When someone presents with drug or alcohol problems at St Vincent’s Hospital in Sydney, a whole specialist team is on hand to provide treatment and support.
The doctors, nurses, social workers, psychologists and occupational therapists are there to provide a multi-disciplinary approach – aware that for many there are a whole host of background issues that are driving their drug or alcohol dependency.
Many are experiencing homelessness, for others there are issues of domestic violence, or mental health problems. All of whom are treated with respect and dignity – a theme at the centre of this year’s International Drug User’s Day (Nov 1).
“I rarely see anyone who’s only problem is with drug and alcohol,” says Dr Jonathan Brett, Drug and Alcohol Staff Specialist at St Vincent’s. “We deal with people who most-often have severe long term issues. Our business is complexity and it is our duty to provide the best care possible. At St Vincent’s it is our mission to look after the most vulnerable people and treat them in an inclusive and dignified way.”
Data from St Vincent’s reveals that around half of all in-patients in its drug and alcohol service have mental health concerns, followed by 14 percent being homeless.
St Vincent’s provides both in-patient and out-patient services and also runs a state-wide on call service called DASAS – a free 24/7 telephone service that provides general advice to health professionals who require assistance with the clinical diagnosis and management of patients with alcohol and other drug related concerns.
Dr Brett notes that fundamentally, he and his team ensure that they treat their patients with alcohol and drug problems no differently to any of their other patients with long term chronic disease.
“That is the nature of the disease and we don’t treat them any differently from say someone with a condition like diabetes. That person may have difficulty controlling their blood sugar levels and may present regularly to the hospital. Someone with a drug problem should be treated exactly the same – we are all humans and everyone deserves to receive the very best care possible and have it delivered with dignity and respect.”
Dr Brett says their work can often be distressing for staff but there are stories of success that continually drive their work.
He said: “During COVID especially we have seen people who have received a boost in government supports which has really helped them to get off the streets and into permanent housing.”
Dr Brett says the public perception about beating a drug addiction is often worse than the reality.
“A lot of people out there have a very pessimistic view about drug addiction. But there are evidence-based treatments that work.”
For example, in the case of someone with a severe heroin addiction, they will be appointed a care co-ordinator who will manage their whole program – starting with opioid substitution. therapy, and then identifying the issues that are often behind the addiction. “It can take months and years of work, but will vary for each person,” said Dr Brett.
Dr Brett says it takes an enormous amount of bravery to seek help. “Often we are the first people they have told about their addiction as there is such a stigma in the community. We still have a long way to go on that front.”
St Vincent’s is about to open a new Psychiatric Alcohol and Non-Prescription Drug Assessment (PANDA) six bed unit in the emergency department.
Dr Brett said it will help meet the needs of a currently underserved population. “Emergency departments are busy places and we have people come in who are severely intoxicated who are treated, sleep it off and then take off.
“Our new specialist team and area will provide a safe space to better assess and treat patients with mental health and drug and alcohol-related conditions.”
The $17.7 million unit is the first of its kind in Australia and was partially funded through a $12 million grant from NSW Health and a generous gift from the SIRENS Group.
Dr Brett said: “We are fortunate at St Vincent’s here in Sydney to have very generous funding to carry out our work, but we don’t know what the future holds and also many other regions in Australia don’t have the resources we have.”
Incredibly up to 500,000 Australians are currently unable to access alcohol and other drug treatment services every year,
This is why St Vincent’s Health Australia is currently coordinating a national campaign featuring 28 peak bodies, medical organisations, and alcohol and other drug service providers to encourage governments (federal, state/territory) to provide more funding and better planning for the alcohol and drug sector, particularly in the light of COVID.
St Vincent’s is calling on political leaders to expand on reforms to telehealth, digital access and pharmacotherapy introduced during the pandemic to better support people experiencing issues with substance use. It’s also calling for the development of a national response to alcohol and other drug needs that covers investment in rural and regional services, workforce training, and more effective data gathering.