When I went to my first appointment at the CAU (Community Addiction Unit) in Cardiff and asked for help in stopping using heroin and crack cocaine, I was told that they could give me methadone for the heroin addiction and there wasn't anything they could do for the crack habit. So I went on to methadone, starting at 20ml/day.
I told them that I was injecting a lot of heroin ( 1-2 grams/day), so would that amount of methadone be enough for me? I was then advised to 'top up with heroin' until the methadone had gone up to a high enough dose to hold me on it's own, and then to gradually reduce my heroin use. The problem was I couldn't control the amount of heroin I used, that depended solely on the amount of money I had, and nothing else! So I ended up on 120ml/day of methadone and I was still using the same amount, if not more, of heroin. I'd gone in with 2 addictions and come out with 3, in a right daze - basically I was up the creek without a paddle!
When push came to shove and I ended up in hospital, with an unconnected injury, for 8 months, I decided to look into rehab options. I met with my CAU key worker, explained that I wanted to get off the methadone as I wasn't using heroin anymore, and go to a rehab, I was told in no uncertain terms that she thought I wasn't ready for rehab and the local authority wouldn't be funding it.
As it happens that was probably for the best as I found a rehab myself, funded by housing benefit in Cardiff, that had a place for me. So I left hospital and went straight into LivingStones Rehab. I wanted to discuss reducing my methadone, so at this point I went to see my key worker again, really chuffed to be able to give my first negative urine sample(negative for heroin), She said that's great but I'd like to increase your methadone dose, just in case. I couldn't believe it, why raise it? I'd stopped taking heroin, was in a stable environment, with support and they wanted to raise my dose? After a lengthy discussion, she agreed to not increasing it but would have none of it when it came to talk of reducing it.
So I decided to write my own reduction plan, as I was on weekly pickup it was possible for me to measure it myself and discard the remainder. I decided on 10% drops every week, until I was completely off it. I let my key worker know my plan, accepted the flack she gave me and got on with it.
Every time I went in for an appointment after that I ended up being chastised for reducing myself,it was going smoothly but she still wouldn't agree to reducing as I wanted and would only drop it to the level I was on that day, so by the next week I was having to measure it and throw away the excess again. No matter what I said or how I explained it, the CAU would not reduce it for me, worse than that they put every barrier possible in front of me. This went on for months, in fact it wasn't until I was on 8ml/day that they realised I was serious about coming off methadone for good and actually started to reduce it for me when I asked.
At a time when I was taking huge steps forward the CAU were trying to drag me back at every opportunity, that was how it felt to me. I'd go as far to say they made it a lot harder than it could of been, it was only because I was so certain that I was making the right decision did I continue it alone. I didn't want to have to argue my point and defend my position at every appointment, I wanted supporting in what I was doing. It was my decision to reduce and it was a decision I didn't make lightly. But I was forced to fight a pitched battle all the way through my reduction.
It took me just over 5 months to get off 120ml/day of methadone, the sweating went on a lot longer but has also improved vastly! But there is one thing I'd like to know - Why was there so much opposition from the CAU to me coming off methadone? I have my own ideas about that but if there's anyone else out there who can help me understand this, then please let me know!
I'd like to add that I know the way the CAU acted was obviously in accordance with the directives passed down to them, and weren't local decisions. So the real question is - Why is it this way?
7 comments:
Excellent Blog Kevin. Thank you.
Yes excellent!
I have so much to say about this subject!
will try to get time to respond in depth over the weekend.
Surfice it to say that I doubt whether any of the policy makers would allow what happened to you and is happening to thousands of other addicts to happen to one of their children or other loved ones! maybe it will take an experience like that, when someone like Paul Hayes has to really consider this reality for a loved one of theirs that they may start to question their so called 'harm reduction' blanket policies.
I suspect it would definately be a case of going straight to rehab on a fat health insurance policy, no blockade methadone maintenance for their kith and kin!!
Hi Kev
I just want to say straight off that I think that the experience you had with this service / methadone maintenance is unacceptable and shouldn't have happened.
But, thinking of why it was the service you went to opposed you reducing your methadone and wouldn't give you funding for residential rehab...
I think part of the problem we have (I work in a DAAT) is balancing the scale of the issues we face with individual choices.
Bit of a digression - I remember managing a community drugs service that had 10 people go into residential rehab in a year. 4 had been on a structured programme first, 6 hadn't. All 4 that had, completed their rehab, all 6 that hadn't, dropped out. In these situations, with limited amounts of money available, you can see why some people believe that people shouldn't be given funding to go to rehab straight off. Other people in the service wanted to know why the rehab budget was being "wasted" on people that were dropping out of treatment.
This doesn't explain why your keyworker wouldn't acknowledge and work with you to reduce.
There are still people in drugs field (I've worked with some of them) that believe treatment is something that you "do" to people, that decisions and choices about treatment are to be made by "professionals" only, and that service users don't have rights. It is amazing to believe, but there really are (quite why they work in the field I don't know).
I believe it's part of my job to make sure that these attitudes are changed or that services that have people with these attitudes within them are changed.
It's also my job to make sure that people accessing drugs treatment have a choice about what treatment they have, but also that this choice is available to as many people as possible. Some people choose maintenence (I honestly believe that) and some people choose reduction and abstinence, and we have to be able to provide both, and everything in between, for the money we've got.
I'm not complaining about it, I like my job! But I just wanted to try an ofer an explanation of some of the factors that could have contributed to your situation.
That said, I have to say again, what happened to you was absolutely wrong, and has made me think about how we make sure it doesn't happen in my town.
Sorry for the long comment, keep up the good blog!
Matthew
Great post. Thanks for sharing your story. We see them same kind of thing in the U.S.
I,ve had pretty much the same experience. In fact I know a lot of people who've had the same experience. My doctor wont let me get my script away to go to work but is trying to make my reduction hard as possible. Although it makes me all the more determined.I'm down to 25mls and reducing. Its so good to hear from someone who has done it.
Hi my name is Steve, i am currently on 70mls and my doc told me off for reducing by 20, i am alright with that and thinking of reducing 5mls every 3 days untill i get to about 15 mls or so, can u advise me?
Hi steve,
It would be very hard for me to advise you as -
1)I'm not a professional, so any advice would just be personal opinion and therefore could be bad advice!
2)I would need to know a lot more information about you ie current & past drug history, any mental health issues etc, etc.
The best advice I could give you at this time would be to get as much advice from different sources as possible! eg Local drugs agencies, addiction units, Narcotics Anonymous etc.
There is a very good website I could direct you to, from which you can get a wealth of advice and more importantly support, from professionals, addicts, ex-addicts and family members of.
This site is called 'Wired In to recovery' and is run by the charity Wired In. the address is -
(http://www.wiredin.org.uk)
And it's completely free. Join the website and re-post the comment you left on my blog and see what people reply to you. In fact, you could do a search for 'methadone detox' on the site and see what that turns up as well!
I'm on the site also. Let me know how it goes!
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