THE TIGER'S DARK UNDERBELLY WILL NOT STAY HIDDEN FOREVER

A Priest Scrounging Methadone On The Streets Is A Cold Fix Of Reality,
Reflects Peter Murphy

A rebel Catholic bishop roaming Dublin after dark trying to score methadone
for the heroin addict he has taken under his wing. It's an image that could
only have been disgorged from the underbelly of 21st-century Ireland.

Dissident bishop Pat Buckley's admission, on Marian Finucane's radio show
last Wednesday, that he had illegally obtained methadone in order to help a
young friend kick his heroin habit didn't just make for an ear-grabbing
opening it also highlighted present and past governments' failures to
implement satisfactory rehabilitation programmes for the estimated 13,000
heroin addicts in Dublin.

Bishop Buckley met his charge, a 20-year-old homeless heroin addict, some
six to eight weeks ago. The young man told him that he was ready to stop
using heroin, and a place was obtained on a 90-day drug treatment course,
with the stipulation that he be clean for 10 days before attending.
Perturbed by the 10-day rule (by no means one common to all treatment
centres), the bishop offered the young man shelter while he prepared to detox.

He also agreed to procure the 185 millilitres of methadone deemed necessary
to wean him off heroin, a figure arrived at through a 10-minute emergency
assessment process carried out at Trinity Court drug-treatment centre.
According to Bishop Buckley, due to waiting times and clinical assessment
procedures, the young man can't be seen there again for another six months.
As Finucane pointed out, the administration of untested methadone without
expert medical supervision is extremely dangerous. However, Buckley
insisted it was not a decision he had taken lightly, and he had enlisted
the help of a GP friend.

``At the moment his two arms are like two pin cushions,'' Buckley said,
``and he's full of abscesses from syringes. If he is left on the streets of
Dublin for the next six months he is in much more danger than coming to me
with the help of medical supervision and then going into a special unit.''

Perhaps surprisingly, Finucane's programme was flooded with calls of
support for the bishop the following day, reflecting a deep dissatisfaction
with the rehabilitation systems that are currently in place, but also
voicing concerns about methadone itself, the subject of ongoing controversy
among drug-treatment experts.

Frank Buckley, who served as an inner-city community representative on one
of 13 government funded drugs task forces from 1997-98, has expressed
concerns about the bishop's actions, and methadone in particular.

``I think what he's doing is very dangerous,'' he says. ``He's trying to
get him physically off heroin, but he's giving him another drug. But that
other drug is more dangerous if that chap decides, `I'm going out to get
stoned', and he's already after drinking 200mls of methadone or whatever.

`With all the will in the world, the guy wants to give up heroin and has
convinced the bishop. But if he doesn't know how a drug addict thinks, he
could be talking to him for days, and then within 10 minutes the guy could
have a needle in his arm.''

Frank Buckley believes that, rather than addressing the core problem of
addiction itself, methadone is a stopgap solution used to keep crime levels
down. ``Any government, they look at the four-year spell that they're in,
and they say, `What's the short-term [solution]?' If 80-90 per cent of
crime is drink-or drug-related, if they can zombie-fy most of the junkies
in Dublin, there's the figures down.''

Buckley also points out that addicts can exaggerate the extent of their
habit in order to obtain higher doses of methadone from drug-treatment centres.

``By the time the Eastern Health Board had come to the conclusion of
administrating methadone, the findings in Europe were coming out that it
was dangerous unless you have complete control,'' he claims.

Drug-treatment centres such as Trinity Court receive literally thousands of
phone calls from parents ready to assist their sons and daughters in
getting clean.

However, the long waiting lists often result in addicts attempting to go
cold turkey in unsupervised or isolated circumstances, without proper
counselling, sometimes resulting in suicide (indeed, Bishop Buckley
admitted to Marian Finucane that a nephew of his killed himself in similar
circumstances three years ago).

``It doesn't necessarily take so long to process people,'' explains Dr
Eamon Keenan, a senior doctor at Trinity Court. ``It's based on the
clinical assessment which is carried out at the emergency assessment to
start with. That's then discussed at a clinical team meeting, each case is
looked at on its own merits and a decision is made in terms of priority for
certain individuals.

``Work is going on to open a number of treatment locations throughout the
city which would significantly impact on waiting lists,'' he continues.
``It's not necessarily funding or resources there's a certain consultation
process that we have to undergo with local communities.''

How does Dr Keenan respond to criticism of methadone treatment as merely
replacing one drug with another? ``Methadone is the most widely validated
and researched form of drug treatment for opiate addiction,'' he indicates.
``What I would say about any methadone programme is, it's not a stand-alone
treatment. Just by giving methadone to a drug user, it doesn't solve the
problem that person does need to be involved in counselling, or social
work, nursing or medical intervention ... so it's a whole package of care.''

But cold turkey can be excruciatingly painful for addicts, and long-term
detox programmes are costly for the State. ``If you can imagine somebody
throwing tar over you, or when you get a burn on your skin, that's how you
feel when you're coming off heroin,'' Frank Buckley testifies. ``There's a
history for everybody it's to get into that history, and that's what
treatment centres do, they bring you back to where it began, where you
decided to forget about life. That's the stuff that's really hard-core. And
that process is not being fully implemented, because it's long-term and
it's too costly.''