Dependent

Hail,
Lots has been going on. I may have to break this down into smaller posts, or it's going to get out of hand. So - today's post is two wildly different stories from the Drug and Alcohol files.

Today I am at the Drug and Alcohol job. It's raining outside, sheeting down, and in most normal practices that would mean fewer patients. But not my patients. Not rain nor snow nor dark of night will stop them from making their appointment. In fact, almost nothing does except a dimly glimpsed but troubling suggestion that the Great Australian Heroin Drought (2000 - current) may be coming to an end.

Anyway. It's not all heroin.

I have just finished speaking to a small, thin Vietnamese man, someone who is already old at forty. I feel I have done him no good at all. Throughout the consultation he hunched forward, blinking unsteadily at me, wearing a shapeless grey jacket and some tracksuit pants, nodding occasionally in a respectful manner, probably as close as he has got to being sober in the last few months. But I know he is only telling me what he thinks I want to hear.

He has, his doctor tells me, been drinking. And not just drinking, but drinking constantly, all day, every day, for as long as anyone can find out. It's common with my clients for the substance-of-choice to become more potent, cheaper and less safe over time - cigarettes become roll-your-owns, paracetamol plus codeine becomes oxycontin tablets crushed and injected - and Mr Vu is a classic example of this. As a thirteen year old he was sharing a sixpack of beer with friends and now his alcohol consumption is truly prodigious.

I do not say this lightly. I have seen men who drink five litres of wine a day, women who keep an open bottle of beer by the bed so that when they wake in the night they are not troubled by alcohol withdrawal, but Mr Vu is something special.

It is impossible to calculate precisely, but Mr Vu obtains two hundred litre barrels of methylated spirits and consumes them at a rate slightly more than one a week. If this is true it is two hundred litres of pure alcohol, two thousand standard drinks in seven days, almost three hundred glasses of wine a day. He mixes each glassful with lemonade to form a drink known as a white lady, a name that to me evokes drinking gin in the nineteen twenties, Etonians and flappers and pince nez and phonographs, rather than blindness, seizures and imminent and sudden respiratory arrest.

Anyway. Two hundred litres of methanol (it is available both as 95 and 100 percent purity) costs only two hundred dollars, making it remarkably cheap and accessible. I think he is already at least partially blind, but I know that precisely none of what I had to say to him impacted at all on him.

There's not a lot left of Mr Vu. That's what dependence is. There is the facial expressions, the physical form, the reflexes and the flesh, but not a lot else.

And just after that I saw Annabelle Trang. Cheerful, leafing through a magazine in the waiting room, almost glowing with health, who almost bounded in through the open door and told me that since we'd started her on the new medication she hadn't used, two months without, longest period without heroin since the late nineteen eighties, and her and her three kids were going on a holiday to Fang Rock. First ever holiday she'd taken her kids on.

"Used to be" she said "the needle got it all."

Well, it's got Mr Vu, and it's got a lot of people, it's got five of my clients since midsummer, but it doesn’t get all of them.

Thanks for listening, and more tonight.

John