December 1, 2001

1:42 PM

Psychiatrists Not Against AIDSIn Portugal and other European countries, although the State provides free needles, free medically-assisted clinics where addicts can shoot up in a safe environment, it's the medical establishment's attitudes that are holding up the fight against AIDS. A very recent case: despite free, no-questions-asked methadone(a well-known heroin replacement)most psychiatrists refuse to prescribe it. Is this just a European problem?
posted by MiguelCardoso (6 comments total)

Methadone can be great for getting people off the streets, but often it is more difficult to kick than heroin. Many use methadone to take a break from heroin or do both. In the states most methadone clinics are run by for profit agencies. It is to their advantage to keep people on very long "maintainance" programs. Although I resisted saying this for a long time, the only thing that really seems to help addicts is Narcotics Anonymous, and yes, that includes the whole "Higher Power" thing. Whatever that may be. Personal spirituality always seems to be at the center of an addict who has cleaned up. Too often people think that methadone is some sort of cure all, certainly there should be access to it though. Good post Miguel. All I am saying is that treatment needs to be comprehensive, including needle exchanges, NA, counseling...etc. But first and foremost, the addict needs to want to get clean.
posted by anathema at 2:22 PM on December 1, 2001

Here is a link to Narcotics Anonymous. This site has meeting lists all over the world. Some even have maps.
posted by anathema at 2:37 PM on December 1, 2001

Sorry, meeting lists.
posted by anathema at 2:39 PM on December 1, 2001

Thanks, anathema. Actually, the problem with NA here in Portugal you'll never believe; it's an example of the dark side of the Latin European class system you never hear about. People generally think the English are the only snobs but we're just as bad.
NA here is a strictly upper-class thing, where well-to-do junkies go to hang out and meet girls/boys. 90% of them are just on tranquillizers or something else not AIDS-related. I've only been to one meeting, out of curiosity, and it was like the royal enclosure at Ascot.
All these toffee-nosed girls and boys going "Wow! I did that too - wasn't it absolutely spiffing!". I'm toffee-nosed as well, mind you, but I hate my own sort.
It's just sad that these attitudes make it so difficult on the socially unconnected addicts, the vast majority, who have the highest HIV+ rate in Europe.
If you're upper-class you get all the methadone - indeed pure heroin - you want, for free, from one of Daddy's friends. That's the honest truth. Also, now that anti-AIDs drugs are easily available the horrible truth is that it's only the poor who get sick and die.
I'm sorry if this is depressing, but it's kinda true...
posted by MiguelCardoso at 3:12 PM on December 1, 2001

That's really a shame. There is variation from meeting to meeting but what you are describing is not the norm. NA is usually very inclusive and generally not used as a platform to find sexual partners. There will always be meetings which suit certain people better. But, the goal/reason-for-being-there should always be the same. One thing that is great about NA in the states is that there is usually an incredible cross-section of socio-economic classes. From folks driving up in brand new BMW's to people stumbling in with not a penny to their name.
posted by anathema at 3:32 PM on December 1, 2001

Anathema: there, in a nutshell, is the superiority of the U.S. over Europe. I imagine the BMW crowd even feel better and less guilty - and perhaps even more motivated - if they find they're in an all-inclusive group.
I love Europe but it does have awful, medieval aspects to it. I refrained from saying it before, out of misguided loyalty, but the truth is AIDS here is considered a "lower class" disease, with all the resulting stigmas.
That's why organizations like Abraço(referred to in the link)and the Terence Higgins Trust are so important here. The government-sponsored agencies consist of stuck-up Catholic, chinless mothers-of-five with purple hairdos, long tweed skirts and generous budgets they spend on "think of the poor children/pity the queers" conferences at luxury hotels.

There, I've got that out of my system. It's just that AIDS is the sort of disease you just want to punch in the face and stomp on; it's so comfortable and convenient for the moralistic potentates that rule over us.
posted by MiguelCardoso at 4:37 PM on December 1, 2001