Pubdate: Wed, 26 Jul 2000
Source: Irish Times, The (Ireland)
Copyright: 2000 The Irish Times
Contact:  11-15 D'Olier St, Dublin 2, Ireland
Fax: + 353 1 671 9407
Author: Kitty Holland


Homelessness, a hostile treatment programme and prostitution all make
recovery from heroin addiction even harder than it already is. Members of a
new lobby group for former drug users talk to Kitty Holland

"Asking an addict what his opinion was about treatment - about anything in
fact - would be like a dog asking the fleas on his back what they thought of
fur. That might sound a bit rough, but that's the truth of it," says Tommy
Larkin. "That's what most addicts believe the world thinks of them, so most
wouldn't think there was any point in even trying to have a voice. Who'd
listen to fleas?"

Tommy Larkin is the co-ordinator of the Union for Improved Services,
Communication and Education (UISCE) - a kind of union for recovering heroin
addicts - formally founded in June last year. With his background in
addiction counselling at the Merchant's Quay project in Dublin and at
several centres in Britain, Larkin was chosen by the North Inner City Drugs
Task Force to take charge of the fledgling UISCE.

UISCE has nine staff and voluntary workers running operations. When asked
about the concerns of recovering heroin addicts now on State-run methadone
maintenance programmes, Larkin points to a survey UISCE carried out among
drug addicts on the street and at drop-in centres last year.

"We listed 10 issues and asked people to indicate which three they
considered the most important. Survey results are empirical data which we
can bring to the task-force and the statutory bodies," he says. "They can't
dismiss data the way they might individual users' complaints."

The issue that most concerned users was homelessness, with 78 per cent
stressing it. "Sixty-one per cent highlighted concerns about their
treatment, and some of the other things that worried or annoyed them were
around discrimination, having to use Benzos [Benzodiazepine, a drug
available on prescription often misused by addicts to supplement methadone
or heroin] and prostitution.

"We have to do something about the methadone situation," he continues.

Phillip (38), an addict who has been stable on methadone for almost four
years, explains addicts' concerns about the "methadone situation": "In the
clinics there seem to be all different types of methadone being given out.
It used to be a brown colour, called physeptone, and that was grand. It
would 'hold' you for 24 hours so you wouldn't go into withdrawals. But they
started giving out this new green coloured one a few years ago and most of
the time it's not actually holding you. It might only last you 16 or 17
hours and then you'd be looking for a `turn-on' [fix] from something else,
just to get you through."

Asked whether he or any other addict had ever voiced concern with the
dispensing clinic or chemist about this, he laughs. "Well I did actually
once but you may as well be talking to the wall."

The then Eastern Health Board decided to move away from physeptone in its
clinics in 1998, when it introduced the Methadone Dispensing Protocol. The
advantage of the new green-coloured methadone, said a spokeswoman, was that
it was more concentrated so less volume gave the same result. Larkin
believes that if UISCE could achieve a re-examination of that 1998 decision
it would give the union "a real mandate". "At the moment a lot of people
think this whole thing [UISCE] is pointless. They think: 'What's the point?
Who's going to listen to drug addicts?' "

Nuala (30) says the thing that most wears her down is the unrelenting sense
that she is seen by wider society as unworthy of respect, or even of being
afforded basic dignity. In particular she cites the "contract" she had to
sign with her local chemist she visits every day, to collect her prescribed
methadone. The contract, with a well-known city centre pharmacy, is headed
"Contract for Supply of Methadone".

Among its 13 points is the following: "I understand that I must attend the
pharmacy alone to leave in my methadone prescription and to collect my
methadone. In the event of my coming to the shop and bringing one or more
people with me, I realise this could mean the end of [X pharmacy] supplying
me with methadone."

Nor is the addict who signs this contract allowed to talk to any member of
staff other than the pharmacist, to "loiter" in or anywhere near the
pharmacy nor to buy anything else in the shop when collecting methadone: "So
if you need some toothpaste or shampoo or something you have to leave the
chemist and come back again," says Nuala. "It's as if you're a junkie when
you're collecting methadone and if you want to do anything else you have to
leave and come back as a 'normal' person. It's as if just because you have
to take methadone you must be a 'junkie' and so you must be a shop-lifter,
who can't be trusted. It's a charter of segregation. I thought I had a good
relationship with my chemist. I thought I was accepted."

There are numerous other issues UISCE members wish to see addressed. Mary
(29) would like an ombudsman to liaise between the authorities and service
users: "It's not that we want a confrontation with anyone. We'd just like if
there was someone neutral we could go to and say, 'Look, this needs to be
sorted out'."

Given that there are an estimated 10,000 heroin-users in the Dublin area
alone - a population Eoin Ryan TD and chairman of the National Drugs
Strategy Review has called the "most marginalised group in society" - there
is clearly a hugely disaffected, unhappy sector of mainly young,
working-class people who feel they have no control over their lives. To
continue with such a situation would hardly be to engage with those who
personify the problem, in a meaningful way. Perhaps recognising this
prompted Eoin Ryan to seek and hold a number of meetings with UISCE.

The North Inner City Drugs Task Force, which instigated UISCE, is one of 14
local task forces established under the First Ministerial Task Force on
Measures to Reduce the Demand for Drugs. Under the chairmanship of Pat
Rabbitte TD, the task force came into being in 1996, in the aftermath of the
murder of journalist Veronica Guerin.

While these task forces for the first time gave local communities a tangible
say in measures to address their problems, only in the past few months has
there been a statutory recognition of the value of including drug and
service users on these forums. The absence of those most directly affected
by the problem, i.e. the drug users, had been neither questioned nor

Larkin wonders whether Irish society is yet ready for a group like UISCE:
"Is a society which, perhaps understandably feels threatened by drug
addicts, that sees them as people who commit crime, who threaten people with
syringes, who don't think about anything but where the next turn-on is
coming from, going to want to change that stereotype? I mean, can people see
addicts as normal men and women with hopes and dreams, tragedies and
despairs like anyone else?"

It will be a challenge, if not an affront, to many people's view of
drug-addiction. But such bodies have existed and thrived in other countries
since the 1970s. In fact, invited to attend an International User's Day
conference in the Netherlands last September, UISCE made contact with
similar groups from eight other European states. Organised by the Landelijk
Steunpunt Druggebruikers or the Dutch National Interest Group of Drug Users,
the conference was a series of meetings where users and professionals met
and discussed pertinent issues, on users' terms.

Among those represented were the users' fellowships and networks from
France, whose representative spoke of concerns about the estimated 80,000
addicts some of whom, he said, were injecting substances which could cause
abscesses and which had resulted in amputations; from Russia, whose speaker
said some 90 per cent of new HIV cases were among intravenous drug users;
and from Belgium, whose representative described a "repressive" statutory
attitude to drugs users, whereby anyone who was convicted for drug dealing
could lose the right to vote.

UISCE is not another therapy group, stresses Larkin, but a forum for
treatment service users to get involved in the decisions around the drugs
issue which, when made, will most acutely affect them.

"A lot of people I'm sure see addicts as just strung-out criminals whose
only concern in life is getting the next fix. Or if they get into treatment,
people assume that's the end of their problem, that they're home and dry.
But that's certainly not how a lot of addicts feel.

"There is a lot of discontent with how things are being done. And what
people should realise is that if an addict is not happy with their
treatment, or feel they have no control over it, the chances of their
succeeding in their treatment are very much reduced."

The group is still in its infancy, but is making strides. As well as meeting
Eoin Ryan, Larkin and colleagues attend not only their local drugs task
force meetings but others also. Last month they produced the third issue of
their newsletter, UISCE. It is distributed free to users.

"But we are really just winging it at the moment. We're sharing offices here
with Dublin AIDS Alliance, and we don't even have a computer or printer of
our own. We're borrowing everything. But it is important that we succeed."

UISCE can be contacted at 53 Parnell Square, Dublin 1
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