Results of a collaborative study between the School of Nursing and Midwifery at Trinity and University College Cork, and a former Ph. students from Maynooth University point out that there is a significant gap between human rights, policies and best practices and how they are operated in the structures and practices of alternative medicine prescribing services. opium in Ireland.
The study was published in the journal International Journal of Drug Policy.
An estimated 20,000 people are dependent on opium in Ireland, with more than half of that being treated. Ireland has the highest drug-related death rate in Europe at more than 3.5 times the European average, and most of these deaths are drug-related.
While prescribing alternatives is directly related to improvement health results (such as reducing mortality) previous research in Ireland questioned the extent of service user involvement in OST services, governance and service organization. Service users, already from marginalized communities, are then subjected to additional “institutionalized” stigma due to their experience of how the service is delivered.
The study aimed to find out whether human rights are operated by drug prescribing services or how from the perspective of 40 service users in the context of their success in negotiate their right to health care.
The findings indicate that there is a significant gap between human rights, policies and best practices and how they are operated within the structures and practices of opiate substitute prescribing services in Ireland. . The treatment of service users, based on human rights principles such as equality, respect, autonomy, empowerment and personal choice remains aspirational and unlikely to be fulfilled without addressing more systemic challenges such as funding, staff training, service culture, governance and independent oversight of opioid prescribing services. . Interviews conducted by a Ph.D. student at Maynooth University who used to use an opioid prescription service.
- There is a significant gap between human rights, policy and best practices and how these are run in the structure and practice of drug prescribing services in Ireland. Implementation of current policy and best practice recommendations remains largely aspirational.
- Health care practitioners amplify feelings of stigma and shame against people dependent on opiates through disrespectful interpersonal approaches and by disregarding best practice.
- Service users’ experiences of participating in opioid prescribing services are fear of power, loss of personal autonomy, and feelings of coercion – in a way that impedes their recovery, including access to addiction treatment, rehabilitation, or planned employment.
- In many cases, current relevant policies, resources, guidelines and practices do not facilitate the provision of services to an appropriate standard.
Dr Peter Kelly, Assistant Professor of Mental Health Nursing, School of Nursing and Midwifery, Trinity College, said: “We know that there are good role models. Practice across the country and practices are slowly changing for the better across many prescribing services in Ireland. However, the views of service users presented in recent studies, including this one, indicate that substandard activities are still far too common. Many service users are being denied the opportunity to reintegrate into society and recover by the treatment system itself.
“Failure to make good use of available resources, provide access to addiction services and post-treatment care, implement a range of expert recommendations, and follow current policies and guidelines there is a lack of independent supervision.
“The consequence of this ‘system failure’ is that people who want or need regular recovery will feel more disadvantaged because of the way they experience services. This must change, not just from a single point of view. human rights point of view, but from a value for money point of view.”
Richard Healy et al, ‘For dignity and respect…. me bollix’: A human rights-based exploration of service user stories in methadone maintenance therapy in Ireland, International Journal of Drug Policy (2022). DOI: 10.1016/j.drugpo.2022.103901
Trinity College Dublin
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