Pubdate: Sun, 15 Oct 2000
Source: Sunday Independent (Ireland)
Copyright: 2000 Independent Newspapers Ltd
Contact:  http://www.independent.ie/
Author: Peter Murphy

THE TIGER'S DARK UNDERBELLY WILL NOT STAY HIDDEN FOREVER

A Priest Scrounging Methadone On The Streets Is A Cold Fix Of Reality, 
Reflects Peter Murphy

A rebel Catholic bishop roaming Dublin after dark trying to score methadone 
for the heroin addict he has taken under his wing. It's an image that could 
only have been disgorged from the underbelly of 21st-century Ireland.

Dissident bishop Pat Buckley's admission, on Marian Finucane's radio show 
last Wednesday, that he had illegally obtained methadone in order to help a 
young friend kick his heroin habit didn't just make for an ear-grabbing 
opening it also highlighted present and past governments' failures to 
implement satisfactory rehabilitation programmes for the estimated 13,000 
heroin addicts in Dublin.

Bishop Buckley met his charge, a 20-year-old homeless heroin addict, some 
six to eight weeks ago. The young man told him that he was ready to stop 
using heroin, and a place was obtained on a 90-day drug treatment course, 
with the stipulation that he be clean for 10 days before attending. 
Perturbed by the 10-day rule (by no means one common to all treatment 
centres), the bishop offered the young man shelter while he prepared to detox.

He also agreed to procure the 185 millilitres of methadone deemed necessary 
to wean him off heroin, a figure arrived at through a 10-minute emergency 
assessment process carried out at Trinity Court drug-treatment centre. 
According to Bishop Buckley, due to waiting times and clinical assessment 
procedures, the young man can't be seen there again for another six months. 
As Finucane pointed out, the administration of untested methadone without 
expert medical supervision is extremely dangerous. However, Buckley 
insisted it was not a decision he had taken lightly, and he had enlisted 
the help of a GP friend.

``At the moment his two arms are like two pin cushions,'' Buckley said, 
``and he's full of abscesses from syringes. If he is left on the streets of 
Dublin for the next six months he is in much more danger than coming to me 
with the help of medical supervision and then going into a special unit.''

Perhaps surprisingly, Finucane's programme was flooded with calls of 
support for the bishop the following day, reflecting a deep dissatisfaction 
with the rehabilitation systems that are currently in place, but also 
voicing concerns about methadone itself, the subject of ongoing controversy 
among drug-treatment experts.

Frank Buckley, who served as an inner-city community representative on one 
of 13 government funded drugs task forces from 1997-98, has expressed 
concerns about the bishop's actions, and methadone in particular.

``I think what he's doing is very dangerous,'' he says. ``He's trying to 
get him physically off heroin, but he's giving him another drug. But that 
other drug is more dangerous if that chap decides, `I'm going out to get 
stoned', and he's already after drinking 200mls of methadone or whatever.

`With all the will in the world, the guy wants to give up heroin and has 
convinced the bishop. But if he doesn't know how a drug addict thinks, he 
could be talking to him for days, and then within 10 minutes the guy could 
have a needle in his arm.''

Frank Buckley believes that, rather than addressing the core problem of 
addiction itself, methadone is a stopgap solution used to keep crime levels 
down. ``Any government, they look at the four-year spell that they're in, 
and they say, `What's the short-term [solution]?' If 80-90 per cent of 
crime is drink-or drug-related, if they can zombie-fy most of the junkies 
in Dublin, there's the figures down.''

Buckley also points out that addicts can exaggerate the extent of their 
habit in order to obtain higher doses of methadone from drug-treatment centres.

``By the time the Eastern Health Board had come to the conclusion of 
administrating methadone, the findings in Europe were coming out that it 
was dangerous unless you have complete control,'' he claims.

Drug-treatment centres such as Trinity Court receive literally thousands of 
phone calls from parents ready to assist their sons and daughters in 
getting clean.

However, the long waiting lists often result in addicts attempting to go 
cold turkey in unsupervised or isolated circumstances, without proper 
counselling, sometimes resulting in suicide (indeed, Bishop Buckley 
admitted to Marian Finucane that a nephew of his killed himself in similar 
circumstances three years ago).

``It doesn't necessarily take so long to process people,'' explains Dr 
Eamon Keenan, a senior doctor at Trinity Court. ``It's based on the 
clinical assessment which is carried out at the emergency assessment to 
start with. That's then discussed at a clinical team meeting, each case is 
looked at on its own merits and a decision is made in terms of priority for 
certain individuals.

``Work is going on to open a number of treatment locations throughout the 
city which would significantly impact on waiting lists,'' he continues. 
``It's not necessarily funding or resources there's a certain consultation 
process that we have to undergo with local communities.''

How does Dr Keenan respond to criticism of methadone treatment as merely 
replacing one drug with another? ``Methadone is the most widely validated 
and researched form of drug treatment for opiate addiction,'' he indicates. 
``What I would say about any methadone programme is, it's not a stand-alone 
treatment. Just by giving methadone to a drug user, it doesn't solve the 
problem that person does need to be involved in counselling, or social 
work, nursing or medical intervention ... so it's a whole package of care.''

But cold turkey can be excruciatingly painful for addicts, and long-term 
detox programmes are costly for the State. ``If you can imagine somebody 
throwing tar over you, or when you get a burn on your skin, that's how you 
feel when you're coming off heroin,'' Frank Buckley testifies. ``There's a 
history for everybody it's to get into that history, and that's what 
treatment centres do, they bring you back to where it began, where you 
decided to forget about life. That's the stuff that's really hard-core. And 
that process is not being fully implemented, because it's long-term and 
it's too costly.''
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