December 15, 2024 • 41 mins
In today’s podcast we chat with Dr Chris Davis who is the Chief medical officer for Clean Slate Clinics.
Chris and I chat about how Clean Slate Clinics started and how the program can assist anyone who has a problem with alcohol and drugs.
The Clean Slate team is led by Chris , who is a global leader in General Practitioner substance withdrawal management. Clean Slate has a highly trained clinical team who can give you support and the care you need to successfully detox from home, (if you are a suitable candidate).
The Clean Slate team are passionate advocates for people who are struggling to cut back.
Support the show: https://www.patreon.com/tendernessnurses
See omnystudio.com/listener for privacy information.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:05):
Apogee Production.
Speaker 2 (00:11):
Hi, my name's beck Woodbine and welcome to Tenderness for Nurses.
Speaker 1 (00:15):
I'm grateful for the person that I have the opportunity
to be, so I hid it and parked it for
nearly four years.
Speaker 2 (00:24):
We always have free will, We always get to choose.
We are autonomous. Thank you everyone for tuning back into
tend Andnis for Nurses. Today we have doctor Chris Davis
with us. He holds two hats, one being one of
the directors of Clean Slate Clinics, which is what we're
going to be chatting to him about, but also his
works in ED at Saint Vincent's Hospital.
Speaker 1 (00:46):
Yeah, I'm a GP by training, so I was a
full time GP until a couple of years ago when
I got a job at Saint Vincent's Hospital in addiction
medicine really in an attempt to become well, hopefully a
successful one, to become an addiction specialist in an addiction
medicine at the hospital part time.
Speaker 2 (01:07):
Fantastic. Well, I, as you know, had your colleague Chris
Kimpaul come in and have a chat with us here
on the podcast, and it today has been one of
our most popular podcasts. He was very raw and honest,
and it made me really want to have a chat
to you in relation to clean Slate Clinic, especially with
(01:29):
Christmas literally a couple of weeks away. So how did
clean slate Clinics start?
Speaker 1 (01:36):
Actually started? Probably about twelve years ago. I was working
as a busy in a city GP in London. I'd
only been a GP for a couple of years, and
I got a partnership in a practice when I was
way too young. To be honest, I'd only been a
(01:59):
GP for about eighteen months. I didn't really know what
I was doing as a junior GP, and but I
was and I went for a partnership role and got
the job, which was so flattering. I didn't even think
to do any sort of due diligence around what this meant.
But it did mean buying into a business and being
(02:19):
a business owner and a manager. And the people that
I went into business with were not the sort of
people that you want to do that with. I mean,
the two senior partners hated each other. One would say
no just because the other had said yes. I remember
being in one practice meeting where the senior partner was
(02:42):
screaming at the other one to the point where he
actually lost consciousness. He fainted. He was during Grammadam and
he hadn't eaten and so he's now unconscious on the
floor and Michelle, the senior partner, was still screaming at him,
and I'm like, Michelle, help him. He's not breathing. So
that was pretty awful. I was there for four years.
(03:03):
But one thing that We're saved me during that horrendous
job was the drug and alcohol work that I got
interested in doing and the local PHN, which is like
the primary health network. So the group of commissioners, we
were really short of methodonne and buper and orphing prescribers
(03:26):
in the area, so they offered us free training to
any interested GPS. So this meant that once a month
I got a day off to go and do this
training and I could escape this toxic practice that I
was in. And I became like a methodone prescriber and
I love that work. And I got to work with
a drug and out on these who would you know,
do roll of the legwork. And but what what I
(03:49):
really became interested in when I sort of developed this
interest was well, it became a sort of journey of
self improvement. To be honest, so I mean it to
to sort of get get right into. I mean, I've
had a lot of special interest. I'd done palliative care,
i was working in nursing homes, I was helping doing
(04:12):
the diabetes management programs, and I loved working with kids.
I've done a lot of pediatrics in my training, and
I always wanted to be a pediatrician. And so I
had all these interests and every aspect of medicine it
always held some fascination for me. And whatever I started
to do, I really got my teeth into and loved it.
But around this time I was gaining this interest in
(04:34):
extra knowledge and drug and alcohol. What I really began
to get insight into, you know, I was maturing and
was that I needed help with my own drinking. I
grew up in very I mean I had a great childhood.
(04:58):
I really did. But when I grew up as a
gay boy in a very homophobic town, the you know
I do. I really did love my upbringing. I had
incredible friends, I really had a loving family. It was
very working class. We didn't have any of the trappings.
But I loved the camping holidays and playing sport. And
(05:22):
but I was I was very closeted and as much
as I had these feelings that I knew weren't okay.
And you know, there was one gay guy I was
aware of in our town who was branded a pedophile,
not because he was a pedophile, just because of his sexuality.
And yeah, and not one kid in my school came
(05:44):
out because of the fear of what that actually meant.
And you know, and there was the HIV crisis. You know,
I was born in the eighties. I was born in
seventy seven, and so being game wasn't okay. It meant
you were going to die and be be villified, you know.
And then when I was about eighty, I remember my
(06:06):
mom sitting us down. My mum was an amazing woman.
She passed away last year, unfortunately, and she taught sex
head and she told me and my brother and sister
that if any of us were gay, that mom and
dad would be fine about it. And we all laughed
because none of us were. And of course I was, yeah,
definitely not out at that point. But I remembered it
really because I clopped it for later, you know, and
(06:27):
went through UNI still in the closet, and you know,
full of shame, you know, about that side of me.
And then when I eventually did, I flew out. I
did my house jobs in Stepping Hill and Stockport in Manchester,
and it was horrendous. They monitored my hours, well all
of the junior doctor's hours at the time, because I
(06:48):
had been some deaths, like junior doctors had died because
they were so tired and they crushed their car and
there'd been a suicide. And my average hours per week
was one hundred and eleven. Oh my god. And so
I hated it because again, you're a junior doctor. You
don't know what you're doing. You're flying by the seat
of your pants. You're hoping that the nurses are going
(07:08):
to be kind to you, and you know, and so
it was awful. So I thought, I'm going to hate
it this much, might as well go and hate it
and live in Australia and be on the beach, you know.
And around that time, you know, I was really coming
to the terms with the fact that I wasn't that
I did have these feelings towards men, and that you know,
they weren't going to go away like I hoped that
(07:28):
they would. So I arrived in Australia and then I
met Luke, who's my now husband, and fell in love.
And it was an amazing sort of way to come
out in a way, because you know, I wasn't telling
people that I was gay. I was telling people that
I was in love. And I wasn't really scared about
telling mom, you know, because she'd said this thing when
I was eighteen, and she I was so close to her,
(07:51):
and so then when I told her, my mom didn't
react very well, you know, and in fact, she reacted
pretty pretty awfully. It was very hard for her to understand.
It was a surprise to her as it, yeah, as
it had been to sort of me in a way,
because I was coming out to myself at the same time,
and I didn't identify as being gay. I knew I
(08:12):
was in love with Luke, but gay had all of
these horrible negative connotations, you know. I was going to
be all of the things that you know that gay
meant when I was growing up. And so I was
coming to terms of my own sexuality and what that
actually meant and who I was. And I was doing
it without the support of my mom at the time, and.
Speaker 2 (08:32):
So I try, how about your siblings, did they support you?
Speaker 1 (08:35):
So Mom, didn't. I was in Australia at the time,
and this is before social media, and you know, I
had to pay a fortune to make a phone call home,
and I was doing group emails once a week, you know,
to all my friends and that's how I communicated. So
Mom didn't want my siblings or my dad to know
because she thought it would be a phase, and you know,
(08:58):
she was protecting them, I guess in a way. So
they didn't know for about a year and it got
too much and Luke and I split up. He went
back to England and it was horrendous for him, horrendous
for me, but I, you know, I wasn't. I needed
to sort my own head out. I didn't think I
was doing anything wrong. But at the same time, my
(09:18):
family was breaking up and was saying things like I
wouldn't be welcome home, and so, yeah, so me and
him split up and he was heartbroken. Anyway, I went
home to England from Australia for a wedding and met
up again with Luke and everything became clear. You know.
It was amazing to see him again and for him
to forgive me, and yeah, I knew that I had
(09:40):
to be with him and I couldn't risk losing him again,
and so told Mom and she wasn't okay about it.
I went back to Australia, leaving Luke in England. But
now I'm like, Mom, I've got to tell my family.
I've got to tell Dad. I've got to heelp because
I'm going to be with Luke for the rest of
my life. You know. Anyway, my brother was flying out.
(10:02):
He's just about eighteen months younger than me. My with her,
and he was flying out to come and stay with
me for a few months because we were really close
and we still are, and I owe him. I owe
him a lot because when my brother was coming out
and I had to tell him, and Luke had just
come out to stay with me for two or three
(10:23):
weeks and he wasn't. He missed his flight because we
were partying so hard. He missed his flight and my
brother arrived the next day and so he came to
sleep in in this in the lounge and there was
this man in my bedroom and anyway, got through his hangover,
(10:43):
flew home. I did a night shift, came back and
you know, all night I was like, I've got to
tell my brother. This massive thing. You know, and so
I sent my brother down and I was like, I've
got something to tell you, and he goes, I think
I know, bro, and I'm like, no, you don't know this.
He goes, I think I do, and I'm like what,
(11:05):
and he goes, are you gay? So no, no, no
I'm not gay because I wasn't in my own head
at this time, you know, I was just in love
with Luke, which obviously I now know is the same thing.
And he goes, he goes, but Luke's your boyfriend, right,
I said, yeah, Luke's my boyfriend. And I'm like, how
did you know? And he goes, well, I found this poem,
(11:25):
found his poem in the kitchen, and Luke had written
me a love rap and had left it there. My
brother found it. It was quite an interesting way for him.
I won't tell you what was in what and decent.
And I was so petrified that my brother was gonna
(11:46):
act in the same way that my mom had, you know.
And then I told my dad. My dad mom had
just told him before I got on the phone to him,
and he just said all the same sort of things
momma was saying. And I'm like, Dad, they're not your words,
then Mom's words, and I'm like, all you've ever said
to me, Dad is that you want me to be happy.
And what I'm telling you is that this is the
(12:07):
happiest I've ever been, and I've met the person I'm
going to spend the rest of my life with him.
This is incredible news. And he goes, oh, but you're
happy as any heads that I'm really happy. He goes, well,
that's good news then, isn't it. So I'm like, Dad,
it's the best news. And he's never looked back from that,
you know, he's but it was really hard because you
(12:29):
go up with this shame and fear of rejection, and
when you're rejected by the person who means the most
to you in the world, which is eventually which is
why I finished with Luke. Initially, it was because I
couldn't imagine not, you know, losing my mum or losing
my relationship with my mum, because it was so important
at that time, and you know, and Luke understands that
(12:53):
of course. Anyway, I'm sort of I'm digressing, but you know, drinking,
and certainly when me and Luke split up for that
six months, I just I drank every weekend when I
wasn't working, I drink and I'd escape, and you know,
you didn't have to worry, and you know, I'd drink
to black out a lot of the time because I
(13:13):
don't know. So then well, you know, Luke and I.
I moved back to England and Luke and I were
great and life was good. I was working as this GP,
and but the bin drinking sort of stayed with me
and it was full part of the pattern. When I
was doing there was one hundred and eleven hours a
week as well. It's like we had the doctor's mess
(13:34):
in the hospital which always had free alcohol in and
we lived in the hospital, worked in the hospital, and
obviously when you're working, you're working, but that on that
one day off or that weekend off, you know, you're
and even when you're in the mess when you are working,
there's one of your mates drunk, you know, in there.
Because so we were bings. We were party hard. We'd
work hard with party hard as a release from the
(13:57):
stress from work and everything else that was going on.
And then when I got this job in London where
Clean State started, and it was awful. It was really
really toxic, and so yeah, so the binge drinking just happened,
and that didn't happen. It just didn't stop happening. And
whilst it was fun, the Mondays and the Tuesdays and
(14:18):
this workplace were so bad that I was suffering with
anxiety for sure. But I remember being at a friend's
wedding and I got a phone call from what I
thought was the landlord and it wasn't, and I got
that tightness in the chest, sweating, and I had the palpitations,
(14:38):
and I'm like, okay, I knew what it was. I'd
had a panic attack when I was younger, but I
knew what it was because I was a doctor and
I dealt with people suffering with panic. But I'm like, yeah,
I can see why people go to hospital with this feeling.
It was that bad, you know. And then I was
doing this extra work with drug and alcohol and I'm like, okay, right,
alcohol is really part of the problem here. It's really
(15:00):
not helping me. And so there was a group of
of GPS helped doing these home alcohol detox clinics. There
was three, well, there was two GPS, and then I
joined the ranks because I really wanted to get involved
a to help myself. It's like, how do you start
the habit of a lifetime. This is how my friends
(15:23):
meet up, but you know, we go out, we drink,
and we get drunk. How do you change that? And
also because I'd noticed it, which it seems like a
crazy thing, particularly for a doctor to say and to see,
but I started asking my patients about their drinking. And
(15:43):
that's not really part You think that would just be
part of every history, and absolutely it should be, but
drug and alcohol, you know, unless someone volunteered that they
were drinking too much, it wasn't part of your normal
questioning smoking. Yes, but I didn't used to ask people
until I've done this extra training about their drug. U
saw they're drinking. But now I was saying that what
(16:03):
an incredible effect it had had on my mental health
and my physical health. And I started asking people about it,
and you know, it just brought brought up so many,
so many things, And so I started helping people detox
from alcohol at home. And because I was going through
my own sort of shame and guilt and all of
(16:25):
these emotions, when patients opened up to me and said, yeah,
I'm drinking too much, it's affected me in this way
and I want to change, and then taking them through
a withdrawal and seeing the incredible change that it made,
and seeing the bravery in my patients, you know, the
courage that it takes to say I've got a problem
(16:46):
with alcohol in this society and I'm going to do
something about it, and I'm going to tell these people
this is It really resonated with my own sort of
coming out story and also my own sort of struggles
with alcohol, and so it was such a privilege. You know,
I was so in awe of my patients who who
were brave enough to put that hand up and make
(17:07):
this change, and to be the one that could help
them do that, and to see the incredible difference it
made to their physical health, their mental health, to the
relationships to their working lives. It was the most rewarding
thing that I'd ever done in medicine. And so then
really to escape the horrible job that I was in.
(17:28):
You know, Luke and I we knew we needed to
change our lifestyle, our drinking patterns, our you know, our
work life balance, and our friends had started to have
kids and Luke never wanted kids, and we knew that
we knew that something had to change, and so we
started talking about moving out of London and I was like, well,
you know, for giving up on abroad and he's like,
(17:51):
well no, and I'm like, why don't we go back
to Sydney which is where we met. But I was
desperate when to bring this model of care with me
because I hated being a GP in that practice, but
I loved my alcohol whole work. And when I got
to Australia, I joined this practice called Killed their Road
and they were super supportive in allowing me to bring
(18:14):
this model of alcohol detox with me and I was
no longer a practice owner, you know. I remember on
the first day, the receptionist came in as I was
being trained by the practice manager and she goes, oh
so and so is called off sick. We've got no
one behind the desk, and I said, oh, well, have
you got an on call wrote for a reception And
they just looked at me like, Chris, this is really
(18:36):
not your problem. And it was like, oh my god,
this is amazing. I can just be a doctor again,
like this is that's not my worry. Reception is not
my worry anymore. And for two years I was just
a GP and not a manager and I could set
I set up the Clean State Clinic, and I just
loved being a doctor again. You know, I'd really burnt
(18:58):
out in London and I've found a joy of general
practice and Clean Slate was just my passion project. Then
I brought it to Darlinghurst eas Sydney Doctors and then
COVID hit and all of a sudden, you know, there's
not that many gps that put their hand up and
say they've got a special interest in alcohol. In fact,
(19:21):
if you googled it, I was the only name that
came up. And because of that, I when COVID hit
and all the detox services had closed, including where I
were now the Gorman unit that was a COVID ward
for a while. So you know, people were drinking twenty
to twenty five percent more through COVID, but try and
get help was virtually impossible. So I'm getting phone calls
(19:43):
and emails from Alice Springs. I did a detox over
the phone to someone on the Gold Coast. I had
two people from Adelaide. They didn't know each other, and
I didn't know this before it happened, but they flew
from Adelaide for a GP appointment with me because they
were that desperate for help with their drinking. And I'm like, okay,
well this isn't this isn't working. There was no there's
(20:04):
bits and obs of Medicare funding, but it just didn't
feel safe for me to be prescribing die as a
paraps people I had not met before, but at the
same time, I was desperate to help them. So that's
when Chris Rain, who was the founder of Hello Sunday Morning,
which I'm sure you've heard of, is really not for
(20:25):
profit charity. And I've met Chris at a conference and
we've done a bit of work together through Hello Sunday Morning,
and I loved Hello Sunday Morning. I recommended it to
all my patients, and we'd be we'd been keeping in
touch to see how we could work together, and he
was like, what were we going to do about COVID And
I'm like, well, I don't know, and he says, why
(20:45):
don't we just put your model of face to face
care entirely onto telehealth and then everybody can access it
no matter where they are and it's completely COVID safe.
And as soon as he said it, I'm like, yeah,
that is a brilliant idea and at the same time, serendipitously,
my best friend Pierre had just left her role as
(21:06):
a national Partner for Health in Deloitte and along the
way had developed alcohol use disorder, which I wasn't aware of.
I mean, she was one of my drinking buddies in London,
one of my binge drinking buddies, you know, for many years,
and we've been through a lot together and had known
each other a very long time. And she's an incredible
she's now our leader, our CEO.
Speaker 2 (21:29):
And well, I actually just preferred someone who reached out
to me last week to you guys. And it's funny,
you know, I haven't had a drink now, it'll be
coming up to six years and amazing. I wish there
had have been. I was very lucky in the fact
that I was able to see an amazing you know
(21:53):
psychiatrist and he guided me through those initial stages. But
I just wonder if there had been something like what
you offer, you know, things, I might have done something sooner.
But I think what you're offering is wonderful. And as
I have my own practice in dermatology and asthetics, of
(22:16):
which if I'm truly honest. My passion is dying and
is certainly going in different directions, probably more this pathway
helping people more. And I'm not saying what I do
now doesn't help people. And you know, I've got beautiful clients,
but I can't tell you since I tell people that
(22:38):
I don't drink, and I didn't, well, I stop drinking
because I had a problem. I get asked. I would
get asked at least twice a week how I did it,
or probably the biggest question is what was the impact
it had on you? How did you go out? How
did you navigate Christmas? It is so terrifying the other
side for so many people. I think what you guys
(23:01):
offer with that support is wonderful. It's not just you know,
let's help you, see you later, it's let's support you
through a period of time, which I think is so
you know, it's not when you stop drinking, it's it's
the stuff that goes on in here after you stop.
Speaker 1 (23:17):
Drinking and telling your story is I think it is
so difficult. And you know, ideally, I think you know,
when I was doing this as a GP, I think
that's that's great because people could come and see me
as their GP. No one had to know they were
just going through a GP appointment and I could I would,
(23:41):
you know, do the assessment. I would see them daily
through DETOS and I could follow them up from cradle
to grave. You know, I could do the mental health
care plan well, stating their blood pressure. But gps don't
have the capacity to do that. And I campaigned for
a long time before we set up this social enterprise
(24:02):
during COVID for incentives, finding some incentives to do this work,
which is what was working in the NHS. And you
don't have to give GPS much money, but they're inundated
with things which their best place to do. Everyone says, well,
it's better, you know, go and see your GP. There's
a new vaccine, see your GP. There's a new weight
los drugs, see your GP. You know, and gps are overwhelmed.
(24:24):
They're overworked, and they are the lowest paid doctors in
the whole healthcare. Now I'm not working as a GP,
I reflect on how hard working my colleagues are and
how much work we do with no payment. You know,
everything that happens when the if the patient's in the room,
(24:45):
there's a Medicare billing, for that if the patient's not
in the room, there's no pay. So the phone calls
a specialists, the letters, the you know, the work covers,
work covers paid, but the centerling. I mean, you just
do so much stuff that isn't paid. And you know,
I'd really like to just pay my respects to GPS.
In Australia, they do such.
Speaker 2 (25:05):
You should try being a nurse practice.
Speaker 1 (25:09):
That's even worse. There's even less remuneration for that. In
the American building is even less. And so when I
when I started out doing doing this, I thought, well,
we'll just do the tricky detox bit and then we'll
hand the patients back to their local services and their
(25:30):
local GP. Actually, what we find is it takes the
hardest bit. And I've always said this, when a patient
comes to see me for the first time to talk
about their drinking, I just I'm so excited for them.
I'm like and I'm in awe. I'm like, what you've
just done is so brave, and I thank you for
giving me the privilege of being the one to hear
(25:51):
this story and to help you with this. And I
absolutely am here to help you. And it takes so
much trust to do that, and often you've told someone
else already and you've faced stigma, or you've told a
healthcare professional and you've not been listened to. It's like
need help with them are drinking. I'm drinking in a
bottle of wine to night. And people get told, oh,
is that all You're fine? Just cook down, you'll be
all right, or just stop, you know, and it's like,
(26:13):
as if I haven't tried that myself, you know, as
if i'd come to you asking about help, if I hadn't,
if it was easy enough to just stop or to
just cut down. And so then people they're like, okay,
well I've tried. I've told one person it didn't go. Well,
I'm not going to do that again. I'll just struggle
on on my own. So to come and when someone's
told you that it's such a beautiful nugget, precious bit
(26:34):
of information, that you've got to really respect it. And
what that also means is they've told they've enlisted you
or for clean Slate, they've told clean Slate their story.
So now it's our responsibility to help them. And by
saying yes, we'll detox you, but now go back to
your GP and ask for your nowtrexone or now go
to your local smart Recovery meeting. What that means is
(26:59):
it means that you're sort of you're asking that person
to tell their story again, and they might not do that,
and a lot of the times they won't do that.
And so once they have trusted us with that bit
of information, we try and offer the same doctor and
the same nurse, which, as I say, we can do
ninety five percent of the time for the full twelve months,
(27:19):
so that you've got that continuity of care which is
so vital. And we communicate with the local GPS every
step of the way and were educating GPS and supporting
GPS to continue that holistic care of the rest of
the patient is really important. But it's one of the
big barriers.
Speaker 2 (27:37):
No, I think there's a lot of GPS, don't. I mean,
I know I went to see GP and was totally
nutterly shamed initially, and she just said, oh, this is
just and I respect the fact she said, this is
completely outside of my scope practice. You're fine anyway. I
remember going out of there and sitting in the car crying, going,
(28:00):
what am I going to do? I know I've got
a problem, and it's you know how they're that tipping
point and it starts to get really out of control.
And I was at that point and just being a
healthcare professional, and you know, I just happened to know
a psychiatrist who I reached out to. He saved my
(28:21):
life because I didn't know who else to turn to.
Speaker 1 (28:24):
Peer thought she had to do to rehab. Pea's been
in health her whole career since she was eighteen, and
she honestly thought her only way out was to go
into impatient rehab, which she couldn't do because she had
work and she had dogs, and so she didn't know
that there was an alternative either. But there is, I mean,
(28:46):
and so we set this up to break down as
many barriers to accessing care as we could. You know,
it takes on average eighteen years for people with alcohol
use disorder, you know, for want of a better term,
to access the health, the health support that they need,
the treatment they need, and the main and that's because
(29:07):
of the many barriers to access and care, and stigma
is probably the biggest one. And by being able to
offer someone with lived experience of the program on the
end of a phone to enroll you onto the program
once you've decided you want help, and then to offer
specialist doctor and nurse to give you treatment in your
own home, you know, so you don't have to tell
(29:29):
your story to more than one person that you know,
unless you choose to. Is really helping to break down
that stigma barrier. But then there's geographical barriers. We know.
The further the further away from a capital city you live,
the greater the chance you have of having a substance
use issues, and the harder it is to access treatment.
(29:51):
I was sort of horrendous story when I went to
visit Armagen Aboriginal Health Service that the current model of
care was to take people into an impatient detops unit,
which wasn't that far away, but it was off country
and within this community and in lots of Aboriginal communities.
To move on to someone else's country, you need to
be invited. And because people weren't being invited onto country
(30:14):
into this detox unit, they were having these psychotic experiences
because they felt unwelcome and that were there were spirits
and ancestors who were not didn't want them in that
detox unit, and they were being diagnosed with delia and
tremens and psychosis, when really it was just the cultural
insensitivity of what had happened.
Speaker 2 (30:33):
There's so much to consider, isn't there.
Speaker 1 (30:36):
I mean I didn't know that. I had no idea.
I thought, oh, it's great, you've got this brand new
detox unit. That's a fantastic service. But actually, if it's
not done with cultural sensitivity, and it's not codesigned with
the people who are going to be using that service,
then you can actually do harm or Another sort of
broken part of our system is that if you're a
(30:58):
victim of domestic or family violence, and if you drink
or use drugs, you're at much greater risk of being
a victim of thema sit violence and being coerced because
of your drug or alcohol use. You can't escape that
relationship easily because all of the women's refugees and shelters
are dry because they have to be for safety. So
if you're drinking and being physically abused, you can't go
(31:22):
to a refuge because you're drinking. So now we're working
with women's community shelters and doing inReach detoxes to finally
break that cycle, and that's been a really exciting project.
We're working with veterans you get a free place if
you've got a DBA card. There's some public rehabs in
regional and rural Australia where they struggle to get prescribers.
(31:44):
We've been able to offer sort of in reach prescribing
to keep some detoxes open. But the big plan is
to make this free for everybody because we get no
government funding other than the PHN contracts we've got in
Western Queensland and western New South Wales. We've got some
phn's in Sydney, but if you don't live in those
(32:05):
postcodes then you have to pay. And we're a social enterprise.
This is a super cheap service. It's as cheap as
we can possibly make it. We don't have any bricks
and water, but it's still three hundred and fifty dollars
a month, and you know for the detox and the
doctors and the nurses to cover their wages, and three
hundred and fifty dollars a month is half of what
(32:28):
people are spending on alcohol on average. But you know,
if you're not drinking, then you and you don't have means,
you're not employed, and then that money needs to go
on childcare and you're built so we've set up a
digital alcohol alliance with Turning Point Sober in the country,
(32:49):
Alcohol Jog Foundation, Hello Sunday Morning, Smart Recovery to really
lobby government to fund this, and I mean, if you
consider that where I work at Saint Vincent's and it
obviously we need our impatient withdrawal units absolutely for people
with complexity, with homelessness with significant physical or mental health home.
(33:11):
But they need to come into the unit like I
work in at Saint Vincent's and they do fantastic work.
But you know, it's about seven thousand dollars for a
five day stay in a public hospital and that's just
for your detox, you know, and then you've got those
problems of accessing after care, where again you've got to
go to either a different service or a different building,
(33:31):
meet a different person, tell your story again. I turn
up in person. We do the full assessment, drawal and
recovery for three hundred and fifty dollars a month. So
it's cheap, but I want it to be free for everyone,
and I'm hoping that government will come to the table.
Speaker 2 (33:48):
Have you been lobbying them for long?
Speaker 1 (33:51):
Yes? Peer is amazing. Peer and Chris are well connected,
and they've been speaking. We've been speaking to anybody that
will listen to us, because we know this is a
great service. I mean, the results we're getting are incredible,
and it's because we've got motivated people who have come
to us for help, who want to make a change.
(34:11):
You know, there's no sort of coersion. Well that might
be from their family and friends, but to reach out
to us means people want help. So we have got
this motivated group of people. But if you stay with
us for the full twelve months, everyone who fills in
their twelve month outcome measure, out of all of those people,
(34:32):
eighty five percent of people are meeting their goals at
twelve months.
Speaker 2 (34:36):
That's phenomenal. So if there were MPs that did want
to do further study in this area, like I'm not
a you know, AOD specialist, certainly something I'm interested in,
where would you go to advance your skills in that space?
Speaker 1 (34:55):
I'd probably start with DANA, the Drug and Alcohol Nurse Association. Okay,
that'd be where i'd go. If you google DINA. The
ANA a fantastic organization. They have conferences and a network
of nps and it's quite a small, small net group.
There's not that many aod nps in Australia, and I
(35:18):
hope I've sort of impressed on how rewarding and satisfying
this work is. I mean, as I say, I had
so many interests, and as soon as I got into
diction medicine, I mean I was hooked.
Speaker 2 (35:36):
It's look, I know, just from me talking and following
up with my own clients to come in and supporting
as much as I can, how great that feels. And
I also love the fact that they feel like they
can talk to me without any judgment, because who might
the judge. I've been there, you know, I'm not judging anybody,
(35:57):
but I now it's wonderful for me to be able
to go. Look, Smart Recovery Australia was a god send
for me. I loved it, and I loved the fact
I could get on. At first, I never had the
screen on. It's running all the time. It's fantastic. And
then you know, now that I know about clean Slate,
I've been telling so many people I think it is
(36:20):
such a brilliant organization and unfortunately, with so much funding
going to the government from the alcohol manufacturers in space,
I hope they see financially, how viable it is to
support organizations like yours because health wise, what alcohol does
(36:42):
to the body is horrendous, you know, and they would
be saving money if they supported organizations like yours.
Speaker 1 (36:51):
So how economics are very clear and have been We've
known them for thirty four years that for every dollar
you spend on drug and alcohol treatment, you see seven
dollars right the public. So it's a real no brainer
put you know, and I mean it's why we've got
(37:11):
we've got eighteen private health insurance on board now because
the current model is to send people to the three
week private detoxes. And again some of these clinics are
fantastic and life changing clinics, but they're very expensive. You know,
you're looking at fifteen to twenty thousand dollars for three
(37:32):
weeks and that's it. You get the three weeks with
limited aftercare. So for you know, a fraction of that
cost get you get twelve months of support in your
own home. So to me, it's a no brainer.
Speaker 2 (37:47):
So Chris, coming into Christmas, is there anything you can
recommend for? You know, people know when they've got a problem.
We innately know whether and we mask it or we
pretend it's not happening, or we go and hang out
with enablers or what you know, we know? Is there
any one thing you would recommend to help people get
(38:10):
through this Christmas phase? And nurses are like doctors where
some of the worst when it comes to partying at
Christmas time. No work hard, play hard. I mean, that's
how it was when I did my nursing drinking and
we did. But you know, it's a tough time of year. There's,
you know, an increase in DV there's an increase in drinking,
there's an increase in breakdown of the family, there's increase
(38:34):
in isolation, loneliness, and then people drink to mask all that.
So is there anything you would recommend?
Speaker 1 (38:43):
It's about being mindful, and that's a hard thing to do,
especially after you've had that first drink and your your
brain is already craving. The next one is really about
when we talk about mindful drinking, it's trying not to
have that drink before you go out, arrive at your
(39:06):
destination already knowing what you want the night to look like.
What is a good night going to look like here?
And if it's a work do then it's you know,
I don't want to embarrass myself. And so it's really
finding your people who you feel safe with in that crowd.
Because if your boss is in the room, or that
person that you fell out with last week, or someone
(39:28):
you just don't like is in the room, you're already
in your fight or flight and you're anxious and you
want to drink, and that's when things sort of go
out of hand. So try and make your first drink
a soft drink. That's really powerful thing to do. To
turn up at the bar or the restaurant and just say, oh, look,
i'm feeling Thursday. I'll have a diet coke or or whatever.
(39:49):
I'll have a soft drink to start with, and just
see the lay of the land. So find out where
you want to sit, where you're going to feel safe,
and then really take your time with that drink and say, okay, well,
I really I want to be home by this time
because for this reason, I'm going to have this is
my exit plan. I've got to do this in the morning.
How do I want to feel tomorrow? So a good
(40:09):
night is going to be a night where I've spent
it with these people that I like, where I don't
get too drunk. I get home on time and feel
good in the morning. How am I going to achieve that?
And have a plan, have a plan for your evening.
You know, we plan our workday, but we don't always
plan our parties, you know, and drink water, slow down,
(40:30):
you know, try and enjoy the moment. And you can
say no, you know, if you're not feeling up for it,
if you're feeling sick, you're feeling tired, if you're worried
that no matter what plan you put in place, you're
not going to be able to hold that sort And
you can say no, you cannot go, or you can
(40:50):
go really early and leave really early. You know, you
can be the first one Friday. Yeah, be the first
one that people have to come and say hello to
you then, because when you turn up to a room
sometimes I'm like, oh, I need to go and say
I have to say load to everyone in the room
or they'll think I'm rude. They haven't said a load
to me. But if you're one of the first people there,
then it's not that's their job to come and say
loo to you. Yeah. So have you have your exit
(41:12):
plan and speaking it out makes it less scary, you.
Speaker 2 (41:17):
Know, it does.
Speaker 1 (41:18):
It does.
Speaker 2 (41:19):
My feedback is that this is a really needed service.
I get asked all the time, and I think you
have some really valuable information to share. So I certainly
would love you to come back on at some stage
next year. But thank you so much. I just appreciate
(41:39):
you taking the time out of your very very busy
schedule and have a merry Christmas. And thanks for the
Christmas tips. I think that was really good advice.
Speaker 1 (41:48):
No problem, and you've saved me an hour this week
so I can cancel my psychologists now I've done my therapy.
Oh my pleasure.
Speaker 2 (41:56):
I do that for free all the time.
Apogee Production.
Speaker 2 (00:11):
Hi, my name's beck Woodbine and welcome to Tenderness for Nurses.
Speaker 1 (00:15):
I'm grateful for the person that I have the opportunity
to be, so I hid it and parked it for
nearly four years.
Speaker 2 (00:24):
We always have free will, We always get to choose.
We are autonomous. Thank you everyone for tuning back into
tend Andnis for Nurses. Today we have doctor Chris Davis
with us. He holds two hats, one being one of
the directors of Clean Slate Clinics, which is what we're
going to be chatting to him about, but also his
works in ED at Saint Vincent's Hospital.
Speaker 1 (00:46):
Yeah, I'm a GP by training, so I was a
full time GP until a couple of years ago when
I got a job at Saint Vincent's Hospital in addiction
medicine really in an attempt to become well, hopefully a
successful one, to become an addiction specialist in an addiction
medicine at the hospital part time.
Speaker 2 (01:07):
Fantastic. Well, I, as you know, had your colleague Chris
Kimpaul come in and have a chat with us here
on the podcast, and it today has been one of
our most popular podcasts. He was very raw and honest,
and it made me really want to have a chat
to you in relation to clean Slate Clinic, especially with
(01:29):
Christmas literally a couple of weeks away. So how did
clean slate Clinics start?
Speaker 1 (01:36):
Actually started? Probably about twelve years ago. I was working
as a busy in a city GP in London. I'd
only been a GP for a couple of years, and
I got a partnership in a practice when I was
way too young. To be honest, I'd only been a
(01:59):
GP for about eighteen months. I didn't really know what
I was doing as a junior GP, and but I
was and I went for a partnership role and got
the job, which was so flattering. I didn't even think
to do any sort of due diligence around what this meant.
But it did mean buying into a business and being
(02:19):
a business owner and a manager. And the people that
I went into business with were not the sort of
people that you want to do that with. I mean,
the two senior partners hated each other. One would say
no just because the other had said yes. I remember
being in one practice meeting where the senior partner was
(02:42):
screaming at the other one to the point where he
actually lost consciousness. He fainted. He was during Grammadam and
he hadn't eaten and so he's now unconscious on the
floor and Michelle, the senior partner, was still screaming at him,
and I'm like, Michelle, help him. He's not breathing. So
that was pretty awful. I was there for four years.
(03:03):
But one thing that We're saved me during that horrendous
job was the drug and alcohol work that I got
interested in doing and the local PHN, which is like
the primary health network. So the group of commissioners, we
were really short of methodonne and buper and orphing prescribers
(03:26):
in the area, so they offered us free training to
any interested GPS. So this meant that once a month
I got a day off to go and do this
training and I could escape this toxic practice that I
was in. And I became like a methodone prescriber and
I love that work. And I got to work with
a drug and out on these who would you know,
do roll of the legwork. And but what what I
(03:49):
really became interested in when I sort of developed this
interest was well, it became a sort of journey of
self improvement. To be honest, so I mean it to
to sort of get get right into. I mean, I've
had a lot of special interest. I'd done palliative care,
i was working in nursing homes, I was helping doing
(04:12):
the diabetes management programs, and I loved working with kids.
I've done a lot of pediatrics in my training, and
I always wanted to be a pediatrician. And so I
had all these interests and every aspect of medicine it
always held some fascination for me. And whatever I started
to do, I really got my teeth into and loved it.
But around this time I was gaining this interest in
(04:34):
extra knowledge and drug and alcohol. What I really began
to get insight into, you know, I was maturing and
was that I needed help with my own drinking. I
grew up in very I mean I had a great childhood.
(04:58):
I really did. But when I grew up as a
gay boy in a very homophobic town, the you know
I do. I really did love my upbringing. I had
incredible friends, I really had a loving family. It was
very working class. We didn't have any of the trappings.
But I loved the camping holidays and playing sport. And
(05:22):
but I was I was very closeted and as much
as I had these feelings that I knew weren't okay.
And you know, there was one gay guy I was
aware of in our town who was branded a pedophile,
not because he was a pedophile, just because of his sexuality.
And yeah, and not one kid in my school came
(05:44):
out because of the fear of what that actually meant.
And you know, and there was the HIV crisis. You know,
I was born in the eighties. I was born in
seventy seven, and so being game wasn't okay. It meant
you were going to die and be be villified, you know.
And then when I was about eighty, I remember my
(06:06):
mom sitting us down. My mum was an amazing woman.
She passed away last year, unfortunately, and she taught sex
head and she told me and my brother and sister
that if any of us were gay, that mom and
dad would be fine about it. And we all laughed
because none of us were. And of course I was, yeah,
definitely not out at that point. But I remembered it
really because I clopped it for later, you know, and
(06:27):
went through UNI still in the closet, and you know,
full of shame, you know, about that side of me.
And then when I eventually did, I flew out. I
did my house jobs in Stepping Hill and Stockport in Manchester,
and it was horrendous. They monitored my hours, well all
of the junior doctor's hours at the time, because I
(06:48):
had been some deaths, like junior doctors had died because
they were so tired and they crushed their car and
there'd been a suicide. And my average hours per week
was one hundred and eleven. Oh my god. And so
I hated it because again, you're a junior doctor. You
don't know what you're doing. You're flying by the seat
of your pants. You're hoping that the nurses are going
(07:08):
to be kind to you, and you know, and so
it was awful. So I thought, I'm going to hate
it this much, might as well go and hate it
and live in Australia and be on the beach, you know.
And around that time, you know, I was really coming
to the terms with the fact that I wasn't that
I did have these feelings towards men, and that you know,
they weren't going to go away like I hoped that
(07:28):
they would. So I arrived in Australia and then I
met Luke, who's my now husband, and fell in love.
And it was an amazing sort of way to come
out in a way, because you know, I wasn't telling
people that I was gay. I was telling people that
I was in love. And I wasn't really scared about
telling mom, you know, because she'd said this thing when
I was eighteen, and she I was so close to her,
(07:51):
and so then when I told her, my mom didn't
react very well, you know, and in fact, she reacted
pretty pretty awfully. It was very hard for her to understand.
It was a surprise to her as it, yeah, as
it had been to sort of me in a way,
because I was coming out to myself at the same time,
and I didn't identify as being gay. I knew I
(08:12):
was in love with Luke, but gay had all of
these horrible negative connotations, you know. I was going to
be all of the things that you know that gay
meant when I was growing up. And so I was
coming to terms of my own sexuality and what that
actually meant and who I was. And I was doing
it without the support of my mom at the time, and.
Speaker 2 (08:32):
So I try, how about your siblings, did they support you?
Speaker 1 (08:35):
So Mom, didn't. I was in Australia at the time,
and this is before social media, and you know, I
had to pay a fortune to make a phone call home,
and I was doing group emails once a week, you know,
to all my friends and that's how I communicated. So
Mom didn't want my siblings or my dad to know
because she thought it would be a phase, and you know,
(08:58):
she was protecting them, I guess in a way. So
they didn't know for about a year and it got
too much and Luke and I split up. He went
back to England and it was horrendous for him, horrendous
for me, but I, you know, I wasn't. I needed
to sort my own head out. I didn't think I
was doing anything wrong. But at the same time, my
(09:18):
family was breaking up and was saying things like I
wouldn't be welcome home, and so, yeah, so me and
him split up and he was heartbroken. Anyway, I went
home to England from Australia for a wedding and met
up again with Luke and everything became clear. You know.
It was amazing to see him again and for him
to forgive me, and yeah, I knew that I had
(09:40):
to be with him and I couldn't risk losing him again,
and so told Mom and she wasn't okay about it.
I went back to Australia, leaving Luke in England. But
now I'm like, Mom, I've got to tell my family.
I've got to tell Dad. I've got to heelp because
I'm going to be with Luke for the rest of
my life. You know. Anyway, my brother was flying out.
(10:02):
He's just about eighteen months younger than me. My with her,
and he was flying out to come and stay with
me for a few months because we were really close
and we still are, and I owe him. I owe
him a lot because when my brother was coming out
and I had to tell him, and Luke had just
come out to stay with me for two or three
(10:23):
weeks and he wasn't. He missed his flight because we
were partying so hard. He missed his flight and my
brother arrived the next day and so he came to
sleep in in this in the lounge and there was
this man in my bedroom and anyway, got through his hangover,
(10:43):
flew home. I did a night shift, came back and
you know, all night I was like, I've got to
tell my brother. This massive thing. You know, and so
I sent my brother down and I was like, I've
got something to tell you, and he goes, I think
I know, bro, and I'm like, no, you don't know this.
He goes, I think I do, and I'm like what,
(11:05):
and he goes, are you gay? So no, no, no
I'm not gay because I wasn't in my own head
at this time, you know, I was just in love
with Luke, which obviously I now know is the same thing.
And he goes, he goes, but Luke's your boyfriend, right,
I said, yeah, Luke's my boyfriend. And I'm like, how
did you know? And he goes, well, I found this poem,
(11:25):
found his poem in the kitchen, and Luke had written
me a love rap and had left it there. My
brother found it. It was quite an interesting way for him.
I won't tell you what was in what and decent.
And I was so petrified that my brother was gonna
(11:46):
act in the same way that my mom had, you know.
And then I told my dad. My dad mom had
just told him before I got on the phone to him,
and he just said all the same sort of things
momma was saying. And I'm like, Dad, they're not your words,
then Mom's words, and I'm like, all you've ever said
to me, Dad is that you want me to be happy.
And what I'm telling you is that this is the
(12:07):
happiest I've ever been, and I've met the person I'm
going to spend the rest of my life with him.
This is incredible news. And he goes, oh, but you're
happy as any heads that I'm really happy. He goes, well,
that's good news then, isn't it. So I'm like, Dad,
it's the best news. And he's never looked back from that,
you know, he's but it was really hard because you
(12:29):
go up with this shame and fear of rejection, and
when you're rejected by the person who means the most
to you in the world, which is eventually which is
why I finished with Luke. Initially, it was because I
couldn't imagine not, you know, losing my mum or losing
my relationship with my mum, because it was so important
at that time, and you know, and Luke understands that
(12:53):
of course. Anyway, I'm sort of I'm digressing, but you know, drinking,
and certainly when me and Luke split up for that
six months, I just I drank every weekend when I
wasn't working, I drink and I'd escape, and you know,
you didn't have to worry, and you know, I'd drink
to black out a lot of the time because I
(13:13):
don't know. So then well, you know, Luke and I.
I moved back to England and Luke and I were
great and life was good. I was working as this GP,
and but the bin drinking sort of stayed with me
and it was full part of the pattern. When I
was doing there was one hundred and eleven hours a
week as well. It's like we had the doctor's mess
(13:34):
in the hospital which always had free alcohol in and
we lived in the hospital, worked in the hospital, and
obviously when you're working, you're working, but that on that
one day off or that weekend off, you know, you're
and even when you're in the mess when you are working,
there's one of your mates drunk, you know, in there.
Because so we were bings. We were party hard. We'd
work hard with party hard as a release from the
(13:57):
stress from work and everything else that was going on.
And then when I got this job in London where
Clean State started, and it was awful. It was really
really toxic, and so yeah, so the binge drinking just happened,
and that didn't happen. It just didn't stop happening. And
whilst it was fun, the Mondays and the Tuesdays and
(14:18):
this workplace were so bad that I was suffering with
anxiety for sure. But I remember being at a friend's
wedding and I got a phone call from what I
thought was the landlord and it wasn't, and I got
that tightness in the chest, sweating, and I had the palpitations,
(14:38):
and I'm like, okay, I knew what it was. I'd
had a panic attack when I was younger, but I
knew what it was because I was a doctor and
I dealt with people suffering with panic. But I'm like, yeah,
I can see why people go to hospital with this feeling.
It was that bad, you know. And then I was
doing this extra work with drug and alcohol and I'm like, okay, right,
alcohol is really part of the problem here. It's really
(15:00):
not helping me. And so there was a group of
of GPS helped doing these home alcohol detox clinics. There
was three, well, there was two GPS, and then I
joined the ranks because I really wanted to get involved
a to help myself. It's like, how do you start
the habit of a lifetime. This is how my friends
(15:23):
meet up, but you know, we go out, we drink,
and we get drunk. How do you change that? And
also because I'd noticed it, which it seems like a
crazy thing, particularly for a doctor to say and to see,
but I started asking my patients about their drinking. And
(15:43):
that's not really part You think that would just be
part of every history, and absolutely it should be, but
drug and alcohol, you know, unless someone volunteered that they
were drinking too much, it wasn't part of your normal
questioning smoking. Yes, but I didn't used to ask people
until I've done this extra training about their drug. U
saw they're drinking. But now I was saying that what
(16:03):
an incredible effect it had had on my mental health
and my physical health. And I started asking people about it,
and you know, it just brought brought up so many,
so many things, And so I started helping people detox
from alcohol at home. And because I was going through
my own sort of shame and guilt and all of
(16:25):
these emotions, when patients opened up to me and said, yeah,
I'm drinking too much, it's affected me in this way
and I want to change, and then taking them through
a withdrawal and seeing the incredible change that it made,
and seeing the bravery in my patients, you know, the
courage that it takes to say I've got a problem
(16:46):
with alcohol in this society and I'm going to do
something about it, and I'm going to tell these people
this is It really resonated with my own sort of
coming out story and also my own sort of struggles
with alcohol, and so it was such a privilege. You know,
I was so in awe of my patients who who
were brave enough to put that hand up and make
(17:07):
this change, and to be the one that could help
them do that, and to see the incredible difference it
made to their physical health, their mental health, to the
relationships to their working lives. It was the most rewarding
thing that I'd ever done in medicine. And so then
really to escape the horrible job that I was in.
(17:28):
You know, Luke and I we knew we needed to
change our lifestyle, our drinking patterns, our you know, our
work life balance, and our friends had started to have
kids and Luke never wanted kids, and we knew that
we knew that something had to change, and so we
started talking about moving out of London and I was like, well,
you know, for giving up on abroad and he's like,
(17:51):
well no, and I'm like, why don't we go back
to Sydney which is where we met. But I was
desperate when to bring this model of care with me
because I hated being a GP in that practice, but
I loved my alcohol whole work. And when I got
to Australia, I joined this practice called Killed their Road
and they were super supportive in allowing me to bring
(18:14):
this model of alcohol detox with me and I was
no longer a practice owner, you know. I remember on
the first day, the receptionist came in as I was
being trained by the practice manager and she goes, oh
so and so is called off sick. We've got no
one behind the desk, and I said, oh, well, have
you got an on call wrote for a reception And
they just looked at me like, Chris, this is really
(18:36):
not your problem. And it was like, oh my god,
this is amazing. I can just be a doctor again,
like this is that's not my worry. Reception is not
my worry anymore. And for two years I was just
a GP and not a manager and I could set
I set up the Clean State Clinic, and I just
loved being a doctor again. You know, I'd really burnt
(18:58):
out in London and I've found a joy of general
practice and Clean Slate was just my passion project. Then
I brought it to Darlinghurst eas Sydney Doctors and then
COVID hit and all of a sudden, you know, there's
not that many gps that put their hand up and
say they've got a special interest in alcohol. In fact,
(19:21):
if you googled it, I was the only name that
came up. And because of that, I when COVID hit
and all the detox services had closed, including where I
were now the Gorman unit that was a COVID ward
for a while. So you know, people were drinking twenty
to twenty five percent more through COVID, but try and
get help was virtually impossible. So I'm getting phone calls
(19:43):
and emails from Alice Springs. I did a detox over
the phone to someone on the Gold Coast. I had
two people from Adelaide. They didn't know each other, and
I didn't know this before it happened, but they flew
from Adelaide for a GP appointment with me because they
were that desperate for help with their drinking. And I'm like, okay,
well this isn't this isn't working. There was no there's
(20:04):
bits and obs of Medicare funding, but it just didn't
feel safe for me to be prescribing die as a
paraps people I had not met before, but at the
same time, I was desperate to help them. So that's
when Chris Rain, who was the founder of Hello Sunday Morning,
which I'm sure you've heard of, is really not for
(20:25):
profit charity. And I've met Chris at a conference and
we've done a bit of work together through Hello Sunday Morning,
and I loved Hello Sunday Morning. I recommended it to
all my patients, and we'd be we'd been keeping in
touch to see how we could work together, and he
was like, what were we going to do about COVID And
I'm like, well, I don't know, and he says, why
(20:45):
don't we just put your model of face to face
care entirely onto telehealth and then everybody can access it
no matter where they are and it's completely COVID safe.
And as soon as he said it, I'm like, yeah,
that is a brilliant idea and at the same time, serendipitously,
my best friend Pierre had just left her role as
(21:06):
a national Partner for Health in Deloitte and along the
way had developed alcohol use disorder, which I wasn't aware of.
I mean, she was one of my drinking buddies in London,
one of my binge drinking buddies, you know, for many years,
and we've been through a lot together and had known
each other a very long time. And she's an incredible
she's now our leader, our CEO.
Speaker 2 (21:29):
And well, I actually just preferred someone who reached out
to me last week to you guys. And it's funny,
you know, I haven't had a drink now, it'll be
coming up to six years and amazing. I wish there
had have been. I was very lucky in the fact
that I was able to see an amazing you know
(21:53):
psychiatrist and he guided me through those initial stages. But
I just wonder if there had been something like what
you offer, you know, things, I might have done something sooner.
But I think what you're offering is wonderful. And as
I have my own practice in dermatology and asthetics, of
(22:16):
which if I'm truly honest. My passion is dying and
is certainly going in different directions, probably more this pathway
helping people more. And I'm not saying what I do
now doesn't help people. And you know, I've got beautiful clients,
but I can't tell you since I tell people that
(22:38):
I don't drink, and I didn't, well, I stop drinking
because I had a problem. I get asked. I would
get asked at least twice a week how I did it,
or probably the biggest question is what was the impact
it had on you? How did you go out? How
did you navigate Christmas? It is so terrifying the other
side for so many people. I think what you guys
(23:01):
offer with that support is wonderful. It's not just you know,
let's help you, see you later, it's let's support you
through a period of time, which I think is so
you know, it's not when you stop drinking, it's it's
the stuff that goes on in here after you stop.
Speaker 1 (23:17):
Drinking and telling your story is I think it is
so difficult. And you know, ideally, I think you know,
when I was doing this as a GP, I think
that's that's great because people could come and see me
as their GP. No one had to know they were
just going through a GP appointment and I could I would,
(23:41):
you know, do the assessment. I would see them daily
through DETOS and I could follow them up from cradle
to grave. You know, I could do the mental health
care plan well, stating their blood pressure. But gps don't
have the capacity to do that. And I campaigned for
a long time before we set up this social enterprise
(24:02):
during COVID for incentives, finding some incentives to do this work,
which is what was working in the NHS. And you
don't have to give GPS much money, but they're inundated
with things which their best place to do. Everyone says, well,
it's better, you know, go and see your GP. There's
a new vaccine, see your GP. There's a new weight
los drugs, see your GP. You know, and gps are overwhelmed.
(24:24):
They're overworked, and they are the lowest paid doctors in
the whole healthcare. Now I'm not working as a GP,
I reflect on how hard working my colleagues are and
how much work we do with no payment. You know,
everything that happens when the if the patient's in the room,
(24:45):
there's a Medicare billing, for that if the patient's not
in the room, there's no pay. So the phone calls
a specialists, the letters, the you know, the work covers,
work covers paid, but the centerling. I mean, you just
do so much stuff that isn't paid. And you know,
I'd really like to just pay my respects to GPS.
In Australia, they do such.
Speaker 2 (25:05):
You should try being a nurse practice.
Speaker 1 (25:09):
That's even worse. There's even less remuneration for that. In
the American building is even less. And so when I
when I started out doing doing this, I thought, well,
we'll just do the tricky detox bit and then we'll
hand the patients back to their local services and their
(25:30):
local GP. Actually, what we find is it takes the
hardest bit. And I've always said this, when a patient
comes to see me for the first time to talk
about their drinking, I just I'm so excited for them.
I'm like and I'm in awe. I'm like, what you've
just done is so brave, and I thank you for
giving me the privilege of being the one to hear
(25:51):
this story and to help you with this. And I
absolutely am here to help you. And it takes so
much trust to do that, and often you've told someone
else already and you've faced stigma, or you've told a
healthcare professional and you've not been listened to. It's like
need help with them are drinking. I'm drinking in a
bottle of wine to night. And people get told, oh,
is that all You're fine? Just cook down, you'll be
all right, or just stop, you know, and it's like,
(26:13):
as if I haven't tried that myself, you know, as
if i'd come to you asking about help, if I hadn't,
if it was easy enough to just stop or to
just cut down. And so then people they're like, okay,
well I've tried. I've told one person it didn't go. Well,
I'm not going to do that again. I'll just struggle
on on my own. So to come and when someone's
told you that it's such a beautiful nugget, precious bit
(26:34):
of information, that you've got to really respect it. And
what that also means is they've told they've enlisted you
or for clean Slate, they've told clean Slate their story.
So now it's our responsibility to help them. And by
saying yes, we'll detox you, but now go back to
your GP and ask for your nowtrexone or now go
to your local smart Recovery meeting. What that means is
(26:59):
it means that you're sort of you're asking that person
to tell their story again, and they might not do that,
and a lot of the times they won't do that.
And so once they have trusted us with that bit
of information, we try and offer the same doctor and
the same nurse, which, as I say, we can do
ninety five percent of the time for the full twelve months,
(27:19):
so that you've got that continuity of care which is
so vital. And we communicate with the local GPS every
step of the way and were educating GPS and supporting
GPS to continue that holistic care of the rest of
the patient is really important. But it's one of the
big barriers.
Speaker 2 (27:37):
No, I think there's a lot of GPS, don't. I mean,
I know I went to see GP and was totally
nutterly shamed initially, and she just said, oh, this is
just and I respect the fact she said, this is
completely outside of my scope practice. You're fine anyway. I
remember going out of there and sitting in the car crying, going,
(28:00):
what am I going to do? I know I've got
a problem, and it's you know how they're that tipping
point and it starts to get really out of control.
And I was at that point and just being a
healthcare professional, and you know, I just happened to know
a psychiatrist who I reached out to. He saved my
(28:21):
life because I didn't know who else to turn to.
Speaker 1 (28:24):
Peer thought she had to do to rehab. Pea's been
in health her whole career since she was eighteen, and
she honestly thought her only way out was to go
into impatient rehab, which she couldn't do because she had
work and she had dogs, and so she didn't know
that there was an alternative either. But there is, I mean,
(28:46):
and so we set this up to break down as
many barriers to accessing care as we could. You know,
it takes on average eighteen years for people with alcohol
use disorder, you know, for want of a better term,
to access the health, the health support that they need,
the treatment they need, and the main and that's because
(29:07):
of the many barriers to access and care, and stigma
is probably the biggest one. And by being able to
offer someone with lived experience of the program on the
end of a phone to enroll you onto the program
once you've decided you want help, and then to offer
specialist doctor and nurse to give you treatment in your
own home, you know, so you don't have to tell
(29:29):
your story to more than one person that you know,
unless you choose to. Is really helping to break down
that stigma barrier. But then there's geographical barriers. We know.
The further the further away from a capital city you live,
the greater the chance you have of having a substance
use issues, and the harder it is to access treatment.
(29:51):
I was sort of horrendous story when I went to
visit Armagen Aboriginal Health Service that the current model of
care was to take people into an impatient detops unit,
which wasn't that far away, but it was off country
and within this community and in lots of Aboriginal communities.
To move on to someone else's country, you need to
be invited. And because people weren't being invited onto country
(30:14):
into this detox unit, they were having these psychotic experiences
because they felt unwelcome and that were there were spirits
and ancestors who were not didn't want them in that
detox unit, and they were being diagnosed with delia and
tremens and psychosis, when really it was just the cultural
insensitivity of what had happened.
Speaker 2 (30:33):
There's so much to consider, isn't there.
Speaker 1 (30:36):
I mean I didn't know that. I had no idea.
I thought, oh, it's great, you've got this brand new
detox unit. That's a fantastic service. But actually, if it's
not done with cultural sensitivity, and it's not codesigned with
the people who are going to be using that service,
then you can actually do harm or Another sort of
broken part of our system is that if you're a
(30:58):
victim of domestic or family violence, and if you drink
or use drugs, you're at much greater risk of being
a victim of thema sit violence and being coerced because
of your drug or alcohol use. You can't escape that
relationship easily because all of the women's refugees and shelters
are dry because they have to be for safety. So
if you're drinking and being physically abused, you can't go
(31:22):
to a refuge because you're drinking. So now we're working
with women's community shelters and doing inReach detoxes to finally
break that cycle, and that's been a really exciting project.
We're working with veterans you get a free place if
you've got a DBA card. There's some public rehabs in
regional and rural Australia where they struggle to get prescribers.
(31:44):
We've been able to offer sort of in reach prescribing
to keep some detoxes open. But the big plan is
to make this free for everybody because we get no
government funding other than the PHN contracts we've got in
Western Queensland and western New South Wales. We've got some
phn's in Sydney, but if you don't live in those
(32:05):
postcodes then you have to pay. And we're a social enterprise.
This is a super cheap service. It's as cheap as
we can possibly make it. We don't have any bricks
and water, but it's still three hundred and fifty dollars
a month, and you know for the detox and the
doctors and the nurses to cover their wages, and three
hundred and fifty dollars a month is half of what
(32:28):
people are spending on alcohol on average. But you know,
if you're not drinking, then you and you don't have means,
you're not employed, and then that money needs to go
on childcare and you're built so we've set up a
digital alcohol alliance with Turning Point Sober in the country,
(32:49):
Alcohol Jog Foundation, Hello Sunday Morning, Smart Recovery to really
lobby government to fund this, and I mean, if you
consider that where I work at Saint Vincent's and it
obviously we need our impatient withdrawal units absolutely for people
with complexity, with homelessness with significant physical or mental health home.
(33:11):
But they need to come into the unit like I
work in at Saint Vincent's and they do fantastic work.
But you know, it's about seven thousand dollars for a
five day stay in a public hospital and that's just
for your detox, you know, and then you've got those
problems of accessing after care, where again you've got to
go to either a different service or a different building,
(33:31):
meet a different person, tell your story again. I turn
up in person. We do the full assessment, drawal and
recovery for three hundred and fifty dollars a month. So
it's cheap, but I want it to be free for everyone,
and I'm hoping that government will come to the table.
Speaker 2 (33:48):
Have you been lobbying them for long?
Speaker 1 (33:51):
Yes? Peer is amazing. Peer and Chris are well connected,
and they've been speaking. We've been speaking to anybody that
will listen to us, because we know this is a
great service. I mean, the results we're getting are incredible,
and it's because we've got motivated people who have come
to us for help, who want to make a change.
(34:11):
You know, there's no sort of coersion. Well that might
be from their family and friends, but to reach out
to us means people want help. So we have got
this motivated group of people. But if you stay with
us for the full twelve months, everyone who fills in
their twelve month outcome measure, out of all of those people,
(34:32):
eighty five percent of people are meeting their goals at
twelve months.
Speaker 2 (34:36):
That's phenomenal. So if there were MPs that did want
to do further study in this area, like I'm not
a you know, AOD specialist, certainly something I'm interested in,
where would you go to advance your skills in that space?
Speaker 1 (34:55):
I'd probably start with DANA, the Drug and Alcohol Nurse Association. Okay,
that'd be where i'd go. If you google DINA. The
ANA a fantastic organization. They have conferences and a network
of nps and it's quite a small, small net group.
There's not that many aod nps in Australia, and I
(35:18):
hope I've sort of impressed on how rewarding and satisfying
this work is. I mean, as I say, I had
so many interests, and as soon as I got into
diction medicine, I mean I was hooked.
Speaker 2 (35:36):
It's look, I know, just from me talking and following
up with my own clients to come in and supporting
as much as I can, how great that feels. And
I also love the fact that they feel like they
can talk to me without any judgment, because who might
the judge. I've been there, you know, I'm not judging anybody,
(35:57):
but I now it's wonderful for me to be able
to go. Look, Smart Recovery Australia was a god send
for me. I loved it, and I loved the fact
I could get on. At first, I never had the
screen on. It's running all the time. It's fantastic. And
then you know, now that I know about clean Slate,
I've been telling so many people I think it is
(36:20):
such a brilliant organization and unfortunately, with so much funding
going to the government from the alcohol manufacturers in space,
I hope they see financially, how viable it is to
support organizations like yours because health wise, what alcohol does
(36:42):
to the body is horrendous, you know, and they would
be saving money if they supported organizations like yours.
Speaker 1 (36:51):
So how economics are very clear and have been We've
known them for thirty four years that for every dollar
you spend on drug and alcohol treatment, you see seven
dollars right the public. So it's a real no brainer
put you know, and I mean it's why we've got
(37:11):
we've got eighteen private health insurance on board now because
the current model is to send people to the three
week private detoxes. And again some of these clinics are
fantastic and life changing clinics, but they're very expensive. You know,
you're looking at fifteen to twenty thousand dollars for three
(37:32):
weeks and that's it. You get the three weeks with
limited aftercare. So for you know, a fraction of that
cost get you get twelve months of support in your
own home. So to me, it's a no brainer.
Speaker 2 (37:47):
So Chris, coming into Christmas, is there anything you can
recommend for? You know, people know when they've got a problem.
We innately know whether and we mask it or we
pretend it's not happening, or we go and hang out
with enablers or what you know, we know? Is there
any one thing you would recommend to help people get
(38:10):
through this Christmas phase? And nurses are like doctors where
some of the worst when it comes to partying at
Christmas time. No work hard, play hard. I mean, that's
how it was when I did my nursing drinking and
we did. But you know, it's a tough time of year. There's,
you know, an increase in DV there's an increase in drinking,
there's an increase in breakdown of the family, there's increase
(38:34):
in isolation, loneliness, and then people drink to mask all that.
So is there anything you would recommend?
Speaker 1 (38:43):
It's about being mindful, and that's a hard thing to do,
especially after you've had that first drink and your your
brain is already craving. The next one is really about
when we talk about mindful drinking, it's trying not to
have that drink before you go out, arrive at your
(39:06):
destination already knowing what you want the night to look like.
What is a good night going to look like here?
And if it's a work do then it's you know,
I don't want to embarrass myself. And so it's really
finding your people who you feel safe with in that crowd.
Because if your boss is in the room, or that
person that you fell out with last week, or someone
(39:28):
you just don't like is in the room, you're already
in your fight or flight and you're anxious and you
want to drink, and that's when things sort of go
out of hand. So try and make your first drink
a soft drink. That's really powerful thing to do. To
turn up at the bar or the restaurant and just say, oh, look,
i'm feeling Thursday. I'll have a diet coke or or whatever.
(39:49):
I'll have a soft drink to start with, and just
see the lay of the land. So find out where
you want to sit, where you're going to feel safe,
and then really take your time with that drink and say, okay, well,
I really I want to be home by this time
because for this reason, I'm going to have this is
my exit plan. I've got to do this in the morning.
How do I want to feel tomorrow? So a good
(40:09):
night is going to be a night where I've spent
it with these people that I like, where I don't
get too drunk. I get home on time and feel
good in the morning. How am I going to achieve that?
And have a plan, have a plan for your evening.
You know, we plan our workday, but we don't always
plan our parties, you know, and drink water, slow down,
(40:30):
you know, try and enjoy the moment. And you can
say no, you know, if you're not feeling up for it,
if you're feeling sick, you're feeling tired, if you're worried
that no matter what plan you put in place, you're
not going to be able to hold that sort And
you can say no, you cannot go, or you can
(40:50):
go really early and leave really early. You know, you
can be the first one Friday. Yeah, be the first
one that people have to come and say hello to
you then, because when you turn up to a room
sometimes I'm like, oh, I need to go and say
I have to say load to everyone in the room
or they'll think I'm rude. They haven't said a load
to me. But if you're one of the first people there,
then it's not that's their job to come and say
loo to you. Yeah. So have you have your exit
(41:12):
plan and speaking it out makes it less scary, you.
Speaker 2 (41:17):
Know, it does.
Speaker 1 (41:18):
It does.
Speaker 2 (41:19):
My feedback is that this is a really needed service.
I get asked all the time, and I think you
have some really valuable information to share. So I certainly
would love you to come back on at some stage
next year. But thank you so much. I just appreciate
(41:39):
you taking the time out of your very very busy
schedule and have a merry Christmas. And thanks for the
Christmas tips. I think that was really good advice.
Speaker 1 (41:48):
No problem, and you've saved me an hour this week
so I can cancel my psychologists now I've done my therapy.
Oh my pleasure.
Speaker 2 (41:56):
I do that for free all the time.
Popular Podcasts
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
Amy Robach & T.J. Holmes present: Aubrey O’Day, Covering the Diddy Trial
Introducing… Aubrey O’Day Diddy’s former protege, television personality, platinum selling music artist, Danity Kane alum Aubrey O’Day joins veteran journalists Amy Robach and TJ Holmes to provide a unique perspective on the trial that has captivated the attention of the nation. Join them throughout the trial as they discuss, debate, and dissect every detail, every aspect of the proceedings. Aubrey will offer her opinions and expertise, as only she is qualified to do given her first-hand knowledge. From her days on Making the Band, as she emerged as the breakout star, the truth of the situation would be the opposite of the glitz and glamour. Listen throughout every minute of the trial, for this exclusive coverage. Amy Robach and TJ Holmes present Aubrey O’Day, Covering the Diddy Trial, an iHeartRadio podcast.
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.