Experiences with Heroin
Preferred Name: Grace
Gender: Female
Age: 58
Background:
Grace is casually employed in the manufacturing sector but wasn’t working at the time of the interview because of an injury. She’s in a relationship and has two children. She lives with her partner and youngest child. She describes her ethnic background as ‘Australian’: she was born in Australia, as were her parents.
Brief Outline:
Grace began taking heroin in her twenties and has taken it fairly regularly since then, with periods in which she stopped while on opioid pharmacotherapy treatment (methadone maintenance treatment [MMT] and Suboxone® [a combination of buprenorphine and naloxone]). A few years before the interview, Grace and her family moved to a new town, a move that Grace found hard as it meant leaving her job and friends. Soon after the move, she says she began feeling depressed and found her drinking increasing. In order to reduce her alcohol consumption, she completed a residential detox program. At the time of the interview, Grace was on opioid pharmacotherapy treatment (Suboxone®) and was taking heroin when she could afford it.
When they first met, Grace and her partner were both working but she says they ‘never had a lot of money’. They took heroin together ‘as often as [they] could possibly afford it’ once they’d paid their rent, bills, and other expenses. During times when she couldn’t afford it, she stopped taking heroin and went on opioid pharmacotherapy treatment (OPT). She’s been on methadone maintenance treatment (MMT) a few times, and says she and her partner sometimes felt they ‘really got stuck on’ it and had difficulty stopping treatment. When she first sought OPT, Grace was also diagnosed with hepatitis C.
A few years ago Grace, her partner and her youngest child moved from the city where they’d been living to a regional town. After leaving her job of twenty years, and finding herself in a town where she didn’t know anyone, she says she became ‘really depressed’ and began drinking more. Her community health centre referred her to a local residential treatment facility, where she completed a week-long detox program, which she found helped her reduce her drinking.
Grace and her partner continue to travel to the nearest major city to get heroin, and to see the doctor who manages their OPT. She says she finds this easier than accessing the limited services available in their town. At the time of the interview, she’d been on Suboxone® for about a year, which she says helps her to avoid taking heroin when she can’t afford it.
While she hadn’t taken heroin for a few months before the interview because of her reduced income, Grace says she’s ‘always liked heroin’ and has no plans to stop taking it altogether. She also has no plans to stop drinking alcohol, which she enjoys when spending time with her partner. Because of a recent work-related injury, Grace wasn’t working at the time of the interview, but plans to find a new job in the near future with a lower risk of injury.
Grace (F, 58, works in manufacturing, heroin) takes heroin when she can afford to, and when money is tight she goes onto OPT to take a break from heroin. (Played by an actor)
[My partner and I would take heroin…] as often as we could possibly afford it without being on our knees. You know, we always kept our rent paid up, bills paid up pretty good. Sometimes [we’d get] a little bit behind but we would use as much as we could afford to. But like, our kids never went without, they always had [what they needed]. We could always organise something for a school camp or, you know, always had their uniforms and books. We’re not into clothes or anything like that, so we didn’t spend a lot of money in that way. We don’t go out for tea or pizza […] But we would just [have heroin] whenever we could. It was usually pretty often when we were [living in the city] and we’d sort of […take breaks by going] on the methadone […We’d] stop it for a while […] Being perfectly honest, [we would take breaks because of] lack of money mostly […and that’s when we’d go onto methadone or Suboxone].
Grace says MMT helped her to stop taking heroin but she later found it hard to reduce her dose. (Played by an actor)
I loved the methadone at first. When [my partner and I] first went on it, it was great. We didn’t touch [heroin for…] a long time but then it took us a long time to get off [methadone] I can’t remember how long […] The first time [getting off it] was all right but I don’t think we’ve ever properly completed it without using [heroin] you know, because once you get [to a] really low dose, just a couple of [milligrams], well then you start […] feeling [ill…] I’ve always thought, ‘Oh, I’ll just be on it for a few weeks and then I’ll be able to cut down’. I found it really hard to cut down quickly and I found myself stuck on it, but that’s me. You hear of other people who can do it in a couple of weeks or a month or two, but I was stuck on it for a year.
Grace and her partner find it hard to access OPT (Suboxone®) in their local town so they travel to the nearest major city for it. (Played by an actor)
We tried to get a doctor [in our local town to prescribe treatment] but apparently there was only one and he’s really hard to get in to see. So that’s why we just keep [seeing our regular prescribing doctor in the nearest major city]. It was just easier to ring up, make an appointment and he can see you in the next couple of days […] But I can’t really tell you much about [this town because…] when I did ring a couple of times [they said] ‘You have to wait. I can give you an appointment in a month or three weeks’. I can’t remember exactly, but yeah, it was like, I’m not waiting that long.
Grace values the convenience of takeaway doses of Suboxone®.
[The prescribing chemist that my partner and I go to is] really good because we can get takeaway doses. And we’re allowed five, I think, a week […] but we sort of just pace it out to average probably three takeaways […] Sometimes we’ll just get two. And they’re not open on Saturday or Sunday so we’ve got to keep that in mind too, to always have the weekend sort of covered […] But it suits. It’s no hassle because you can get the takeaways.
Grace describes negative experiences when she and her partner accessed OPT or sought medical care at the chemist. (Played by an actor)
Well just recently [my partner and I] stopped going to the doctor and the chemist because our prescription had run out so I can’t go back to the chemist and pick up the Suboxone. And we were feeling really, really crook, both of us […] And we went and saw this [pharmacist] and she was actually not the one who’s usually there. I mean, all we wanted was some Valium or something like that, you know, just to get through for a few more days […] and she virtually said, ‘Get out’ […] She was horrible.
[…]
A lot of chemists [are] fantastic […] but some just treat you [differently to other clients…] We’d have to stand outside the door. We weren’t allowed in the shop. I think they were scared somebody was going to shoplift something. I think that was the reason. And we’d have to wait outside the door until they’d call us in, ‘You can come in now […] lord of the drugs’ [laughs] Not all of them, but I can think of one who was really shocking.
Grace questions the need for the strict, highly structured program and daily drug testing in place at some residential treatment facilities. (Played by an actor)
I just don’t have much faith in […] these rehab joints […] Only because of my brief experience at one […] Yeah, I guess it’s because of that […] You had to pee in a jar every day, and you had to be there by a certain time, you know [It was] really pathetic, just the way you were treated. I suppose they’ve got to have some sort of schedule or something. I don’t know. I just didn’t like it. [Especially the staff…] if they go into that sort of work or whatever, you think they’d have a little bit more [compassion] and not be so mean.
Grace found it difficult to stop drinking so that she could begin hepatitis C treatment. (Played by an actor)
I was diagnosed with hepatitis C more than 10 years ago…] I know it’s been there for a long time, yeah. And I did go and see someone at the hospital here about it but he said, ‘Well, you’re going to have to stop drinking before we start [interferon treatment]’ and I did. I got quite good for a while. That’s when I went to that rehab joint […But the drinking] just kept sneaking up again and I’ve just never done anything more about it […] Apparently [interferon is] not supposed to be a very pleasant treatment […] I heard a few horror stories from friends of friends who’ve done it, felt like they were sick for a year. I think that put me off a little bit too […] I’m just having a hard time stopping drinking at the moment, but if I ever do, I could go back and see [the doctor].