Tom*, 63, first used heroin when he was just 20 years old and has struggled with addiction ever since.
“Everyone says they’re chasing their first blast, and I suppose there’s the thought that you can get something good,” Tom said.
Staying on the straight and narrow has been difficult for Tom, but one thing keeping him there has been drug replacement therapy.
Since 1992 he has been a client of the Alcohol Tobacco and other Drugs Service (ATODS) in Cairns.
ATODS is a part of Queensland Health that provides support for people struggling with substance abuse.
“It basically matches a person’s needs with a replacement drug so they can go into society and not have a constant need to be chasing their tail,” Tom said.
Assistant clinical director of ATODS in Cairns, Dr Leann Mortimer said medications issued to clients mimicked the effects of illicit drugs, but were more stable and long-lasting.
“It’s taken orally or sub-lingually (under the tongue) and it keeps the drug’s levels stable for 24 hours,” she said.
“[That means] clients don’t actually have to use heroin, which only lasts four to six hours, or use morphine, which may only last for six to 12 hours.
ATODS’s clientele is varied: some attend the clinic daily, others, like Tom, attend only every few months.
“I’m quite stable as far as the staff are concerned,” Tom said.
“But in the past I have spent more time here, with psych doctors and doing health checks and things like that.
“I don’t know where I’d be if I didn’t have this service … certainly when I worked I wouldn’t have been in a position to be reliably employed.”
Like Tom, most ATODS clients attend the clinic because they want to be free of their addiction.
According to Dr Mortimer, long-term use of drug replacement therapy has been discouraged in recent years but sometimes it can not be avoided.
“We usually say that people should be on treatment for at least six months, but the best outcomes are people who stay on for 12 months to two years,” she said.
“We like to see that people get back to full-time or part-time employment, that they reunite with family, that they get a whole set of friends that no longer use, and that they find other ways to actually pass their time.”
“They’re the people we try and keep on long-term as a maintenance program.”
For Tom, who knows how close he came to destroying his life, the stability offered by drug replacement therapy has meant he has been able to work and stay off heroin.
But he admits he still considers himself a drug addict.
“Once you’re an addict for something you’re always an addict,” he said.
“There’s no use fooling yourself, once you’ve used drugs or overdone anything it’s very easy to fall back into it.”
*Not his real name