Two of my friends are presently in palliative care with cancer. One is from Tyrone, the other from Donegal.
The attention and the support they are receiving from their respective health systems is impressive. It is a mixture of medical, social and welfare care provided by the health authorities and enhanced by expertise from the voluntary, independent sector.
It appears that when it comes to end of life care, there is a seamless cooperation between the statutory and voluntary sectors. I remember some tension years ago between the statutory and the independent hospice services, but that disagreement seems to have been resolved.
The same can’t be said about that other difficult health and social issue, drug and alcohol addiction.
An editorial in this newspaper recently highlighted the deaths in the Derry/Strabane areas, pointing up the dangerous use and abuse of pregabalin, a fairly new prescribed drug which was originally thought to be non-addictive and that was seen as a replacement for benzodiazepines.
Read more:
Derry priest warns of drug crisis in north west
Three die in drugs related deaths in north west at weekend, court hears
Cuan Mhuire offers safe haven for all struggling with addiction
There have been mounting official reports about the increasing death rate and social destruction but sometimes the anecdotal is more revealing.
I ran into a newly-ordained priest who has only been in a parish a few weeks and what surprised him most has been the number and the severity of the addicted people coming to the door of the parochial house. Not just their physical condition but also the severity of the disintegration of social and family life.
The official reports coming from the Department of Health and the health trusts always propose greater and better cooperation and coordination between the limited services that are available and most especially between the statutory and the voluntary services.
One of the favoured new words is pathways, a word advocating smooth and uncomplicated connections for patients and families into the services and between the services. A grand idea that doesn’t work in day-to-day reality.
Organisations and disciplines tend to work in silos. A multitude of families will tell stories of their loved ones being shuttled between mental health services and addiction services, both claiming an inability to provide treatment until the other condition is dealt with. Which might be a complication for the ones the newly-ordained priest is running into.
The last statutory residential facility for drug and alcohol treatment, Shaftesbury Square Hospital in Belfast, closed 13 years ago and never replaced. The three residential facilities in the north and indeed many in the south are run by voluntary organisations.
None of the three treatment facilities in the north have detox, a medical procedure which, at the extremes, prevents sudden and unpredictable deaths and is essential for clearing the mind and body from the effects of drugs to allow proper treatment to take place. In older times people would have said that you can’t treat a drunk man. Neither is there a detox facility in the west of Ireland, anywhere between Malin Head and Galway city.
Anyone who has any familiarity or knowledge of addiction knows only too well that one of its characteristics is disintegration and even chaos. In an increasingly disintegrated and chaotic world, it should be no surprise that mood-altering drugs will flourish.
One of the aims of treatment is to overcome the chaos and restore, or more frequently, provide integration for the first time.
The best treatment is when the psychiatrist and the priest, the medic and the councillor work under the same roof. That is what you will find in the expensive treatment centres where the rich and the famous go for their treatment. That is what we need, and what we have not got, in all our treatment facilities.
That integration of skills and disciplines will cost more money than being provided by governments at present, but it will cost a lot, lot less than what is being poured into hospital beds and hostels and prisons, where many of the addicts end up.
