LETTER TO THE EDITOR: LOOKING FOR STABILITY

LETTER TO THE EDITOR: LOOKING FOR STABILITY

Lewis is currently in jail. He injected for the first time in jail and got hep C there. Once he wanted to stop, his attempts to get on methadone inside got him nowhere. He wrote to us to call for methadone and bupe on demand for NSW inmates.

Dear User’s News

The first time I used was in jail, when I first got locked up 6 years ago.  

I’ve got big holes in my arm from that crash initiation. I learnt how to inject under stressful conditions, having to always rush, and using old, blunt jail fits that mutilate your veins. I know that seems crazy, but it felt worth it at the time. I was at my lowest. I didn’t care about myself because I felt that no-one cared about me. I needed to get away from the crap in my head and there aren’t many other distractions in jail. 

It wasn’t long before I wanted to stop, and from what I knew about methadone I felt it would help. I learnt the hard way that it’s rare to get on methadone in jail – you usually have to already be on the program outside to get on it, and even then, there’s no guarantee.  

I started slashing up my arms because I was trying to draw attention to how upset and stressed I was, in the hope they would put me on a program. But that didn’t work.  

I told them I would do anything to get on methadone, even get HIV. That meant I didn’t care about sharing, didn’t care about getting hep C or infections or anything. I did get hep C in here. I didn’t want to stay alive and healthy. The exact opposite. I wanted to draw attention to how dangerous using was in jail in the hope they would put me on a program. I got quite messy, but I didn’t get methadone. 

I did get put on a suboxone pre-release program to prepare me for getting out. But it was a detox program and wasn’t ongoing, so I was vulnerable to overdose. I ended up overdosing on fentanyl within a couple of days of getting out. Luckily, I was with friends who knew what was going on and I’m still here to tell the tale.  

I got on methadone soon after, but it wasn’t long before I had new warrants and the police were hanging around the clinic looking for me. Of course, I just stopped picking up. Most people on the run just stop picking up their dose because if you are at a clinic where you have to pick up daily, they know just where to find you, once a day. 

Of course, I started using again straight away. I was picked up anyway and went back to jail. My plan to get on methadone outside and be on a program if I went back to jail had failed miserably.  I was no longer on methadone so I couldn’t get onto a program in jail.  

So I kept using once I got to jail. Again, I begged to get back on methadone. However, it just wasn’t on offer.  

I have my ups and downs and sometimes all I think about is having a shot. I’ve come to the conclusion that it’s important to do what you can, when you can, to be safe if you are using in here and I’m on treatment for my hep C. 

I really believe the methadone or buprenorphine (suboxone) program should be available for everyone in jail who wants it. I think they need to do it if they are serious about reducing injecting in jail and stopping the spread of hep C. It’s my personal opinion that by not putting people on methadone or bupe on request, they are basically pushing drugs into jails and encouraging everything that comes from that. 

Thanks for a great mag, 

Lewis. 

Dear Lewis, 

Thanks for your letter. Sorry to hear you’ve been doing it tough but thank you for raising some really important issues about pharmacotherapy programs in jail.  

We agree that it’s important that inmates who want and need methadone or buprenorphine should be getting it.  

We are told it is a budget issue – anyone on a program knows how time consuming getting dosed is and the amount of personnel needed to dose inmates daily is huge. Diversion is obviously another issue of concern to Corrective Services. Some jails don’t dose at all. 

Things could change with the new weekly and monthly injections of buprenorphine – see the article in this mag. This new format will allow people to have a depot (pronounced dee-poh) injection of bupe once a month, so it’s easy on the resources and there’s no capacity for diversion. There is a trial being held in one of the smaller jails, so we will see how it all pans out soon. 

We think this is a great option for inmates and welcome any product that will increase the capacity for inmates to access the program. Our concern is that we do not want to see depot bupe as the only product on offer in NSW jails simply because it is convenient. There has not been a suggestion that people on methadone will be transferred to depot bupe we believe that the option should remain for those on methadone. eople who are already on methadone should be able to continue that treatment and not be required to transfer. Please note that there has been no suggestion that methadone dosing will be removed from NSW jails. 

We will keep an eye on the progress of doing in our jails and keep UN readers posted. 

Best wishes, 

Leah 

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