Sunday, 20 March 2011
Fear on methadone doctor shortage
THE number of Victorians dying from drug overdoses or suicide will rise if more doctors are not recruited to treat heroin addicts and tackle a crisis in the state's methadone prescribing service, drug experts warn.
An audit of the system found the number of people receiving methadone and buprenorphine has risen by 15 per cent to more than 13,000 in the past four years. In the period, the number of GPs prescribing the opiate-based heroin replacement drugs fell by the same percentage, to only 400, or about one in 10 GPs.
People in rural areas face the biggest challenge, as an estimated 20 doctors, mostly in inner Melbourne, look after 80 per cent of pharmacotherapy patients.
The Victorian Auditor-General's report, released this month, has renewed fears that patients trying to kick heroin will find it difficult to get help.
David Nolte, a pharmacist who dispenses methadone to about 100 people at his Carlton North pharmacy, said the shortage of doctors and pharmacists willing to treat drug-dependent patients was ''outrageous''.
''If people can't get to see a pharmacotherapy or a drug and alcohol doctor there is a time where they're hot to trot and they want to start on a program. If you miss that opportunity you lose it altogether and people can go back to drug-using, they can overdose or commit suicide,'' he said.
Doctors are more reluctant to take on patients with drug problems, with the Auditor-General's report showing that last year only 24 GPs carried out the training required to prescribe methadone. The state government's target was 70.
Associate Professor Paul Dietze, head of the Burnet Institute's alcohol and other drug research group, said a properly funded and managed pharmacotherapy system was cost-effective.
''It really does save the community a lot of money and a lot of heartache,'' he said. ''It fundamentally alters the way in which illicit drug markets operate and because there's going to be much less demand for drugs, there's much less crime associated with drug use.''
State government reviews of the pharmacotherapy system in 1993, 2003 and last year all recommended an overhaul of services, but the Auditor-General found little progress had been made.
Professor Dietze said the system had been heading towards crisis for several years.
''The prescribers are getting older and some of them are nearing retirement age and they're burdened with what seems to be an extraordinarily large number of clients, so we need to be responding effectively now,'' he said.
Damon Brogan, executive officer of Harm Reduction Victoria, a group supporting illicit drug users, said the worst shortages were in regional and urban growth areas, where one GP could look after up to 500 drug-dependent patients.
''If these patients aren't able to have their prescriptions and their dispensing maintained, they're going to get very, very sick. They might go back to heroin or mix other drugs with alcohol, so there would be the increased potential for both suicide and poly-drug overdose,'' Mr Brogan said.
Harry Hemley, president of the Victorian branch of the Australian Medical Association, a GP in Northcote, believed many doctors were reluctant to prescribe methadone because drug-dependent patients could be disruptive and aggressive.
Professor Dietze called for New South Wales-style public clinics where patients could access methadone for up to a year. Once stabilised, they are seen by GPs privately.
A spokeswoman for Mary Wooldridge, the minister responsible for drug and alcohol policy, said the Coalition's drug strategy would improve access to pharmacotherapy but gave no detail on how this would be achieved.
Jill Stark @'The Age'
An audit of the system found the number of people receiving methadone and buprenorphine has risen by 15 per cent to more than 13,000 in the past four years. In the period, the number of GPs prescribing the opiate-based heroin replacement drugs fell by the same percentage, to only 400, or about one in 10 GPs.
People in rural areas face the biggest challenge, as an estimated 20 doctors, mostly in inner Melbourne, look after 80 per cent of pharmacotherapy patients.
The Victorian Auditor-General's report, released this month, has renewed fears that patients trying to kick heroin will find it difficult to get help.
David Nolte, a pharmacist who dispenses methadone to about 100 people at his Carlton North pharmacy, said the shortage of doctors and pharmacists willing to treat drug-dependent patients was ''outrageous''.
''If people can't get to see a pharmacotherapy or a drug and alcohol doctor there is a time where they're hot to trot and they want to start on a program. If you miss that opportunity you lose it altogether and people can go back to drug-using, they can overdose or commit suicide,'' he said.
Doctors are more reluctant to take on patients with drug problems, with the Auditor-General's report showing that last year only 24 GPs carried out the training required to prescribe methadone. The state government's target was 70.
Associate Professor Paul Dietze, head of the Burnet Institute's alcohol and other drug research group, said a properly funded and managed pharmacotherapy system was cost-effective.
''It really does save the community a lot of money and a lot of heartache,'' he said. ''It fundamentally alters the way in which illicit drug markets operate and because there's going to be much less demand for drugs, there's much less crime associated with drug use.''
State government reviews of the pharmacotherapy system in 1993, 2003 and last year all recommended an overhaul of services, but the Auditor-General found little progress had been made.
Professor Dietze said the system had been heading towards crisis for several years.
''The prescribers are getting older and some of them are nearing retirement age and they're burdened with what seems to be an extraordinarily large number of clients, so we need to be responding effectively now,'' he said.
Damon Brogan, executive officer of Harm Reduction Victoria, a group supporting illicit drug users, said the worst shortages were in regional and urban growth areas, where one GP could look after up to 500 drug-dependent patients.
''If these patients aren't able to have their prescriptions and their dispensing maintained, they're going to get very, very sick. They might go back to heroin or mix other drugs with alcohol, so there would be the increased potential for both suicide and poly-drug overdose,'' Mr Brogan said.
Harry Hemley, president of the Victorian branch of the Australian Medical Association, a GP in Northcote, believed many doctors were reluctant to prescribe methadone because drug-dependent patients could be disruptive and aggressive.
Professor Dietze called for New South Wales-style public clinics where patients could access methadone for up to a year. Once stabilised, they are seen by GPs privately.
A spokeswoman for Mary Wooldridge, the minister responsible for drug and alcohol policy, said the Coalition's drug strategy would improve access to pharmacotherapy but gave no detail on how this would be achieved.
Jill Stark @'The Age'

BorowitzReport Andy Borowitz
BREAKING: Pentagon Finds Traces of LSD in Office of Mission Naming #OperationWTF #Libya
Damon Albarn Prepares New Elizabethan Opera
Anyone who still thought that former Blur frontman Damon Albarn was just a showboating mockney popinjay - and bumptious to boot - is probably going to have to give in to the overwhelming body of evidence to the contrary, if not now, then soon.
Just look at his workload in the past 10 years: the final Blur album, three Gorillaz albums, a solo album of home demos, countless excursions across Africa, bringing the best talent back to perform with UK musicians in his Africa Express concerts, an opera based on the Chinese legends of a monkey god, a triumphant Blur reunion tour and Glastonbury headline slot, a Blur 7" single, a Gorillaz tour and Glastonbury headline slot, a fourth Gorillaz album (coming next month) and now another entire opera.
In the same space of time, Oasis have effectively made and toured four albums, and then split up, and then reformed without Noel. On, and Liam went to see the Spongebob Squarepants movie.
Damon's new opera, Doctor Dee, is set to premiere in June, at Manchester's International Festival, before moving down to London's Coliseum next year, as part of the city's Cultural Olympiad.
The production is based on the life of John Dee, who was Queen Elizabeth I's scientific advisor, specializing in medicine, and his reputation as an alchemist, astrologer, and spy. Which makes it a kind of cross between Harry Potter and James Bond, in ruffs, and set to music. Amazing.
Having originally started the project with comic book sage Alan Moore (he wrote, among other things, Watchmen, From Hell and V for Vendetta), Damon went on to finish it alone, and plans to take a major role in the production too. It will be directed by Rufus Norris, the Tony-nominated director who revived Don Giovanni for the English National Opera last year, and brought Les Liaisons Dangereuses to Broadway in 2008.
Manchester International Festival director Alex Poots told BBC News: "It will be a big, spectacular show. I know that Damon's passionate about it and he's already written some incredibly beautiful songs, some anthemic songs."
And that's on top of the beautiful and anthemic songs he wrote when he was 'just' a pop star.
@'BBC America'
Just look at his workload in the past 10 years: the final Blur album, three Gorillaz albums, a solo album of home demos, countless excursions across Africa, bringing the best talent back to perform with UK musicians in his Africa Express concerts, an opera based on the Chinese legends of a monkey god, a triumphant Blur reunion tour and Glastonbury headline slot, a Blur 7" single, a Gorillaz tour and Glastonbury headline slot, a fourth Gorillaz album (coming next month) and now another entire opera.
In the same space of time, Oasis have effectively made and toured four albums, and then split up, and then reformed without Noel. On, and Liam went to see the Spongebob Squarepants movie.
Damon's new opera, Doctor Dee, is set to premiere in June, at Manchester's International Festival, before moving down to London's Coliseum next year, as part of the city's Cultural Olympiad.
The production is based on the life of John Dee, who was Queen Elizabeth I's scientific advisor, specializing in medicine, and his reputation as an alchemist, astrologer, and spy. Which makes it a kind of cross between Harry Potter and James Bond, in ruffs, and set to music. Amazing.
Having originally started the project with comic book sage Alan Moore (he wrote, among other things, Watchmen, From Hell and V for Vendetta), Damon went on to finish it alone, and plans to take a major role in the production too. It will be directed by Rufus Norris, the Tony-nominated director who revived Don Giovanni for the English National Opera last year, and brought Les Liaisons Dangereuses to Broadway in 2008.
Manchester International Festival director Alex Poots told BBC News: "It will be a big, spectacular show. I know that Damon's passionate about it and he's already written some incredibly beautiful songs, some anthemic songs."
And that's on top of the beautiful and anthemic songs he wrote when he was 'just' a pop star.
@'BBC America'
Banned plants
What's growing in your garden? The (Australian) Federal Government wants to expand the list of prohibited plants listed in the Drug Act to include among others all Angel's Trumpets, many common cacti and many native and exotic wattles. Is this necessary to fight drug trafficking and manufacture? Or will these laws make criminals out of nurseries, gardeners and botanic collectors?
Download
Listen @'ABC'
DISCUSSION PAPER (Implementation of model schedules for Commonwealth serious drug offences)
Download
Listen @'ABC'
DISCUSSION PAPER (Implementation of model schedules for Commonwealth serious drug offences)
Police support for protesters is growing as government cuts start to bite
A deepening antipathy for the government's public spending cuts has been revealed as the head of the police union said officers patrolling next weekend's demonstrations against austerity measures would have "a lot of sympathy" with the protesters.
Emphasising the growing opposition to the speed and breadth of the cuts programme, the chairman of the Police Federation, Paul McKeever, said that officers on duty at Saturday's March for an Alternative in central London would be feeling a sense of solidarity as they policed the event, which is being organised by the Trades Union Congress (TUC).
"The great irony is that officers policing marches like the TUC are actually facing greater detriment than many of those protesting against the cuts," said McKeever, whose union represents 140,000 rank-and-file police officers.
"We're not members of the TUC and have to be careful about having too close an association, though there will be a lot of sympathy towards those marching."
The march, due to be held in London's Hyde Park, looks set to be the largest rally to date against the coalition government's policies, with organisers hoping for more than 100,000 people to attend.
Along with the unions and other campaigning bodies, a plethora of other protest groups has sprung up as the strength of feeling grows against a package of issues as diverse as tuition fee rises, the scrapping of the education maintenance allowance, bankers' bonuses, tax evasion by big business, library closures and arts and public spending cuts.
One peace activist, and veteran of the anti-war marches in 2003, told the Observer: "We will get a lot of first-time protesters on Saturday because people are getting more confident that protest is for them. It's not for a bunch of anarchists, it's families, students, old people, maybe now even the odd police officer, who don't want to put up with cuts and unfairness in Britain any more."
Groups are using technology and social media to share expertise and information as well as co-ordinate and manage direct action more efficiently. The day is expected to see traditional protests take place at the same time, with sit-ins at high street shops and banks and occupations of public buildings and universities.
In the past five months, the protest group UK Uncut has staged a steady campaign of sit-ins against tax dodging that have forced the temporary closure of branches of Barclays, Vodaphone, Boots, British Home Stores and Topshop up and down the country.
"26 March is going to be a really important day," said Anna Walker of UK Uncut. "We had the student protests and we have seen the growth of UK Uncut, but this is the first time we are going to have people from all over the UK together whose lives are being turned upside down by these cuts. It is going to be the start of something powerful."
Scotland Yard has already suggested that "troublemakers" could attempt to hijack the protest. The Met was criticised for its tactics at student tuition fee protests last year, when dozens of people were arrested during violent outbreaks. This time, members the of human rights organisation Liberty will act as independent observers.
McKeever suggested that, far from being hostile to the protesters, many police officers would share the frustrations of the day. He said that a massive march of police officers themselves could not be ruled out if the home secretary, Theresa May, pushes forward with government plans to cut back on police pay and perks.
More than 20,000 police officers marched through London in 2008 in protest about their pay, the biggest demonstration in police history.
"We had 23,000 officers on the streets on a point of principle. Imagine how many might be involved with the level of feeling at the moment. Nothing is ruled out," said McKeever.
He also warned that attempts by the government to force through changes in pay and conditions might lead to legal action. "We are exploring every avenue to make sure officers are treated fairly.
"The first duty of any government is the protection of its citizens. Yet it is being vindictive against a police service it seems to hold in very low regard.
"Mervyn King has said that it's not those in the public sector who are to blame for the crisis, but it doesn't feel like that in the police service."
He added: "They don't seem to be so accusatory towards those where the blame actually lies. There seems to be a dislike of policing with this present government – the so-called party of law and order is dead, it's buried, it's gone."
Mark Townsend and Tracy McVeigh @'The Guardian'
(GB2011)
Emphasising the growing opposition to the speed and breadth of the cuts programme, the chairman of the Police Federation, Paul McKeever, said that officers on duty at Saturday's March for an Alternative in central London would be feeling a sense of solidarity as they policed the event, which is being organised by the Trades Union Congress (TUC).
"The great irony is that officers policing marches like the TUC are actually facing greater detriment than many of those protesting against the cuts," said McKeever, whose union represents 140,000 rank-and-file police officers.
"We're not members of the TUC and have to be careful about having too close an association, though there will be a lot of sympathy towards those marching."
The march, due to be held in London's Hyde Park, looks set to be the largest rally to date against the coalition government's policies, with organisers hoping for more than 100,000 people to attend.
Along with the unions and other campaigning bodies, a plethora of other protest groups has sprung up as the strength of feeling grows against a package of issues as diverse as tuition fee rises, the scrapping of the education maintenance allowance, bankers' bonuses, tax evasion by big business, library closures and arts and public spending cuts.
One peace activist, and veteran of the anti-war marches in 2003, told the Observer: "We will get a lot of first-time protesters on Saturday because people are getting more confident that protest is for them. It's not for a bunch of anarchists, it's families, students, old people, maybe now even the odd police officer, who don't want to put up with cuts and unfairness in Britain any more."
Groups are using technology and social media to share expertise and information as well as co-ordinate and manage direct action more efficiently. The day is expected to see traditional protests take place at the same time, with sit-ins at high street shops and banks and occupations of public buildings and universities.
In the past five months, the protest group UK Uncut has staged a steady campaign of sit-ins against tax dodging that have forced the temporary closure of branches of Barclays, Vodaphone, Boots, British Home Stores and Topshop up and down the country.
"26 March is going to be a really important day," said Anna Walker of UK Uncut. "We had the student protests and we have seen the growth of UK Uncut, but this is the first time we are going to have people from all over the UK together whose lives are being turned upside down by these cuts. It is going to be the start of something powerful."
Scotland Yard has already suggested that "troublemakers" could attempt to hijack the protest. The Met was criticised for its tactics at student tuition fee protests last year, when dozens of people were arrested during violent outbreaks. This time, members the of human rights organisation Liberty will act as independent observers.
McKeever suggested that, far from being hostile to the protesters, many police officers would share the frustrations of the day. He said that a massive march of police officers themselves could not be ruled out if the home secretary, Theresa May, pushes forward with government plans to cut back on police pay and perks.
More than 20,000 police officers marched through London in 2008 in protest about their pay, the biggest demonstration in police history.
"We had 23,000 officers on the streets on a point of principle. Imagine how many might be involved with the level of feeling at the moment. Nothing is ruled out," said McKeever.
He also warned that attempts by the government to force through changes in pay and conditions might lead to legal action. "We are exploring every avenue to make sure officers are treated fairly.
"The first duty of any government is the protection of its citizens. Yet it is being vindictive against a police service it seems to hold in very low regard.
"Mervyn King has said that it's not those in the public sector who are to blame for the crisis, but it doesn't feel like that in the police service."
He added: "They don't seem to be so accusatory towards those where the blame actually lies. There seems to be a dislike of policing with this present government – the so-called party of law and order is dead, it's buried, it's gone."
Mark Townsend and Tracy McVeigh @'The Guardian'
(GB2011)
Subscribe to:
Posts (Atom)