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How Addiction Begins
Addiction is a very simple process in genesis.
It begins when a person decides they “like” a drug rather than need a drug.
That is why it is so easy to become addicted. Taking large amounts of medication to control severe pain such as from trauma or post-operatively is not a problem. But the moment you decide you like the feeling of the drug: potentially you have a problem.
Governments throughout the Western world support and fund opioid addiction management programs. They do this because there is very strong evidence that these types of programs have substantial benefits. People who undertake these programs are substantially better off than people who do not enrol.
Family members and acquaintances of drug users who do not support addiction management programs are making a stand against all evidence. The evidence is very clear. Failing to support people to enrol in addiction management programs will hurt and kill people. Thinking you know how to fix the problems best when you have no knowledge and no experience is a recipe for disaster.
Family and friends have a critical role in stopping people using. This does not include telling the "user" to be strong and stop using.
These Family members or acquaintances are dangerous uninformed fools
who will get people killed.
Addiction management programs for enrolled ex-users:
- Improve health (by reducing disease exposure, improving nutrition, reducing conflict injury and crime consequences).
- Improve finances (by reducing money spent on drugs).
- Improve social aspects of people’s lives.
- Reduce crime and the negative consequences of crime on a person’s life. (For example, people do not need to steal, prostitute or trade to acquire money for drugs).
Drugs damage people’s lives. They keep on doing so unless active steps are taken to reduce the consequences of drug addiction. Opioid management programs are one of the main strategies whereby the negative consequences of seeking and using narcotics on a person’s life, are controlled.
- Prevent opioid withdrawal symptoms, These Medications Stop the patient’s physical need for opioids and allow him/her to function in their required activities
- Block the effects of illicit opioid use and
- decrease opioid craving
In my experience as a doctor, people who undertake opioid management programs do very well. They do very well if they remain on a program. Users cannot stop using unless they change their lives. People do not choose to stop drugs. It is life circumstances and the people around a user who stop them using drugs.
One of the most critical factors to doing well, is for patients to "decide" to seek treatment
. People who get themselves to an addiction doctor or to a Clinic like Biala or Melaleuca - in Brisbane will do well. I see 90% response rates in people who get themselves to these clinics or to me. It's not so good if they are dragged to these places against their will.
The odds are stacked heavily against people who use drugs. To survive, an addict needs to be "lucky" every day. One single episode of bad luck can make a person's whole life come unstuck. One bad call can lead to an overdose or death. One bad hit can give you Hepatitis C or HIV or a heart valve infection/ even a crippling spinal abscess or infection. One unlucky pickup or journey brings police attention and legal / criminal problems. A moment of irritability due to the drug roller coaster can destroy relationships.
Sooner or later, an addict's run of luck is over. Generally, I find addicts either opt to stop using, or they die. One single mistake can end in death. As I said, the odds are stacked against surviving a lifestyle of addiction.
People can successfully stop opioid management programs:
- If they have a partner and/or family who does not support drug use and actively seeks to minimise the drug use of the user. (For example, I remember one patient who spent the family budget on drugs. His wife appeared with the user in tow, to make sure he got back on the program, to make sure he stopped using). Problem fixed. Family life and finances back to normal.
- They have a house, mortgage, bills, children and responsibilities which occupy the users’ time and money and which limit their resources for using and accessing drugs.
Too much spare time and too much spare money is a definite recipe for drifting into using. People who want to stop using need to have strategies in place to limit the time available and the money available to support a “using” habit.
If you are a user, and you want to do as well as many others who have accessed opioid programs, you need to make an active choice to enrol in such a program. If you do not enrol in a program, you are headed down and out, towards death and destitution. Other people who had made the choice to get into a program are slowly rebuilding their lives, their happiness and are really enjoying life all over, once again. Don’t be one of the ones who didn’t make it.
Rules of the Programme:
the Agreement
Re Clinic:
Patient Name: Mrs.. Last Tester
Patient Date of Birth: 1/11/1967
Takeaway Dose Agreement
I have discussed the policy regarding takeaway (unsupervised) doses with my doctor/case manager and am aware of the following issues and requirements for approval.
1. I will not share information regarding possession or use of takeaways with others. Methadone and buprenorphine are potentially dangerous medications that can cause death when taken by anyone other than for whom they are prescribed. Do NOT Share.
2. Mixing other depressants such as alcohol, benzodiazepines or other opioids with these medications can lead to drug overdose and death. Don't MIX drugs or drinks.
3. I accept responsibility for safe storage and use of all takeaway doses I may receive. I will store all doses in a secure place out of the reach of children and am aware that a locked cabinet or safe is recommended. Storage in a refrigerator is not acceptable Do Store.
4. All doses will be consumed according to directions given by my prescriber. If more than one dose is prescribed, each dose will be taken on the day for which it is prescribed. Doses will not be accumulated and no more than the daily dose will be taken. Take it as prescribed.
5. Methadone if prescribed will be swallowed, and buprenorphine will be dissolved under my tongue. Buprenorphine absorbs best once dissolved if held in contact with as much of the mouth as possible , for as long as possible. Take the medicines the way you are told to. Do not inject your drugs. They are not safe to use this way.
6. I will not sell, swap or give away my takeaway dose or any part thereof. Meds for "me" only.
7. Doses that are spilled, vomited, lost or stolen will not be replaced and will be reported to my prescriber. Stolen doses should also be reported directly to the police.
Daily checkups and documentation required if problems.
8. Access to takeaway doses will be suspended if members of my treatment team consider them to be unsafe for me or the community at any time. Safety First- always.
9. Access to takeaway medication may be suspended if my urine drug tests detect other opioids, non-prescribed benzodiazepines or illicit drugs. Failure to provide a urine sample for drug testing when requested will be deemed a positive urine test. Urine tests are required at times.
10. Access to takeaway doses will also be suspended if I am assessed as being under the influence of any substances, if I have diverted or attempted to divert any of my supervised or unsupervised doses; if my circumstances change and are deemed unsuitable for takeaway medication; or for any other reason that the treatment team consider to indicate increased risk to myself or the community. Safety first-don't mix drugs.
11. Takeaway doses can only be prescribed under the conditions and requirements set out within the policies and procedures of the Toombul Medical Centre. Follow the rules- safety first.
12. Any deviation from this agreement will result in a review of my treatment which will include access to takeaways and possible suspension/removal.
If you break rules- we have to do something about it- safety first.
signed by client / patient.............................
signed Doctor ...................