There is a homeless guy who sits outside my building every morning. He says g’day to the people he recognises. I always say good morning. I’ve noticed other people sometimes stop to chat at length. He begs. Lately, he’s been getting a bit more insistent on the begging front. I hope he’s doing ok.
This morning, after walking into the building, I got into the lift with an older man who I’ve seen quite a number of times around the building, but who I don’t actually know.
He turned to me, his eyes wide with horror and disgust. “Did you know that man out the front is a drug addict? He doesn’t have schizophrenia or anything … he injects drugs, methadone or something … I’ve just been to the pharmacist and they told me!”
Now, leaving aside the patient confidentiality issues with the pharmacist giving out that kind of information (and I am going to go and have a yell at the pharmacist later about that!), (1) methadone is not injected [ETA: well, I got that wrong – see Robbo’s comment below] (and if he’s on methadone, he doesn’t need money for it and also, it suggests he’s “doing something” about his “problem”, which is what I assume people like my interlocutor want to happen); and (2) poor mental health, homelessness and drug use often go hand in hand. Oh, and (3) who the fuck are we to judge?
I put (2) to my friend (that’s sarcasm) in the lift (going with (1) and (3) could have been career-limiting moves) and said in as reasonable a voice as I could muster: “But mental illness and drug use often go together. Sometimes people are trying to use the drugs to deal with the illness.”
He blustered on, even standing in the lift door (his floor was before mine) while I stood there, mute, as I couldn’t think of anything to say other than: “you fucking judgemental douche.” Which I didn’t think would be a good idea.
So I’m having it out here.
Let’s start with:
1. Drug use is none of our business, and is not precisely the greatest moral crime.
2. If you choose to give money to someone, whether that be to someone who is begging or to someone who you buy something from, your control stops there. It’s then their choice what to do with that money. Including: buying drugs.
3. There is a huge co-incidence of homelessness and poor mental health (although “[i]t is important to note that most homeless people are not mentally ill”).
4. It is not uncommon to see drug use amongst people who are homeless and mentally ill. (And who can say they wouldn’t use drugs if they were homeless, regardless of mental health?)
5. People deserve our support, not our judgement.
NB: the pages I’ve linked above are from the Australian Federal Department of Health and Ageing. They suggest that drug use is a mental illness in and of itself. I don’t think this is necessarily the case, but the pages are a useful resource.
If you choose to comment, please keep the following in mind: note that I am referring to drug use generally, not drug abuse. I am using the word “use” very, very carefully. I don’t think that drug use, even abuse (whatever that actually means), is a moral crime or problem. I agree that drug use may, for some people, be problematic (this also applies to prescription and other legal drugs, not just illegal drugs). However, I am not in a position to judge whether someone else’s use of a drug is problematic (note that I am STILL not using the word “abuse”). Neither are you, unless that use is directly affecting you, or you are their treating health professional.
The man who sits outside my building may have an incidence of drug use which is problematic. I don’t know. But even if his drug use is problematic, I’d say that his bigger problem is that he’s homeless and that he is not receiving adequate support from the State and the community.
Definitely take it up with the pharmacist! :o(
You make some excellent points.
Steph: oh, don’t worry, I will. I didn’t get the chance yesterday, but I will go down in a little while.
Steve: I deleted your comment because it falls foul of my comments policy because it appears to be nothing more than an ad for your commercial website. I initially just deleted the links to your site, and then realised that your comment also had no actual relationship with mine, apart from the fact that you mention methadone and I mention methadone.
I have no idea if you’re a bot or a real person. If you’re a real person, you’re welcome to comment, but please try to ensure that your comment has some relevance to the topic. Helpful hint: coincidence of words alone is not enough!
and if he’s on methadone, he doesn’t need money for it
I don’t know what state you’re in, but in Victoria, he does need money for it. It’s subsidised, but not free to the patient unless they’re in a residential treatment or in jail. And I really hope the pharmacy isn’t the source of that information, because that’s just revolting.
Re paying for methadone: I stand corrected. I’d imagine it would be the same in every state – pharmaceutical benefits generally are. For some reason I was of the understanding that it was completely subsidised on prescription. That must just have been wishful thinking about fairness and other such illusory concepts…
And be prepared to be revolted, because the pharmacist confirmed that they were the source of the information. My conversation with the head pharmacist went along the following lines:
That went on for another few minutes, but you get the idea.
I think I did manage to get the message across that it doesn’t matter if he’s not a welcome customer (or, for that matter, not even actually buying anything, just asking for freebies – not free drugs either, I should mention, unless the pharmacist just didn’t get to that bit before I kept stopping him from telling me anything!), if he’s asking for something, he’s doing so as a patient and therefore should be treated confidentially. Even if he is an annoying one. The pharmacist said that he’d speak to all the staff and ensure it doesn’t happen again. I’m not entirely convinced, but I’m not going to make a complaint to the pharmacist’s board on this occasion. If it happens again, though, I will not hesitate for one moment.
The word “methadone” was not mentioned in my conversation with the pharmacist, so it’s possible that the name of that drug just came out of the head of the horrified judgmental man. Somehow, I doubt it; it just doesn’t seem the most obvious drug name to come up with in the circumstances!
Yeah, the drug is subsidised, but the service provided by the pharmacy is generally not, so that falls on the customer – it’s the same for medication dosettes (except for veterans), though there’s a study being done on dosettes currently that may bring about some subsidies.
That pharmacist horrifies me! Attempting bonding experiences over “that homeless man” does not, by any stretch of the imagination, trump patient confidentiality. And, even if the man in question is not a patient, the pharmacist is using his professional status to imply he is.
Thanks, LS, for contributing to my education :) (I am not being at all sarcastic, by the way!)
Re pharmacist: yes, indeed. I will not be going there again. Which, you know, teaspoon, but hey.
Thanks, LS, for contributing to my education :)
It’s the feminist internet, we’re all educating each other all the time! I love it!
As a pharmacist I am apalled by the action of the pharmacist if he has divulged information. He needs to be reported to either his boss or the Pharmacy Board. Pharmacists do not have to run methadone progams. Most do so as they see the need and benefits a program brings to patients.
Methadone can be injected. Having methadone not swallowed in the pharmacy then expelled into a botle once the patient leaves the pharmacy is a problem.Due to its length of action it is more dangerous than heroin if injected, particularly if other drugs are involved.
A compassionate post.
Oh, and nicotine is the most addictive drug we have.
Robbo
Thanks Robbo, for the info and for your outrage.
I’m not sure if the pharmacist actually is running a methadone program – or treating the man at all. I suspect that what is happening is that the man is going to the pharmacy and asking for certain items, and the pharmacy is refusing. The pharmacy sees him as someone causing harassment rather than a patient because they are not actually treating him; my take is that even if they are not actually treating him (for whatever reason), anything he requests should still be considered as communication by a patient.
I think that’s what the head pharmacist was trying to explain to me, but I kept cutting him off because I considered that him telling me any information (including whether or not the man is a patient there) was a breach of confidentiality.
Re nicotine: yes. I haven’t seen my interlocutor smoking, so I can’t call him a hypocrite on that account, but I’m sure he is not quite so judgmental about it. Certainly not so incredulous.