Addiction and Healthcare

road-in-the-ring-of-kerry-ireland-eltpicsBlog by Dr. Liam Farrell @drlfarrell. Introduction by Colin Hung.

Healthcare is full of personal stories. Often these stories are shared during the “quiet times” – when nurses are taking a break over a meal, physicians are grabbing coffee together, families are sitting with loved ones in their rooms or between sessions at healthcare conferences. Sharing personal stories is powerful. Stories educate. Stories heal.

We are privileged and honoured this week to have Dr. Liam Farrell as #hcldr guest. Dr. Farrell reached out to Joe Babaian and I to ask us if he could be a guest host for an upcoming chat. As an active member of the #hcldr community and host of the #irishmed chat, we were obviously thrilled with his offer. He then surprised us with the topic – Addiction – something that is very personal to Dr. Farrell.

Over the years we have had a number of guests share their personal stories with us. I think you will find Dr. Farrell’s story compelling. Please join him when he guest hosts #hcldr on Tuesday February 7th at 8:30pm ET (for your local time click here).

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From Dr. Liam Farrell

This is a long and painful story, so I’m not going to tell it all, but it does have a happy ending, as I’ve been clean for over 8 years. But once an addict always an addict.

At the time I became an addict, I was a family doctor in a country practice on the border between the Republic of Ireland and Northern Ireland, an area seriously affected by the Troubles. I was on duty every second night, was a columnist for a number of journals, including the BMJ and the Lancet, was a postgraduate tutor, and had launched my own (short-lived) medical newspaper. None of this is an excuse, only background.

Both my parents died from cancer in the early 1980s, and both had a hard time; there was little palliative care then, so when I started practice I didn’t want my patients to suffer in the same way. I completed a Diploma in Palliative Medicine and was subsequently appointed a postgraduate tutor. An important element of this tutoring role was to de-stigmatize morphine, to try to encourage other doctors not to be afraid to prescribe it, and advise them how to use it appropriately and safely. I knew how morphine worked; I knew its side-effects; I knew how to limit these side-effects. I knew the safe and effective dosages; I knew when to give it by mouth or subcutaneously or intravenously; I knew the risks of addiction. I knew my enemy every well, and it didn’t make any difference. Familiarity is no defense.

I became an addict in 1998. It may seem strange, for such a seminal moment in my own self-destruction, but I don’t remember the first time I injected morphine into my own veins. Neither do I remember when or why it first occurred to me to try it. What I do remember is how it made me feel . . . To describe what it was like will take too long for this blog, see this link http://drug.addictionblog.org/what-its-like-to-take-and-withdraw-from-morphine/ I went though rehab, attended NA and a doctor’s fellowship, and voluntarily refrained from prescribing controlled drugs. I was clean for 10 years, then had a very brief but critical relapse in 2008. In medical terms it was minor relapse, but I was reported to the Medical Council and received a criminal conviction; because I was a media doc, it was reported widely.

Worst of all, so many people, my family and friends and most of my colleagues, had been kind and supportive and helped me to stay clean, and I felt had let them all down; the feeling of shame and self-loathing is something I still acutely remember.

The Medical Council suspended me for three months, but because of the overwhelming and quite humbling support form my patients, their judgement specifically stated that they wanted me to return to practice. But the bureaucracy was labyrinthine, and was wearing me down, and since I had an alternative career (I’m a big shot in the small yet dull world of medical satirical columnists) I retired in 2010. An interesting aside is that before I became an addict, my writing had been quite serious and analytical, but since then it’s been all satire; not a conscious decision, perhaps a way of deflecting my own squalid Calvary. Apart from the above blog, I’ve never written about my addiction but now it’s distant enough to have some perspective, + I’ve started to write a book counterpointing the history of morphine (which goes back to 4000 BC) with my own individual struggles.

I still miss my patients, and my experience of addiction had made me a better doctor; it’s easier to understand frailty in others when your own frailty has been so starkly exposed. But I’m satisfied I no longer have access to temptation, and life is good. My experience made me a happier person, less restless, less discontented, more appreciative of the good things in life. Sometimes the things that are good for you can hurt for a while, but for the still-suffering addict out there I want to say this; there are good people who will help you if you ask, you can get better, and there is such a thing as redemption. I’m writing this on Jan 31st at 1.30 am in the morning. It’s cold, dark and stormy outside, yet I can hear a robin singing, plaintive yet defiant.

Please join me on the next #hcldr tweetchat – Tuesday February 7th at 8:30pm ET (for your local time click here) – when we will discuss the following topics:

  • T1 As a friend or loved one of someone struggling with addiction, how might you help?
  • T2 How might the stigma of “addiction = weakness” be eliminated?
  • T3 What can the healthcare system do better to help individuals suffering through addition?
  • T4 What can we, as healthcare leaders, do to address the societal problems around addiction (pre and post)?

Image Credit

Road in the Ring of Kerry, Ireland – eltpics https://flic.kr/p/8QZnvA

 

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