A priest scrounging methadone on the streets is a cold fix of reality, reflects Peter Murphy

A REBEL Catholic bishop roaming Dublin after dark trying to score methadone for the heroin addict he has taken under his wing it's an image that could only have been disgorged from the underbelly of 21st-century Ireland.

Dissident bishop Pat Buckley's admission, on Marian Finucane's radio show last Wednesday, that he had illegally obtained methadone in order to help a young friend kick his heroin habit didn't just make for an ear-grabbing opening it also highlighted present and past governments' failures to implement satisfactory rehabilitation programmes for the estimated 13,000 heroin addicts in Dublin. Bishop Buckley met his charge, a 20-year-old homeless heroin addict, some six to eight weeks ago. The young man told him that he was ready to stop using heroin, and a place was obtained on a 90-day drug treatment course, with the stipulation that he be clean for 10 days before attending. Perturbed by the 10-day rule (by no means one common to all treatment centres), the bishop offered the young man shelter while he prepared to detox.

He also agreed to procure the 185 millilitres of methadone deemed necessary to wean him off heroin, a figure arrived at through a 10-minute emergency assessment process carried out at Trinity Court drug-treatment centre. According to Bishop Buckley, due to waiting times and clinical assessment procedures, the young man can't be seen there again for another six months. As Finucane pointed out, the administration of untested methadone without expert medical supervision is extremely dangerous. However, Buckley insisted it was not a decision he had taken lightly, and he had enlisted the help of a GP friend.

``At the moment his two arms are like two pin cushions,'' Buckley said, ``and he's full of abscesses from syringes. If he is left on the streets of Dublin for the next six months he is in much more danger than coming to me with the help of medical supervision and then going into a special unit.''

Perhaps surprisingly, Finucane's programme was flooded with calls of support for the bishop the following day, reflecting a deep dissatisfaction with the rehabilitation systems that are currently in place, but also voicing concerns about methadone itself, the subject of ongoing controversy among drug-treatment experts.

Frank Buckley, who served as an inner-city community representative on one of 13 government funded drugs task forces from 1997-98, has expressed concerns about the bishop's actions, and methadone in particular.

``I think what he's doing is very dangerous,'' he says. ``He's trying to get him physically off heroin, but he's giving him another drug. But that other drug is more dangerous if that chap decides, `I'm going out to get stoned', and he's already after drinking 200mls of methadone or whatever.

`With all the will in the world, the guy wants to give up heroin and has convinced the bishop. But if he doesn't know how a drug addict thinks, he could be talking to him for days, and then within 10 minutes the guy could have a needle in his arm.''

Frank Buckley believes that, rather than addressing the core problem of addiction itself, methadone is a stopgap solution used to keep crime levels down. ``Any government, they look at the four-year spell that they're in, and they say, `What's the short-term [solution]?' If 80-90 per cent of crime is drink- or drug-related, if they can zombie-fy most of the junkies in Dublin, there's the figures down.''

Buckley also points out that addicts can exaggerate the extent of their habit in order to obtain higher doses of methadone from drug-treatment centres.

``By the time the Eastern Health Board had come to the conclusion of administrating methadone, the findings in Europe were coming out that it was dangerous unless you have complete control,'' he claims.

Drug-treatment centres such as Trinity Court receive literally thousands of phone calls from parents ready to assist their sons and daughters in getting clean.

However, the long waiting lists often result in addicts attempting to go cold turkey in unsupervised or isolated circumstances, without proper counselling, sometimes resulting in suicide (indeed, Bishop Buckley admitted to Marian Finucane that a nephew of his killed himself in similar circumstances three years ago).

``It doesn't necessarily take so long to process people,'' explains Dr Eamon Keenan, a senior doctor at Trinity Court. ``It's based on the clinical assessment which is carried out at the emergency assessment to start with. That's then discussed at a clinical team meeting, each case is looked at on its own merits and a decision is made in terms of priority for certain individuals.

``Work is going on to open a number of treatment locations throughout the city which would significantly impact on waiting lists,'' he continues. ``It's not necessarily funding or resources there's a certain consultation process that we have to undergo with local communities.''

How does Dr Keenan respond to criticism of methadone treatment as merely replacing one drug with another? ``Methadone is the most widely validated and researched form of drug treatment for opiate addiction,'' he indicates. ``What I would say about any methadone programme is, it's not a stand-alone treatment. Just by giving methadone to a drug user, it doesn't solve the problem that person does need to be involved in counselling, or social work, nursing or medical intervention ... so it's a whole package of care.''

But cold turkey can be excruciatingly painful for addicts, and long-term detox programmes are costly for the State. ``If you can imagine somebody throwing tar over you, or when you get a burn on your skin, that's how you feel when you're coming off heroin,'' Frank Buckley testifies. ``There's a history for everybody it's to get into that history, and that's what treatment centres do, they bring you back to where it began, where you decided to forget about life. That's the stuff that's really hard-core. And that process is not being fully implemented, because it's long-term and it's too costly.''

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