Home > We're people too - Drug users views on the health services

Connolly, Johnny (2005) We're people too - Drug users views on the health services. Drugnet Ireland, Issue 15, Autumn 2005, pp. 5-6.

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A collaborative piece of action research involving the Participation and Practice of Rights Project (PPR), the Union for Improved Services Communication and Education (UISCE) and the Mountjoy Street Family Practice has sought to identify and address issues confronted by drug users in relation to Irish health services.

The PPR is an initiative linking representatives of community networks from North Dublin and North Belfast which advocates the adoption of a rights-based approach in addressing social and economic issues confronting communities. UISCE is a group made up of drug users, ex-users and professionals who seek to ensure that the views of the drug user inform the development of drug policy and treatment responses. Mountjoy Street Practice is a GP-run family practice which has a large group of patients receiving methadone maintenance. It also provided financial and technical support to the research project, as did the Royal College of Surgeons.

The initial stage of the research involved focus group discussions with 25 drug users about their experiences of health care. Topics of discussion included drug users' perceptions as to how they were treated with regard to their health entitlements. Drug users' views of health services were then ascertained so as to facilitate practical improvements in services. Participants were identified by UISCE through being approached outside the City Clinic drug treatment centre, through informal meetings on the street and through visits to flat complexes. Three focus groups were held on three consecutive days, involving a total of six hours of recorded discussion. Four months later, after the interviews were analysed using a thematic approach, participants were brought back together to verify the initial findings and to prioritise problems with services. Thirteen of the original 25 participants took part in this feedback session.

Concerns raised included perceptions of poor attitudes towards drug users among some staff at some acute hospitals and perceptions of discriminatory treatment of users at some hospitals and pharmacies. Some users regarded the use of identifying stickers on their charts and the use of signage, such as ˜infectious diseases', as insensitive and stigmatising. Some participants felt that GPs were reluctant to take drug users onto their lists and that, since GPs are gate keepers to medical cards, this created obstacles to health care. Dental care was identified as an important issue. However, some users reported difficulties in obtaining access to dentists. A number of concerns were raised in relation to treatment services, particularly in relation to privacy and confidentiality issues and a consequent reluctance to enter counselling. Related to this broader treatment need, another theme which emerged was the perceived need to develop a more holistic, individual-centred approach to address the multi-faceted problems being encountered by users. A broad consensus that methadone was not the whole answer to these complex issues came out of the focus groups. The focus groups also heard many positive comments about individual staff members and institutions.

One of the most innovative aspects of the research project was the presentation of the research findings to an informal meeting of service providers and key stakeholders. This meeting, which was attended by representatives from Merchants Quay, the Health Service Executive, St James's Hospital, the Drug Misuse Research Division of the Health Research Board, AOM Addiction Services, the North Inner City Partnership, UISCE, PPR, a pharmacist, GPs and a dentist with experience in treating drug users, provided a useful opportunity to discuss the findings of the report and identify practical steps to address the issues identified. The report is due to be published shortly.

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