Experiences with Heroin and Prescription & Over-the-Counter Drugs
Preferred Name: Kate
Gender: Female
Age: 36
Background:
Kate works in the health sector. She’s single, lives on her own, and has two children who live with family members. She describes her ethnic background as ‘English Australian’: she and her father were born in Australia, and her mother was born in England.
Brief Outline:
Kate began taking heroin every day in her late teens. In her twenties she took it on and off, stopping when pregnant with each of her children or when undertaking a drug treatment program. Over the years she’s completed a youth detox program and a residential rehabilitation program, and has been on opioid pharmacotherapy treatment (methadone maintenance treatment [MMT] and buprenorphine). She’s currently on buprenorphine and no longer takes heroin. She now takes benzodiazepines (Valium®/diazepam) and ice regularly. She feels her consumption of these drugs has become a ‘habit’, which she plans to break.
When she became pregnant with her eldest child, Kate reduced her heroin consumption and eventually she and her partner stopped taking it altogether. However, shortly before the birth, Kate’s partner resumed taking heroin, and before long she did too. After the birth, she sought advice from a nurse at the hospital on the possible effects of heroin consumption on the baby, and the child was removed from her and her partner’s care. Having no formal arrangements to see her child, Kate says she was ‘in a really bad space […] mental health-wise’. She and her partner separated, and her partner late regained custody of the child. Kate then completed a youth detox program, went on opioid pharmacotherapy treatment (methadone maintenance treatment) and stopped taking heroin.
Kate resumed taking heroin and speed in her early twenties with a friend. They then moved interstate and she says she found herself in a ‘bad’ situation in an ‘abusive’ relationship, and felt ‘isolated’ from her family and friends. Around this time, she discovered she was pregnant with her second child, and again stopped taking drugs during her pregnancy, resuming after her child was born.
A few years later, in an effort to stop taking heroin, Kate completed a residential treatment program, and her youngest child went to live with her partner’s family. For several years after completing the program, she didn’t take any drugs. Around this time she ended her relationship with her partner, and a few years later, she began seeing a new partner. When she discovered he took heroin, she resumed taking it herself. Kate later completed a residential detox and then started opioid pharmacotherapy treatment (buprenorphine).
When she was in her late twenties, she began working in the health sector. She says she started taking benzodiazepines (Valium®/diazepam) once a week to help her relax after work and sleep. She gradually began taking Valium® more often and now takes it every day. Kate says she experiences ‘withdrawal’ symptoms and trouble sleeping when she doesn’t take it, and thinks she might have developed a ‘dependence’ on it. However, because it isn’t affecting ‘other aspects’ of her life, she doesn’t see this as ‘problematic’, and while she intends to reduce her consumption, she has no plans to stop taking benzodiazepines altogether.
In the past year, Kate also began taking ice every day, which she says gives her ‘more pep’ and ‘focus’ at work. However, she thinks this has become ‘a bit of a habit’, and she’s ‘re-evaluating’ her consumption with the aim of limiting it to the occasional weekend.
Kate says she now feels ‘well-established and well-respected’ in her job and is saving money to buy a new car. In the future, she plans to travel and spend more time with her family and children.
For Kate (F, 36, works in the health sector, prescription drugs and ice), taking drugs only in moderation is crucial to enjoying them so she keeps track of her consumption and cuts down when necessary. (Played by an actor)
Moderation with everything is the thing because if you do it too much the enjoyment is sucked out of it and you build a tolerance to it. And you don’t enjoy anything you do all the time as much. [I’d like to go back to just doing ice when I go to nightclubs or I’m out partying…] instead of having to think I want to do it during the day to have a bit of pep or focus at work. So yeah, it’s only probably been three weeks [since I’ve been taking it…daily].
[…In terms of taking Valium] I think I have enough self-regulation and knowledge to […] not have it out of control […] You know, one Valium a night isn’t really that out of control. I have cut down from where I was. I was taking a lot more a few months ago so I am regulating it already.
Kate says that while others might say she has an ‘addiction’, her consumption doesn’t affect others parts of her life so she doesn’t see it as an issue. (Played by an actor)
If you can afford [to take drugs] and it’s not affecting your lifestyle, and you’re still working, and undertaking your duties, and paying your bills and saving, and buying things that you want, and going out and doing stuff, then how is it problematic? And if it’s not affecting the other things that I was doing before […then again how is it problematic?] So yeah, I’m sort of still reconciling this in my head, and leaning towards the fact that, yes, I may be dependent. But as long as I have a regular supply, then it shouldn’t be an issue, because it’s my choice, and it’s not affecting any other aspects of my life.
Kate prefers to keep her ‘personal and work life separate’ and does not disclose her consumption to co-workers. (Played by an actor)
I do kind of have a dependence [on benzodiazepines] now for sleeping and relaxation after work. That concerns me at times, yeah […] when I’m nearly running out and I have to take time out of my day or after work [to get hold of them… It also concerns me that my colleagues could find out] I have that sort of feeling that if they knew, they would feel differently about me or something […] I don’t want them to know […] I think it’s also about keeping my personal and my work life separate, because I can see it as a personal thing and not necessarily something that everybody needs to know about.
For Kate being on OPT helps her avoid the financial cost of taking heroin.
I’ve been on opiates for nearly 20 years now, 19 on and off, and whenever I haven’t had them in my system except for a few […] periods [of several months], I have returned to them. So if I’ve got something that’s feeding that [opioid] receptor as well as blocking it, and is doing what it does for me, and it’s not costing me any time or minimal time, minimal effort, minimal money […] then I’ll just stick with it, because it’s working. And it’s a lot cheaper than having that risk of going back to, you know, putting $50 to $100 [of heroin] up my arm every day.
Kate explains how she manages her OPT dosing in relation to her work commitments.
I have my opioid substitution therapy. I actually don’t take all of it in the morning. I just take enough to hold me through the day and I’ll take the rest at night or as I just finish work. So it sort of spaces out, because I’m able to do that. I’m in a privileged position with regards to my doctor and stuff and I only have to go into the chemist once a week. And it’s just over seven years of doing it, that I’ve worked out that it works for me […] The [clinic where I get OPT is] very good and over the years, since I’ve been so stable […] my doctor […has] been very flexible about [giving me] takeaways.
When Kate was arrested, her child was removed from her care so she sought drug treatment to help her regain custody.
[I was arrested for a driving offence] and then, yeah, a week after withdrawing [from heroin] and actually nearly receiving a sentence in jail I received the notification from [the court] or something that my [child] had been removed. And [then later Community Services] came in and said, ‘He doesn’t speak.’ Well, yeah, you’ve just taken him away from everything he knows and he’s only just starting to use his words. Of course he’s not speaking. He’s shut down. You are traumatising him […] So I sort of had a bit of a think about [it] and got in touch with the rehab […] and went on a waiting list to go on a program that I could take my [child] into as well [as a step towards regaining custody].
Kate describes what makes a good residential detox service. (Played by an actor)
The most recent [detox] that I underwent out in my area […] didn’t make you do groups or anything. Like, we would have NA [Narcotics Anonymous] come in once a week and we’d sit and listen to some old timers’ stories, but that was about it. They left you to your own devices. And the [interstate] youth detox was very good […] We got to pick what meal we had. We did art classes. They had acupuncture, aromatherapy, four-hourly medication. You could bring stuff in like books and things with you. You could have visits whenever. So it was very, very good and supportive.
Kate criticises the negative coverage of drug consumption in the media, pointing out that it repeats stigmatising assumptions.
If you are […] a heroin or an ice addict then […] it’s just so looked down upon and sensationalised as well with the media […] Unfortunately, it’s very demonised […] A lot of people use different substances in different […] ways and for different reasons. You don’t always have to have a troubled past or a problem or, you know, some sort of therapeutic need to self-medicate or anything. It might just be for fun […] I hate the way [drug use] is sensationalised, I very much avoid news […] They just put fear in people with everything, you know. Like, if you watch the news every night […] you’d be scared to use any kind of drug because it will kill you or turn you into someone wearing Adidas and yelling on the street. It puts you into a stereotype. Yeah, like, the mainstream media in particular are so biased.
Kate suggests expanding pharmacotherapy programs, greater investment in harm reduction and decreasing the cost of treatment. (Played by an actor)
I really think there needs to be more pharmacotherapy places, not just for opiate users, but for stimulant users as well. I think that pharmacotherapy is very lacking in that area […] I think that […] with the media going on about all this ice stuff, and then the government not investing in harm reduction […] and not opening any more NSPs [and primary healthcare centres], and not expanding the pharmacotherapy clinics, and having […] very high recidivism rates amongst people who use drugs in the jail cycle. [This is related to] not having NSPs [needle and syringe programs] in jail, and not giving people good health access or information in jail.
[…In terms of opioid pharmacotherapy treatment more options are needed] even with the current pharmacotherapy system, there’s only two options, and they’ve pretty much got rid of buprenorphine […] And yeah, there’s private clinics around that you can get into, but like on the dole, if you are just starting out on a treatment journey, then you don’t have like $80 […] a week to have to fricking pay for that so then people will end up getting take-away [doses] and selling them. And if they are still participating in things that might be deterring them from being able to then hold down a job, or do study, or further their goals that they do have, no matter how buried or dormant or unspecified [those goals might be]. Everyone’s got aspirations you know, so [the cost of treatment is] really a big deterrent.