Frequently asked questions

[mcdermott]

Frequently asked questions about The Alliance, Advocacy, this forum, etc.

Q. I've been trying to get through to someone on the Alliance Helpline but there's never anybody there. What's going on!

A. We're very sorry about your experience. If this happens to you, you have two options. You can either leave a message on our answering system, or you can try and call back.

The way the system works is that if someone calls while we're already taking a call, that call will be diverted to the answer machine. Unfortunately, we have a tendency to forget to check the answer machine if we've been doing the helpline, so the chances are that someone might not hear your message until the following day. But if you've waited longer than that without hearing back from us, please give us a call back.

Q. That's just not good enough. You need to be more responsive to the needs of your client group.

A. We'd really like to be more responsive. However, we're a very small organization, and most of our staff work part time. Although we all take turns on the helpline, at the moment, there are only two people working on national advocacy cases. One full-time staff member who has other responsibilities, and one part time staff member. Some times, they get really busy and might get a little bogged down, but they *will* get back to you. Until then, we're genuinely sorry you've had to wait.

Q. Still not good enough. I've got a problem that needs sorting out right now! Do you realize how important this issue is to me?

A. Yes, we do realize how important your problem is. Most of us have either been in treatment ourselves, or have had a family member in the same situation. We know the way that a bad decision by your treatment provider can completely screw up your life.

However, even if you did manage to catch us immediately, it's very rare that we can solve your problem immediately. For a start, your doctor/keyworker/clinic isn't going to even talk to us until they've had a copy of your consent form. So we need to get some copies of the consent form out to you -- usually at least three: one for you, one for us, one for the treatment provider. Then, we have you sign them and return them to us. Then, we need to send them out to the treatment provider. It's rare for this process to be completed in less than a week, so if you have got a problem that requires advocacy, we'd suggest that you get in touch with us before the final crunch happens and your meds get stopped. Because it's always going to take a little time to get it restarted, even if the clinic is the most helpful and sympathetic clinic out three and they completely accept that they're in the wrong.

Q. The Alliance are rubbish. I had a problem with my clinic, and they were neither use nor ornament.

A. I'm sorry that you had a bad experience. While we always strive to provide our clients with the best possible advocacy service that we can, we aren't always able to get them everything that they want. Sometimes, we can't actually get them anything that they want. There are a number of reasons why this can happen:

- Sometimes, the thing that the client wants is just not achievable. If you've punched a staff member -- sometimes even just threatened a staff member, and that service has a policy of Zero Tolerance and there's no other services in your DAT area, there might not be anything that we can do.
- Sometimes, the people that we're negotiating with simply won't budge. Most of the issues that we have can be resolved with a few quick phone calls. However, there are still services out there where the staff don't like the clients that they work with, and they like us at The Alliance even less. Such services tend to be very inflexible, and I suspect that the outcomes they get are similarly poor. They try to blame everyone for their poor outcomes than themselves. When we meet such a service, we can complain until we're blue in the face, but it doesn't necessarily get us anywhere.
- Sometimes, policies change. And so something that was doable in the past, might not be doable in the present.

Our usual approach to advocacy is to try and avoid worrying about what has happened in the past. Getting into long arguments about what he said, and then whaty she said aren't usually productive and can often get in the way. Generally, we're trying to focus on what's going to happen from this point on -- how we can take this case forward, and reach some sort of agreement between the client and the provider. Both sides need to be flexible in this process, but both sides have an interest in seeing the client achieve the best possible outcome, and so its not surprising that most services are happy to work with us when we take this kind of productive, blame free approach to getting the problem solved.

Q. Can you get me a diamorphine script.

A. We can't even get *ourselves* diamorphine scripts. What makes you think we could get one for you?

Seriously, the new guidelines recognize that there is a place for diamorphine and injectables, but its seen as a very limited place. If you've been on this kind of script for a long period, and are doing well on it, chances are that you'll be left alone. If you can get a place on one of the limted number of research projects, you might be able to get one -- but these are time limited and random controlled trials, so you *might* end up on a methadone script anyway.

If you've got some sort of really exceptional circumstances, we might be prepared to advocate for this for you, but 'I've been using for twenty years and the methadone just doesn't suit me' doesn't fall into that category. And there are people we've advocated for who did have exceptional circumstances, where we were able to get numerous second opinions saying that this patient would benefit from diamorphine -- but three years down the line, they still aren't on a diamorphine script. Do yourself a favour and forget about it. Move on.

Q. The person that I spoke to on the helpline say they could do X for me. Now, my advocate tells me he can't do what I was promised.

A. You've probably misunderstood wht the person on the helpline actually said. While we try and be as clear as possible, sometimes, people mistake our sympathy for some sort of commitment or promise. The advocate on the helpline should just be taking down your details and telling you how the process works. While we'll always try our hardest to put forward a client's case, sometimes what they want just isn't achievable, so we try not to make promises we don't know whether we can keep or not. But it's the job of the advocate that's been allocated to handle the case to tell you what he can or can't do for you. After all, they're the person who has to do the work, so they are in the best position to know what can or can't be done.

[tpvalley]

hw do I write a new post
I cant see the option anywhere

[Mark R.]

Frequently asked questions about The Alliance, Advocacy, this forum, etc.

Q. I've been trying to get through to someone on the Alliance Helpline but there's never anybody there. What's going on!

A. We're very sorry about your experience. If this happens to you, you have two options. You can either leave a message on our answering system, or you can try and call back.

The way the system works is that if someone calls while we're already taking a call, that call will be diverted to the answer machine. Unfortunately, we have a tendency to forget to check the answer machine if we've been doing the helpline, so the chances are that someone might not hear your message until the following day. But if you've waited longer than that without hearing back from us, please give us a call back.

Q. That's just not good enough. You need to be more responsive to the needs of your client group.

A. We'd really like to be more responsive. However, we're a very small organization, and most of our staff work part time. Although we all take turns on the helpline, at the moment, there are only two people working on national advocacy cases. One full-time staff member who has other responsibilities, and one part time staff member. Some times, they get really busy and might get a little bogged down, but they *will* get back to you. Until then, we're genuinely sorry you've had to wait.

Q. Still not good enough. I've got a problem that needs sorting out right now! Do you realize how important this issue is to me?

A. Yes, we do realize how important your problem is. Most of us have either been in treatment ourselves, or have had a family member in the same situation. We know the way that a bad decision by your treatment provider can completely screw up your life.

However, even if you did manage to catch us immediately, it's very rare that we can solve your problem immediately. For a start, your doctor/keyworker/clinic isn't going to even talk to us until they've had a copy of your consent form. So we need to get some copies of the consent form out to you -- usually at least three: one for you, one for us, one for the treatment provider. Then, we have you sign them and return them to us. Then, we need to send them out to the treatment provider. It's rare for this process to be completed in less than a week, so if you have got a problem that requires advocacy, we'd suggest that you get in touch with us before the final crunch happens and your meds get stopped. Because it's always going to take a little time to get it restarted, even if the clinic is the most helpful and sympathetic clinic out three and they completely accept that they're in the wrong.

Q. The Alliance are rubbish. I had a problem with my clinic, and they were neither use nor ornament.

A. I'm sorry that you had a bad experience. While we always strive to provide our clients with the best possible advocacy service that we can, we aren't always able to get them everything that they want. Sometimes, we can't actually get them anything that they want. There are a number of reasons why this can happen:

- Sometimes, the thing that the client wants is just not achievable. If you've punched a staff member -- sometimes even just threatened a staff member, and that service has a policy of Zero Tolerance and there's no other services in your DAT area, there might not be anything that we can do.
- Sometimes, the people that we're negotiating with simply won't budge. Most of the issues that we have can be resolved with a few quick phone calls. However, there are still services out there where the staff don't like the clients that they work with, and they like us at The Alliance even less. Such services tend to be very inflexible, and I suspect that the outcomes they get are similarly poor. They try to blame everyone for their poor outcomes than themselves. When we meet such a service, we can complain until we're blue in the face, but it doesn't necessarily get us anywhere.
- Sometimes, policies change. And so something that was doable in the past, might not be doable in the present.

Our usual approach to advocacy is to try and avoid worrying about what has happened in the past. Getting into long arguments about what he said, and then whaty she said aren't usually productive and can often get in the way. Generally, we're trying to focus on what's going to happen from this point on -- how we can take this case forward, and reach some sort of agreement between the client and the provider. Both sides need to be flexible in this process, but both sides have an interest in seeing the client achieve the best possible outcome, and so its not surprising that most services are happy to work with us when we take this kind of productive, blame free approach to getting the problem solved.

Q. Can you get me a diamorphine script.

A. We can't even get *ourselves* diamorphine scripts. What makes you think we could get one for you?

Seriously, the new guidelines recognize that there is a place for diamorphine and injectables, but its seen as a very limited place. If you've been on this kind of script for a long period, and are doing well on it, chances are that you'll be left alone. If you can get a place on one of the limted number of research projects, you might be able to get one -- but these are time limited and random controlled trials, so you *might* end up on a methadone script anyway.

If you've got some sort of really exceptional circumstances, we might be prepared to advocate for this for you, but 'I've been using for twenty years and the methadone just doesn't suit me' doesn't fall into that category. And there are people we've advocated for who did have exceptional circumstances, where we were able to get numerous second opinions saying that this patient would benefit from diamorphine -- but three years down the line, they still aren't on a diamorphine script. Do yourself a favour and forget about it. Move on.

Q. The person that I spoke to on the helpline say they could do X for me. Now, my advocate tells me he can't do what I was promised.

A. You've probably misunderstood wht the person on the helpline actually said. While we try and be as clear as possible, sometimes, people mistake our sympathy for some sort of commitment or promise. The advocate on the helpline should just be taking down your details and telling you how the process works. While we'll always try our hardest to put forward a client's case, sometimes what they want just isn't achievable, so we try not to make promises we don't know whether we can keep or not. But it's the job of the advocate that's been allocated to handle the case to tell you what he can or can't do for you. After all, they're the person who has to do the work, so they are in the best position to know what can or can't be done.

[wastedyouth]

I didn't know where to put this but at the top where it tells you who's on the forum there was (1 hidden) person what is this and who could it be, why would they be hidding i dont understand

[Ursula]

Basically, if you're a forum member you can choose to hide your identity while browsing threads.  It's one of the settings options for your personal profile.  It's nothing sinister, just a matter of personal choice.