Pubdate: Mon, 19 Feb 2001
Source: Age, The (Australia)
Copyright: 2001 The Age Company Ltd
Contact:  250 Spencer Street, Melbourne, 3000, Australia
Website: http://www.theage.com.au/
Forum: http://forums.f2.com.au/login/login.asp?board=TheAge-Talkback
Author: Chloe Saltau

HANGING IN THERE

For Paul McDonald, helping young people with drug addictions is all about 
color and movement. It seems strange, in a business so full of sadness, but 
in an effort to explain what he means McDonald who is about to leave 
Victoria's Youth Substance Abuse Service to take up a senior role in drug 
policy development with the State Government delves into Greek mythology.

Sisyphus, the King of Corinth, was condemned in Hades to spend an eternity 
pushing a marble boulder up a hill, only to watch it roll down again once 
he reached the top. Pink Floyd wrote a song about it, which McDonald 
recalls was an instrumental track flecked with synthesisers and color and 
movement. He thinks the story and the song are metaphors of sorts for the 
work the YSAS has done with substance abusers aged between 12 and 21 since 
it was established as a result of Dr David Penington's first set of 
recommendations to the Kennett government in 1996.

There's a repetitive grind about the work, McDonald says, but sometimes, 
such as the time a Buddhist Tibetan nun visited the YSAS day program in 
Fitzroy, the color and movement rise above everything and a rare sense of 
peace and stability settles on the place.

"It's about hanging in there, I suppose. It's hard to talk about it in 
terms of successes and failures because the boulder never quite gets over 
... I think it's more about the journey than the destiny."

The voyage started three years ago, when McDonald a former chief executive 
of the Council to Homeless Persons, director of Crossroads Salvation Army 
and program director for St Kilda Crisis Contact Services was appointed as 
the YSAS's executive officer. Mostly the individual journeys have been 
private ones, winding their paths behind the bigger, more public, more 
political battles for supervised injecting rooms and heroin trials in 
Victoria. McDonald supports both proposals, but has argued consistently in 
recent years that they are only part of a "bigger game".

Last year YSAS outreach teams contacted 8000 young people on the streets of 
Melbourne and provided casework, treatment and support to more than 1400. 
About 90per cent of those helped have a heroin addiction, while others are 
dependent on benzodiazepine, chroming, alcohol and cannabis.

About 30per cent are 16 or younger, and 20per cent have mental illnesses. 
The YSAS has also developed a home-based withdrawal service for young 
people addicted to heroin or cannabis, and has tendered for the state's 
first residential rehabilitation facility exclusively for people aged 
between 12 and 21.

Then, the saddest statistic. In the YSAS's first three years, 22 young 
people connected with the organisation have died.

McDONALD remembers the most recent death, just before Christmas, the most 
vividly.

"It was a very sad death. He was very young. They're all young...," he says.

This boy was 14 and, according to YSAS outreach worker Helena Jedjud, he 
seemed even younger, a child. He was due to fly out of Australia in a last, 
desperate attempt by his mother to remove and protect him from the city 
drug scene the day after he died.

Jedjud had known the boy since he was 12, when he first came into contact 
with the YSAS after smoking heroin. His heart was set on being a DJ and he 
loved sport, but before long he was expelled from school. He lived in 
"extreme and utter poverty" and Jedjud explains that, sometimes, "trading a 
couple of caps" first to "buy some groovy clothes" and later to support a 
heroin habit can seem the most attractive of many evils through the eyes of 
a 12-year-old.

Two years later, the boy's friends burnt incense sticks in the stairwells 
of the inner-city Housing Commission flats where he lived. He had died of 
an overdose.

More than 150 people turned up to the funeral on that Wednesday in 
December, and only a handful were adults. Every pall-bearer was younger 
than 17.

The widespread public perception of heroin users would have us think that 
the next hit is all-consuming and that all else food, drink, sex, 
friendship fades into insignificance, but something jarred inside the 
teenage drug users, and indeed among the mates who had never touched 
heroin, when the popular 14-year-old died. It showed McDonald that among 
drug users, as among any cluster of young people, there is genuine 
camaraderie, not to mention real sadness when the lifestyle most of them 
detest kills someone. One of them.

Two days after the funeral, about 30 close friends turned up at the YSAS 
day program to reflect and grieve.

"It really affected them," McDonald says. "When they see one of their 
friends go, it really is like a death in the family. These are young lives 
and they're living against the odds...

"I think there's a deep paradox in the way we treat young people. We expect 
too much. On one level they are independent, on the other they crave 
dependence and nurturance."

Last November McDonald presented a submission to the House of 
Representatives Standing Committee on Family and Community Affairs, which 
was investigating substance abuse in Australian communities. In the 
submission, he offered a snapshot of the young people whom YSAS had been 
unable to save.

All were under the age of 21. Half were under 18. The youngest was 14. 
Two-thirds of them were male. One-third of the young people died in a 
public space, and another third died in temporary accommodation. Eighteen 
died directly from heroin overdoses. There were two asphyxiations from 
chroming and, alarmingly, the submission pointed to a "mini-epidemic of 
inhalant abuse among 14-year-olds". About 75per cent of the young people 
connected with the YSAS who died of substance abuse over the past three 
years had begun using heroin where they were 15 or younger.

Five years ago, McDonald doubts there would have been any heroin users aged 
12 or 13. Now the numbers are small, but nonetheless they are there, on the 
cusp of their adolescence, and that is of immense concern to the YSAS.

"We need a vision for disadvantaged young people. The majority of the young 
people that we would see at the Youth Substance Abuse Service would have 
traumatised backgrounds," McDonald told the committee.

Indeed, 80 per cent of the young people coming in for residential 
withdrawal were traumatised through disconnection from their original 
countries of origin, sexual abuse, violence or dysfunctional families.

"We may have a vision for those in training and we may have a vision for 
those in school in regard to the drug issues. We would encourage in that 
sense the concentration on how to assist young people who have already 
fallen off or been derailed through no fault of their own on the journey 
into adulthood."

Over the past year, public health officials from the United States, 
Britain, Canada and China (where the National Narcotics Control Board in 
Beijing recently released figures revealing a six-fold increase in the 
number of registered drug addicts and a serious heroin problem) have all 
visited the YSAS headquarters in Brunswick Street, looking for clues to 
solve some of the illicit drug problems among young people in their own 
communities. Some of the possible answers will be explored further when 
Melbourne hosts the second International Conference on Drugs and Young 
People in April.

By then McDonald will be the assistant director, drugs policy and services, 
with the Department of Human Services, in charge of developing and 
implementing the State Government's $77million package to reduce and manage 
drug abuse. He will also have a role in managing the impact of tobacco and 
alcohol, and restricting the spread of blood-borne viruses such as HIV and 
hepatitis C in high-risk groups.

In his time at the YSAS, McDonald has discovered that young people do not 
generally seek help for their drug addictions by themselves, so the 
organisation developed a an active approach to coax them into treatment 
that might otherwise have passed them by.

"Sixty per cent of these young people who come into residential withdrawal 
have never undergone any sort of intervention despite having an addiction 
for 18 months to three years," he says.

There was no template for youth substance abuse to learn from, but although 
the boulder has never quite reached the top of the hill, the YSAS has 
strived hard in McDonald's terms to "engage them, keep them and treat 
them". It has embodied what he calls a more caring approach to the drug 
problem, an approach with color and movement.
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