How stupid is your 'key worker'/'doctor'/'health care professional?'

[F.U.B.A.R.]

Went for my appointment with my key worker at the drug clinic t'other neet. Not been for over 6 months (they've been leaving me alone while I settle back into working life). Anyway, for some reason the key workers have been swapped around and I've now got some woman I hardly know at all. So we were going through the 'getting to know you a little better' bit (no, not like that you filthy minded bastards..), and the conversation went something like this...

Her: 'when did you last 'use'?' (heroin)
Me: 'Nearly two years ago now, the drought pretty much put an end to things'
Her: 'Oh, that's brilliant, well done you!' (patronising bitch)
Her: 'Any other drug use? Crack, amphetamines, cannabis?'
Me: 'Unfortunately not, no. Trying to get hold of some pot but having problems at the mo'
Her: 'But it's illegal!'
Me: 'Since when has that ever mattered? 8)'
Her: 'What about legal highs, have you had any of those?'
Me: 'You mean research chemicals? Yes, I've been experimenting with some of the legal benzodiazepines recently.'
Her: 'What, like Benzo Fury?'
Me: 'Er, no.. that's a benzofuran, not a benzodiazepine...'
Her: 'Oh'.
Me: .............................

She then proceeded to berate me for my alcohol use, to which I replied 'But it's legal!'

I then tried to convince her that I would much rather my kids smoked pot than drank alcohol, but I could see I was getting onto dodgy ground there so shut up and just agreed with everything she said (which at one point included the immortal words "I'm a mental health professional") in order to get out of there.


Everytime I go to that place I come out wanting a bag more than at any other time, just due to simple frustration...

 

[Mental Kenny]

Mine is excellent, he has level of knowledge I did not expect, he shares his anti-prohibitionist views with me, we discuss experiences, I have a strong feeling he's tested a ton of things, when we were debating the holing effects of MXE he was nodding in agreement way too much and knew more sites where to buy it than I did, something tells me he did his own investigations.

He works at the drug clinic, but he's only offering psychological assistance to me, no treatment, as I'm not registered as an addict, it's just my parents were given his number by a lady who had a son with drug problems and so I go there twice a month to have a chat with him.

He's extremely keen on listening to experiences especially those with psychedelics, he believes they could have a use in the mental sector, he's seriously a top bloke, I didn't expect it to be honest, very informed and understanding.

Who know I might be unknowingly contributing to the use of psychedelics being adopted one day in this country with the information I'm giving him, forgot to mention he's one of the top doctors at national level when it comes to drugs, one they consult when they ban things.

 

[mydrugbuddy]

Mine isnt stupid at all, but i find it difficult to say what help she has been. Though she has been honest and supportive, ultimately and obviously she couldnt do the quits for me and i had to do them myself, and i had to find the will to do them myself, she became just as frustrated with me as some other people on here, when after finally quitting bupe i went and obtained almost a kilo of kratom. " Do you want to stop or not !?" I did, I do, I just found it difficult. I'm a bit wary of saying 'this time is really it' as i know ive said that several times on here before.

I may make an exception for wild poppies, but other than that i dont want to be going back down that road. However small my habits may have been in comparison with other peoples they havent been easy to stop. I can get back to keeping my etizolam taper reduction diary now, now that i feel that im out of the woods with kratom. I think ive passed the stage where that stuff is forgiving if you quit within a month. Took about 10 days of feeling exhausted just climbing the stairs. Im 43 not 83. This isnt a 'poor me' post before anyone starts on all that, its just statements of fact.

 

[StoneHappyMonday]

Went for my appointment with my key worker at the drug clinic t'other neet. Not been for over 6 months (they've been leaving me alone while I settle back into working life). Anyway, for some reason the key workers have been swapped around and I've now got some woman I hardly know at all. So we were going through the 'getting to know you a little better' bit (no, not like that you filthy minded bastards..), and the conversation went something like this...

Her: 'when did you last 'use'?' (heroin)
Me: 'Nearly two years ago now, the drought pretty much put an end to things'
Her: 'Oh, that's brilliant, well done you!' (patronising bitch)
Her: 'Any other drug use? Crack, amphetamines, cannabis?'
Me: 'Unfortunately not, no. Trying to get hold of some pot but having problems at the mo'
Her: 'But it's illegal!'
Me: 'Since when has that ever mattered? 8)'
Her: 'What about legal highs, have you had any of those?'
Me: 'You mean research chemicals? Yes, I've been experimenting with some of the legal benzodiazepines recently.'
Her: 'What, like Benzo Fury?'
Me: 'Er, no.. that's a benzofuran, not a benzodiazepine...'
Her: 'Oh'.
Me: .............................

She then proceeded to berate me for my alcohol use, to which I replied 'But it's legal!'

I then tried to convince her that I would much rather my kids smoked pot than drank alcohol, but I could see I was getting onto dodgy ground there so shut up and just agreed with everything she said (which at one point included the immortal words "I'm a mental health professional") in order to get out of there.


Everytime I go to that place I come out wanting a bag more than at any other time, just due to simple frustration...

Please BL don't ever get a "like" button. But if there was one...this post was very entertaining.

 

[F.U.B.A.R.]

Fubar, can you ask to be referred to another key worker. She sounds ignorant- not just her drug knowledge. It seems to me if a drug worker is trying to help someone with a drug problem then there should be no need to even mention legality (obvious exceptions but not just to moralise drug use). She needs retrained to say the least.

Mind she did think make us laugh :D

I could ask to change key workers, yes. But in the 15 years or so that I've been going there, I think I've been through 'em all! There's only two that I respect, and I've served my time with them already. I think many of them aren't really there to try and make a difference, it's more of a necessary stepping stone on their mental health career plan. Plus I don't think they really know what to do with me so they just keep passing me around to different key workers. I don't fit the typical stereotype of a drug user; I openly admit that I have no desire to stop using drugs and I have no interest in their faddy rehabilitation and therapy groups. I actually like methadone because it does stabilise me and limits my drug use somewhat (though you probably wouldn't think that if you've read some of my other posts on here). However, I've agreed to start reducing again, mainly because I want out of the shitty system and am sick of having to deal with 'professionals' that simply haven't got a clue about the people they 'treat'.


Furthermore, there's something in the air; the times they are a changin'... I've heard noises that the whole system is going through changes and moving more toward rapid tapers and total abstinence, as opposed to long term treatment and maintenance. I was also told the other night that they are going to be concentrating on the family rather than the individual, so junkies with kids watch out! I predict more home visits and general interference in your private life than at present. I warned her that if that happens, they're going to find a lot of people dropping out of treatment and going back to the gear full time, a fact she was forced to concede. This is another reason I want out of the system.

 

[ScotchMist]

I feel you FUBAR, i've been in and out of treatment places for 10 years or so. It doesnt seem to be working does it... Ive finally reached a point now where I just want out..!

I've only been back on a script for 2 weeks and Ive had enough. I didnt even take the first weeks worth, I took a couple this week and decided I dont want to be tied to the services for god knows how long so I jumped back on the gear taking the bare minimum to get me through the day and im going cold from tomorrow.

Theres a number of reasons for me doing this which I wont go into but I feel absolutely ready.

If what you say is true about them prying into families more then that just galvanised my want even more. Im simply not putting my children through that, or my long suffering partner. Im not bragging but I have a good job, my kids want for nothing, most of all love. There is no way im letting somebody come into my life and judge my family based on my problem as it has zero impact on them.

Saying that though I know of a few folk on the gear who most definitely need their childrens home lives looking at more closely, ive come close to phoning the social myself on them. Fortunately those families I know do have the social on to them now so I didnt have to. So there is a need but they can get to fuck snooping around my home and kids because it would do more damage than good.

 

[rickolasnice]

I had a doctor who was tending to a ex-friend of mine for paracetamol overdose tell me that codeine and caffeine are basically the same thing..

 

[StoneHappyMonday]

I had a doctor who was tending to a ex-friend of mine for paracetamol overdose tell me that codeine and caffeine are basically the same thing..

Funnily enough...there are some new co-codamol out. With added caffeine. WTF?

 

[maxalfie]

I've
heard noises that the whole system is
going through changes and moving
more toward rapid tapers and total
abstinence, as opposed to long term
treatment and maintenance.

I've been told the same from our local DSP. It appears that anyone getting a methadone script now, will not be allowed to stay on it for years & years such as me & my friend.
We have been allowed to keep our script even when we used to provide 'dirty' urine samples but now a new person will only be allowed to get away with that for a short period before having their script withdrawn.

 

[5StarSquatHotel]

Max, yeah that's right and it will be universal for the whole of the Uk. You get 12 weeks for the induction period (finding the right dose), then 12 week maintenance (on said dose) then a 12 week taper followed by after care (what ever that is). This model will work great for those wanting to stop and 9 months is still quite some time. I wish they had this in place vefore I got scripted and was left on 100+ mls of meth for over 8 years while still using. I hope they do offer a long term maintenance option as well though as some will need that or they will be stuck in the cycle of being forced off script and using then applying for another script.

 

[THECATINTHEHAT]

Not in the slightest.

Thank the lord I ended up with a good one! A really good one. He even asked me if I had heard of a site called bluelight on our first meeting, was a bit of an ice breaker when I told him I used to mod here. His drug knowledge better than mine which is a really good start for me in being to respect and work with a key worker, but by no means essential.

I have had some shit ones in my time though, it's pot luck really.

 

[THECATINTHEHAT]

Funnily enough...there are some new co-codamol out. With added caffeine. WTF?

It's to cancel out the supposed drowsiness from the codeine or just generally give you a bit of a pick up if you're, you know, actually using them for their intended use.

 

[bummer]

with regards to the OP.
Gunna play devils advocate here. That woman does sound pretty useless. But most of us here know that keeping up with RCs can be a time consuming hobby. Maybe doctors and drug workers etc should get regular TL;DR memos keeping them up to date with whats hot and whats not. I'm sure the NHS could get this done at very minimal cost.

 

[pinkpapaver]

Mine used to be ok but shes getting more stupid. My appts are all about filli g in a daft qnaire and yeah she talked about the quitting the green thing until people started dying. Im speaking to more and more people who are sick of being treated like muppets by tbese people

 

[THECATINTHEHAT]

Talked about quitting the juice until people started dying???



With regards to the OP it doesn't sound like you're really deserving of a good drug worker if you've been going there for 15 years and are still quite happy to continue using hard drugs despite having had drugs been enough of a problem to warrant you going to the services?...and you're drinking to a level that is of concern as well?...and I guess you're probably still on an opiate script?

The whole idea of a drug clinic is to help people stop using drugs, why are they going to give the good drug workers to someone who has no interest in working with them towards that goal? Maybe if you shaped up and started to actually work with them rather than against them you might get given a good drug worker?

Look at it from their point of view....you walk in the door (presumably) wanting a prescription and having no intentiontion of quitting any other potentially problematic drugs. Would you give your best members of staff to you or would you give them to the people coming through the door wanting to work to stop using drugs?

Just a different perspective on the situation.

 

[Shambles]

^ A fairly widespread perspective but not a very useful one I don't think. Not everybody does want to quit drugs and you can't force people cos that just doesn't work. What drug services can do for people in that position is to at least help to stabilise them somewhat, minimise harm, minimise crime and so on. It may not be exactly what "the average person" would like to see but it's a damn sight better than just leaving people to it with no help.

Furthermore, there's something in the air; the times they are a changin'... I've heard noises that the whole system is going through changes and moving more toward rapid tapers and total abstinence, as opposed to long term treatment and maintenance. I was also told the other night that they are going to be concentrating on the family rather than the individual, so junkies with kids watch out! I predict more home visits and general interference in your private life than at present. I warned her that if that happens, they're going to find a lot of people dropping out of treatment and going back to the gear full time, a fact she was forced to concede. This is another reason I want out of the system.

This is a real problem and is definitely the way things are going (at governmental insistence obviously). It was made very clear to me when I was last attending my DSP regularly that I would not be allowed a longterm maintenance script as they are being phased out in all but the most extreme cases. I have no idea how they'll choose to define 'extreme' but probably however they're told to. That doesn't bode well given the way government seems to want to push the abstinence thing above all else. I blame Russell Brand. Actually I don't but that really didn't help matters. I can see big problems coming from these type of policies. Puts people off from seeking help when there is no real help on offer other than "Just stop it". That approach only ever increases drug problems of every kind - to the individual and to society. Not a good time to be an addict (if there ever is - an especially bad time to be an addict is perhaps more accurate).

 

[THECATINTHEHAT]

^ A fairly widespread perspective but not a very useful one I don't think. Not everybody does want to quit drugs and you can't force people cos that just doesn't work. What drug services can do for people in that position is to at least help to stabilise them somewhat, minimise harm, minimise crime and so on. It may not be exactly what "the average person" would like to see but it's a damn sight better than just leaving people to it with no help.

I think it's exactly a useful one. Why would you waste your best workers on people who show no inclination to stop using? If you want to reduce crime, minimise harm etc then it's absolutely logical that you're going to use your most skilled workers on people who are going to engage with them. Why waste them on people who are just there to rock up for a script? If they have no interest in engaging then give them the shit workers. They walk off with a script and no help (no point forcing it on people who are not ready to quit) and those who are ready to quit to get the best help increasing the chances of them breaking free from addiction ergo reducing crime/medical problems/general harm to society etc. Giving the best workers to people who aren't ready to stop using is utterly pointless.

Of course you can't force people to quit (which is precisely why skilled workers shouldn't be wasted on those who aren't ready), and I don't know why you even mentioned the notion of leaving people with no help?


With regards to the removal of long term maintainance scripts it's a very difficult question and I'm undecided as to whether it's a good idea. I can see both pros and cons to the idea. The real issue is the decline in funding for drug services that is forcing these changes, but I can't see that being likely to change any time soon unfortunately. Or really, IMO, the issue is prohibition. That's even less likely to change though.

 

[StoneHappyMonday]

The whole idea of a drug clinic is to help people stop using drugs, why are they going to give the good drug workers to someone who has no interest in working with them towards that goal?

First, maybe the idea of a drug clinic shouldn't be to help stop people using drugs.

Second, what is a 'good' drugs worker?

Third, if a good drugs worker is one who knows their stuff, is highly knowledgeable about substance use, and still holds the opinion that users shouldn't be made to give up then why wouldn't they be the exact right person for someone like the OP? Someone who can reinforce positive perspectives about drug use, thus making the OP feel fine about themselves instead of feeling like a piece of shit when they leave the interview?

I have friends who are drug workers who do just that. In Brighton if anyone wants a shoe-in. Quickly, before they are forced out of the profession. Coz that is what's happening.

 

[THECATINTHEHAT]

First, maybe the idea of a drug clinic shouldn't be to help stop people using drugs.

Second, what is a 'good' drugs worker?

Third, if a good drugs worker is one who knows their stuff, is highly knowledgeable about substance use, and still holds the opinion that users shouldn't be made to give up then why wouldn't they be the exact right person for someone like the OP? Someone who can reinforce positive perspectives about drug use, thus making the OP feel fine about themselves instead of feeling like a piece of shit when they leave the interview?

I have friends who are drug workers who do just that. In Brighton if anyone wants a shoe-in. Quickly, before they are forced out of the profession. Coz that is what's happening.

First: That's kind of an absurd suggestion. They do serve the secondary purpose of knocking out scripts to people who have no interest in quitting in the hope of minimisinng the negative effects on society, but we've covered that. They are NHS clinics, their primary focus is healthcare, which in this case revolves around helping people recover from their substance abuse. What should the NHS be doing with their drug clinics pray tell? Given they already don't have enough funding to deal with that problem in a satisfactory manner. When someone comes to you and says they need help with their drug abuse because it's destroying their life, the primary goal has to be to help them stop using drugs.

Two: Someone who has a good foundation in the pharmacology of substances of abuse and medications used in the process of recovery. Someone who has a good working knowledge of the drug culture of the local area. Someone who is preferably empathetic towards their clients through first hand experience, but at the very least sympathetic. Someone who is focused on helping improve the lives of their clients. Someone who is commmited to pushing the field of the care of drug addicts forward. Someone who is able to educate their clients as to harm reduction techniques.

Three: Given the answer to the first point, that NHS drug clinics should be centered around helping improve the health (physical and mental) of people who have come to them because drugs are destroying their health (physical and mental), helping them stop using drugs is central to their goal and as such a drug worker who isn't focused on that can't possibly be a good one. See above re the tenets of someone who is sympathetic/empathetic. Unfortunately resources are limited and we don't live in a magical world where every drug worker is perfect and as such managers have to allocate their resources appropriately. You're going to use your strongest employees to work with the people who are willing to engage in the process of reducing harmful drug use, it's simple common sense. You seem to have equated that with advocating the poor behaviour of certain drug workers, which is, frankly, pure bullshit. However whena service user responds by saying they're not interested in stopping using hard drugs that are destroying their lives (if they aren't why the fuck are they there, given that it's a healthcare service), you can't expect to be given the cream of what is available in the way of workers. It isn't their job to enforce positive perspectives of drug use. They're healthcare workers, their job is to improve the health of the services users.


Drug services are having their funding cut to the extent that they can't even help the people who want to stop their drug use. What possible justification can there be given to shifting resources towards people who have no interest in stopping their drug use, and the resultant negative effects it has on the local community? If they're not engaged in negative effects on the local community then that's even less reason to be shifting resources towards them.

 

[StoneHappyMonday]

You are equating drug use with negative effects all the way through your post. That perspective is not inevitable. People's health can be improved through giving them support re different attitudes to drug use. People can take drugs responsibly and be helped to do so. You seem to have missed a guy on here called Charlie Clean.

I would give you a longer response but frankly your post was aggressive and insulting enough "frankly bullshit" etc for me not to bother with you. Have a good day.