Third
Annual Turning Point Oration: From Tears To Hope-10/12/99
Melbourne
ref:
May 99 Heroinsight
TONY
TRIMINGHAM was invited to give the Annual Turning
Point Oration following in the footsteps of Deputy
Police Commissioner Neil Comrie and then Premier
Jeff Kennett.
Thank
you for your kind invitation to give this talk.
I only hope I will be around in 12 months' time,
unlike one of my predecessors.
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 realise 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, Paedophilia 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 counselling, 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 counsellor and group leader. For over
20 years I have counselled 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 de-tox 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
de-toxed 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 de-tox 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, Tony, for your quite
calm messages-for us it was a chance to stop and
listen, share and gain some renewed energy at the
end of a hectic year when people maybe are a bit
tired and jaded. Your way of allowing Damien to
speak to us is potent. 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.' Margaret then went
on to make a personal apology to families she may
have discounted or hurt in her thirty years of work
in the field. She agreed that including families
in the process was a definite necessity for all
professionals.
