a study project. One aspect was to show that consumer (drug user) participation in the outcomes of their pharmacotherapy (methadone) treatment program lead to a higher positive result in what they wanted to achieve from the program. The study findings provide clear evidence to support the importance of consumer (patient) participation in drug treatment and show how drug users' experiences in treatment can be positively influenced if they are given the opportunity to be actively engaged and involved in that treatment.
Despite recognition of the benefits of involving consumers in their own treatment, there is limited research on consumer (chronic pain sufferers) participation in drug treatment both in Australia and internationally. While there has been significant inclusion of consumer participation activities in mental health and disability services, there has been little formal support for drug users to participate in their own drug treatment. There are studies that suggest participation by consumers had outcomes such as a better sense of empowerment, better mental and physical health, fewer legal or criminal justice issues, longer stays in treatment to achieve success and reduced heroin and other drug use.
Methadone Treatment Has Not Evolved
This being the case with showing what can be achieved just by consumer participation in a drug treatment program, why is there only one fax machine dedicated to receiving the four-page, over 20-year old application form for pharmacotherapy? The government spent hundreds of thousands of dollars on attempting to produce an online e-form which apparently does not ask the prescriber (doctor) to fill in pages of unnecessary information (which doesn't see the light of day or is collated); however, to date there is no result for all that money spent.
Regional areas are totally neglected with hardly any and/or no services or prescribers (doctors). There are reports of people travelling every day on the train to come to Sydney from regional areas to pick up their methadone treatment as they have been on waiting lists in their areas for years. Being Aboriginal, suffering HIV or having a serious mental illness seem to be only criteria that will fast track you into a public treatment program otherwise you go onto a waiting list if they still have one.
This combination of a lack of prescribers (doctors) and treatment places has resulted in a huge increase in self medication with Oxycontin (oxycodone) or MS Contin. Now drug users are turning into doctor shoppers and judging by the $40 million spent on Oxycontin in subsidies over the last 12 months, there is a thriving trade with this chronic pain medication. Furthermore, a "point" (0.1 gram) of heroin costs $50 on the streets as opposed to an 80mg Oxycontin tablet which costs $30.
Injecting Room Surprise
Data from the Medically Supervised Injection Centre (MSIC) indicates that 80mg Oxycontin is the number one drug injected at the Centre in Sydney's Kings Cross. Infections at the site of the injection or blood stream infections are common as cold water filtering of the tablet filler that separates from the oxycodone is risky and dangerous. A specialist in addiction medicine, Dr. Raymond Seidler comments that he sees very little willingness to make the system work efficiently and successfully for a marginalized and disadvantaged community of drug injecting users not to mention the consumers who require pharmacotherapy for chronic pain. He also comments that his general practice (GP) colleagues would rather treat anything else than engage with drug users as they are concerned with the legal ramifications of prescribing opioid replacement therapy.
Methadone is also a very effective pain killer for people who suffer serious chronic pain yet are treated like criminals with enforced case management and regular drug urine screens. There is no distinction between those who are being treated for drugs or those who take methadone/buprenorphine for chronic pain. The stigma associated with methadone often means that it is dismissed as a treatment by the consumer (chronic pain sufferer) regarding alternatives for pain due to the negative reputation as perceived by the general public of drug treatment programs.
Again there is a shortfall between demand and supply, due to the fact that if a drug addict on a treatment program finds themselves incarcerated, several days in serious and dangerous withdrawal is normal despite evidence that methadone or buprenorphine replacement whilst in jail means that prisoners are less likely to reoffend.
These studies provide evidence of cost and crime reduction as some of the benefits of pharmacotherapy treatment yet policy has not changed for over 20 years.
Author John Muroto
Despite recognition of the benefits of involving consumers in their own treatment, there is limited research on consumer (chronic pain sufferers) participation in drug treatment both in Australia and internationally. While there has been significant inclusion of consumer participation activities in mental health and disability services, there has been little formal support for drug users to participate in their own drug treatment. There are studies that suggest participation by consumers had outcomes such as a better sense of empowerment, better mental and physical health, fewer legal or criminal justice issues, longer stays in treatment to achieve success and reduced heroin and other drug use.
Methadone Treatment Has Not Evolved
This being the case with showing what can be achieved just by consumer participation in a drug treatment program, why is there only one fax machine dedicated to receiving the four-page, over 20-year old application form for pharmacotherapy? The government spent hundreds of thousands of dollars on attempting to produce an online e-form which apparently does not ask the prescriber (doctor) to fill in pages of unnecessary information (which doesn't see the light of day or is collated); however, to date there is no result for all that money spent.
Regional areas are totally neglected with hardly any and/or no services or prescribers (doctors). There are reports of people travelling every day on the train to come to Sydney from regional areas to pick up their methadone treatment as they have been on waiting lists in their areas for years. Being Aboriginal, suffering HIV or having a serious mental illness seem to be only criteria that will fast track you into a public treatment program otherwise you go onto a waiting list if they still have one.
This combination of a lack of prescribers (doctors) and treatment places has resulted in a huge increase in self medication with Oxycontin (oxycodone) or MS Contin. Now drug users are turning into doctor shoppers and judging by the $40 million spent on Oxycontin in subsidies over the last 12 months, there is a thriving trade with this chronic pain medication. Furthermore, a "point" (0.1 gram) of heroin costs $50 on the streets as opposed to an 80mg Oxycontin tablet which costs $30.
Injecting Room Surprise
Data from the Medically Supervised Injection Centre (MSIC) indicates that 80mg Oxycontin is the number one drug injected at the Centre in Sydney's Kings Cross. Infections at the site of the injection or blood stream infections are common as cold water filtering of the tablet filler that separates from the oxycodone is risky and dangerous. A specialist in addiction medicine, Dr. Raymond Seidler comments that he sees very little willingness to make the system work efficiently and successfully for a marginalized and disadvantaged community of drug injecting users not to mention the consumers who require pharmacotherapy for chronic pain. He also comments that his general practice (GP) colleagues would rather treat anything else than engage with drug users as they are concerned with the legal ramifications of prescribing opioid replacement therapy.
Methadone is also a very effective pain killer for people who suffer serious chronic pain yet are treated like criminals with enforced case management and regular drug urine screens. There is no distinction between those who are being treated for drugs or those who take methadone/buprenorphine for chronic pain. The stigma associated with methadone often means that it is dismissed as a treatment by the consumer (chronic pain sufferer) regarding alternatives for pain due to the negative reputation as perceived by the general public of drug treatment programs.
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Again there is a shortfall between demand and supply, due to the fact that if a drug addict on a treatment program finds themselves incarcerated, several days in serious and dangerous withdrawal is normal despite evidence that methadone or buprenorphine replacement whilst in jail means that prisoners are less likely to reoffend.
These studies provide evidence of cost and crime reduction as some of the benefits of pharmacotherapy treatment yet policy has not changed for over 20 years.
Author John Muroto
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