Drugs in Shetland

[Graeme_Storey]

May I please ask for restraint among some of the comments being made?

 

Every one of us is an individual, and every one of us needs drugs at times to help with medical conditions. We should not so quickly judge others.

 

The strength, type and method of taking these drugs is varied according to needs and circumstances and no two people are exactly the same in the way they react, or the way the drugs affect them.

 

Rather than be negative about the drugs issues raised, very openly I may add, by some of our contributors, I would like us to be very positive that there are folk among us - on this forum - who have fought the demons and have made a huge effort to rid themselves of the problems drugs have brought to their lives.

 

These people deserve our praise, help and support, not aggravation that they are still on some substance or other (illegal or not).

 

Also, we need to look at how society (that is all of us collectively) can help prevent such terrible problems being such a curse on other folk too.

 

I have never used illegal substances, but I have had to struggle to deal with legal medications for my chronic asthma over a period of more than 50 years - and it is NOT easy when drugs HAVE to be part of your life.

 

I choose to not be anonymous on this forum, but to those of you who are then please do not use your secret identity to 'have a go' at folk who are trying their best in extremely difficult circumstances.

 

Rant over.

 

Peace, and good health everyone.

[OP8S]

you said in an earlier post that you were on 5mg. its stronger than morphine

the british national formulary is a very good source for the med levels.

 

The pupose of replacing street drugs with methadone is to stablise the user so that they can come off drugs gradually.

 

Why if you had been clean for 6 months would the doctor then give you the drug again. You were physically clear of the drug and I can't believe he would restart you on it. Did you not get any counciling in those 6 months.

I believe it was SP who remarked that he knew someone who's daily dose was 5mg of methadone. I posted afterwards ( if my drug-addled brain can remember ) saying that the last 5mg of a reduction were the hardest physically & psychologically on all users aiming for recovery. Simply because you're reducing your dose by 20% each 1mg you reduce. Most Consultants agree that between 10-12% should be the maximum at any one time. So it is by far the hardest part of anyones reduction.

As for the 6 months I abstained from taking my medication by doing it myself I had at least two months supply kept that had been legally prescribed & as I hadn't been using in a chaotic manner while on the drug previously my GP didn't see any problem in prescribing it again.

Also I don't want to nit-pick but 5mg of morphine sulphate is far weaker than 5mg of methadone. The way our bodies metabolise them is very different to. You can look up conversion tables on the net but they vary quite a lot.

[shetlandpeat]

The research cements the critical role of the mu opioid system, in which naturally produced chemicals called endogenous opioids, or endorphins, match up with receptors on the surface of brain cells and reduce or block the spread of pain messages from the body through the brain.

 

http://www.opioids.com/painkiller/index.html

 

I know it is old but still valid.

 

Good post Graeme.

 

You are right about folk hiding their identities. It would be nice even for folk to know where they are in the world.

The aggressive nature of some of the posts I hope are not a reflection on the whole of society.

 

As I said, if taking a small amount stops any further downward spiral and lets the taker and their family live a better life, why are you still having a go?

For what is the purpose of your post?

Not very progressive.

 

It is the attitude of these folk that inhibits folk from getting help.

[unlinkedstudent]

^ & ^^ I hope you both aren't insinuating I'm having a go - I've tried to be fair and just. That said, whilst I have a degree of sympathy, I have voiced my opinion (in general) and I don't believe staying on a drug which prime aim is to get the addict totally free (and by that, I mean including methadone) is the right thing to do.

 

I've posted two links - one stating the benefits of being on methadone, the other saying otherwise.

 

Personally, I would rather be outspoken than be a member of "Wrap everyone up in cotton wool brigade" because I try not to be hypocritical, and I fail to see how by lying and not being honest would be helpful to a (recovering) addict - or are you advocating that those of us who don't believe people should be on methadone forever or without a time limit don't say so? I've said that more rehabilitation facilities should be available and as Paulb enquired, what about counselling?

[paulb]

Shetlandpeat thats your real name then. my user name is my name i was adviced to remove my residence from the info given out.

 

we have been questioning op8s views and reasons. most people are not picking at him/her. We understand they are in a crappy situation and that they feel safer on methadone.

 

we question why they need it long term and again thats not attacking or being judgemental. Op8s seems to be a reasonably stable person but we do have to question their real reason for wanting to remain on methadone.

 

thats the reason we are asking questions. I am not going to prentend its ok to depend on drugs to function its simply not. But that does not mean that i don't understand were they are coming from.

 

So op8s if I have offended you im sorry.

 

When did you do this home rehab were you stored controlled drugs for a number of months. Did you tell the doctor that you were storing a supply. I thought that methadone was now ment to be taken under supervision.

 

Strange that your doctor put you back on the drug and did not try other things instead.

Again this is not an attack on op8s it does raise questions on the doctor however. Storing a controlled substance can be classed as an offence.

[Fjool]

I am not going to prentend its ok to depend on drugs to function its simply not.

Why not?

 

There are loads of conditions which require the sufferer to depend on drugs to function.

[OP8S]

Heavens this is getting tedious. Anyway it was many years ago that I reduced myself ( against the judgement of my GP ) off the painkillers I was being legally prescribed. My GP didn't change the prescription because in his views I was being ambitous. So I had a stock of legally accuired painkillers, which to the best of my knowledge isn't against the law & I'm sure loads of folk have left over medication of some sorts in their houses?

I don't have a crappy life, it's not the most exciting in the world working to pay the mortgage, look after the family, doing up the front room just now. Just the usual stuff. I go to my local pharmacy once a week to pick up my prescription from a really nice old bloke & I will continue to do so, until I have reduced myself at my own rate ( as thier are no arbritary time limits, unless you break the rules by providing positive opiate tests ).

Enough said ?

I've gotta get the tea on.

[shetlandpeat]

Sorry unlinkedstudent, my post was more general in two terms, I was not having a go per say but wondering why if a drug designed to do one thing helps in another why not leave it. Counseling can be very expensive. It is also what works for folk, folk are folk.

the ideal would be great but it does not always work. It may be better to spend 20,000 on treating many rather than the one when budgets are involved.

We do not spend near enough money on this. The trouble being is the money as well, MPs will have to justify at elections why they are trebling the cash available for this for the short term until the replacement settles down and starts to work. Sadly this can take many years, along comes another MP to change it again. The cash is also swallowed up in the cost of changing.

[unlinkedstudent]

This Report is quite interesting:-

 

http://www.scotland.gov.uk/Resource/Doc/180406/0051268.pdf

 

... as is Shetland's stance compared to some other NHS regions:-

 

We did not ask Boards explicitly about the emphasis they place on moving clients from drug dependency to a drug free lifestyle. However some Boards’ local guidance is explicit in stating that the main treatment goal for clients is a drug free lifestyle. For example, NHS Borders state that a key aim of their integrated care scheme is “to provide good quality accessible, confidential and flexible services which promote stability in drug

users lives with a view to moving them on to abstinence and reintegration into the communityâ€. Indeed, one of the factors in assessing whether a client is suitable for a methadone programme is that the client “understands the role of methadone and is willing to aim for complete abstinence from illicit opiatesâ€. Ayrshire & Arran’s guidance stresses that

“the ethos throughout this model of treatment and rehabilitation emphasises the need for partnership agencies to enable client progression from a problematic and often chaotic drug addiction to a more stable and ultimately drug free lifestyle. Shetland’s local guidelines state

that “the team is not prepared to offer indefinite maintenance prescribing of methadoneâ€.

[OP8S]

That has been policy for many years now, though it is just that policy & not law. In my experience from talking to the health professionals involved with treatment, most are in agreement that to reduce somebodies medication without them being in agreement has a negative effect & most GP's wouldn't do it without good reason. The decision is made between the user & their Consultant as to when they feel ready to reduce their dose, as it says in the N.I.C.E Guidlines. There are no legally binding time scales set.

I would imagine that your local CDT tries to follow the recovery model, but even this can be a grey area. Addictions can be a result of various factors abuse, peer pressure, mental health issues, there is even scientific theory that some people have a genetic pre-disposition to addiction ( of all sorts ) & to remove somebodies medication before the root cause of the problem is dealt with isn't providing the medical care that person needs at all. So every case should be dealt with individually which would prove problematic if the patient only has a limited time-scale in which to deal with what can be for some horrendous personal issues.

[unlinkedstudent]

That has been policy for many years now, though it is just that policy & not law. In my experience from talking to the health professionals involved with treatment, most are in agreement that to reduce somebodies medication without them being in agreement has a negative effect & most GP's wouldn't do it without good reason. The decision is made between the user & their Consultant as to when they feel ready to reduce their dose, as it says in the N.I.C.E Guidlines. There are no legally binding time scales set.

 

Yes, it does state in the report re negative effect if dosage reduced without both parties in agreement - that is why, in many instances, when GPs are first approached, the GP makes it clear that the end intention is for the person to be drug-free/non-drug dependent.

 

However, re your point about the law:-

 

Many cases (And not just health-related matters) when going before a Court do rely on the Guidelines issued by a Government Department - Education, for example, being one of them. Whilst there may be no statutory provision, many cases do rely on common law/tort/delict. Many a legal case has been won where the Defendant tried to argue that "Guidelines" were not statute and thus not applicable, but the Judge found such Guidelines did carry weight because if not, they wouldn't exist!

 

Medical professionals have a duty to follow the guidelines. If they don't, they could well find themselves in a situation where somebody brings about Court action. Insurers are well aware of this and those cases that do succeed tend to be settled out of Court, albeit with a hefty deduction (Say 60% to 70%) for contributory negligence, especially where somebody got addicted to prescribed painkillers. Such cases are difficult and many such Court actions do fail, but the occasional one does settle in favour of the Claimant.

 

Many GPs/PCTs/Health Boards will not prescribe methadone unless through the local CDT. Other GPs, on the other hand, are happy to do so - one reason perhaps being because they get extra dosh for offering an 'Enhanced Service" - just as they get extra money if they also have a pharmacy or run a diabetes clinic. Oh, and let us also not forget that for every prescription they write, they get paid for that too.

 

Some places in the UK have increased rehabilitation facilities and counselling provisions but many have not. Whilst these may be expensive when compared to the cost of methadone, they could be deemed as not so expensive when one takes into account the additional sums paid to GPs over the years and, more importantly, the cost to society as a whole.

[the pursuit of oblivion]

I am new to this forum but joined as it seems the only safe place to discuss drugs in Shetland without being stigmatised for your views.

 

Many people I talk to are concerned about the effectiveness of dogs against drugs but are frightened to raise this in public in case they are seen as being in favour of drugs. I am in this category.

 

Now Shetland is getting more dogs. http://www.shetnews.co.uk/component/content/article/36-latest-new/360-second-dog-to-join-anti-drugs-charity.html

 

A lot of people think there is a very strong correlation between the initial introduction of the dogs and the rapid acceleration in the heroin problem in Shetland that followed shortly afterwards.

 

Orkney didn't introduce sniffer dogs and have nothing like the problems we have experienced. It is claimed that the dogs could easily smell strong odours from cannabis and because of its bulk it was the main drug that reduced when the dogs were first introduced. This left a vacuum for dealers to fill with more easily secreted heroin and the rest is history.

 

I understand it is still the case now and Shetland is a community that is mainly focused on hard drugs as the dog’s effect on the supply chain is to reduce profit and interest in transporting softer drugs.

 

Now this is all fairly basic economics. You press a segment in the supply chain and you affect some result. Unfortunately it appears that the dogs may be contributing to the very problem they are designed to resolve.

 

This fear may be abated if it is highly trained professional people with experience in illegal drug use who are behind the dogs against drugs. But again unfortunately, this does not seem to be the case. Somebody who seems quite good at removals and somebody who has done well in the oil industry seem to be heavily involved in extending this policy further.

 

I have looked at some of the debates on this board and have read several books on this subject. It is very complex and seems to me to need incredibly smart people to come up with the answers. I am not sure if handing over the controls to amateurs in this field is really the answer. No disrespect intended.

 

Perhaps Petrofac's £60,000 would be better used funding a thorough investigation into the drugs problem in Shetland carried out by fully qualified independent professionals making recommendations as to how best to tackle it. Maybe they could discover why heroin use exploded after sniffer dogs were introduced. It would be nice to know the real reasons for the situation in Shetland. Then we might be able to deal with it.

[Twerto]

I second your comments ^^

 

I have been a long term believer that the DAD campain has in a lot of ways increased the use of Heroin in shetland, rather than eleviate the problem, with little to no repsonce from the powers at be to prove that it has worked. I would be very interested to see why the police feel another dog will help in the current situation.

 

A shocking quote i heard from someone in the force admitadly a couple of years ago was that there is only 2 - 3 streets in lerwick that doesnt have someone known to the force as either a dealer or user of illegal substances, I would be interested to know if that is still the case or if it has gone up or down ( not that it can go up much )

[Mag]

Well put, 'Pursuit of oblivion'. I especially like your proposal for a study of the causes of our spiraling hard drugs problem and the best method of tackling it.

[Guest Anonymous]

The heroin explosion as you put it came shortly after the introduction of the needle exchange and methadone program. Allowing users to negotiate the intermittent supply chain, and avoid going cold turkey. the dogs came later as a response to the numbers using the programs mentioned above.