Page 96 - Week 01 - Wednesday, 8 April 1992
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Methadone also has its place and a role in getting people off drugs completely. Where you have a methadone reduction program, it is used to take people off drugs slowly. In particular, methadone is used as a method of removing people from heroin. Methadone programs also are used in the ACT as a maintenance program. In other words, the person is allowed to use methadone, which is an opioid very much like heroin; but it allows people to reduce what is often referred to as a "chaotic lifestyle". Where it is used as a maintenance program, people are often then encouraged to move to a reduction program, and I agree with that. I think that is very sensible.
The difficulty with some of the methadone programs in the ACT is that, whilst they provide those very good services that suit a large number of people who are ready and willing to try to get out of that chaotic lifestyle, who are ready and willing to try to leave their illegal drug use behind, they have not taken into account some of the other people who have different views, people who have decided that they do not want to leave the other drug; they are not ready to leave the other drug. In the case of methadone, we are talking about heroin.
One of the interesting things about it is that a methadone program that requires urine testing, for example for heroin and for other drugs, really takes away the dignity of the people who are on that program. Where people have voluntarily said, "Yes, that is what I want to do because I want to have that extra pressure on me", I think that is entirely appropriate. Where people have said, "Yes, I want to reduce", and that is what they want to do, I have no difficulty with that.
Where people say, "No, I want to retain my dignity; I do not want to be tested by my hair" - a quite common method of testing people now is by looking at a hair sample, and it is a quite cheap method - "and I do not want to have my urine tested", we ought to be prepared to look at how we can reduce the harm associated by providing that alternative service, and it is an alternative service that is not provided in the ACT at the moment.
It provides a harm reduction approach because the people who are still on drugs can well have a chaotic lifestyle sorted out. There is quite a deal of evidence to indicate that where people are on methadone programs, even though they are not reduction programs, even though the goal is not purely to get people off drugs - that might be a long-term goal of the people who are running it, but it is not the goal of the individual involved - the methadone program, which is non-judgmental and provides dignity, reduces the harm to the community because the people involved in it are not so likely to be involved in burglaries and robberies. We understand that a high proportion of our crime in the ACT is associated with the use of illegal drugs and attempts to get the money for those illegal drugs.
Our methadone program needs to be expanded in order to provide for those people; so that they have a chance for some dignity; so that they have a chance to be empowered to make their own decisions; so that they are recognised as individuals who can make their own decisions. Once we start recognising those people as individuals who can make their own decisions and we start empowering them, they are obviously in a much stronger position to be able to make that decision and to say, "Enough of having a life dependent upon these drugs; it is time for me to get off it". It happens to suit society because we will have a reduction in the harms associated and will not have the sorts of problems that are evident in many Western countries throughout the world - most notably of all, the United States.
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