‘Reflections’ by Ann Finlay

I acknowledge the Traditional owners of the land on which we are gathered, the Ngunnawal people and I pay my respects to their elders, past and present.

I also acknowledge those who have died and who we remember today and offer my condolences to those who loved them, particularly the newly bereaved.

Thank you to the Family and Friends for Drug Law Reform for inviting me to speak today about my experience. My story will be similar to many peoples’ stories here today.

We were a fairly ordinary family who had many difficult experiences but no major trials or tribulations, until Paul’s mental health deteriorated and his descent into escaping his struggles by self-medication began. From then on uncertainty and at times chaos roamed our family life up until Paul’s death in 2010.

But in the midst of all of this we remained pretty strong and close, we still had fun and most of all we had hope. We hoped that with our support, Paul would recover, that he would be OK. I thought if we could keep him safe until he reached the magic age of 25 that he would come good. But that wasn’t to be, he died of an overdose not long after his 21st birthday. Upon reflection I wondered, were we the ordinary family I had thought we were? I fossicked through the family files and history trying to find a reason why. Why Paul could not see the goodness in himself or recognise his worth, why he struggled so much with his mental health and life and why he wanted to escape it so badly. Was it because of all the change in our lives and the absence of his father? Was it genetics or just bad luck? Was it all of the above?

Paul came into this world on the 30th of September 1988, he was overdue by almost two weeks. It was a traumatic birth, the umbilical cord was wrapped three times, tightly around his neck, asphyxiating him. Paul was rushed away from me and I could hear the staff trying to get him to breathe. Waiting for his first cry was the longest few minutes of my life. Despite this traumatic start to life, Paul was healthy, weighing in at 8 pounds 12 ounces and thrived throughout his early years. He was a sensitive, quirky, shy kid, who thought deeply and took things to heart. He had some unusual interests as child, such as cello, archery and architecture, but also the usual things kids love, Lego, dinosaurs and books.

In adolescence Paul struggled emotionally, he had good support from his high school, but he was becoming isolated, he didn’t have the friends around him that he had had at primary school. Something happened for Paul around that time that caused him to retreat and favour isolation, his self-worth was low and anxiety became a constant shadow. Even so, as soon as he was old enough, he managed to get employment in hospitality, he made new friends and had the money to indulge his passions of music and fashion. Things were going well.

When Paul was about 16, after jobs and friendships changed again I realised he had begun to use alcohol to escape difficult things in his life. This was the start of my concerns for his mental and physical wellbeing. It was hard to understand why he struggled but we supported him as best we could along with his high school where a flexible education program was developed for Paul.

Paul’s alcohol use became more problematic, his safety and reputation were at risk, and it was impacting on all aspects of his life. Paul entered the Ted Noff’s program here in Canberra, where he learned about harm minimisation. After leaving Ted Noff’s he started a retail apprenticeship which he really enjoyed. About 9 months into this job he was approached by a different company to work at a higher level. I tried to persuade him to stick with the apprenticeship and finish it, but Paul did not want to pass up the opportunity for his career and to earn more money. Along with this promotion came the stress of the major responsibilities of the job, which was way too much for an inexperienced adolescent. Paul’s anxiety became a major problem, and he started taking over the counter medications to try and help him sleep. Around this time Paul was diagnosed with, depression, anxiety and social phobia and was prescribed several different kinds of anti-anxiety medications. Alcohol was no longer an issue for him, the use of medications to relieve anxiety and stress had taken over.

In 2007 Paul had his first psychotic episode and was admitted to Calvary 2N and from there was transferred to The Canberra Hospital Psychiatric ward, he was discharged soon after with no follow up plan in place. Later that year he spent almost three weeks in 2N after an overdose, and was discharged home on multiple medications including, benzodiazepines, anti-psychotics and anti-depressants, with a plan to wait for a rehab place in NSW. While waiting for a place, Paul was heavily sedated at home, his mood was low and the effect of the medications left him very unmotivated. Paul entered the NSW rehab but left after 2 weeks, he said he felt completely out of his depth, vulnerable, isolated and unsafe there. After this, Paul tried his best to remain well, he found work, however his anxiety and low mood meant his medications were increased but he also self-medicated, leading to more overdoses.

Mid 2008, Paul entered detox and then rehab in Canberra, he left that program after 2 weeks, overdosed within days and once again was admitted to the psychiatric ward. When I questioned staff about Paul’s sedated presentation on the ward and the increasing the amount of medications prescribed, I was told he needed them and that this was normal. Again, he was discharged on multiple medications and without a solid discharge plan.

Over the last two years of his life, Paul had periods where he did not use drugs. There were times when he used illegal drugs but mainly he overused the medications prescribed for his mental and physical health. Unfortunately, several things happened around that time that led to more shame and guilt for Paul, which then set off a vicious cycle of substance use and attempts at trying to stop using. Paul was living at home at different periods throughout this time when he was not using drugs and understood why he could not stay if he was using.

It seemed Paul had turned a corner, he was working in hospitality and was home every day. Things were going well. Just before his 21st birthday, he was badly burned in an accident at home. Paul was airlifted to Concord Hospital Burns Unit from the Canberra Hospital and was prescribed very much needed pain relief, he was conscious of his previous vulnerabilities with these medications and worried about getting back into that cycle, but what can be done when a person needs medications for pain?

After 3 weeks, Paul was discharged from Concord on several pain medications, he was dealing with physical, emotional and psychological pain and was diagnosed with PTSD. Paul was OK at home for the first few weeks but then he started struggling again, he was becoming heavily sedated from overuse of his medications. We desperately tried to find a detox and rehab but because of the medications he was on, were unsuccessful.

Paul had a number of overdoses and admissions to hospital in the months before he finally managed to get into detox and rehab. Paul had been drug free for about six weeks when he was asked to leave the rehab facility. Again his life spiralled out of control. We tried to keep him safe, but due to his escalating substance use, overdoses and mental health crises, he was unable to live at home and it was impossible to find adequate or appropriate supports. He had exhausted all options that were available at the time. Paul was trying to get support up until the day he died. But his request for detox fell on deaf and dismissive ears and he was allowed to leave the hospital, straight to another overdose and death.

Over those years, I warned GPs, pharmacists and other health service providers that he was in a dangerous position, but I wasn’t taken seriously. It is a very lonely and isolating place to be, I constantly questioned my view on Paul’s condition – was I biased? Was it because I was his mother? Why was I the only person to see that there was a problem? It felt like no one cared or understood how perilous the situation was. It is devastating to feel so powerless, seeing your child struggling with substance use and other mental health issues and not being able to find community supports for help. It is traumatising and exhausting for families and carers in situations such as this. I still try to understand what happened, how it came to this…Paul dead from an overdose…

The fact is now I will never know why things went so terribly wrong for Paul, why he needed to escape his life and himself by self-medicating. But I do know things could have been different. We as a family tried all we could do to help him, he loved us and we loved him, but he needed more than that, he needed community supports, he needed not to have access to such lethal doses of medications but most of all he needed timely and appropriate MH and AOD supports.

If there had been a real-time monitoring system in place and enough appropriate health services his life could have been saved. If Paul had been shown care and understanding instead of being judged, stigmatised and dismissed then he could still be alive today.

Those of you who have lost a child will know that there is very little solace to be found in those early days. Among other things, what kept me going was the knowledge that Paul’s death could have been prevented and that needed to be addressed. I knew that his experience was not unique, people continued to die in similar circumstances. I needed to ensure that his death was not just going to be forgotten and dismissed just as he was dismissed and forgotten about in life, by a system that didn’t take him seriously.

I did not want Paul to be just another statistic. I knew I had to act and so the letter writing started and the meetings with coroners, health officials and politicians began.

I never thought I would still be advocating and lobbying for change almost nine years after Paul’s death. I really wish I didn’t have to but it is important to do so because until real time monitoring is implemented nationally, until adequate health services are available, nothing will change, we will continue to see deaths from overdose, we will continue to hear families telling the same stories, and coroners will continue to recommend the same things over and over again.

Substance use is a major health issue, no-one is immune. Addressing this issue by – drug law reform, recognising substance use as health issue rather than a criminal justice issue, prioritising and implementing adequate support services, and addressing our punitive culture of stigma and judgement – will help halt the rising death toll.

Paul is gone from this world. Nothing can change that fact. We miss everything about Paul, his blue blue eyes, his smile, his deep melodious voice, his creativity – particularly his music, the sounds of his cello and violin playing throughout our home, the waft his Dior aftershave, his tricky, quirky ways, his sense of style and most of all just him, a young man who was generous, fun and kind.