Showing posts with label Naltrexone. Show all posts
Showing posts with label Naltrexone. Show all posts

Monday, 9 May 2011

Drug Free Australiaʼs Dr. Stuart Reece & Culpable Abuse Of Patients

If you're part of the movement that opposes vaccines for kids, a homeopathy witch doctor or one of the dangerous, anti-harm minimisation loon squad, then the chances are you have been targeted sometime by Paul Gallagher. As one of Australia's leading skeptics, Paul Gallagher is especially passionate about those who reinterpret science as some kind of self righteous crusade usually involving their religious beliefs or personal ideology. Read on as Paul uncovers some disturbing truths that feel more akin to a science fiction novel than something that can happen in a so called, advanced society. 


DRUG FREE AUSTRALIAʼS DR. STUART REECE & CULPABLE ABUSE OF PATIENTS
By Paul Gallagher

A critical look at faith based practices and superstition used in the abuse of heroin dependent patients, in conjunction with poorly monitored naltrexone prescription.
Dr. Reece continues to practice today and still claims to hold “a world safety record” in naltrexone prescription, despite over 25 fatalities in 20 months.
He continues to write in the anti-drug, ambitiously named Journal of global drug policy and practice. See final pages.
We begin with publications from just after Dr. Reece found the QLD Medical Tribunal indefinitely adjourned his case.
This easy to access and a pleasure to read, embedded PDF of Focus magazine has two relevant stories. On page 1 we meet Graham Preston who was jailed back in June 2003 for pro-life antics. His sole direction was Proverbs 24, verse 11: “Rescue those being led away to death”. Note the bias in how his story is reported and please understand this is an excellent example of using religion to cement tribal cohesion. Now read the story on page 2: Naltrexone Doctor Vindicated and remind yourself of the above proverb. Dr. Reeceʼs “feelings were hurt”. No news on how the 25 corpses are feeling.

For the record, not only is it entirely irrelevant to launch ad hominem attacks on the application of demonstrably efficacious therapy {MMT}, but the claims made have been followed up and found to be fallacious. These statements simply reinforce that fundamentalist indoctrination and zealotry of such lethal extent is resilient to rehabilitation. Attacking an evidence based therapy indicates his aim was never about adding to the rehabilitation arsenal. It was about a personal vendetta over old funding disagreements and his religious conviction that certain policies are immoral. Science is immoral, evolution is immoral, democracy is immoral... Anything not backed by bible blubbery is of course, immoral.

In reality the QLD Health Practitioners Tribunal adjourned indefinitely over the 25 deaths at his bastard baptising, demon exorcising, sin stopping, faith healing hands. Letʼs consider a more expansive view, given that he has since claimed multiple times – and before a Parliamentary inquiry – to “hold the world safety record” in administering the very treatment he killed 25 Aussies with. Like most junk scientists his arguments arenʼt about his supporting evidence, as much as about misinforming people about aspects of medicine he considers immoral. Much like homeopathy, Christian fundamentalism as a medical option [christian science] must discredit that which exposes itʼs lies: simple, ordinary evidence. Dr. Reece is the gentleman who coined the term “hedonistic delirium” to describe modern democracies. Or the simply gorgeous: “Sometimes the best way forward, is the way back” in a brave attempt to argue pre-industrial revolution societies were superior.

Okay – letʼs begin. By 1999 Australia knew naltrexone was far from safe despite “miraculous” stories of recovery. Wodak and Hall discussed the evidence in an editorial in the MJA, that also briefly noted the role of the media in confusing community attitudes. Stuart Reece would never forget this and has “blamed” not only these scientists but projected responsibility for his disgusting conduct onto these very individuals. He has slandered both of these brilliant internationally renowned scientists whilst under Parliamentary protection accusing Hall of “scientific fraud” [Page 61/FHS 55 ]. And he has ignored the Hippocratic oath in his quest to slander and destroy Dr. Wodakʼs reputation.

In September 1999 after being raided and threatened with closure he claimed the QLD government would have blood on itʼs hands if he didnʼt get his way. 20 months later, 25 patients were dead  because he got exactly what he wanted. He was raided and closed down again, much to the ire of the Christian Democrat Party – whose “federal drug policy” proudly claims individual Aussies have no civil rights in this respect. Biblical love is in abundance whenever Dr. Reece is faced with evidence. Three months after claiming 25 “drug addicts” died as “part of a conspiracy”, Reece dropped all pretense and did the media circuit as a faith healer. In fact these “patients” earned him thousands of dollars per head only to be prescribed addictive benzodiazapines – later to contribute to cause of death – as the untrialled and untested naltrexone failed. Had basic support – such as a contact or counseling – been available, heroin overdoses would be highly unlikely. As I noted above, this was never about helping addicts so much as winning a moral argument, and the lucrative contracts that must one day follow.

In October 2005 Christian conservative Tony Abbott MP Liberal (then Federal Health Minister) funded Drug Free Australia to the tune of $600,000. They breached almost every condition under which they were awarded the funding, ultimately emerging as right wing lobbyists – not therapists – and set about promoting Creationism, Conservatism and Punishment for all. They are devout followers of Swedenʼs zero tolerance policy and the USA hardliners [open letter] who cling to lucrative contracts and powerful identities. Reece, a supporter of biblically driven abstinence and Texas trained fundamentalist was back with backing.

By April 2007 Dr. Reece was testifying to a Parliamentary Inquiry that the immoral policies that permitted condoms – the real cause behind AIDS – clean needles, opioid therapy for addicts, non-punitive cannabis laws, harm reduction and general tolerance for ill Aussies would be our doom. In utter amazement the Senate Standing Committee stared as this “expert” whoʼd introduced himself by saying “I certainly know the science”, displayed a photo of “the archaeological site of Sodom” and a tree with snakes instead of branches. [Page 33/FHS 27]. The point to this? “There will be consequences”.

As reported in Crikey by Ray Moynihan our world expert decided the “disease drugs, sex and rock-n-roll” was the problem at hand. Asked about the safety of naltrexone, Dr. Reece immaturely attacked the internationally renowned scientist, Dr. Wodak [Page 59/FHS54], who specialiseʼs in blood born viruses and epidemiology – which means he supports condoms, clean syringe access and used syringe collection: dire threats to our very civilisation, claimed Reece. This childish ad hominem approach is common despite the fact entire shires with dozens of dispensaries and hundreds of clients report no methadone deaths. A minority report death, and methadone is one toxic substance on a list of many. It is taken under supervision, immediately after being prepared by a pharmacist. Compared to 25 deaths at the hands of one man in a year and a half, a scattering of deaths across hundreds of outlets in every state, is of no significance. Dr. Albert Stuart Reeceʼs real world record is clearly in reckless fatalities.

How did Committee Chairperson react to this insanity? Bronwyn Bishop slandered and abused public health scientists yet gushed uncontrollably in support of Dr. Reeceʼs voodoo. A pre-determined agenda in what was billed as the most important family relevant inquiry of Howardʼs government spoke volumes. Bishops final report was rejected nationwide by all but religious fundamentalists and Christian lobbyists. Read my lips. Not one single publically funded treatment or advocacy agency in our nation missed the opportunity to criticise in scathing terms her “report”. Which you may remember from coverage of her wish to “take the children” of drug users with “absolutely no chance” of reunion.

Gordon Moyes also forgot about Proverbs 24, Verse 11 shouting praise for naltrexone despite the grave concerns of our medical community about it remaining unregulated – but lucrative for the same people year in, year out. When the Medical Journal of Australia exposed the fact these same misguided faith healers were not reporting adverse reactions – despite TGA requirements under the Special Access loophole demanding it of them – Dr. Gods team were having none of this “academic stuff”. Drug Free Australia actually published a sorta, kinda rebuttal. And yes, adorning the page is direct reference to Dr. Stuart Reece himself. In deeply offensive mockery boasting how Reece “studies” death rates post treatment they entitled their piece of twaddle, Australia could be the biggest loser.

I could go on and on, and the above is a cut down sanitised version sparing you Dr. Reeceʼs sickening obsession with teenage and childhood sex and sexual assault, murder, violence... all due to “the depraved advertising industry” which catalysed “the disease sex, drugs and rock-n-roll”. Advertising womenʼs nudity, outside of “a strictly medical context” is, in his ever so wise [and medically qualified] eyes, “incredibly powerful pornography.”

Today, a decade plus since this intellectual repugnance began, Reece is front and centre as a pin up boy for religious fundamentalism. Three years ago he promised Parliament with a blinding flash of Peacock Terminology that his results were “statistically powerful” and “revolutionary”. Of course, there are no results. Itʼs the same certainty that only faith can sustain. If prayer cures homosexuality, addiction is a certainty. His latest work “proves” naltrexone is safer than opioid therapy. As reported on ABCʼs 7:30 Report  in 2006 multiple disciplinary teams have steadily found naltrexone has a fatality rate over four times that of opioid therapy. Dr. Reece, and others who seek funding and massive contracts seem to have a magic formula no others can find.

My point to this indulgent diversion is that Australia is no stranger to standing back with folded arms and by not acting as we would expect a just society to act, reinforces the misguided belief that religion is the “untouchable” tool. For over ten years a huge part of our public health system has been exploited in the name of religion. How have we allowed progressively malignant superstition to dictate to us on morality? Given the example set by the USA why are we intentionally expanding and funding fundamentalist religions? Why do we insist that junk Christian science is “harmless” and ones own choice, in the same way we insist alternative medicine is harmless and “an informed choice”?

Only in recent years has the orchestrated rejection of default respect for religion found a strong voice. We no longer accept in total the authority of those who use God as an `excuse – as we see done above – but we still have a very long way to travel intellectually. I would also argue that we must not be led further astray by those who use the “F Word” – family values – so liberally. The value of any family is much like the institution of marriage. Place it above human rights and human beings will be abused in the name of subjective value judgement.

So my greatest question is along the lines of concerns already raised: the intentional maligning of science. In its typical tradition, the splintered and fractured divergences of Christianity that stoke the engine furnace of conservative fundamentalism invite steadily more bizarre practices into its protective fold. Only a fool would accept abundant taxation and Equal Opportunity exemption is not exploited and as with all power, will be jealously guarded and arrogantly inflated.

How long before we as a community demand legislators acknowledge that default cap in hand respect and trust is fraught with risk already evidenced by the abuse of our vulnerable, flagrant law breaches, financial scams, bigotry, insouciant discrimination and, as seen with orchestrated child sexual abuse, an excuse for crushing immorality? What future can we expect if we allow this illusion of god-given elitism to increasingly include rejection of realities that conflict with demonstrably false and absurd beliefs? How long before Equal Opportunity exemption includes rejection of educational standards? Is not freedom of religion at risk of abandoning its duty to community cohesion such that Christians may enjoy an escape from reality?
Already we allow home schooling that is overtly biblical and anti-ʼmodernityʼ. We permit dietary restrictions that run in direct contrast to national daily nutritional intake requirements, never questioning if the children starved of iron and protein this way are simply pawns in their parents deluded vacuum. We allow parental denial of the administration of medical technology that would save a childʼs life: a simple blood transfusion. Anti-vaccination conspiracy theorists promote “conscientious objection”. We fund schools not to educate students but to fill their minds with archaic ideals. Ideals so easily refuted by merely looking around our Fair Go nation that a great deal of supporting intellectualism is spent mocking, discrediting and misinforming on the topic of science.

The Christian god demands he be loved above and beyond any and all – including family members. Having perhaps not insignificant experience fending off ʻchapter and verseʼ arguments Iʼm reminded by this video [Part 2] of Abraham and Gods test of his loyalty. He was ordered to kill his son on Mount Moriah according to Genesis 22: 1-24. Not until he had bound his son Isaac to a sacrificial alter and held the dagger aloft did good oleʼ god step in and say, “Ho, Ho – just joshing old friend”. Or, words to that effect.

The final question is perhaps, how many will be abused, exploited, tormented, mocked, slandered and threatened simply because we are yet to demand the burden of proof be met? But to do so in any serious legislative manner is to lose ones political influence. A direct loss of votes. Religious apologetics – even moderate Christian Kevin Ruddʼs “working families” dash to church each week – is steadily cranking that heavy jagged wheel of global superstition.

And it is our very selves and our species brightest traits that is crushed beneath.


Comments posted online from a relative and a friend of Reeceʼs patients.
Just Jules says: June 5, 2010 at 6:01 am Ahhh there is none so blind as those who can not see .. Dr Reece in my eyes is a discusting (sic) human being .. I am the mother of a child he treated .. He also treated my daughter in law and the mother of my first grand child .. If you want to see what his methods leave you with, go see my daughter in law who for the last 11 years has been in a home for the severely brain damaged .. In is own words to me ” they are just reoffending drug addicts”. He is a wolf in sheeps clothing and should of been stopped before he started

Vicki PS says: July 5, 2010 at 12:02 pm I came across this site looking for help for a friend of my daughterʼs. This young woman has been increasingly unhappy with her treatment under Dr Reece. He is treating her addiction with Suboxone, a subutex/naltrexone combination drug. Her big concern is that this unethical, immoral disgrace to the profession reduces her dosage if she has not been to church! This girl is now in early pregnancy and is scared that she could miscarry if this idiot messes around with her medication to suit his pathological world view. I find it frankly incredible that Dr Reece is still permitted to practice.


Stuart Reece:
The Journal Of Global Drug Policy And Practice
Gordon Moyes - “a Christian voice in politics”:
House Standing Committee on Family and Human Services: Australian Parliament
Inquiry into the impact of illicit drug use on families. Chair: Bronwyn Bishop MP - Liberal Party.

Final Report - The Winnable War on Drugs - Bronwyn Bishop September 13th, 2007. Audio of Bishopʼs launch of The Winnable War 


"To the crimes against humanity, it is incumbent upon us as oath takers, advocates of neutrality, professionals and ethicists to note one more. The intentionally malignant anthropomorphism of "science". Science is the vehicle that set us free and we owe our global cousins everything we have gained - indeed as we gain.

To demand that affluent society must now see it as a lumbering, monstrous, "evil" and sentient agent with the single aim of polluting human morale is puerile, ideological, mischievous and markedly in error. We are agents of morality far, far before and because we are agents of evidence."
- Paul Gallagher. August 2009


Paul Gallagher. May 5th, 2011 - republished from October 17th 2009. Copyright: All Rights Reserved.

Thursday, 28 May 2009

Miranda Devine Vs. Reality

Miranda Devine Going Ape Shit
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
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.
Related Articles: