This year (1998)I started studying full time at a TAFE (Technical and Further Education) college. I am studying art, you know, drawing, painting, sculpting, all that fun stuff. Being on methadone has caused a few difficulties with my study; it is like being under some form of arrest. Methadone treatment, especially here in Victoria, Australia, badly needs to be changed. Patients who are completely stable while on methadone are being driven off their medication only to experience cravings, depression and often relapse into addiction. Why don't the authorities realise the parallels between addiction treatment and the treatment of other psychiatric illnesses? Leave us to live our lives with the medication that we need to make our brains function comfortably. Here is my personal account of the difficulties I am experiencing trying to have a reasonably normal life while on methadone.

Here in Victoria, Australia, the state government rules are no more than one take-away per week without special permission from the Drugs and Poisons Dept. For those who are unfamiliar with the jargon that means that no matter how long you have been stable on methadone - three months or ten years - you must pick your dose up at a pharmacy at least six days a week, year in, year out. My doctor, for reasons I could only speculate about, was reluctant to put in an application. He dismissed my requests by saying that applications for extra take aways are never granted, so I was stuck with picking up my methadone 6 days per week. This alone impacts on my ability to study: allowing half an hour a day (getting there and back, waiting around, getting kids ready, bundling them in and out of the car, etc. a minimum rather than an average I think) over the length of the semester this adds up to more than 40 hours. I lost more than an entire working week from my available study time. Also I could not pick up before I went to school because I start at 9am and the pharmacy doesn't open till 9am. So when school finished I had to go into town to pick up which meant I couldn't work back late. Either that or I could spend my lunch hour - every lunch hour - driving into town and back. Also there were fortnightly doctor's appointments eating into my time.

I felt my doctor was very uncooperative which was a big disappointment. When I had moved to this country town six and a half years ago I was on a methadone program. I transferred my methadone from Melbourne and he was the doctor I was transferred to. I really liked him as a doctor: he didn't speak down to me, treated me like a human, seemed concerned and interested in what I was thinking and feeling. I chose to continue with him as my GP even after I finished taking methadone. I had always felt that he liked and respected me. He visited me in hospital when my children were born, and always made himself available on the rare occasion there was a problem out of hours.

It hurts when someone you think is on your side turns and kicks you in the guts and that's how this felt. One day I forgot about my fortnightly appointment, I was at school, so rapt up with what I was doing in ceramics that time just passed. I got to the pharmacy, thought 'oh my god, I should be at the doctor's.' If I had kept my mouth shut at that stage everything probably would have been all right. The pharmacist probably would have dosed me without noticing that he needed a new script that day. But, no drama I thought, everyone here has my best interests at heart. I was literally in shock over what happened next. I said to the pharmacist, 'Oh shit, I'm supposed to be at the doctor's now. Can you call him up?' The pharmacist called the doctor to tell him I was running late and could I please have my dose now because it was getting close to closing time and that would make it easier for everybody. The doctor said that, no, I couldn't have my dose and if I couldn't be there on time then he had no obligation to see me. He refused to see me that evening and explicitly told the pharmacist that I was not to have my dose.

As I said, I was in shock. I was on 80 mg at the time and had never missed a dose and was terrified of what would happen. I have two children under five years old to care for and didn't know whether I would be capable of that by the time morning came. The pharmacist was speechless. He just kept repeating, 'I'm so sorry, he told me straight out not to, there's nothing I can do. I'm so sorry' The doctor's secretary magnanimously (so she thought) allowed me the first appointment in the morning, which of course still meant missing classes. As it turned out I wasn't feeling too bad physically by morning but I had been plunged into the worst depressive episode I had had since starting the methadone. I was feeling under-dosed for a few days while my blood levels caught back up to where they should be and the depression cleared slowly when I started feeling comfortable again.

When I saw the doctor the next morning it was even more distressing. He was rude, threatened to stop prescribing for me, demanded to look on my arms for needle marks. I decided then and there that I was going to change doctors. The problem was when. At that time he was the only doctor in the area (within about 400km) who was licensed to prescribe methadone. He did a lot of ranting and raving, pointing to his bookshelf to invoke the methadone regulations. I asked to see which regulations he was talking about, but he refused to let me look. He told me to get my own copy, but the book he was pointing to was "Guidelines for Providers" which isn't given to patients. I later asked the pharmacist if I could look at his copy, he gladly let me borrow his copy to take home and read. There was nothing in the regulations to back up the doctor's arguments.

Over those few days I found study and attending school very difficult. One teacher took me aside after a class and asked me if I was OK and I just burst out crying all over her. One of my symptoms with depression is uncontrollable crying fits; being asked what was wrong was enough to trigger one. My teacher is a wonderful woman, she gave me lots of hugs and I told her the whole story. She has been very supportive since. The people around me generally know nothing of my past or methadone, not because I'm ashamed of it and keep it a closely guarded secret, just because I don't generally find suitable openings in conversations to say 'oh by the way I'm an ex-junkie and I take methadone now'. It's not hard for me to talk about it, I just don't talk about it often.

But, back to the regulations. The state regulations say that the doctor must see the patient at least once every three months. My doctor, after a year on methadone, was making me attend every fortnight. So at the next appointment I confronted him with that particular regulation. He admitted that the fortnightly appointments were his idea because "you just don't know what's going to happen with a methadone patient", he didn't feel comfortable leaving us to our own devices for any more than a fortnight.

It was at this stage that I got the full picture of how much I had been betrayed. I had been thinking that over the past year my doctor had been doing his best to make things easier for me but was being thwarted by draconian regulations. The regulations were draconian, but his whims were worse by far! I could be provocative just now and suggest that he was making me attend at all these extra appointments in order to make more money: in effect that he was over-servicing me for financial gain. It sure sounds more reasonable than you just can't trust a person who is picking up their methadone from a pharmacy seven days a week (which at the time I was).

To justify seeing me every fortnight, he would have to be suggesting that I am not stable. And if I am not stable how can he put in an application requesting that I have more take-aways? When this dawned on me I stopped asking him for more take-aways, because I suspected that if he put in an application it would not, could not show me in the best possible light and could jeopardize my chances of a successful application some time later when I changed doctors.

Let me make it clear that I am completely stable. I have had heroin once since starting on methadone in April '97; it was near the start of the program when I could, quite fairly, have been termed as unstable. For over a year now I have had no drugs whatsoever and have no desire for them. I am successfully juggling a young family, full time study and some freelance work. What more do I need to do?

I had considered that methadone is essential to my mental health. I expected to be taking methadone for the rest of my life because I am sure that the crippling depression that I experienced before I was on methadone will return if I stop. The last few months have been so draining though that I am thinking of chancing it. In my world view, it is inhumane that a patient is forced to consider stopping an essential medication because continuing it is so extremely stressful.

Since the above episode I have had moods bordering on panic when I think of missing a dose. One Saturday, my husband went out, taking our only car, and forgot that I needed to be at the pharmacy before 1pm. I was verging on physical sickness from panic when I phoned the pharmacy at 12:45 to tell the pharmacist that I had no way of getting there unless my husband returned very soon. My pharmacist, being the great person that he is, actually delivered my dose to my home. He really does his best for every one of his customers, but the system unnecessarily makes his job that much harder.

I am about to have my first appointment with the new doctor in a few days. He is totally new to methadone prescribing. He is working in conjunction with my drug counsellor who is an experienced methadone nurse. I have a great relationship with my counsellor so I have high hopes for the future. I hope that the delivery of my medication can be tailored to suit my needs as a full time student with a young family and some free-lance work on the side, or any busy lifestyle. I really hope that my medication can become a side-issue in my life, rather than a major hurdle every day, because I really do not want to take the chance of attempting to detox.

Is that all? Well, no. Yet another issue has come up. An integral part of the curriculum in the second semester is a field trip to a national park. This trip will last 7 days. First I was told that I would need a letter from the Institute stating that the trip is part of the curriculum, how long it would be, where it would be, and the dates. I got that. Then I was told that I could only have enough medication for 4 days, but I may be able to get around that by getting another letter to say that a teacher will take responsibility for and supervise my medication. That, as far as I am concerned, is a breach of my right to medical privacy. And who is to say that, unbeknownst to all, the teacher in charge isn't a dope fiend who will misuse my medication? But it seems that they can trust anyone except the person who actually takes the medication. I am tainted in their eyes and nothing I do, no amount of time will change that.

I am trying my arse off to make the best of my life and at every turn I have doctors and methadone regulations trying to rip my heart out. Seriously, at times this bullshit is enough to kill my will to do anything. Why shouldn't I just sit about like their stereotyped view of the junkie they consider me to be? It seems to confuse them that I don't.

Rose Whithers - mid 1998

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