Preferred Name: Jack
Jack works full time in a retail store. He’s single, lives on his own, and has two young children from a previous partner. His children live with their mother but he sees them regularly. He describes his ethnic background as ‘Dutch-Czech’: He was born in Australia, one of his parents was born in Czechoslovakia, and the other was born in the Netherlands.
Jack began taking heroin occasionally in his twenties and stopped in his early thirties after his doctor prescribed him morphine and Xanax® (alprazolam). Over the next few years, he began to think he was ‘hooked’ on morphine and Xanax®. He experienced a number of overdoses from the medications and decided to reduce his consumption. After a disagreement with his doctor he was no longer prescribed morphine and Xanax®, and resumed taking heroin to manage withdrawal symptoms. Jack later began seeing a different doctor and stopped taking heroin after starting opioid pharmacotherapy treatment (Suboxone®, a combination of buprenorphine and naloxone). He’s now on Suboxone® and takes prescribed Valium® (diazepam) but plans to gradually reduce his use of both and eventually stop entirely.
Over the next few years, however, Jack says he began to think he was ‘hooked’ on morphine and Xanax®. He experienced a number of overdoses for which he was treated with naloxone and hospitalised. Concerned about the risks to his health of continuing to take morphine and Xanax®, Jack decided that he wanted to reduce his consumption. At the suggestion of his mother, he attended alcohol and other drug counselling, but says he ‘never got much out of [it]’.
After telling his doctor that he wanted to reduce his consumption, he was prescribed fentanyl patches to manage his withdrawal symptoms. However, Jack reports that when he used the fentanyl patch at the prescribed dose he overdosed and was hospitalised. He began to feel concerned that he was being overprescribed Xanax®, fentanyl and morphine. When he raised his concerns with his doctor, he says he was refused further treatment at the medical clinic and at other clinics in his hometown, and found it very difficult to find a new doctor. No longer able to access the prescribed medications and experiencing withdrawal from them, he resumed taking heroin to manage the withdrawal symptoms which he describes as ‘the worst pain and torture you could ever imagine’. Eventually Jack found a different doctor in a town nearby and was prescribed opioid pharmacotherapy treatment (Suboxone®) and Valium®. He stopped taking heroin and under the guidance of his new doctor, began a ‘reduction program’ to gradually reduce his doses of Suboxone® and Valium®. Jack now feels that he is ‘on the medication [he] should be on’ and no longer experiences the anxiety he did a number of years earlier.
In the future, Jack plans to ‘continue on the road [he’s] on’, ‘enjoying [his] job’ and ‘enjoying [his] life’. He plans to ‘buy a property’, pursue further study, and continue to have a ‘close relationship with [his] kids’.
When Jack (M, 38, works in retail, prescription drugs) asked his doctor to prescribe antidepressants, he says he was dismissed as ‘doctor shopping’.
I went [to a doctor] looking for an antidepressant and [he] dismissed me straightaway. He was very rude, and he obviously thought I was doctor shopping […] I was really depressed and I wasn’t sleeping well and I didn’t go in there saying, ‘I want this’ or ‘I want that’. I said, ‘I need something to [help me] sleep and I need something for my anxiety’. I said ‘I’ve just come out of a relationship and I’m not doing well’, and he said – I can’t quote him verbatim, because my memory is not that good – but he said something along the lines of, ‘Sorry, I’m not that kind of doctor’, and I went out of there with nothing, not [even] a referral.
Working full-time gives Jack a sense of ‘personal pride’ and also helps him maintain his physical health.
[To look after my health and well-being…] when I’m at work, [I] just try and focus, and get as much out of work as I can […] It helps me because I have a cause. You’re contributing to society. You’re not sitting back, living on a pissy $500 a fortnight. Breaking open cigarette butts to roll, to try and scrape enough tobacco to roll a cigarette. It just gives you meaning, and it gives you personal pride, and […] physically, it improves your health. I like interacting with the public […] There is [a lot to get out of in terms of work…] Every time I go down the street, someone will just say, if I see someone who I haven’t seen in over a year, they’ll tell me that I’m like a different person. Everything [about me is different], my eyes look different, I don’t have the dead stare, I walk with my shoulders back, I don’t slur, I’m just more on the ball all round.