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

[pinkpapaver]

Oh mr monday, it does my head in it really does. Im so tired of my family shutting me up everytime i give an informed opinion on any subject on the grounds that i am an addict and dont deserve to speak and be heard and that i just might be listened to when ive been off the drugs or cleanfor a time specified by them. Sickening.

 

[THECATINTHEHAT]

You are equating drug use with negative effects all the way through your post. That perspective is not inevitable.

For people who have ended up at a clinic it's already happened, otherwise wtf are they doing there?

Agressive throughout, have a word with yourself. I pointed out the part of your reasoning that was bullshit as it was. The rest was just words.

 

[masaz]

'Magic Mushrooms? I'm sorry we don't have those in our database. Psilocybin? Spell that? No we don't have that either. How much methadone are you on?'.

I'm addicted to benzos, for reference. I'm thinking of giving up and just doing CBT and keeping on the taper with my GP who seems to know her shit very well.

 

[Shambles]

They are NHS clinics...

Whilst that used to be the case all the ones I know of now are actually privately-run charities or actual businesses. They don't receive NHS funding at all but do seem to have to abide by government orders which is a slightly odd situation. I'm sure NHS clinics still exist but they are a dying breed. Aside from the government's stiffening of attitudes and reversion to "Just stop it" policies I'm a bit confused as to why privately-run services would really want to get clients off their books. They get funded (somehow - it has been explained but is apparently a very confusing nightmare of having to please various people with quite different desires) per client so it's really in their best interests to treat people properly and allow however long is required for those clients to deal with whatever issues they have.

I also agree with SHM that getting people off drugs completely should not be the focus for DSPs. Healthcare and a smattering of social services-type care is what they are there for. They're there to support people, to stabilise their use as much as possible and to be - often the only - reliable contact who is non-judgemental. As soon as you start making decisions about this person being more deserving than that person you set up a two-tier system which simply rights off a large group of people who need help just as much as anybody else. They may not realise it yet, they may not actually need it as much yet, but the time will probably come when they do and it will be much better for all concerned if they have a good existing relationship with their DSP.

The type of system you seem to be arguing for is the old one where GPs wrote scripts at whatever whim they happened to have. All this leads to is doctor shopping to find somebody who will give a better script. The more holistic approach taken by DSPs is far more beneficial to both client and society.

 

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

Owen Owen 2, i have a lot to say to your frankly condescending and judgemental posts, but it will have to wait until i get off this goddamn phone...!

 

[Eveleivibe]

I was told by my service that they would NEVER involve social services because people will not seek the support if that happened. I would not have if that had happened. I think 'tis a case of the media doing their usual scare mongering. Personally I think services like keeping people on scripts because if everyone recovered they'd be out of a job.

I can see two sides to the other debate too. In one respect they are there to get people off drugs and into recovery. And there are lots of people that want this so why give the good key workers to people who are just going to waste their time? Why give someone a script if they are not ready, give it to people who are. HOWEVER, as they do where I live, it's important to have services for harm reduction means such as needle exchange, breakfast and hot drink for the homeless and naloxone kits and training. Those are useful and those are methods helping people who are still wanting drugs - but it's not fair to allocate the best workers to someone who isn't seeking recovery.

Fubar, I don't understand why you have to be rude about her complementing your efforts to stay sober? Are you saying that it was easy for you???? I can understand your issues with some of the other stuff she said to you, about legality and so forth, but I don't understand you finding offence to her congratulating you on coming off Heroin? I found it difficult to get off codeine, I'm on suboxone. I find anyone who has become sober from ANY sort of opiate, or sort of addiction for that matter, nothing short of inspirational.

Also she may have got some information misinformed. She's a human being - she may be knew to the job. Did you take this up with another member of staff so that maybe your key worker could be offered further training / given the necessary information to enable her to become "less shite" and thus be of more use to yourself and future as well as current clients???? Have you never made a mistake in your life? your job? Maybe give her a bit of slack and, instead of ridiculing her and your drug service, how about working with them to make the service better both for yourself and others?

Sorry I don't mean that to come across as argumentative or offensive in any way. Just some things I'm throwing out there for you to think about, just another perspective so to speak!

Evey

 

[THECATINTHEHAT]

Owen Owen 2, i have a lot to say to your frankly condescending and judgemental posts, but it will have to wait until i get off this goddamn phone...!

I have been neither condescending or judgemental. I have't looked down on anyone or passed moral judgement on anyone (I specifically kept my moral judgement to myself, if you really want to hear it you can though). It's a case of basic resource management.

I'm definitely interested to hear what you have to say though and where you think I have been condescending or judgemental, I'm always interested in reasoned debate.

 

[Sprout]

Drug Services are an odd thing to ponder. Everything has two sides, but with drugs it ranges from polarisation to a mishmash of grey area. I have never used the services available, and so there is great potential for me to completely uneducated, and thus wrong. Whether you view addiction as a health problem or as a societal scourge which is completely optional, the fact remains that some people are not, and very well may never be, ready for complete abstinence. Should these people be 'thrown to the scrap heap and left without help, in favour of those who do wish to completely quit? Though, on the other hand, one 'recovered' addict may be more functional than three people stable on a script, and so those who wish to quit should take precedent.

It is an awfully complex thing to consider, given addiction reaches FAR wider than: 'are you still using?'
I, personally, try not to form a concrete view on rehab services due to my aforementioned lack of experience, but I do sway towards the viewpoint that addiction is better 'managed' than demonised, and that 'help' doesn't always equate to complete abstinence.

I concede I may be biased given my own problems with opiate addiction, though I see that more as having experience of 'the other side'.

 

[THECATINTHEHAT]

some people are not, and very well may never be, ready for complete abstinence. Should these people be 'thrown to the scrap heap and left without help, in favour of those who do wish to completely quit?

No, they shouldn't be and they're not. They receive a key worker and the same opportunities as everyone else. It would be nice if we lived in a world where all key workers were perfect, but that's not reality, and to get a good one you have to show a willingness to engage with the services in a positive manner and work with them. What is the logic in giving your most skilled workers to those who are not ready to quit?

It's pretty much an accepted fact that no one can be convinced to quit, they have to be ready to do so themselves. So what is the point in using the best workers on those where they're going to have no effect when they can be used to help those who are ready and trying, thus increasing the number of people getting clean, and all the benefits to the individuals and society that follow from that? (every person that gets clean means money in the pot for better training of key workers for a start)

I have honestly held off from being judgemental of the OP (if I were doing that I would have made an entirely different post, but that would be counter productive), I'm simply pointing out that the people managing these clinics have scarce resource and have to use them where they think they will be most effective.

 

[Sprout]

I completely agree with the resource argument, the funding cuts to anything that isn't the Treasury is disgraceful. However, I was talking more about treatment on the whole.

 

[THECATINTHEHAT]

I would agree that treatment options are far from ideal, where are the improvements supposed to come from without the money though? Unfortunately I can't see that problem being resolved anytime soon.

 

[Sprout]

I would agree that treatment options are far from ideal, where are the improvements supposed to come from without the money though? Unfortunately I can't see that problem being resolved anytime soon.

Funding for treatment options won't improve without success. Success of treatment requires funding. Sadly, too many people hold the 'addicts are scum, but me drinking 2 bottles of wine to help me sleep after too many coffees is completely different!' mentality for funding to improve.

 

[Eveleivibe]

Sprout you do make a good point. I go to a recovery group n they mention certainthings in recovery, which all seem to be aimed at abstinence. Where does that leave the likes of me? I've been on suboxone a year n when I sought help I was not ready to give up codeine n psychologically could not do it at that time. For harm reduction purposes, as well financial, relational (family, parents) I had no choice but to come off it. Being on 900mg codeine a day isn 't good when you're in charge of a child, so like it or not, I had to get off codeine but was not ready. For me, a script was the best option. As I've mentioned numerous times on here, a friend had been on suboxone n it stabilised her n kept her addiction at bay - so I decided to go that route.

Before anyone starts with the "you shouldn't be on suboxone with a codeine addiction" nonsense I 'll ask one question why should people with "weaker " opiate addictions have to continue suffering in their current state for years when people with "stronger" opiate addictions get the help of opiate replacement therapy. I 've spoke to numerous about of ex-heroin addicts who are now addicted to codeine n they have ALL stated how the addiction to codeine is just as difficult to battle as heroin. They then go on to say how surprised they were. An opiate is an opiate.

Mods: sorry for subject change I maybe should have put it in my codeine thread - but I think it's appropriate to the discussion here. Please feel free to move it if you disagree.

However, that was an argument in terms of scripts and how they help a persons addiction. So thus the person is seeking help in stabilising their addiction. I'm not sure about people who wish to give up an addiction to, say opiates , but wish to continue taking other drugs. I suppose it comes down to a few things such as money (where do they get funding, how long for, what is the funding specifically for n so on...). And what is the aim of the drug service. If the aim is to help people reach full abstinence then of course, the best help should be given to those aiming for full abstinence. If the aim is to help battle the person 's current addiction (look at underlying issues and so forth ) then what matter is giving help to anyone wishing to battle that addiction despite any other substance taken. For instance , I drink n was not asked to stop alcohol (thats a kinda 12 step approach: abstinence) - just tge codeine as that 's what I asked for help for in the first place.

I suppose , end of the day, it all boils down to funding n what those a
Who are delivering the funding, say.

Sorry - I've gone on a bit.

Evey xxxx

 

[Shambles]

No, they shouldn't be and they're not. They receive a key worker and the same opportunities as everyone else. It would be nice if we lived in a world where all key workers were perfect, but that's not reality, and to get a good one you have to show a willingness to engage with the services in a positive manner and work with them. What is the logic in giving your most skilled workers to those who are not ready to quit?

I'm not sure you can generalise about drug services in that way. They've become quite fragmented with various private companies buying up swathes of DSPs on a regional basis. I suspect we're very much in pot luck territory based on who happens to run the DSP you can actually get to. There may be a choice in some areas but there certainly ain't in rural areas and the one near me (and several in the surrounding wider enivirons) got bought up by a big American drug service provider - which was rather nerve-racking for a while cos the US don't exactly have a glowing record with drug services.

There were changes and they have been detrimental but with government interference happening around the same time it's hard to say which is causing more problems. I do know I saw the same, highly-regarded key worker for just shy of a decade on a weekly, fortnightly or occasionally monthly basis depending on my situation at the time. At no point was there any suggestion I was wasting her time although I have never even hinted at having any desire for total abstinence. Then after all that time they suddenly switched everybody she saw in this town to some other geezer who was (and presumably still is) utterly useless and is pretty much the reason I drifted away from services to the extent they cut me off (is a bit more complex and a bit more my fault but that was a large part of why I lost my enthusiasm).

I have no idea if he is actually any good for other people - it largely depends on how two people get along I suspect (we just clashed horribly from day one). But none of us got a choice it was purely down to where we lived. You get whoever covers that area. Things will be different in other areas but that's kinda the point I'm trying to make. There is no joined up DSP policy cos they're all owned by different organisations and take different approaches.

 

[THECATINTHEHAT]

Yeah the system is fucked in that respect I agree, my theorising only applies to urban drug clinics where you have lots of keyworkers serving what is usually an overload of service users (which is all I have an experience of). When I was last on a script the agency was changed after a couple of months due to funding cuts and I went from having a pretty good worker to an absolute cretin. She was truly terrible, good for nothing but looking at.

I do feel blessed having the worker I have at the moment. Although I've only been with him a short while he seems absolutely on point. For a start his drug knowledge is better than mine which is the first time I've ever had that in a key worker so I'm immediately kind of put in my place and have respect for him. He's an ex user too so he can empathise, even mentioned bluelight in conversation. I've got a feeling he might float around and post still maybe, but I don't know really and I think it's best it stays that way. When I went to him I was on supervised and in a month or so he moved me to three times a week. For my part I'm completely honest with him though (e.g. I kind of fucked up and sniffed a line of coke on friday and I'll be quite open about it and telll him when I see him tomorrow) and we seem to have common goals when it comes to my care. He's a psychiatric nurse prescriber too so he can help with my mental health and associated issues too.

 

[maxalfie]

The best keyworkers I've had have always been the ones that are ex addicts.
They have much more of an understanding of what I was talking about & going through.
One keyworker I had who had never tried drugs once compared my heroin addiction to her like of chocolate.

 

[Shambles]

A properly trained drug counsellor/key worker/whatever they call it is a godsend. They are sadly few and far between in my experience (have attended various drug support services over the last 20-odd years in both rural and urban areas - half of each actually). I often get on well with the keen but inexperienced ones cos they're so much less jaded even if they know nothing beyond what it says in textbooks. Some of the ones who've been at it for years have been frankly depressing. Others have been brilliant cos they just get it cos they've seen it for so long.

There is no consistency anywhere though. One will have relevant degrees but no actual knowledge or experience - even when they really should have cos have been working with clients for years. The next will have no qualifications but came up through the direct experience route and then there's the split between ardent 12 Steppers who can't help themselves trying to inflict it on others and the others who never went the 12 Step route - both learnt from doing it but very different approaches to dealing with a client's needs.

If you're somewhere where choice is given and you can switch workers make the most of it and find the one you can best work with. There is no choice at all in some places and with such wild variations in approach, experience and even basic knowledge (I had to correct the fella teaching key workers let alone actual key workers - and had to do so so often he asked me not to come back the next week ) it's a complete lottery unfortunately

 

[THECATINTHEHAT]

One keyworker I had who had never tried drugs once compared my heroin addiction to her like of chocolate.

Would have fucked her off in a second.

 

[THECATINTHEHAT]

then there's the split between ardent 12 Steppers who can't help themselves trying to inflict it on others and the others who never went the 12 Step route - both learnt from doing it but very different approaches to dealing with a client's needs.

If you're somewhere where choice is given and you can switch workers make the most of it and find the one you can best work with. There is no choice at all in some places and with such wild variations in approach, experience and even basic knowledge (I had to correct the fella teaching key workers let alone actual key workers - and had to do so so often he asked me not to come back the next week ) it's a complete lottery unfortunately

My guy's a fellowship man but he's shown no signs of pushing that angle on me. I explained that I had been in and out of NA for a couple of years and I wanted to try something different and he was quite fine with that, suggested SMART recovery etc.

He's looking at starting to run a scheme involving service users helping to train new drug workers, which is a superb idea, and hopefully one I might get the chance to be part of. No certainties in that at alll yet though.

 

[Eveleivibe]

My key worker is truly ace. Told her straight up I need to go on script. I had an appointment for July 2014 to see the doctor in April n she found a wsy of getting me in the next day as she was extremely worried over me. I had to a urine sample n btw, codeine comes out as morphine in the test, twas ace.

Anyway the doctor was lovely with me, put me on suboxone the very next, He wrote the script there n then, shook my hand, never judged me but was genuinely lovely.

My key worker listens to me. They let me increase subs last November because I was sti craving badly, was drinking heavily n self-destructing. I'd take lots of citralopram or anything which could harm me.

They put me on Mirtazapine for a bit but it made me angry all the time so went back to GP n went back on citalopram. Once I'd quit the drink I started feeling better.

My key worker has never give up on me n she says I have made lots of progress. She was also worried about me once when I was going on certain sites because i was always going there in tears , nit slept but she says I'm starting to look a lot happier now. And she is going to do CBT with
Me so I change my way of thinking n reactions to things - and hopefully I'll achieve some goals I have set myself. But everything takes time n patience is the key in this life.

So yeah I'd hate it if my key worker got changed because of the help she has given me. And I'm so glad to have her as my KW. As for the place itself I hate it because we're treated like criminals which I find slightly offensive.

To be honest I have to thank a friend of mine. The doctor had me referred to some prescription service who weren't able to put people on scripts - just acupuncture - and why on EARTH would I want a load of needles in me? A friend kept on at me to try the other place so I did. Tbe place I'm at now said as I was purchasing codeine illicitly the prescription service wouldn't have taken me on - they were for OTC clients. Thank God! LoL.

Evey