URBAN BITES: RURAL USERS ON THE BIGGEST ISSUES THEY FACE
WE ASKED RURAL USERS WHAT THEY THOUGHT THE BIGGEST ISSUES CONFRONTING THEM ARE AND THIS IS WHAT THEY SAID:
I think the health departments need to consult with us properly to get services that are going to help us. They put services in but they don't ask us what we really want or how we think they will work. They just stick to the same old models and ways of doing things. Next thing we hear, we haven't used the service and the money's going somewhere else. There can be good reasons why the services haven't worked. Maybe the confidentiality of the service isn't good enough. Our main NSP is near the police station. We get known by the police just by going there, it's not safe for us.
Editor: NUAA is often involved in giving feedback to health and health services. You can get involved in a number of ways, drop us a line at firstname.lastname@example.org or ring (02) 8354-7300 and ask for Lucy.
I think we need more places that provide injecting equipment, but we need them to be in better locations, we need them to be open at night and we need our own people to run it, people that we trust. Location is tricky. Getting the location right is important. Mostly the health people have got it wrong. We need the services to be near where we use. It is great to be able to get supplies from hospitals as a back up, but they are miles away from where most users live. We want them near where we use, but not in busy places like the main shopping area because we don't want to be seen accessing them.
Editor: It's important to speak up and let your local services know what you want. Your experience is essential in helping them to establish a useful and quality service.
They just put in a huge police station worth millions in this little country town. Why? There's a big blackfella population. Don't you know we take a lot of control? There's not many of us, but we're a wild bunch. And don't you know that on the ice we have super human powers? They're scared of us. The health department say they want to help us and give us fits. We take the bait. Then the police take our fits back off us, even if they are new. We're tagged as users and that's it - they go at us until they get us in jail. It's a circle and we're stuck in the middle.
The biggest issue is confidentiality. If you are on bupe or done, you don't dare get a fit or you're off the program quick smart, and no second chances. So you reuse fits. You know you might get hepatitis or HIV, but sometimes you just take the risk because it's a case of definitely sick today or maybe sick tomorrow. I'd use new fits if it was easier for me to get them without risking my programme. I'd like to see better privacy in place or even mail order fits.
Editor: If you are having trouble getting fits, call us at NUAA on 8354 7300 or 1800 644 413. We may be able to assist.
I don't like getting fits. It's the shame thing. If you get needles somewhere, they know your face to that. Your face is associated with the black box. Then after that, you're nothing but a junkie. No matter what else is going on in your life. And as a junkie, they think you deserve nothing. Certainly not respect. Not privacy. You lose all your rights. I'd rather take my risks with reusing fits than end up a non-person like that. It's worse in the country because you have no privacy at all. Everyone knows everyone.
We need more choice. If you want to get on methadone or bupe there can be really long waiting lists and very few spots for the area's public clinic. A mate of mine waited for four months to get on. And too bad if you clash with the only prescriber for some reason. You are very lucky if you have a local chemist to dose you so you don't have daily dosing a couple of hours away from you. You have hit gold if you have a local GP that will prescribe. We have to put up with whatever the prescribers and dosers decide and do. There are no choices. They have all the power just because they are the only ones who do methadone or bupe. If we try to talk about our rights or argue with them about a decision, they just say we are difficult, so you say nothing because you're scared. If you do end up on the outs with a doctor or chemist, that's it, you either lose your takeaways and have to pick up every day or they won't have you as a patient. Because there aren't any options, that pretty much means you're off the program or travelling a ridiculous distance. I do know someone who used to drive 7 hours to Sydney every couple of months to get a new script. You also have to pay whatever they ask, no choices there either. Your doctor probably doesn't bulk bill and your chemist can charge whatever they want. And you know what? You are just so grateful to be on the program that you pay whatever you have to, put up with the bad treatment and play the game according to their rules.
I did a stupid thing recently. Someone left a package behind in my local chemist where I get dosed and I saw it and just put it in my bag. It turned out to be just a cheap thing, worth a few dollars. I don't know why I did it. I regretted it straight away. It was like a brain fizz. I have never shoplifted from there. Anyway they knew I had done it. I had already arranged to get it back to them but they won't listen. I've apologised, I've explained, but nothing doing. Now they won't dose me. My only other choice is a few hours away and I am worried that my last chemist have rung them to say I'm not trustworthy so they won't dose me either. I don't know what I am going to do now. Even if the public program had places, it's still over an hour away and I can't get there every day. So I am probably going to pay for this by being off the program. If I lived in the city, I would be able to find a way to fix this if I lived in the city, but here the distances make it seem totally unworkable.
Editor: Cameron you should talk to your doctor and see if s/he will advocate on your behalf. If you have no luck there, try ringing NUAA and we will see what we can do or direct you to another service.
I think the biggest issue is confidentiality.
There's one chemist in town that does methadone and needle exchange. I'm never going to get needles from there. If my doctor found out, I would lose my takeaways and that's my job gone. And buying butterflies or wheel filters? Forget it! May as well have a sign round your neck that you shoot your 'done. I can't get supplies from the community centre because that's where I see my prescriber and besides I know people working there.
There are other places, but in a small place you have to be really careful. People talk. You know, your doctor's receptionist sees you get needles or someone sees you using the machine at the hospital when they're visiting someone - and you're lost. I sometimes pay someone to get equipment for me, or a friend sends stuff up from Sydney. I really wish there was a mail order service, preferably free!
Accessing key harm reduction interventions such as Needle and Syringe Programs (NSP) or pharmacotherapy isn’t so simple when you live in a small town. NUAA is working on establishing a mail order program as we know this would help a lot of people.
People say “you should give up drugs” but they just don’t realise it isn’t that easy. As a single mum living in a country town, it feels virtually impossible. I never wanted to be a single mum. My drug of choice had always been smack but I started using meth with my partner. We soon found it wasn’t really good for us as a couple. We started to argue heaps. I had to put our child first, so we split. After that, I went back to heroin. It has been really tough. I decided that as much as I loved drugs, I loved my kid and my life more. I knew something had to give and that I needed to quit using. When I felt ready to get help, I rang up a local rehab. I was told there was a waiting list of 5 to 6 months and that I had to detox first! The only way to avoid being on the long waiting list was to pay an additional fee to achieve “Priority Admission”. This is in addition to the usual accommodation charges. I just can’t afford it. Plus what am I supposed to do with Daisy? I don’t have family here and I can’t just give her to someone to mind for 12 weeks while I go “rehabilitate” myself. My family don’t live in the state and I can’t let my ex know I’m using again. See what I mean? Life’s easier in theory than practice.
Editor: Ally, this is a really difficult situation that many of us face. There are rehabs that take children such as Jarrah House (02 9661 6555) but there are no options for single dads (for example). Children must be under eight years old. Call ADIS on 1800 422 599, tell them your story and ask them what the options are.
I live in a regional town and this means sub-standard service. We have a drug and alcohol clinic once a week only. Also it must be very difficult to recruit staff in the country because the doctor and nurse who work there don't appear to be trained in working with people who use drugs. I believe we should have a proper clinic, run by health care workers with qualifications and experience in the drug and alcohol field.
The current registered nurse is an older woman with experience from hospital wards and no understanding or compassion in dealing with people who use drugs. The doctor is a local GP. I knew him from before; as a GP he would prescribe anything for you; he was the pill doctor. Now they expect me to respect him in my treatment. He is all about power and control. He gives everyone bupe because he thinks it isn't addictive, that it isn't being diverted and injected. There is a real issue in my town with injecting bupe. It's easier to inject than methadone. He even puts people on bupe for ice use. I asked him about going on methadone and he said it was too hard to dispense, "all that mucking about with cups". But my chemist does methadone - it's easy. Heaps of people do it.
The nurse is in the room when you see your doctor, which I don't like. I want my sessions with my doctor to be confidential. The nurse talks over the top of you. There is no respect there at all and no understanding. I don't feel I have any say at all, it is all about them controlling me. There is no understanding of what it is to be me and they don't listen to my needs. I feel so alone here, there is no one to hear me. I wish there were people with a history of drugs working there, someone who will listen to me.
When I walked into my local chemist to get on bupe for the first time, the pharmacist greeted me, smiling, and asked nicely how she could help me. When I said I was there for my bupe dose, her voice changed, her attitude changed, the way she stood changed. She became hard, angry. I was suddenly scum in her eyes. It was total discrimination. I feel that they look at us and judge us, knowing only part of the story. They are obviously not in it because they care about people, they just want the dollar. It's not like I can go somewhere else either. There is one chemist I can go to in my area, so I just have to cop it sweet. If we stand up for ourselves, they throw us off the program for being difficult and aggressive.
Editor: Garry these issues affect people all over the state. We are working to get your stories told and to get respectful care for everyone but it’s going to take a massive culture shift.