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Blue Tablet

6 min read

This is a story about customer service...

Bedside table

Amongst a small group of my friends, we have all found that a medication called pregabalin - marketed as Lyrica in the UK - has been useful to us, but also has adverse side effects and is difficult to stop taking. Pregabalin is quite good at combatting anxiety and improving sleep, which are obviously the desirable effects: most of us have stress in our lives, and struggle to get enough high-quality sleep. Personally, pregabalin is an effective treatment for the phantom limb pain I feel, due to damaged nerves - I can't feel my left foot. Pregabalin is far better than the opiate painkillers, which left me sweating and nauseous at times. However, stopping taking pregabalin leaves me feeling anxious and gives me insomnia - what goes up must come down.

Soon pregabalin - "the new Valium" - will be scheduled as a class C controlled substance, which makes it much harder to obtain a prescription, and possession without a prescription could be punished with a criminal conviction.

Here on the psych ward, a man screams for a "blue tablet". Perhaps more blatantly obvious as an addiction, another man attempts to wheedle more Subutex (buprenorphine) out of the staff - he's been droning on about having his dose restored from 8mg to 16mg, because he is being weaned off the synthetic opiate he is addicted to. I can hear this guy, who is obviously no stranger to our prison system, chopping and snorting drugs his room. The man who screams for a "blue tablet" is actually asking for a 10mg diazepam pill - blue in colour - which is Valium. Our screaming friend decides he wants to leave hospital, and the staff tell him he can't leave because he's going to take heroin. "It's my body! I do what I want!" he screams. Then, he starts getting abusive.

Early on in my hospital detention under section 2 of the Mental Health Act, I ask a nurse if she can nip to the shop to get me a 4-pack of beer. We lock eyes for what seems like an eternity. I maintain a completely straight face. Then, we both snigger and she regains her composure. She jokes that we should have a big piss-up on the ward. With a different nurse, I tell her with a straight face that they have forgotten my methadone and she immediately unlocks the cabinet containing the opiates that are so coveted by some patients here... I hastily tell her that I was joking, but she still continues to search my medication chart. Do I look like a junkie? I certainly don't have track marks on my arms or other identifying features of an injecting drugs user, such as abscess scars.

A doctor comes to take my blood. She doesn't shut my bedroom door. Three men, who I know were heroin users, peer into my room and I feel bad that I didn't ask the doctor to close the door or get up and close it myself - surely the sight of a needle going into a vein is going to be a terrible trigger. There's good evidence that addicts' brain reward pathways are activated when they see drugs and drug paraphernalia for just 33 milliseconds, which is less than the 40 milliseconds that a single frame of cinema film is shown for.

Having been detoxed from my physical dependency on benzodiazepines and alcohol, I find that I crave nothing more than a few drinks in the evening - some wine or some beer - to take the edge off the stress and anxiety of my situation and help me relax during what is a fairly dreadful clusterfuck of issues with employment, housing, accommodation and my health. However, I don't want to sabotage my treatment and recovery.

I'm incredibly grateful to the NHS, for accidentally detoxing me while they were treating my deadly deliberate overdose - my suicide attempt. Being physically dependent on a medication is to be shackled to it - to stop taking it would cause seizures and potentially death. There wasn't a 'buzz' that I was chasing with booze & benzos. I was using mind-altering substances to soothe my jangled nerves: self medication.

Am I glorifying drug taking, or making light of serious matters? Don't be so ridiculous.

An epidemic of illicit opiate use sweeps across the United States, with the number of overdose deaths and addicted babies born, skyrocketing in the past few years. An epidemic of mental health issues has pushed the services that are there to support those who become unwell, to breaking point. Only a wilfully ignorant person would turn a blind eye to what's happening all around us.

Carfentanil - a synthetic opioid - is so powerful that an aerosol of it could be sprayed in a packed metropolitan area and cause hundreds of people to die from respiratory arrest. This drug is being sold as an adulterant in bags of heroin, in the United States today. In the UK, carfentanil's less potent - but still deadly - chemical cousin, fentanyl, is quite common now in batches of street heroin. If you're worried about terrorism and weapons of mass destruction, these things have already arrived on the shores of the US and UK, in the form of incredibly deadly chemicals that are available for sale to anybody with the money.

My fellow patients are unrelenting. There's been a 2-day nonstop assault on the staff, as the patients attempt to get a tiny amount more synthetic opiate out of the doctor. There's not much else to do on the ward, and whatever medications the doctor has decided to write on their chart will remain fixed for a whole week. I guess they've got nothing to lose apart from their 30 minutes of escorted leave from the ward. One patient has done a runner, sensing that the doctor's decision has not gone the way he would prefer.

"You've not done anything wrong. You can come back and you won't be in any trouble" a stressed looking nurse is saying down the telephone, to the patient who has gone AWOL. Meanwhile, a patient takes breaks between harassing the staff for 8mg more Subutex, in order to chop and snort lines of white powder in his room - presumably he has a plentiful supply of his own drugs, which he wishes to supplement with a legal prescription.

I try to calmly await my section tribunal, despite the chaos outside my bedroom door.

It should be noted, that the quality of care does not vary with one's behaviour - the staff are supremely professional - but good manners are declared as the number one thing that every staff member wants, on a notice board that tells the patients a little more about the team of people who look after us.

Good manners cost nothing.

 

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