Wednesday, 28 March 2007

The NHS Replacment Therapy to Quitters

The National Health Service, or NHS, was set up on 5th July 1948 to provide healthcare to all citizens, based on NEEDS, not ability to pay. I like the part where it says based on needs, which i fully support its philosophy. It's great knowing that when i am old and sick, i don't have to sell my car to fund for my operation. It's great.

But this is not it. Of course, being a faithful employee of NHS (so far), there are aspects which i think are way over the top. One of them is smoking cessation support.

So today i attended a meeting with the smoking cessation specialist team. So, according to this "based on needs" philosophy, a patient can obtain free Nicotine Replacement Therapy from the pharmacist and we pay them. Nicotine Replacement Therapy for those who want to quit but are not ready to live without nicotine. To me, that's a sign of weak will power. What's the point of having some form of "replacement" if you want to quit.

Nicotine Replacement Therapy come in different forms, patches, nicotine gum, lozenge, nasal spray.Bascially just feeding the bloodstream with nicotine to stop the craving. We pay the high street pharmacists for the consultation with them, the motivational sessions, and we pay the products as well. All free. On top of that, when the client actually quit (may be for the time being), we top up the payment. The GPs also get paid when their patients who successfully quit , after seeing the pharmacist. Meaning, pharmacists do the hardwork, get paid, GPs don't do the hardwork, but get paid.

Another "Replacement Therapy" in the UK is methadone for drug addicts, whom we call them service users over here. So the department of health think we can't stop them, we minimize the harm. So, for service users , we give them methadone instead. Methadone has its street market value, so we pay pharmacist to supervise some of their comsuption. By the way, no kidding, methadone is a liquid green in colour.

Running alongside methadone is the needle exchange which i find it hilarious. So, again, harm minimisation. So, to prevent HIV , we promote clean needles for the service users. NO sharing and you dispose them each them you used it. So we pay pharmacists both for the service and the needles. So service users exchange their used old needles for new ones. Yes, we pay the needles for them to continue doing what they do.

The other day, i attended a meeting where we invited few service users for their views on the "cooker" that we are going to give it to them. The company who design/make the cooker was there as well. The cooker is actually a receptacle in which the drug (i mean real drug) is dissolved and heated prior to being drawn into the syringe. Yes, we want harm minimisation and we want safety and hygiene. The company designed two cookers, and the service users gave their views. They complained that the first cooker wasn't stable, not heat transferable.. have to wait very long for the drug to be heated etc.I was sitting there and was a bit uncomfortable. I wasn't brought up in a culture like this. I don't know how to feel. It's like approving something that you disapprove. So you can't get them to this side, you help them at theirs.

As for the outcome of this replacement therapy, to be honest, i don't think it's great. It's like putting a plaster on the wound. The plaster can keep the wound from water and germs, but the plaster can heal the wound. These users have far more complex issues than just giving them needles and cookers. The family background is complex,so is their social background.

They need and they hunger for a new life, new possibilities. The society, ie , we have to blame partly for this. We don't give them the space that they deserve.How easy is it for service users to get a job without getting those kinda looks? When things go missing in the workplace, where will they first point the fingers before the actual investigation?

Well let's not get there. It's complex.

All i am saying today is this thought of mine that replacement therapy DO NOT WORK. It's a fake comfort. A political thing to satisfy the general public that we are doing something about this kinda issues, we are not letting them rot. But is it really?

You want to quit, JUST quit, JUst do it. You want to get off sugar, no sweetener stuff, just get off it! No such thing as replacement therapy, you are only deceiving yourself.

p/s: You can disagree with me, but Jesus do change and transform life! My uncle was a service user. No one could help him, but he went to a christian drug rehab centre, eventhough he wasn't a christian then. He was transformed. He's off it for many years now, my grandmother saw with her very eyes this new transformed son of hers. My mom found her brother. That explains my heritage, i am a third generation christian.

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