http://www.smh.com.au/comment/losing-paul-prescriptiondrug-addiction-will-continue-to-kill-20180106-h0ehyh.html

  • Ann Finlay

My son, Paul Fennessy, had a serious health issue. He was a young man struggling with physical and mental illnesses and substance misuse.

The system did not treat him with the care and support he needed. He was considered a “drug addict”, a condition that, ironically, was enabled by the unchecked prescription of legal medications by medical professionals. Poor management of physical and mental pain was lethal for Paul. Punitive responses to his search for help were the norm.

This was confirmed by the eventual coronial inquest, which acknowledged that the system had failed Paul.

He presented many times to hospitals for acute and chronic care in the two years before he died. Unfortunately, he was treated mostly as someone with a “hopeless addiction”, rather than a vulnerable young person with mental-health problems.

The stigma and judgment Paul experienced still prevails. Anecdotes from other families with similar experiences shows little has changed. Addiction is often seen as a lifestyle choice rather than the medical condition it is. Those seeking support are still told that their substance misuse must be sorted out before their mental illness can be addressed.

I am well aware of Paul’s choices and his struggles, but it causes me great distress knowing that aspects of his substance misuse were amplified, while at the same time his mental health was ignored or dismissed. Addiction is a chronic, relapsing disease and must be responded to and treated as such. Support and recovery services are limited and not easily accessed in Canberra, which is exacerbated by the fact it lacks a no long-term public residential alcohol-and-drug rehabilitation facility.

It is astounding that the new University of Canberra Public Hospital, a purpose-built rehabilitation centre due to open later this year, does not include such a facility. Particularly when the projected rise in Canberrans seeking support for substance misuse will be evident from February (when codeine becomes prescription only) and again in 2019, when the ACT government implements a real-time prescription-monitoring system. One can only assume that the government does not see this vital care as a priority.

No one involved in the coronial inquest or the related hospital clinical reviews admitted there was a problem with the circumstances of Paul’s care – that a young man obviously in dire medical need was not offered any support after being resuscitated earlier that morning. Instead, on the same day, he was escorted from the hospital, straight back to the situation that brought him there in the first place. This was against my wishes and without my knowledge. He died later that evening.

The inquest identified other system failings, including easy access to any amount of prescription medications and a lack of recovery services to meet Paul’s needs.

When system failures are evident, no amount of ignoring or obfuscation by government departments can make this evidence go away. Clinical reviews, expensive dragged-out investigations, and gruelling adversarial coronial hearings are pointless unless lessons are learnt, and taken seriously. There is something rotten in a system that continuously defends and denies the hard reality of mistakes made. Instead of denial, failings such as those that happened in Paul’s case should be seen as opportunities to improve our health services.

I hope that when the ACT government delivers its prescription-monitoring system, it will have already increased recovery services to meet the needs of those struggling with mental illness and addictions. At the same time, medical professionals faced with a patient who is “prescription shopping” must be better resourced to provide prompt and specialised non-judgmental care.

Paul was a handsome, creative and talented young man who lost his way.

Paul was a handsome, creative and talented young man who lost his way. As a parent, it is easy to feel at fault when your child dies in circumstances such as Paul’s. But I know I did not have sole responsibility for his care. Professional support was essential but not forthcoming.

Until mental health and substance misuse is seen as a combined medical issue by professionals and the community, until our health system’s failures are addressed and recovery support increased, nothing will change. The Pauls in our community will continue to suffer and die.

Comment;

There are so many areas where an intervention of some sort could have had an impact.  So much emphasis is being put on the prescribers as being at fault, the treating physicians and system as being at fault.  My personal experience is that addiction kills people.  Addicts WILL get what they want, they are very motivated and can be very creative at solving the puzzle of how to get what they want.  This is more of a “Powers and Principalities” spiritual/demonic problem than a simple epidemiologic problem to be fixed.  It’s a commentary on a society that has lost it’s moral compass and connection to God.

Dr. Raymond Oenbrink
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