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Third Annual Turning Point Oration: From Tears To Hope-10/12/99 Melbourne, May 99
by Tony Trimingham.
Last Tuesday, I was driving to an appointment in Sydney-it was a beautiful summer's day, the radio airwaves were full of Australia's successes in the Davis Cup and the cricket against Pakistan. It seemed incredible that I was actually going to an event at NDARC that would see Australia collect another championship-this one we could do without-the releasing of figures which stated that we had the highest rate of heroin overdose deaths in the world.
It seems incredible, doesn't it-the paradox of everything that is good about Australia and the fact we are losing more of our young people than ever to drugs, suicide and alcohol-related traffic accidents. Seven hundred and thirty-seven deaths in 1998, in the population 15 to 44, with every indication that the figure will hit over a thousand in 1999. I now want to show some pictures of Damien's life because when we quote statistics it's easy to lose track of the fact that we are actually talking about real people: someone's son or daughter, partner, brother sister or friend.
Damien was 23 when he died. He was white, Anglo-Saxon and I guess, middle-class. He could have been female, 14 or 40, black, Asian or European, from a poor or rich family, from Toorak, Dubbo, Alice Springs or Cabramatta. If you remember nothing else about this morning I hope these images will remain with you especially when you hear comments about junkies which reinforce the stereotype. The most sickening thing for me to hear is that 2500 people have died since he lost his life.
As well as showing pictures of Damien's life and death, I am including at the end some photos of people who have died in the last 12 months. These are loved ones of attendees at our recent Memorial Service in Sydney.
As you can see from these slides, Damien was a talented person. State champion athlete, elite footballer, prefect, house captain, actor, poet and musician. He was loved by all his friends-and their parents. He was at times a person who lived close to the edge-he was fearless on the football field. In past eras he would have been first in line to enlist for battle etc. He had many fine qualities but he was certainly no angel, often getting into strife in his adolescence. The first substances he used were alcohol and tobacco as a young teenager and he used his share of cannabis. When he left Chatswood High School in 1992 there was no heroin in or around that school-something which, I found out on a return visit to speak last year, has changed dramatically. Two 13-year-old girls admitted to me they were using. Up to the time that he was introduced to heroin along with his girlfriend about 16 months prior to his death, he had been in a stable job as manager of a service station and his girlfriend of three years was employed as a hairdresser.
Damien had often expressed his negativity to hard drugs and so when I saw signs that caused concern-change in eating and sleeping habits, constant lack of money, niggling health problems and, when I questioned him and got the answer, 'don't be stupid, Dad. Do you think I'm crazy!', I breathed a sigh of relief. What I didn't know until June 1996 was that he had developed a severe habit over an eight month period. Another couple, including Damien's best friend, had persuaded them to try it and what started as a social experiment quickly developed into a costly and isolating activity.
When we finally found out about everything we discovered that he and his girlfriend had been using about $600 a day. They had gone through their combined savings-about $30,000. Sold all their property of value and borrowed extensively from friends and strangers. They had stopped paying their rent and bills and I believe they were probably one step away from crime when his girlfriend's father discovered their debts and confronted them. I returned from a trip to England to find Damien on my doorstop with his sad and sorry tale.
Like most parents I was totally unprepared and unable to deal with the news. My emotions were a mixture of disbelief, anger and most of all fear. Unable to get much help or support from the services that I contacted, I packed him off to my daughter's place in the Blue Mountains. I had no idea what I was putting her through-somehow she and Damien managed to survive a cold turkey withdrawal. At that time I was using all the normal but negative coping strategies-denial, anger and self-blame.
My major denial came shortly after- when I thought that because he had stopped using, we were through most of the danger. It's common in these situations for families to breathe a sigh of relief and think their problems are over. For the next eight months Damien was largely drug-free, occasionally drinking heavily and weighed down with guilt and a sense of failure. He felt he'd lost all his friends. There were often times of optimism-he started mountain climbing, took up rugby training and had developed a new relationship.
What I didn't discover until reading his diary and journal after he died, was that in times of bleak despair he would take off for the city, secure some heroin, use it in a sordid isolated place like a back alley or public toilet, sleep it off and then return to the mountains. It was on the third or fourth of these trips that he died in February 1997.
After an argument with his girlfriend, a heavy drinking session, he drew his last $50 out of his bank account and caught the 7.30 train from Katoomba. Getting off at Central Station he walked to Bourke Street Pharmacy at Taylor Square where he bought his needle fits. This pharmacy normally turns over 8000 syringes in a week-the week of Damien's death was Gay Mardi Gras week and they supplied 15,000 that week.
He was discovered by a security guard in the stairwell of St Margaret's Hospital, Surry Hills-ironically the hospital of his birth. By the time the guard called for back-up and then called an ambulance, Damien had died.
It was to be three days before I was informed of his death-by telephone. Three months later when I got the autopsy report it told me how healthy he was. Not a thing wrong with any of his vital organs-he had the body of an athlete.
To lose a child to an early death is devastating-to find that the death was totally preventable is tragic. On top of this, to realize that in the eyes of the law and our society he died a criminal is heartbreak beyond belief. Three Families a day in Australia are going through this kind of heartbreak.
In the part of my grief process, about six months later, when I was in a real trough of depression, with no appetite for anything and nothing to look forward to, just going through the motions of living, Justice James Wood handed down the findings of his Royal Commission into Police Corruption, Pedophilia and drugs in NSW.
I could not believe the reaction of politicians from both sides to his recommendations regarding heroin, such as injecting rooms and heroin trials. It all seemed just too difficult for them. One evening, after listening to a politician ducking and weaving, I couldn't sleep. I got up at three in the morning and wrote a letter to the Sydney Morning Herald. After the letter was published there was significant media interest and eventually our story featured in the TV show 'Witness'.
My phone started ringing and didn't stop for a week. Letters from parents were forwarded on from the newspaper. Most of the phone calls and letters were from family members of drug users. One of the first people who contacted me was the only child of the great Doc Evatt. She shared with me the fact that her 19-year-old daughter had died some years earlier from a heroin overdose. Others talked of the shame and stigma-one woman from Queensland had lost three children to heroin. The common thing about these phone calls was that the people were decent people from all walks of life who had done their best in dealing with the drug use. There were common themes: no immediately available detox beds or rehab places; lack of support and even discounting of families by professionals; lack of strategies for coping with all of the issues surrounding the drug use. One woman from a small country town rang about the recent death of her 16-year-old daughter. She talked about her isolation and grief; she talked about the gossip: her daughter was a prostitute, she'd been murdered-all totally untrue. She had become agoraphobic because of her fear of confronting her uncaring community. She was also angry that another family in the town who had lost a child in a rail accident had received emotional and financial support from that same community.
Rev Bill Crews from Ashfield Uniting Church, a man with a history of ministering to minorities, contacted me and said, 'Invite all these families to a public meeting.' With little notice we held a meeting at his church-450 people came and Family Drug Support was formed.
Not only did we start an advocacy campaign for families-writing to newspapers and politicians, educating the community, fighting for the rights of users and their families-we also decided to try and address some of the gaps that families were identifying as needing to be filled. Since then we have held our support groups which are an alternative to the 12-step groups like nar-anon and other more directive-orientated tough-love groups. Starting with three groups, we now run twelve a month in Sydney and have others running in country areas like Albury and Wagga. Our bulletin heroinsight, which started as a two-pager, is now a 36-page booklet which goes out bi-monthly to 1800 families across Australia, and contains good up-to-date articles, poems and stories. This issue contains the recent 'Call to Consciousness' message to his fellow judges by Justice Wood. We have developed a parent education kit 'A Guide to Coping' which contains information and strategies for families with drug problems.
Our major project has been the establishment of our Telephone Support Line, manned 24 hours a day, seven days a week. This 1300 number receives more than 25 calls a day at an average call length of 34 minutes from all over Australia. Not a counseling, information or advice service, this is purely there to lend support and be a listening ear. In eighteen months we have run 12 training courses for 120 volunteers. Most of these volunteers have been personally affected themselves-either having lost children or gone through all the traumas associated with drug-use.
Prior to my involvement in drug and alcohol matters, I had been a counselor and group leader. For over 20 years I have counseled people with relationship problems and had a lot of experience in assisting people going through separation and divorce. There is a definite process in divorce recovery. Although it was far from apparent at first, I gradually started to observe the process of adjustment and change that occurred for people going though drug crisis. Like myself, the majority of families generally cope inadequately and negatively when first becoming aware of drug problems.
'Control and direction' is often the common strategy used. Fathers want to solve the problems quickly-mothers often become over-responsible and sometimes collude with the drug user to keep things secret from Dad. Relationships get strained, siblings become antagonistic and family systems start to crack. All of these aspects make the feelings of helplessness, confusion and sense of failure even greater. The lure of a 'cure' is ever seductive- naltrexone being the most recent 'magic bullet'. Just last week I had a sad conversation with a mother who had thought she was home free after rapid opiate detox and naltrexone maintenance seemed to have solved all their problems. The side effect of deep depression led him to an overdose death -she is now tormented by the question of whether it was deliberate or accidental or whether pushing him into the treatment was the right strategy.
I discovered from our earliest group sessions that simple education on things like 'The Stages of Change' model, combined with a safe environment to 'tell their story', and support, enabled attitudes to change and they started to report positive outcomes and strengthened relationships. Over time I saw fathers whose initial reaction to their sons' activities was to order them out of home, gradually change their attitudes and become supportive and guide them through lapses and other difficulties. I also saw mothers who had previously reclaimed property form hock shops to 'keep the peace', start to construct boundaries and engage their user into contracts with workable consequences. In recent times I have been developing a closed group follow-up to the less formal support group that provides a road map through the process. This group will be called 'Stepping Stones to Coping' and will incorporate accepted drug and alcohol theories, like motivational interviewing, combined with the 'collective wisdom' of the group members in a model that is easy to understand and interactive.
And wisdom they've got, maybe not in the academic aspects of this issue, but certainly in pain, in perseverance and in unconditional love; some of us with great hindsight, knowledge of intervention and strategies that may help others.
One of the most difficult things for families to come to terms with is that their preferred goal of 'getting them off drugs' may not be achievable as quickly or as easily as they would like. Explaining the reality of the 'long haul' -it may take many years to get through the drug-using process-without ever taking their hope away is the most difficult task. Some families enjoy successful outcomes relatively quickly. I know three families whose daughters were entrenched in drug use three years ago. Their similar stories include prostitution, crime and chaos-one young lady is now stable on the methadone program, another totally drug free after getting pregnant and the third enrolled initially in a buprenorphine/ methadone double blind trial in Sydney. When she discovered after six months that she was on a high dose of methadone, she determined to get off and in six months had reduced to nil. Other families struggle for years through the ongoing cycle of hope and despair with little apparent progress.
I recently spoke to a Melbourne mum whose son died last November at the age of 31 after eleven years of heroin use -the astonishing thing was he had detoxed 41 times in that eleven years. Now here was a young man who wanted to give up but just hadn't been able to! Success is relative with this chronic relapsing condition. Families often ring our line in despair saying they have been trying to get him or her into detox for months. He finally went in on Saturday and left after six hours! Their despair turns back to hope again when I say, 'Isn't it good that he walked in? Maybe next time he'll stay a bit longer!' Family support seems to be a common denomination in the success stories I've seen.
I want to finish by telling two stories- one that illustrates the distance we still have to go in overcoming prejudice and stereotyping, the other to illustrate why we must never give up hope and also why, among resourcing prevention, education, treatment, pharmocotherapy and supply reduction, we just have to make some resources available to maintain life.
I spoke to a lady yesterday who rang me in great distress-her son facing a robbery charge because of his drug use had started a methadone regime. Duly convicted, he went into Long Bay Gaol. His methadone dose was 2O mls, which he reported to the prison drug clinic. At his first dose he was mistakenly given 90 mls and needed two shots of narcan to revive him. While waiting to hear of his progress at the prison hospital, a prison guard, who knew she was his mother, spoke loudly enough for her to hear, 'Why didn't they just let the junkie die!'
The other story concerns a woman who rang me a while ago and asked me to meet her for coffee. She was a woman in her early 40's who explained to me that she was a general practitioner. To my amazement she confided that up to the age of 29 she had been a heroin user. A prison sentence, two broken marriages, children taken away and attempt at every form of treatment available had got her nowhere. She explained to me that for her the single fact that at 29 she wanted to go to University did it for her. She has never used heroin since. I am sure there are thousands like her who with family support eventually reach their personal 'magic moment'. My son never had the opportunity to reach his. We must put in place strategies that allow as many people as possible to remain alive to reach this point. If it takes things that are distasteful, like injecting facilities, heroin trials or even prescription heroin, then for God's sake let's have the courage to do it.
In responding to Tony's speech Professor Margaret Hamilton, Director of Turning Point, Drug and Alcohol Services in Melbourne, said, Thank you, for allowing Damien to speak to us. Damien was not somebody's son -he was your son. He had a loving supportive family. He had all the attributes and chances for resilience. He should have been low risk for illicit drug trouble-yet he is dead. She agreed that including families in the process was a definite necessity for all professionals.
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