Argus title : End methadone reliance and fund abstinence – Addicts must go cold turkey or more children will die
Last Saturday, the Argus reported on the tragic death in Hastings of 9 week old Leon Faith Acton. Leon spent the first three weeks of his life in hospital being given doses of morphine to wean him off heroin addiction caused by his mother’s drug use during pregnancy.
Despite the fact that his mother was a using addict, Leon was discharged from hospital into her care before his body was free of heroin. According to the Argus report, his mother was instructed to give the baby methadone, a legal heroin substitute, to continue the “weaning” process.
On November 28, 2006, she gave him his usual dose of Oramorph, a morphine solution, However, the baby had also been given the painkiller Calpol. He developed severe breathing problems.
Leon was rushed by ambulance to the Conquest Hospital in St Leonards but despite efforts to resuscitate him he died. There were high levels of morphine in his body, but, according to a toxicologist, at a level that could have been caused by a prescribed dose. East Sussex Coroner Alan Craze recorded an open verdict, confirming “There was not a shred of evidence pointing towards this being in any sense a homicide whether by recklessness or deliberately.”
Hastings Police had suspected Leon’s mother might have deliberately over-medicated him to keep him quiet. They can’t be blamed for being overzealous. In July 2001 another Hastings couple killed a one month old baby by putting a massive dose of heroin on his gums or in his bottle. Amanda Turner and partner Joby Shorter were jailed for five years after they admitted manslaughter. Agencies were aware of drug use and domestic violence in the home.
In August 2006 at Hove Crown Court an addict called Emma Kelly pleaded guilty at to supplying class A drugs to her 9 year old son. She admitted her son was opiate-dependent and had been using methadone daily for about five weeks. Unlike baby Leon, her son survived and subsequently thrived in foster care.
The inquest on Leon heard that his mother had used heroin since she was 18, but at the time of his death was under treatment. Police found drug equipment in her property including syringes and burned tin foil together with methadone – which is commonly prescribed as part of a “drug treatment” programme. Mrs Rolfe admitted she had used heroin on the Sunday before the baby died, but said she did not do so often.
The Argus website includes many comments on this case, many of them critical of parents who continue to use drugs when they have the care of children. I have sympathy with this perspective and share public frustration with social workers and courts that continue to take risks with children’s safety. However, at the same time I question how much genuine support is available to mothers in this situation.
Some years ago, I met with a group of women in recovery from addictions. Almost all had experienced domestic and sexual violence and some had had children taken into care. Their violent partners controlled them not just by fear, but also by the fact that typically they controlled the drug supply. They spoke passionately about the urgent need for safe women-only treatment facilities within which women could either care for their babies or meet their children on contact visits.
The women pointed out that it remains very difficult to access detoxification or treatment facilities. They complained that professionals often seemed to discourage abstinence, saying that all too often they were fobbed off with prescribed methadone and forced back to the very environment which fed their habit. They said methadone is highly addictive and that withdrawal is often worse than from heroin.
I vividly remember attending a local training session on drug use and women, held around that time. A specialist drug worker employed by Health Services spoke at length about the virtues of “harm minimisation” and the need to “stabilise” addicts’ drug use during pregnancy.
When the time came for questions, I asked whether pregnancy might not be the best possible time to assist a woman into detoxification and abstinence, particularly given increased access by health professionals, concerns about foetal addiction and the possibility that children might be harmed or taken into care.
I shall never forget the withering contempt with which this idea was dismissed. I was forcefully informed that women could not cope with the rigors of detoxification at such a time and that stabilisation on methadone was by far the best option.
Years ago, I worked in local recovery services. I saw at first hand how vital abstinence-based treatment programmes were to people with serious addictions. I also observed the damage that could be done if doctors over prescribed medication, allowing drugs which should have been used for short term detoxification to become a permanent feature of addicts’ lives. By this means many local alcoholics became multiple drug abusers – and benzodiazipines and other legal drugs came to be traded like heroin on the city’s streets.
Successive governments, much influenced by the USA, have based their drug policies upon a two-pronged strategy of harm minimization and crime reduction. The primary focus has been to encourage “safer” drug use by addicts, while reducing the theft, burglary and street crime which traditionally funds their habit, by substituting the illegal substance with a legal one.
There is little doubt that methadone has its uses as a short-term solution. The difficulty is that the government has treated the “methadone maintenance programme” as an end in itself. Many addicts said to be “in treatment” continue to use heroin and other drugs. Indeed, there is no reason why they should not for they are not really in recovery. In effect, the state has become addicts’ supplier – and international drug companies are pocketing the profits.
Health professionals reassure addicts that their addiction is an illness which is being effectively “managed” by use of prescribed medication. So it is hardly surprising – given the distorted logic of using addicts – that many convince themselves that any additional illegal drug use is simply “recreational”. Hardly surprising too that social workers charged with the protection of children buy into the myth that a Methadone-dependent addict is a recovering addict – and therefore likely to be a safe parent.
It beggars belief that a woman known to be addicted, her body disrupted by child birth, whose judgment was known to be impaired by reason of her drug use and with the care of four other children, could be relied upon to administer addictive dangerous drugs to her small baby. The most basic commonsense should have made this impossible. Yet it happened and no doubt will happen again.
There are two factors in play here. One is the collapse of Social Services which means that greater and greater risks are being taken with children’s safety. But more significant by far is the naïve notion that an addict on methadone maintenance is different in kind from an addict on heroin.
Vernon Croaker, the Parliamentary Under-secretary for Crime Reduction, visited Brighton last week, to launch national awards for groups tackling drugs in communities.
He acknowledged that: “With any problem, whether substance misuse or alcohol, we can’t just solve it through one approach.” He was making a distinction between the criminal justice approach and community based solutions. However, he might with more reason have talked about the need for a range of different treatment options.
If the Government is to have any chance of tackling drug misuse – and the violence which comes with it – it must improve the range and effectiveness of treatment options and cease its slavish reliance upon methadone.
In addition, it must support and fund abstinence-based treatment programmes, ensure adequate child protection training for professionals and provide safe residential and community services for addicted parents and their children.
Until it does this, children will continue to die.