Waiting lists send addicts back to life of crime

01:43, Jan 31 2009
OVERBURDENED PROGRAMME: A new report shows that hard drug addicts are having to wait too long to enter recovery programmes, leading many to turn to a life of crime and prostitution.

Hard-drug addicts are lapsing into lives of crime and prostitution while waiting up to eight months to access "poorly resourced and overburdened" treatment programmes, experts say.

A report from the National Addiction Centre, obtained exclusively by The Press, estimates that crime by opiate addicts awaiting treatment costs the country $286 million a year.

A 12-month course of addiction treatment with methadone costs about $5000.

The report estimates that almost 10,000 New Zealanders, including 1429 in Christchurch, are daily dependent on opiates such as heroin, morphine, homebake and opium from poppies.

About 4600 addicts are receiving methadone through opioid substitution treatment (OST) programmes, but demand far outweighs the resources available.

Waiting lists were a "significant problem" and addicts had "considerable ambivalence" about seeking treatment. Addicts were waiting an average of 90.3 days between their first presentation and their first dose of methadone at New Zealand's 18 treatment centres.

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In Christchurch, non-priority addicts were waiting 94 days, with a 260-day wait in Otago (with interim methadone prescribing) and no service available on the West Coast because of a lack of resources.

Ministry of Health guidelines recommend a four-week wait.

Addiction experts have slammed the delays and say they could lead addicts back to lives of drug use, crime and prostitution.

"If those people are open to and willing to enter treatment, that's when we need to get them on to methadone, not six months later or even three weeks later," Needle Exchange Programme national co-ordinator Charles Henderson said.

"The horse could have bolted by then, thereby missing a very important chance to both improve the overall societal effects and certainly that individual's health."

Opiate addicts, whose addictions could cost about $1000 a week to maintain, were often engaged in crime, prostitution and drug abuse, experts said.

They were also 13 times more likely to die prematurely than their peers, and have health problems such as Aids and hepatitis B and C.

"Most people I know with opiate addictions, they don't like themselves either when they're in addiction. It's not a nice world," said National Addiction Centre lecturer Dr Daryle Deering.

Henderson said needle-exchange staff saw addicts with "abscesses that are taking calves apart and gaping holes in thighs" owing to squalid living conditions and unclean injecting behaviour.

"You've got the shackles of addiction and the shackles of procuring a black-market drug. Generally it's a fairly chaotic lifestyle in most areas prior to going on to treatment, but that treatment generally turns that around pretty quickly," he said.

Comments from addicts, including 43 Cantabrians, widely criticised aspects of the OST programme. One participant was "sick of liquid handcuffs" and withdrew, while another said: "People on the programme have very little control over their addiction or their lives. I don't want to be told to take a full dose every day."

Treatment centres reported that staff and pharmacist availability, clients not attending their appointments and waits for urine results contributed to the delays.

Alcohol and Drug Association chief executive Cate Kearney, also co-chairwoman of the National Committee for Addictions Treatment, said 90 days was "far too long" for people to wait but that population-based funding for district health boards did not account for regional variations in opiate addiction.

Christchurch had a well-documented opiate problem and higher rates of addiction than Auckland, she said.

The report, commissioned by the Ministry of Health for public release next week, recommends the OST programme be renewed. Deering said there was a "real opportunity" to bring opiate addiction under control with better resourcing.

The Press