‘A miracle if anyone got clean’: Australia’s drug users fight for treatment during pandemic

Four years ago, Lucky Rich found himself homeless, living in a 24-hour storage facility, in his 21st year of drug addiction and desperate to get help.

“I was trying to get into treatment but it was just really difficult,” he said. “Sometimes the stars align and you get into [rehab], but obviously, there are lots of factors that can stop that from happening.”

Even before Covid-19, it was hard to find a bed in a Victorian rehabilitation facility, so after months of trying, Rich saved up and flew to New South Wales to be admitted.

Now sober for more than three years, Rich says he is glad he managed to get clean before the pandemic swept over Australia.

“When Covid hit, I literally could not believe how hard it would be for anybody that is going through the same sort of thing,” he said. “It would be a miracle if anyone got clean during this time.”

Wait times for drug and alcohol treatment have ballooned during the pandemic, with service providers fearing the worst is yet to come.

Sam Biondo from the Victorian Alcohol and Drug Association says the lockdown has been particularly risky for those battling addiction.

“If you’re using in a closed environment, particularly alone, that’s extremely dangerous,” he says.

“If you’re buying bulk drugs while isolating there is a temptation to use more than usual, and because of shortages you could be being supplied with stuff that’s been mixed.”

While providers generally agree increases to drug and alcohol use have been modest during the pandemic, decreased capacity combined with an already overwhelmed public treatment sector has placed extreme pressure on support systems for users.

In 2018 a coalition of health organisations, including the Royal Australasian College of Physicians, called on the government to nearly double funding for rehabilitation programs. They suggested 200,000 to 500,000 Australians were unable to access treatment each year.

Health experts warn that because of illicit drug shortages during the pandemic, users are in danger of being supplied with substances that have been mixed. Photograph: monticelllo/Getty Images/iStockphoto

The introduction of telehealth at the beginning of the pandemic has expanded the capacity to treat people in the community, but social distancing has required a huge reduction in beds across residential facilities, generally required for those with the most complex issues.

In Victoria, 20% of all recovery beds have become unavailable, while fewer people are seeking to be discharged during the pandemic, leading to fewer spaces opening up.

The chief executive of Odyssey House Victoria, Stefan Gruenert, says this has “blown out” wait times for residential treatments.

“Previously we had probably a four-to-six-week wait for a residential bed … Now it’s three-to-four months, particularly in our metro Melbourne facilities,” he says.

“What we’ve seen in the past when wait times get really high, is people give up … motivation comes and goes, and it’s really hard for a treatment organisation not to have the capacity to respond when someone is motivated at that moment,” he says.

Rich says he cannot imagine being asked to wait four months for help.

“That’s just ridiculous. That person would be lucky to be alive.”

Biondo says the pandemic may be artificially suppressing the true level of demand, as people avoid medical treatment during the crisis.

“People are self-isolating, they are staying away from people, and as things open up then those issues will come out to the public. So we’re expecting the bubble to really manifest as things get better [with the pandemic].”

Gruenert says this also concerns service providers.

“I think most workers in the drug treatment sector would say that they’re feeling overwhelmed and exhausted.

“We don’t have any further capacity to manage what there is now, let alone what’s coming.”

A snapshot survey conducted by the Victorian Alcohol and Drug Association showed that during lockdown there were around 2,347 people on waitlists for drug rehabilitation treatments on any given day. Of these, about 230 were waiting for a bed in a residential facility.

Locals walk by a deserted laneway in Melbourne. During coronavirus lockdown in Victoria, there have been around 2,347 people on waitlists for drug rehabilitation treatments.

A deserted laneway in Melbourne. During coronavirus lockdown in Victoria, there have been around 2,347 people on waitlists for drug rehabilitation treatments. Photograph: Dave Hewison/Speed Media/REX/Shutterstock

Disruptions to the global supply of illicit drugs have seriously affected Australia’s black market. Anecdotally, Gruenert says, there has been a significant increase in the prices of methamphetamine, along with shortages and reductions in purity.

“Sometimes people move to more harmful and more potent substances if that’s all they can get … that certainly increases risks of harm.”

Biondo says the drug known as GHB, traditionally used in the club scene, has become more accessible and may be being used as a substitute.

“A couple of millilitres can be the difference between life and death,” he says.

Dr Monica Barratt, an expert on illicit drug markets from RMIT University, helped conduct a survey to quantify the effects shortages have had on the Australian drug trade.

“Australia data shows over 50% of people who use any kind of illegal drugs, said that they’d had trouble finding drugs. One third was reporting increases in price, and then around 20% reporting decreases in purity,” she said.

The manager of alcohol and drug services at Ballarat Community Health, Suzanne Powell, says more dependence problems are coming to light during the pandemic.

“Because people have been at home more, those who previously may have been able to hide the amount that they have been drinking from family and friends have not been able to do that,” she says.

In the youth sector, the number of parents calling for help has more than tripled, says Andrew Bruun, the chief executive of Youth Support and Advocacy Services.

“It’s been a massive increase. [The parents] are becoming aware of the problems and they are looking for support … it’s a very large demand.”

The pandemic has also affected recreational drug use, but for opposite reasons. Barratt says “party drug” use has dramatically decreased across Australia and the world.

“These people were consuming MDMA, cocaine, ketamine, amphetamines in nightclub settings and festival settings. Naturally, those settings were no longer available for these people and they reported a massive reduction or complete cessation of those drugs,” she says.

But this global change to the drug market could also produce unexpected and dangerous consequences.

“With something like MDMA, which is mainly manufactured in the Netherlands, there were concerns by some Dutch colleagues that [pills] were being stockpiled, and would be released by manufacturers later. There could potentially be a glut of very high-dose MDMA that would be very cheap,” she says.

“People’s tolerances have decreased … That’s something to really watch when the lockdowns are finally lifted and people who were not partying for a long time go back to that.”

Biondo says state and federal government will need to increase investment in drug and alcohol treatments to deal with the fallout from the pandemic.

“If social distancing is going to be factored into the future, then they certainly need to look at infrastructure. There’s also a range of concerns around the workforce, to be able to stretch out to be able to cope with the additional demand that might be forthcoming. We just can’t grow this workforce overnight, you need to plan for it.”

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