تعاني البلاد ارتفاعاً في الوفيات الناتجة عن تعاطي مواد مخدرة
اندبندنت عربية / أليكس ماثيوز كينغ
في إنكلترا، انخفض عدد المراكز التي يدخلها مدمنو المخدرات والكحول بهدف إعادة تأهيلهم، بمقدار الثلث في السنوات الست الأخيرة، وفقاً لتحليل حديث يكشف تبعات سياسة التقشف وخفض الإنفاق الحكومي، في وقت ارتفعت فيه الوفيات الناتجة عن تعاطي المخدرات.
سجل 195 مركزاً لإعادة التأهيل وإزالة السموم لدى “لجنة جودة الرعاية” في إنكلترا في 2013، ولكن في 2019 انخفض العدد إلى 132 مركزاً نشطاً.
في العادة، تدير مراكز التأهيل مؤسّسات خيرية أو شركات خاصة، إلا أن كثيراً منها يعتمد على المجالس البلدية لتغطية نفقات دخول أشخاص يعانون مشاكل الإدمان.
استناداً إلى ذلك، حذّر الخبراء من أن خفض ميزانيات ذلك النوع من المراكز العلاجية يفرض على المجالس المحلية مزيداً من الأشخاص إلى مراكز إعادة التأهيل المجتمعي لأنها أقل تكلفة، وتشمل مراكز الرعاية النهارية وجلسات العلاج الجماعي.
وفي حين أن الخدمات المجتمعية يمكن أن توفر الدعم للبعض، يشير مقدمو العلاج والأشخاص الذين استفادوا من العلاج مع الإقامة داخل مراكز متخصصة، إلى أن الأخير لا يزال جزءاً أساسيّاً من التحرّر من قبضة الإدمان، ويمكن أن يكون “منقذاً للحياة”.
وفي حديث إلى “الإندبندنت”، سرد بيتر كريكانت (42 عاماً) تجربته مع الادمان مشيراً إلى إنه “ينظر إلى رحلة الشفاء التي قطعها، ويرى أنها ما كانت لترى النور لو طُلب إليه الخضوع لعملية إزالة السموم وإعادة التأهيل في المجتمع، وليس مع الإقامة في مراكز متخصصة”.
في مطلع الألفية الثالثة، بقي كريكانت بلا مأوى ثلاث سنوات بعد انتقاله من اسكتلندا إلى برمنغهام البريطانية. كان يتلقى وصفة طبية تتضمن مادتي “ميثادون” و”بنزوديازيبين”، لكنه استمر في تعاطي “كميات كبيرة من الهيروين والكوكايين”. وتحسّنت حالته بفضل منحة من فريق داعم للمشردين في شوارع المدينة موّلت مسكناً في “مركز الأميرة ديانا لعلاج المخدرات والكحول” الذي أغلق منذ ذلك الحين.
أضاف كريكانت إنّه “من غير المقبول خفض خدمات العلاج السكني الآن… وحاضراً، يطلب من المدمنين التمتع بمواصفات كثيرة، وإذا كنت منخرطاً في تعاطي المخدرات والجريمة، ومشرداً، فمن الصعب الوصول إلى الخدمات الحكومية كي تحظى بالعلاج في مراكز التأهيل”.
ووفق كلمات كريكانت، “يشكِّل ذلك الأمر مصدر قلق بالنسبة لي”، مشيراً إلى أن إعادة التأهيل مع الإقامة داخل مركز متخصص، تشكّل فرصة لتقديم المشورة إلى جانب علاج الإدمان، ويستفيد من ذلك الأشخاص الذين لديهم تجارب مؤلمة أدت إلى تعاطي المخدرات، أو نتجت عن ذلك.
“نحن سطحيون في طريقة تعاملنا مع المدمنين على المخدرات والكحول. عندما لا نقدِّم لهم المكان والوقت اللازمين للشفاء فإننا لا نمنحهم الفرصة للتغيّر والتخلص من الإدمان”، بحسب كريكانت.
ولم ينه حديثه من دون أن يعبّر كريكانت عن سخطه مما آلت إليه الأمور. إذ ذكر أن “استمراره في العلاج تكلّف أموالاً كثيرة، ولكنني منذ سنوات عدة صرت أدفع الضرائب التي تموّل تلك المراكز”.
على صعيد متصل، يأتي خفض مساكن التأهيل في وقت تكافح المجالس البلدية في إنكلترا للحفاظ على خدماتها في مواجهة التخفيضات الحكومية المتأرجحة.
وفي المقابل، سجلت الوفيات الناتجة عن المخدرات أرقاماً قياسية متوالية في إنكلترا وويلز، خلال السنوات الأربع الماضية. ويعزى ذلك إلى ارتفاع نسبة تناول المسكنات الأفيونية القوية مثل الفنتانيل، مع وجود جيل يتقدّم في السن فيما يتعاطى الهيروين مدى الحياة.
على الرغم من ذلك، انخفض الإنفاق على خدمات إعادة التأهيل السكنية والتخلص من السموم، فضلاً عن خطط إعادة التأهيل المجتمعي، بما يصل إلى 135 مليون جنيه إسترليني، وفقاً لتحليل تناول إنفاق البلديات على إعادة التأهيل تولّته “مراكز علاج الإدمان في المملكة المتحدة” غير الحكومية.
ونتيجة لذلك، صارت المجالس البلدية أقل رغبة في فتح أبواب مراكز العلاج مع الإقامة أمام المدمنين، ما يعني أن الأخيرة قد تُضطر إلى الإغلاق. وأظهر تحليل “مراكز علاج الإدمان في المملكة المتحدة” أن خدمات إعادة التأهيل داخل مراكز إقامة، انخفضت من 42 إلى 18 في لندن، بينما في الشمال الشرقي ما زال مركز من بين ستة مراكز أنشئت في 2013 محتفظاً بقدرته على العمل.
وفي نموذج معبّر، توقّف مركز “برود ريتش هاوس” في مدينة بليموث عن العمل في يوليو (حزيران) الحالي بعد أن عمل حوالى 40 عاماً في إعادة تأهيل مرضى في أنحاء المملكة المتحدة.
“المفارقة في هذا المأزق أن المراكز امتلأت ولم تعد تستوعب مزيداً من المرضى، لكن الطلب على خدماتنا في الأشهر الأخيرة بات أكبر من أي وقت مضى”، وفق كلمات وضعها ذلك المركز الخيري على “فيسبوك”.
من ناحية اخرى، ذكر مايك باتينسون، المدير التنفيذي في “تشينج. غرو. ليف” Change Grow Live، أحد أكبر مراكز العلاج من المخدرات وإعادة تأهيل المدمنين في إنكلترا، إن المراكز المستقلة استمرت في أداء “دور أساسي” في العلاج.
“نشعر بالأسف تجاه الإغلاق المستمر والقاسي لتلك الخدمات مع كون “برودريتش هاوس” و”سيتي رودز” في لندن من المراكز التي أقفلت أبوابها أخيراً”، بحسب باتينسون.
وأعرب عن قناعته بأنه على الرغم من كون “العلاج السكني مكلف أكثر من إعادة التأهيل في المجتمع، فإنه في بعض الحالات يُشكل الوسيلة الناجعة وبإمكانه إنقاذ الأرواح”.
ويرى باتينسون أن خفض خدمات التأهيل ونقل مسؤولية علاج الإدمان على المخدرات (وغيره من خدمات الصحة العامة) من يد المؤسسات الحكومية إلى أيدي السلطات المحلية، تركا تأثيراً شديداً في مراكز إعادة التأهيل. وبمجرد إغلاق المساكن ذات الخبرة المرتبطة بخدمات إعادة التأهيل يمكن أن تنتهي الأخيرة إلى الأبد.
في سياق متصل، ذكرت نيامه إيستوود من مؤسسة “تشارتي ريليس” التي تدعم معالجة المدمنين وليس محاكمتهم جنائياً حفاظاً على الصحة العامة، إنه “بالنظر إلى أزمة الوفيات المرتبطة بالمخدرات في البلد، فإن الأرقام بشأن خفض خدمات العلاج في مراكز العلاج مع الإقامة، تولد صدمة قصوى”.
في المقابل، حذرت ايستوود من أن الخدمات المجتمعية خُفضت بشكل كبير أيضاً، إلى درجة أن البعض كان يكافح من أجل توفير وصفة طبية للـ”ميثادون” الذي يشكّل بديلاً علاجيّاً يسهم في خفض الوفيات الناجمة عن تناول جرعة زائدة من الهيروين.
وعلى نحو مشابه، أفاد المستشار إيان هدسبث، رئيس مجلس الرعاية الاجتماعية في “رابطة الحكومات المحلية”، إنه “في العام الماضي، أنفقت السلطات المحلية أكثر من 700 مليون جنيه إسترليني على معالجة إساءة استخدام المواد المخدرة… ومع ذلك، ثمة عواقب تنتج من التخفيضات التي تجريها الحكومة المركزية في المنح المخصصة إلى المجالس المحلية من أجل الصحة العامة. دافعنا عن فكرة أن خفض أموال الصحة العامة المخصصة للمجالس، التي تُستخدم لدفع تكاليف خدمات الوقاية والعلاج من المخدرات والكحول، يشكل توفيراً مالياً خاطئاً ولن يؤدي لسوى مفاقمة الضغوط الحادة على تطلّب العدالة الجنائية وخدمات “هيئة الخدمات الصحة الوطنية”.
وبحسب هدسبث، “ليس خياراً جيّداً أن تسند إلى المجالس مهمة تحصيل الفاتورة من أجل معالجة أعداد جديدة ومتزايدة من المدمنين مع وجود موارد أقل”.
وكذلك أوضح متحدث باسم وزارة الصحة والرعاية الاجتماعية إن “تعاطي المخدرات في المملكة المتحدة انخفض عما كان عليه قبل عقد مضى، مع إتمام عدد أكبر من البالغين العلاج بنجاح، بينما انخفض استهلاك الكحول عموماً”.
ولفت إلى وجود “خطة طويلة الأجل تنهض بها “هيئة الخدمات الصحية الوطنية”، تتضمن نشر فرق لرعاية مدمني الكحول في المستشفيات التي تضم أكبر عدد من حالات الدخول المتعلقة بالكحول، وكذلك تقديم 3.5 مليارات جنيه إسترليني إلى المجالس البلدية هذا العام لتمويل خدمات الصحة العامة، من بينها الإدمان”.
© The Independent
المزيد عن: إدمانعلاج/رعاية صحية/افيون/ميثادون
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