GRV - Under the Influence: Dealing with Dependency Wrap Up

15 September 2023

Grv August Blog Image

​Go Rural Virtually (GRV) is an online forum for health students, from all disciplines and year levels, to come together and learn about the day-to-day realities of practicing and living in rural and remote locations.

On the evening of Tuesday, 29 August, we hosted our highest attended GRV online event to date, with nearly 90 participants joining us for a thought-provoking discussion onUnder the Influence: Dealing with Dependency. This event offered attending students a unique opportunity to connect and learn from individuals who have firsthand experience in addressing issues related to drug and alcohol dependency, both personally and professionally.

The event went beyond the theoretical knowledge of substance use, and focused on real life experiences, understanding that there are underlying causes behind dependency, and emphasised the importance of establishing an empathetic connection with a patient is imperative to their recovery.

Our first guest speaker, Sean Popovich, Deputy CEO of the Queensland Network of Alcohol and other Drug Agencies (QNADA), spoke to students about the importance of using respectful communication, particularly ‘person first language’. Examples of this approach include using ‘substance use’ instead of ‘substance abuse’ and referring to a ‘person with a dependence’ rather than an ‘addict’. You can find more examples of appropriate language when discussing alcohol, other drugs and the individuals who use them here.

Dr Ebonney van der Meer, a Rural Generalist located on Magnetic Island, elaborated further upon Sean’s comments, stating that ‘substance is just one myriad of things that people present with’ and ‘each person in front of me is just a person’. Dr van der Meer conveyed the importance of creating a safe, non-judgemental environment for patients to discuss their dependency issues.

Additionally, Dr van der Meer highlighted that every patient’s experience is different and provided the example that any substance can be harmful, including the overuse of caffeine. Sean elaborated that there are ‘things that will make dependency more likely’. Sean further stated that a service like a Drug Checking Service can help prevent overdose, an increase in hospital admissions, and safe space for a person who uses. Dr van der Meer emphasised that she ‘has never met a person who is struggling with dependency that hasn’t had some kind of trauma happen to them - ‘it’s big deal’.

Our third speaker, Michael Short, now 26, shared a deeply personal story of his journey through dependence on prescription drugs which began at the age of 14. Michael detailed that after a handful of injuries from a young age from representative sport, he commenced experimenting with various substances with friends. Michael explained that he started off with trying a small dosage of Endone which soon escalated into a 60 pill per day dependency. At its peak, Michael revealed that he was seeing up to eight doctors per week to obtain the substances he needed. His turning point came when a doctor confronted him about his prescription history. Michael detailed that it was at this point that he was almost homeless, ‘blacklisted’ by Medicare, and his relationship on the edge of collapse.

Following on from this open discussion, Shanna Whan, CEO of Sober in the Country (SITC), bravely discussed her own experience as a high-functioning alcoholic and how she overcame a lifelong battle with chronic alcohol dependency. Shanna attributed her dependency to ‘trauma and repressed unaddressed internal pain’. Shanna detailed that her alcoholic dependency started when she took a gap year after finishing boarding school, where her consumption of alcohol stemmed from a sexual assault.

Shanna’s consumption of a couple of schooners on the weekend turned into every weeknight, which turned into ‘several bottles of wine a night’. Shanna stated that she would ‘vehemently deny’ that she was addicted to alcohol despite knowing she was a high-functioning alcoholic. Shanna disclosed that she would ‘switch up bottle shops’ that she would purchase her alcohol from, believing that this would help cover her addiction. Shanna’s story highlighted how seemingly harmless weekend indulgences can spiral into a chronic dependency, leading to devastating consequences.

Dr Yvette Morcos, a Senior Medical Officer at Mulungu Aboriginal Corporation Primary Health Care Service in Mareeba, provided an insight into the complex cultural challenges her patients face, particularly concerning alcohol consumption. Dr Morcos detailed that after her five years of working in the Indigenous medical centre, she has come to the realisation that ‘a lot of the alcohol abuse is a way to treat mental health problems and forgetting the past’.

Associate Professor Dr Chris Fleming, author of his personal memoir,On Drugs, shed light on his 20-year dependency on drugs and alcohol. Despite outwards appearances and that he was ‘kicking goals’ and ‘from the outside it was fine’, he was using substances to numb himself from the pain of childhood bullying. Dr Fleming confessed that he had an inability to deal with life’s complexities and ‘to live in my own skin’, and that his drug use numbed him from his own existence, thus living in a perpetual state of detachment and escapism.

The conversation grew into how there is no one treatment option for everyone and that one size doesn’t fit all. Sean provided examples of treatment options and that any treatment should take a holistic approach. Sean explained that there are several intervention scenarios available. These include:

  • Residential rehabilitation

  • Alcoholics Anonymous (AA) / Narcotics Anonymous (NA)

  • Community based intervention / case management

  • Withdrawal management

  • Harm reduction services – including needle and syringe programs, medically supervised injecting rooms (n/a in QLD), drug checking services etc.

Shanna then shared her experience regarding her attempt to set up an AA group in her rural town. Shanna came to the realisation that it was difficult to have an AA meeting in a small town and keep anonymity for attendees, as everyone knows everyone. This is when Sober in the Country was born that includes Bush Tribe, an online peer support group which provides a safe space for community members to share their experiences and is specifically tailored to those living in rural areas.

Dr Morcos discussed the cultural considerations needed when caring for Indigenous patients. Dr Morcos described that in her Mareeba community, there is a strong sense of family and belonging which plays a significant role in Indigenous communities, and that excessive alcohol consumption can be deeply intertwined with these dynamics. Dr Morcos reiterated that culturally it is difficult for Indigenous people to say no, as individuals feel a need to ‘belong and be part of the group’.

Following on from this honest and emotive discussion, some key learnings for students were:

  • To not judge patients;

  • Be kind and use kind and respectful language;

  • Build a relationship with your patient;

  • Try and determine what is the root cause;

  • Consider a patient’s previous and/or current trauma that is keeping them in their situation;

  • Be a voice and advocate for your patient; and

  • There are many options and avenues for treatment as one size doesn’t fit all.

In conclusion, this event highlighted the complexity of dependency issues, the importance of personalised treatment, and the need for health professionals to be sensitive and empathetic to their patients. We thank our speakers for taking the time to share their stories and their honesty and openness. We hope that these insights will contribute to a more empathetic and effective approach when addressing dependency in our communities.

If you missed the event, you can watch the recording below.

Stay up to date with our next Go Rural Virtually in 2024 by keeping an eye on our website.

Go Rural Virtually