Miranda Devine Vs. Reality

What is it with Miranda Devine and reality? Is she really that far detached from the real world? Every time the Sydney Morning Herald publishes her ramblings about illicit drugs, the more obvious the answer becomes. Every drug related article by Devine that I have read reeks of ultra conservative ideology and is hellbent on pushing the "War on Drugs" mentality. This is not some concerned citizen nobly defending society from drug crazed junkies but a hardcore zealot using deceit and the media to pursue her ultra right wing views. Most worrying is that she is free to proselytise her flimsy views via a national platform like the Sydney Morning Herald. Considering her conservative, apocryphal articles and the quality of her information, it’s surprising that that her rants are not under the corporate umbrella of News Ltd.


And where does she get her information from? In her latest article, Addicts Say Abstinence Sets Them Free, Devine once again, takes deceit to a whole new level. The assumptions are brain chilling and much of her information is simply wrong. For example, Cabramatta police turning a blind eye to drug dealers? Very few options for addicts apart from Opiate Substitution Treatment (OST) like methadone? Abstinence is a dirty word in the AOD treatment industry? The biggest advocates for drug prohibition are former addicts? An addict’s last hope is naltrexone implants? The “methadone industry” benefits greatly from a large number of patients? Nearly every point Devine makes is a fantasy dreamt up to support the “drug free world” illusion. This is not worthy of publication in Mad Magazine let alone the Sydney Morning Herald.

Devine argues that Opiate Substitution Treatment (OST) like methadone is evil and abstinence only programs are unfairly being ignored by a greedy, self serving “methadone industry”. The attack includes her old favourites, Harm Minimisation and the NSW government whilst flying the flag for the "War on Drugs". It’s standard fare for Miranda Devine.

But abstinence has no place in the curiously monocultural drug and alcohol world of NSW

-Addicts Say Abstinence Sets Them Free by Miranda Devine - Sydney Morning Herald

So what is the basis for Devine's article? Believe it or not, it’s a few recovering drug addicts who disagree with the mainstream. Three out of hundreds of thousands who have benefited from OST, declare they were not happy being on methadone and buprenorphine. I know first hand that methadone or buprenorphine is not for everyone but that’s not unusual for any medication or treatment. But the facts speak for themselves. Opiate Substitution Treatment (OST) is the most successful treatment we have readily available for opiate addiction. That’s not to say that abstinence only treatment doesn’t have a place in recovery but unless an addict is 100% ready to quit, it’s pointless. Devine's solution is naltrexone implants. Whilst implanting naltrexone is fine for some, pushing patients into this treatment has shown to have dire consequences including death. Devine and co. feel that being totally drug free should be the only goal of drug treatment including programs like the Narcotics Anonymous(NA) 12 steps program, drug free detox centres and of course naltrexone implants. But this model of abstinence only treatment has really only been mainstream since prohibition where before that, the actual drug of addiction was prescribed to the addict until they were ready to quit. It seemed to work very well until the conservative, religious loonies got involved. Now many decades on and with a world where abstinence treatments compete heavily for the this lucrative market, addiction rates remain as they were a hundred years ago when they first stared recording these statistics. The big difference is the number of relapsing patients thanks to abstinence only programs.

Reuben, too, was prescribed methadone when he sought help for his addiction. He was given no other option but to accept addiction for life, a slave every day to the methadone clinic he hated.

-Addicts Say Abstinence Sets Them Free by Miranda Devine - Sydney Morning Herald

It’s difficult to examine the example addicts in Devine's article without knowing more details. The story of Sam being put on buprenorphine appears inappropriate but ironically, once out of jail he was back on heroin. Both Sam and Rueben have only been clean for less than 8 months which is way too early to examine their success. The real danger comes when their naltrexone implants stop working and they relapse. With no tolerance to opiates, even a tiny dose of heroin will kill them. But that’s not important. What counts to Devine and co. is that these addicts are now clean and whether they relapse and die doesn’t matter.

Methadone

Three grumpy, recovering heroin addicts does not compete with the success of OST. Methadone Maintenance Treatment(MMT) was never meant to be a cure for heroin addiction but a way to stabilise a patient’s life. It removed the insatiable need to feed their addiction every day which often involved crime. It allows time to re access priorities and slide back into society giving addicts the chance to work and function like everyone else. Using methadone as a holding treatment until the patient is ready to start a decline in dose wasn’t the standard practice until the last few decades. This has lead to a popular belief that those who don’t completely stop methadone are not successful. And that’s where Miranda Devine’s article fails once again. To ignorant, moral conservatives like Devine, abstinence should be the only goal and methadone is seen as some sort of excuse that just keeps a patient addicted. She is either unwilling to allow medical facts and logic to overcome her conservative views or she’s just thick. The other option is she doesn’t really care and is simply a dickhead.

Devine uses psychologist Ross Colquhoun to back up her argument against methadone. Colquhoun makes some remarkable statements and assumptions that plainly show how wrong Devine is.

The Government does not have an exit strategy for people on methadone, who they are prepared to leave addicted for ever

-Dr. Ross Colquhoun

This is simply a lie but it’s not uncommon for anti-Harm Minimisation zealots to take myths and declare they are facts. It’s only recently that doctors have started to rethink their strategy for some methadone patients. Nearly all patients were weaned off their dose over a period of time but doctors have started to concentrate on keeping some patients stable and maintaining a steady dose. Contrary to Colquhoun’s claim, most MMT patients still have a reducing dose with the goal of abstinence.

Methadone has a place in treatment in the short term but many people grow out of it and want to get on with their lives

-Dr. Ross Colquhoun

Methadone was never meant to be a short term treatment but with pressure from anti-drug groups and tossers like Colquhoun, the push was on to produce results. For naive governments and abstinence only supporters, success meant addicts being totally clean. There was no room to count rehabilitation whilst on MMT as a success as it only muddied their results. This lead to pushing addicts thorough the system quicker. Being on treatment wasn’t enough, they wanted clean, fully recovered patients regardless of relapse. You probably have heard it before from politicians who call methadone, "liquid handcuffs" or claim addicts are just swapping one addiction for another. A recent announcement from Scotland said that they were considering the removal of MMT and replacing it with abstinence only programs. The reason was of course that too many addicts were still on methadone. Bronwyn Bishop and John Howard have made a point of it, Fred Nile raised it in parliament, John McCain tried to introduce a similar bill in the US and several UK politicians have pushed for it. All of these attempts are based on ignorance and winning popularity. The fact is, OST has helped millions of people worldwide and is accepted by addiction specialists as the best solution currently available.

Naltrexone

I have experienced Rapid Opiate Detoxification (ROD) and naltrexone first hand. Luckily for me, the naltrexone was administered by taking a pill each day because after 3 days, I had a bad reaction and had to stop taking it. If it was an implant, I probably would have taken the same course of action like many others and cut it out myself with a razor blade. The ROD was the worst experience of my life which left me almost comatose for 2 months. So what was the problem? Apart from being on a high dose of methadone, naltrexone didn’t agree with me. Those pushed into naltrexone implants don’t have the easy option to simply stop taking a pill and must request that it be removed surgically. Fat chance of that. The main problem with naltrexone implants is the risk of overdose. If the patient does cut it out or the implant ceases to work, they are left with no tolerance to opiates which means their next hit of heroin might be their last. There are dozens of cases of death from overdose after naltrexone treatment and usually from those who were coerced into receiving the implants. 

What most people don’t know is that naltrexone implants have not been approved by the Therapeutic Goods Administration (TGA).  For 10 years, the biggest clinic in WA which is funded by the government, still has to get a special permit to operate because the implants have not been approved yet. The clinic, Fresh Start is using a clause in health legislation that allows experimental treatments for life-threatening conditions. There have been many articles and reports criticising the practice but the faithful continue to praise the treatment as the only way forward for opiate addiction. The push for naltrexone implants comes from several dedicated anti-Harm Minimisation warriors including Drug Free Australia (DFA), Bronwyn Bishop, Dr. Stuart Reece and Dr. George O’Neil. The latter two being owners of addiction treatment centres who specialise in these implants. Reece was once charged with the deaths of 25 patients and was investigated for treating a pregnant addict although naltrexone implants were never cleared for use during pregnancy. Both Reece and O’Neil are opponents of needle exchanges, OST and even promoting condoms for safe sex. They frequently use quotes from the bible and other religious symbolism in their quest for abstinence only treatments and Reece even went as far as saying that “Jesus cures addiction". These 2 doctors are the basis for the promotion of naltrexone implants. Not because they offer some magic formula for curing opiate addiction but because it is an alternative to OST and Harm Minimisation. Naltrexone implants stop the effects of heroin and force the patient into total abstinence which is the key to it’s popularity amongst the religious right, moral crusaders and prohibitionists. Damn the results, the deaths and the relapses. Who cares if someone is not suited to an implant ... it’s not Harm Minimisation!

Zealot

What drives Miranda Devine to repeatedly push myths and misinformation onto the public? What does she have to gain except criticism from those who are more knowledgeable than her? Every time she writes about drug related issues, dozens of people expose the flaws and fallacies in her article which would be enough to force most writers to re-examine their views. It would at least prompt most writers to double check their facts. 

Devine despises Harm Minimisation and believes that drug use is an issue of law and order. She is a self confessed supporter of the "War on Drugs" and will go to great lengths to discredit any opposition.  Devine has no ability to accept modern medicine and scientific research if it steps on her ideology. It feels remarkably like someone who believe in creationism and who will do anything to prove science wrong for their convictions. These are not the traits of an intelligent, rational adult but a fanatic, obsessed by misguided dogma, fighting their own fears. Ignoring facts and evidence are the traits of a zealot - a person who is fanatical and uncompromising in pursuit of their religious, political, or other ideals, someone who considers their own views more important than those of experts, someone who believes their own bullshit. Having an opinion is one thing but misleading and deceiving nearly a million readers is bordering on the edge of lunacy. 

Addicts Say Abstinence Sets Them Free

By Miranda Devine

Sydney Morning Herald

May 23, 2009

When it comes to drug prohibition, the biggest advocates are former addicts, if you can find any in NSW, where abstinence is a dirty word and the state requires its heroin users to be sedated on methadone for the rest of their lives. 

Just ask addicts what they thought of the harm minimisation experiments of the 1990s, when police were instructed to turn a blind eye to drug use in Cabramatta, Australia's heroin capital.
"While it's so easily available its always a problem," says Reuben, 28, a former heroin and methadone addict who has been drug-free for four months. In the mid-1990s, he was smoking marijuana every day, when he and his friends started riding the train to Cabramatta to get heroin.
"I avoided it for a little while but it was so good, so pure, so easy to get. Police never told the dealers to back off. A 13, 14, 15-year-old kid doesn't know right from wrong.
"You use it because it's there and because the people around you use it."
Sam, a 30-year-old former heroin addict, is still angry when he talks about Cabramatta. "You couldn't ride on the train without people asking you 50 times [if you wanted to buy heroin]. Why did the government stop police from arresting [dealers]? There were no police whatsoever. It was a safe haven for heroin dealers. It isn't good for us … We need prohibition."
Sam ended up in jail, where he took the opportunity to go cold turkey. He spent three days in a dry-out cell, enduring the nausea, diarrhoea, hot and cold flushes, insomnia, pain and stomach cramps. He spent the rest of his three-year sentence drug-free - or he would have. Three months before he was due to be released he was told that, as a heroin user at risk of relapse, he would have to start taking a highly addictive synthetic opiate, buprenorphine, or "bupe", a methadone substitute, or he would not get parole.
"I didn't want another habit," Sam says. "I kicked the habit when I got locked up. [But] you've got no option." He describes bupe and methadone as "liquid handcuffs". He left jail a buprenorphine addict, and was soon back on heroin.
Reuben, too, was prescribed methadone when he sought help for his addiction. He was given no other option but to accept addiction for life, a slave every day to the methadone clinic he hated.
The harm minimisation industry philosophy that holds sway in NSW is that once you're an addict, you are always an addict. But, for those who don't want to spend their life as a drug-addicted zombie, there are few options.
One of their last hopes is the psychologist Ross Colquhoun's addiction clinic in Ultimo, the only place in NSW to perform rapid detoxification on addicts using implants of the non-addictive drug naltrexone, which blocks the effects of opiates on the brain for about three months.
This morning two addicts will undergo the rapid detox, sedated and under the supervision of a doctor and two registered nurses. Their physical cravings gone, they will need counselling and further implants but, like thousands before them, their chances are good, Colquhoun says, of freeing themselves from addiction.
But abstinence has no place in the curiously monocultural drug and alcohol world of NSW. And so Colquhoun's naltrexone clinic has been under heavy fire for 10 years, with 10 complaints to the Health Care Complaints Commission - all cleared - withdrawal of a federal grant, and general bad-mouthing, to the point where one staffer says: "We are being treated like a backyard abortion clinic in the 1950s."
Two weeks ago came the latest blow that may prove to be the killer, when the NSW Department of Health's Pharmaceutical Services Branch withdrew permission for the clinic to use a morphine drug (MS Contin) as a "bridge" for detoxing methadone addicts. Because methadone is so addictive and causes such terrible withdrawal problems, addicts must abstain for at least five days before detox. Switching to MC Contin stops cravings and is easier to detox.
Critics regard naltrexone as a tool of "coercive abstinence". They say it causes deaths because, when the implant effect wears off, an addict's previous resistance to heroin is gone and they can overdose.
But what is the alternative?
"The Government does not have an exit strategy for people on methadone, who they are prepared to leave addicted for ever," Colquhoun says. "Methadone has a place in treatment in the short term but many people grow out of it and want to get on with their lives."
The methadone industry is booming. Figures from the Australian Institute of Health and Welfare this week showed the number of people on methadone has almost doubled since 1998, up from 24,600 to 41,300 last year, with the majority of doses dispensed privately. No wonder the methadone industry is defensive.
Colquhoun regards methadone as an instrument of "social control".
"They want to keep you nice and happy and sedated and drugged," says Jodde, who managed to wean herself off a massive 120-milligram daily dose of methadone three years ago.
"I was like a vegetable … The doctors, the police, they're all working to keep you in a shithole.
"Once you're a methadone addict, you're public property. You're a piece of crap; you have no rights. It's degrading. You go to seek help and that's what happens."
Sam and Reuben have overcome their addictions so far with the help of naltrexone. Sam has reunited with his family, and has not taken drugs for eight months.
Reuben is at TAFE studying adult literacy. "I've only just started enjoying being straight. It's a dramatic change from not being able to do anything.
"I feel productive for the first time in my life. I haven't ever really felt that."
You need a good reason to deny Reuben that chance.

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