Drink and Drugs News DDN October 2018 - Page 8

comment Valuing the future Post-its from Practice Guiding people towards hepatitis C treatment can be a matter of self-esteem, says Dr Steve Brinksman ONE OF THE SERVICES I WORK WITH has been looking at setting up a hepatitis C treatment programme in conjunction with the local hospital trust, based in the prescribing centre. This is obviously a good idea and is a model of treatment that needs to be replicated across the country if we are to make serious in roads into eliminating hepatitis C – which given the efficacy of modern treatment, could be achievable. Speaking to the hospital consultant, it transpired they have the provision to treat far more people than are currently on their waiting list. And as they struggle with engaging active service users, due to high drop-out rates, it is envisaged that more readily accessible treatment will help reduce this. This prompted me to think about why people in drug treatment who know they have hepatitis C don’t engage with a treatment that is highly effective and, these days, relatively low in severe side effects? I couldn’t imagine not having treatment, if it was me who was affected. I spoke to Andy – a patient at my practice who has had hepatitis C treatment and who is now virus free – about my puzzlement. He told me that he put off treatment for a long time because although aware there were significant health consequences to having hepatitis C, something that might harm him in ten to 20 years didn’t seem a big issue when he knew he risked overdose every time he injected, had nowhere stable to live, and was being regularly arrested. He also knew treatment was expensive – and quite frankly, he didn’t think he was worth it. It was only some time into treatment for his drug use, and after he began attending a peer support group and started to develop self-esteem, that he felt ‘It is a simple mistake to think that others think as we do and place value on the same things we do.’ he could make a commitment to his long-term health and other health issues. It is a simple mistake to think that others think as we do and place value on the same things we do. If we continue with that paradigm, I fear large numbers of people will remain with untreated hepatitis C and we will keep scratching our heads and wondering why. I fully support the enhanced provision of hepatitis treatment and welcome the move to provide it in a geographically accessible way to service users. However, I think we also need to realise that difficulty getting to a treatment centre isn’t the sole reason people don’t engage in anti-viral treatment. Alongside making treatment accessible, we need to work at improving our services to develop our service users' selfesteem, ensuring that they value themselves and their future in the way we might value our own. Steve Brinksman is a GP in Birmingham, clinical lead for SMMGP and RCGP regional lead in substance misuse for the West Midlands MEDIA SAVVY The news, and the skews, in the national media SCOTLAND IS A SMALL COUNTRY with some big problems. For too long we’ve accepted drug and alcohol problems as part of our society and culture. If we can look beyond these shores we will see brave people who have found creative solutions to their unique circumstances. It is time for us to be brave. Andrew Horne, Herald, 4 September IN WALES AND SCOTLAND minimum unit pricing is on the table or enacted. The government’s failure in England to act on price seems to disregard the weight of expert and empirical evidence. Such is the reality of having a tax funded, politically accountable NHS while public policy relating to wider determinants of health rests with other government departments, Treasury included. …My concern is that however switched on our health service and public health leaders may be, the funding and the wider social policy to make their ambitions a reality rely on ministers, government communications teams, and Treasury officials. These parties are late to the party. David Oliver, BMJ, 11 September WE CAN’T SIMPLY TELL YOUNG PEOPLE to ‘say no to drugs’ at festivals. It hasn’t worked for half a century and it won’t work now. Instead, we need a mitigating factor – and that’s what pill testing is. It’s not a silver bullet. But it is backed by international evidence. Shelley Smith, Guardian, 17 September TO THE RELIEF OF ANYONE who for medical or cultural reasons isn’t getting sloshed and doesn’t feel like constantly explaining why, the stigma of not drinking may be wearing off. Personally, I’ve got no intention of going on the wagon. But a world where people are neither slut-shamed out of drinking, nor bullied into it? I’ll raise a glass to that. Gaby Hinsliff, Guardian, 27 September THE CULTURAL PULL OF TOBACCO, its hardiness in the face of hostility, may be weaker than it once was – those who would have smoked until they dropped are mostly now fogged in clouds of vape – but its survival instincts are those of a cockroach in the aftermath of an atomic strike. Eleven years ago, I watched as pubs erected smoking shelters for the incoming smoking ban; I don’t see them pulling them down in the near future. Stuart Evers, Guardian, 24 September REOFFENDING RATES ARE FAR TOO HIGH, few alternatives to custodial sentences are pursued – because of populist political pressure – and the result is more recidivism, more violence, more burglary, more crime generally and more emotional and financial costs loaded onto peaceful citizens when offenders are released. It is a classic example of a false economy. Independent editorial, 20 September 8 | drinkanddrugsnews | October 2018 www.drinkanddrugsnews.com comment Valuing the future Guiding people towards hepatitis C treatment can be a matter of self-esteem, says Dr Steve Brinksman ONE OF THE SERVICES I WORK WITH has been looking at setting up a hepatitis C treatment programme in conjunction with the local hospital trust, based in the prescribing centre. This is obviously a good idea and is a model of treatment that needs to be replicated across the country if we are to make serious in roads into eliminating hepatitis C – which given the efficacy of modern treatment, could be achievable. Speaking to the hospital consultant, it transpired they have the provision to treat far more people than are currently on their waiting list. And as they struggle with engaging active service users, due to high drop-out rates, it is envisaged that more readily accessible treatment will help reduce this. This prompted me to think about why people in drug treatment who know they have hepatitis C don’t engage with a treatment that is highly effective and, these days, relatively low in severe side effects? I couldn’t imagine not having treatment, if it was me who was affected. I spoke to Andy – a patient at my practice who has had hepatitis C treatment and who is now virus free – about my puzzlement. He told me that he put off treatment for a long time because although aware there were significant health consequences to having hepatitis C, something that might harm him in ten to 20 years didn’t seem a big issue when he knew he risked overdose every time he injected, had nowhere stable to live, and was being regularly arrested. He also knew treatment was expensive – and quite frankly, he didn’t think he was worth it. It was only some time into treatment for his drug use, and after he began attending a peer support group and started to develop self-esteem, that he felt MEDIA SAVVY SCOTLAND IS A SMALL COUNTRY with some big problems. For too long we’ve accepted drug and alcohol problems as part of our society and culture. If we can look beyond these shores we will see brave people who have found creative solutions to their unique circumstances. It is time for us to be brave. Andrew Horne, Herald, 4 September 8 | drinkanddrugsnews | October 2018 IN WALES AND SCOTLAND minimum unit pricing is on the table or enacted. The government’s failure in England to act on price seems to disregard the weight of expert and empirical evidence. Such is the reality of having a tax funded, politically accountable NHS while public policy relating to wider determinants of health rests with other government departments, Treasury included. …My concern is that however switched on our health service and public health leaders may be, the funding and the wider social policy to make their ambitions a reality rely on ministers, government communications teams, and Treasury officials. These parties are late to the party. David Oliver, BMJ, 11 September Post-its from Practice ‘It is a simple mistake to think that others think as we do and place value on the same things we do.’ he could make a commitment to his long-term health and other health issues. It is a simple mistake to think that others think as we do and place value on the same things we do. 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