When there is a change of government there are always ramifications in the health sector - some obvious and immediate, some evolving over time. People who were watching the campaign may have noticed a commitment to reinvest in Medicare ($1B promised), and to put significant energy into making the NDIS more efficient and impactful.

Less obvious is Anthony Albanese’s long-standing commitment to viewing addiction and substance use primarily as a health problem, rather than a matter for law enforcement. This would not seem a radical perspective for our community, but it is a rare and welcome attitude from the highest office in Australia, which we hope will lead to a more compassionate attitude across the country to people living with addiction.

I want to thank everyone who donated to our Harm Reduction Campaign. We raised over $35,000 which means we can continue supporting the most vulnerable people in our community throughout their recovery journey.

Now, as we approach the end of financial year, it is your last chance to reduce your taxable income by donating before June 30th.

For a grassroots organisation like First Step, tax-deductible donations are essential to our continued existence. We need your help so that the people we support can get all the help they want and need from one team in one place.

Patrick Lawrence Chief Executive Officer

Are illicit drugs bad? Thought Leadership Event

In late May, we hosted our Thought Leadership Event to explore the topic: ‘Drugs saved my life’ – are illicit drugs bad?

It was an insightful, inspiring, galvanising event with an extraordinary panel offering perspective, delving deep into their own lived experiences and answering tricky questions. All of this, overlaid with intense passion and compassion.

Dr Alex Wodak, Australia’s leader in harm reduction and addiction treatment reminded us to ‘put the patient in charge’ and provided a potted history of the racial motivations behind prohibition. Baden Hicks, lived-experience peer worker and advocate for change, emphasised the impact of kindness in his recovery. Dr Gyu Lee shared insights from so many corners (academic, clinical, personal, coal-face) and told us that recovery was by far the hardest thing he’s ever done - harder than multiple medical degrees. And Dr Shalini Arunogiri brought research alive, challenging some of our compassionate, but rusty ideas, encouraging us to believe that trauma-focussed care doesn’t have to wait for recovery.

You can watch a recording of the event:

Perhaps the quote of the night was from Dr Wodak: ‘A network is great. But a movement is even better.’ We curated Monday night’s conversation because human beings only make real progress when we get in a room together and nut it out. We need to keep having these conversations, we need to be clear on what we are asking of our leaders, and we need to continue to refuel our compassionate hearts.

Photos from the night are available on our Facebook page. 

Thomas Ponissi - First Step Legal

I’m in my fourth year of Law and Global Studies at Monash Uni, specialising in human rights.

But that’s not what I thought I was going to do when I was a teenager – I wanted to be a film director! My first year out of high school, I studied media and hated it.

It was a discouraging time to be young and progressive, because everywhere I looked, I felt like I saw systems or structures going in the opposite direction. I really struggled to see where I fit; I became lost and fell into a depressive slump. I ended up dropping out of Uni and spending a lot of time evaluating what I needed to do to have a sense of purpose again, to feel that it was worth getting out of bed. I had to reconfigure how I understood success and value.

I have always been passionate about equality. As a queer person, I have lived experience of prejudice; at the same time, I am mindful that I come from a place of privilege in many other ways. Coming to terms with this tension made me interested in understanding how I could work collaboratively towards challenging some of these problems. I didn't want to just talk about things on the sidelines; I wanted to actually get in and contribute, to be of service in some capacity.

Practicing law is itself a performance; when done right, it can radically improve someone’s life.

I started as a volunteer paralegal with First Step Legal last year, and this March moved into a paid role as Legal Administrator. I triage all the new First Step Legal clients, work with our lawyers and clinicians, and manage the volunteers.

Because I started as a volunteer first, I have some unique insights to support new volunteers. I try to encourage them to have good boundaries, to recognise and accept the limits of their resilience and their capacity to empathise. In this work, it’s important to accept our limits and that there are situations beyond our control. I’m trying to contribute to a workplace culture that is actively mindful of this.

I’ve always been interested in the things that I’m doing now, I just had a roundabout way of getting here. I thought that I would use the media to highlight these issues, but instead I interact with them directly.

I’m mindful of the limitations of the law, but I am also increasingly interested in criminal defence, particularly through the lens of restorative justice and therapeutic jurisprudence. This fits in with how I view the world – I think restorative practices are applicable to every area of our lives, both day to day and in the larger issues facing us: race, gender, climate. It’s about rethinking the traditional approach to health and justice and recognising that there’s so much more we could be doing.

Reorienting my life to be more values based, as opposed to outcome driven, has been incredibly helpful.

 Thomas Ponissi, First Step Legal Administrator

The Road Home Project good news story

The Road Home project sees our unique integrated team embedded in crisis accommodation 1 day per week. Working with Launch Housing East St Kilda, a First Step Legal lawyer, GP and mental Health nurse provide wrap around services to some of Melbourne’s most vulnerable women.

The project has been running for 6 months and in that 28 individual residents have made 113 appointments.

Brianna* is one of the clients who has seen practitioners across all three disciplines:

Brianna hasn't had somewhere safe to sleep for over a year. She started living in her car after her ex-partner assaulted her (again), but then the car got stolen.

Brianna comes to Launch Housing with a very long list of things that are stressing her out – she is in debt and her Centrelink payments are about to be suspended, she has outstanding legal matters and she hasn't been able to get advice about an intervention order against her ex, she hasn't been able to see a doctor in a while and she is running out of medication, and she is not sleeping and is noticing that she feels anxious all the time, has very little tolerance for others, and sometimes thinks about how much easier things would be if she just ended it all.

Through the Road Home project, Brianna is able to see a doctor for her medication and some overdue health checks, talk to a lawyer about her legal matters and see a mental health nurse who works with her on developing strategies to help her feel less anxious and manage her mental health better.

The Road Home collaboration meant Brianna’s Launch Housing case worker could refer her to receive brokerage funding which paid for new glasses. Brianna reports that these things have helped her gain confidence about what is next for her and is very appreciative of the support she has received.

* We have changed the clients name to protect her privacy

 Kym Coupe, Program Manger, The Road Home Project              

Dom Vigilanti - ResetLife

I was always interested in supporting people that were struggling, marginalized people.

I started my career with the Salvation Army in 2000 and over the next 15 years moved through many of their programs.

My first placement was at Flagstaff crisis accommodation, and that was tough for a new worker - I hit the ground running and learnt quickly! I saw that clients being released from jail had access to drugs, and it became evident that what they needed was case management to prevent drug use and a plan to support their mental health.

Over the years, I learnt that whilst drug and alcohol issues might start as a behavioural pattern, they very quickly become an illness. And then we need to deal with the illness, rather than the behaviour. When we focus just on behaviour, we’re missing the point, and that’s where judgement comes in. When we start addressing a behaviour that started 20 years ago, it’s no longer about the behaviour.

After the Salvos, I moved to Gamblers Help Eastern, managing teams who support people experiencing harm from gambling. Gambling impacts the same reward pathways that drugs and alcohol do in our brain. It’s a behavioural issue that needs community education.

And then onto Incolink, a commercial building industry organisation, where I was again in a management role and providing policy advice. We implemented an industry policy that took a supportive, rather than punitive, approach, to members who tested positive for drugs. We looked at how we could support them to keep their job, rather than completely destroying their lives by taking it away from them.

But I was missing hands on work with clients. I wanted to return to my roots. So, when the role at First Step became available as a ResetLife Primary Therapist, I thought, ‘perfect, I just want to be a clinician!’

Since starting at ResetLife, it’s been a breath of fresh air. I love the structure; I love the support that we provide to people that are committed to the program. In the past, I worked in harm minimisation - it’s a completely different mindset working with ResetLife clients who are committed to abstinence. And I love it because you can see outcomes.

Throughout my career, I thought that advocacy was where I sat best and what I wanted to do because it would have the greatest impact. But that didn’t bring me as much personal fulfilment because you don’t see the outcomes for a long, long time. With one-on-one work, you get that instant fulfillment and see that change from one week to the next. So, for me this work, this gets me going!

Dom Vigilanti  Primary Therapist ResetLife

July 2022

“Everything you think you know about addiction is wrong” – Johann Hari

So, it’s happened again. A really important public health issue in the realm of addiction is a bit complicated, aspects are being conflated, scientists disagree and we’re all terribly confused.

Let’s break it down just a little bit.

Firstly, smoking cigarettes is still the biggest single cause of disease and death in Australia - more than road accidents, alcohol, illicit drugs, overdose and suicide put together.

Approximately 24,000 people die each year in Australia from smoking related illnesses – that is a lot of avoidable human misery.

Secondly, although this is a bit simplistic the following is true:

Tobacco (used daily) is extremely harmful. Nicotine alone (used daily) is MUCH LESS harmful (UK Royal College of Physicians estimates that vaping is 5% as harmful as smoking, though this is contested.)

Thirdly, there are two quite separate issues at play:

Issue A
Vaping of nicotine is now a well-proven method of reducing harms from tobacco for people who are already addicted to cigarettes. Vaping nicotine is proven to reduce cigarette use significantly on average, often to zero. Vaping nicotine is far more effective for smoking cessation (reducing or quitting) than patches or gum, both of which are products of Big Tobacco.

There is a lot of peer-reviewed research on this, and it is being led in Australia by the Australian and New Zealand College of Psychiatrists (with First Step’s own Dr Basanth Kenchaiah heavily involved), because this is the field of addiction.

Issue B
There is concern in the community that children who would not otherwise have commenced smoking are vaping. The existence of child-friendly flavours (like berry) adds enormous credence to this perspective. It is, however, almost impossible to prove that kids are vaping who wouldn’t be smoking, and the data about trends is unclear.

Society also has a history of getting a bit hysterical about new ‘drug types’, forgetting that the old ones had great potential to harm.

I’m not saying for a second that the ‘kids are vaping who wouldn’t be smoking’ argument isn’t true, in fact I think it almost certainly IS true: it’s a question of how many people and how much harm is this creating.

The conflation of these two issues unfortunately means that there is more legislation around pure nicotine vaping than is helpful, considering its therapeutic benefits for people who smoke cigarettes.

Note:
- Anyone over 18 can buy as many cigarettes as they like from tens of thousands of locations in Australia, but
- You need a prescription to vape nicotine which is MUCH safer than cigarettes.

I’m not going to attempt to promote public policy here and now, but barriers to smokers accessing nicotine vaping products (like the need for a prescription) will slow any reduction in annual deaths, prolonging suffering in thousands of Australians and cost the system billions.

This needs a tailored response from legislators, unsullied by the influence of Big Tobacco or tax revenues from cigarettes.

Watch this space. Please.

#lifewithaddiction #firststep 

Patrick Lawrence Chief Executive Officer

26 May 2022

Addiction is the most complex area of medicine. Why? Because it involves every part of a person: their history, relationships, socio-economic life, physical health, mental health, brain physiology etc. And with the ramifications of harmful drug use, you can also add risk of death, hospitalisation, cancer, palliative care, homelessness, incarceration and more.

Like most extremely complex subjects, addiction is riddled with contradictions. At the heart of it all is the dichotomy between the universality of vulnerability (‘there, but for the grace of god’), and the predictable precursors for chronic, life-threatening addiction and mental illness.

1 in 5 Australians will suffer an episode of mental illness in any given year, whether or not it’s diagnosed and/or treated. Furthermore, the disruption and threat of COVID-19, and the isolation of lockdowns, have made us all aware that our mental health is fragile.

On the flip side, research has demonstrated the connection between Adverse Childhood Events (ACEs) and mental illness. The connections are even more shocking with ACEs and substance abuse. Some of the research from large population studies shows a terrifying exponential graph linking the incidence of ACEs to addiction in adulthood. One ACE, and you’re a few times more likely than the general population to suffer from addiction. Two ACEs, and you’re many many times more likely. Three ACEs and we start to leave the charts…

Overlay across this mental health and addiction debate the fact that many drugs (depressants like heroin, stimulants like amphetamine. and hallucinogens like LSD) are classed as illegal. Dealers in illegal drugs are classed as the worst kind of human, and drug users suffer tremendous stigma also.

The AOD sector, families and carers, and other compassionate people in society say, ‘People who use drugs are people too and good people worthy of your respect and support. They are mums and dads and sisters and brothers and sons and daughters.’

But this message hits up against the stigmatising, usually unspoken question “If they’re good people why don’t they see what their drug use is doing to themselves and others, get their act together and stop?” Then we get in to a back and forth on that issue, discussing trauma and disadvantage.

But what if we flip this and listen to the words of people who use illicit drugs? To the mums and dads and sisters and brothers. It’s strange when you first hear it, but many of them will tell you, ‘I want to stop using. It’s killing me. I’m full of shame. I want to change. But actually, drugs saved my life.’

Vilified, criminalised, stigmatised, dangerous, unpredictable, unidentifiable, illegal drugs saved their life? How can they have a health benefit?

When I see people behave in a way I can’t understand, I ask myself, ‘What would be worse than that? What would be worse for that person than, for example, injecting heroin?’

The answer is suicide.

Many young people, disproportionately those who have survived childhood abuse and neglect, are in so much pain that they want to die. As a society, we are coming to grips with the impact of child sexual abuse, universally regarded as the worst of the ACEs. There are classroom photos of boys from religious schools in regional Victorian where every third boy has taken his own life. What if it turns out that drugs like heroin, might provide relief from extreme existential pain? Yes, this is dangerous. But also life-saving.

Adult survivors of child sexual abuse – that’s practically every second client at First Step. Sometimes I tell people, ‘I work for an organisation that supports adult survivors of childhood sexual abuse.’ I don’t mean to belabour this one particular form of harm, and it is certainly not universal in our client population, however, because it creates a visceral response of despair and anger when we are forced to think about, it’s a theme that can help us see the truth: illicit drugs sometimes save lives.

If we accept that this is true, then where do we go from here?

Well, as civil servants, politicians, health sector workers, philanthropists and voters we support the design of a service system that goes past the question of ‘Why the drug use?’ to ‘Why the pain?’. We seek to understand ACEs and prepare for complexity and co-occurring needs in the people who seek support for addiction. We create an environment of treatment and support that is non-judgemental, patient, strength-based and trauma-informed. We provide welcome, empathy and hope all day, every day. We provide all the help people want and need from one integrated team in one place. And we resource and continue to develop that ecosystem.

To call drug use a ‘choice’ is a gross oversimplification. People with a lived experience of chronic addiction tell us that for them it was a choice between the temporary oblivion of drugs and real, permanent oblivion. We can’t really call that a choice, can we?

If there is a choice to be made, it’s ours. It’s up to us as to how we will think of, interact with, and treat people who are living with addiction. Will we judge? Will we heap scorn? Will we think we know the answers? Will we look the other way? Or will we listen?

#lifewithaddiction #firststep 

Patrick Lawrence Chief Executive Officer

As the federal election looms, it is a good time to take stock of what we care most about. Yes, our families of course. But as we extend the circle of care outwards, where do we put our efforts, our passions, our vote, our resources? What movements for change do we admire from afar, and which do we want to be part of?

First Step is part of a global movement for compassionate support of people who use illicit drugs, not least of all the many who are adult survivors of childhood abuse. Don’t hesitate to be part of this conversation across our social media channels.

Our renowned multidisciplinary team is funded from a number of sources including Medicare, Victorian Government (Department of Justice) and Federal Government (Primary Health Network).
None of these funding pools allow for sufficient overheads to cover the true cost of helping people – the communication, the teamwork and the patient planning needed; none of them fund the ‘glue’ that holds it all together – the Operations Manager or the Reception team; and there is certainly no funding for advocacy to government or to reduce stigma.

Whilst we advocate to government for adequate funding of programs, we continue to rely on our community to support our work.

This week, we are launching our Harm Reduction campaign. With the generosity of Wheelton Philanthropy, every donation made before May 7th will be matched dollar for dollar, up to $20,000.

Please enjoy the stories and perspectives we bring you in our Autumn Newsletter.

Our best wishes to you all.

Patrick Lawrence Chief Executive Officer

Helping lawyers just be lawyers

The First Step Legal (FSL) team recognised that some of our most vulnerable clients who needed case management support, didn’t fit the eligibility parameters of existing programs of our Health Justice partners. This meant that the client simply was not able to receive the support they needed, or our lawyers would try to be all things to all people.

And what FSL needed, was for someone to support our clients while they navigated the resolution of their legal matter.

With the support of the Collier Charitable Trust and other funders including Igniting Change, I was appointed as a Social Worker in the FSL team in October 2021.

When I started, my role was to build a bridge between legal and non-legal services. This has now evolved to include intensive care coordination, information and referral support, developing long term plans, and incidental counselling.

What I find most rewarding about my role, is being able to identify gaps in the system, or in services, and work out how we can better support clients, how we can advocate for them, and how we can elevate their voice.

That is the core of Social Work for me – social justice and empowerment, working alongside clients and looking at the broader systems for social justice.

And that is what drew me to First Step Legal. The team are so passionate about getting the best outcomes for our clients, and equally as passionate about what we learn from working with them that can inform policy change. Otherwise, we are just putting a band-aid on individual clients, rather than addressing underlying issues.

Working as part of a Health Justice Partnership, we focus on all aspects of a client’s life – we want to understand what else is going on that contributes to the offending or the legal matters.

My legal literacy has grown exponentially! And our lawyers can now focus on being lawyers, rather than also trying to be an advocate, support worker, and source of information and referral.

It also means that our clients have another therapeutic person to support them through the legal process, through court hearings, and to translate legal terminology. I engage with clients early, to build a good rapport, as we know this leads to better outcomes.

We recently had a client that FSL was supporting for fines and criminal charges. She had complex mental health issues, a significant eating disorder and misuse of alcohol. Initially, she was attending her appointments regularly, but then became overwhelmed and her mental health deteriorated, and she stopped turning up.

At first, she was difficult to get in contact with, but we persevered and over time learnt that she had other fines and debts she needed support with and got a better understanding of additional services she could benefit from to help manage her mental health. For example, we referred her to a financial counsellor so she could learn to manage her money.

The magistrate was able to see the impact of the client’s mental health conditions and saw evidence of appropriate support mechanisms in place. We had a good legal outcome and the legal process for the client was well supported.

I am so grateful to work for an organisation where I can make a direct impact on the lives of our clients.

Hannah Barker First Step Legal Social Worker

Who are you and what matters to you?

Through our newsletters we share stories about our clients, our impact and our work.

But we are also interested to learn about you, our supporters.

In February, we sent out a short survey, welcoming your thoughts on a few key questions, and this is what you told us:

1. What describes your connection to First Step? 54% of our supporter’s study or work in the field of mental health and/or addiction or the legal sector. We heard from a supporter: The information I have learned from this organisation [First Step] I have used in my current role of employment consultant in the disability sector. I have been able to build connections with my clients and we have developed an open dialogue in regards to AOD issues and harm reduction techniques. I am currently linking my harm reduction techniques with counselling to maintain my clients while waiting for services to intake them in Geelong.
2. What would you like to read about in our newsletters? 43.9% of our supporters would most like to read about client stories and testimonials in our newsletters, followed by how to reduce stigma (21.2%) and about First Step programs and projects (15.2%) We heard from a supporter: I am in recovery and want to see stories of similar efforts toward recovery and it isn’t necessarily focused on success. You have to give people who have lost a loved one, or lost themselves, a forum to openly speak. So, we took this feedback on board and have created a ‘Client Stories’ page on our website: https://www.firststep.org.au/client_stories If you would like to contribute a story or testimonial, please email [email protected]
3. Who would you prefer to hear from in our communications? 30% of our supporters would prefer to hear from clinical staff and 26% from our clients. Bringing you stories from our clients can sometimes be tricky, but we are working hard to ensure that the voice of lived experience has a greater platform in our communications. Check out our new Client Stories page on our website and we encourage all members of our community to engage with us across social media.
4. First Step is grounded in the following principles - which of these are most important to you? Over half of our supporters felt that our goal of providing vulnerable Victorians with all the support they want and need from one team in one place is the principle that resonated most with them. One supporter commented: That principle is so rare in the Victorian health system – First Step are in the vanguard / system leaders in this regard.

We greatly appreciate that positive feedback, but we are not resting on our laurels. First Step is in the middle of its strategic planning process and even better service coordination and collaboration is top of the list.

If you missed out on responding, not to worry as we will send another survey out later this year.

How art helped Sammy heal

Sammy is a 22 year old gifted artist and talented writer.

Sammy is a survivor of sexual abuse, perpetrated by her stepfather.

She was referred by Headspace Elsternwick, when it was determined that her complex PTSD and mental health needs would be better managed by the First Step Mental Health Integrated Complex Care (MHICC).

In exploring what her goals and aspirations were, Sammy identified that she wanted to again create art – she had previously made art to manage her mental health symptoms and as a form of income, selling her works at street and art markets.

On Sammy’s behalf, we applied to the National Psychosocial Flexible Funding Brokerage program to purchase art supplies. This program is designed to support people with severe mental illness overcome financial barriers to social inclusion. In other words, we can pay for those things people need to really start being active, contributing and using and developing their skills.

For Sammy, it provided an outlet for her emotions and assisted in the healing process during her self-reported ‘dark days’. And it allowed for her to make new social connections selling at the markets.

Sammy’s work was discovered by a local artist who invited her to present at an upcoming exhibition. This opportunity broadened her life skills, increased her confidence and resilience, and made significant improvements to her self-worth and wellbeing, as measured by her treatment team.

As a teenager, Sammy journaled to help process her experiences. With the team, she identified some training goals to complete a short creative writing course. This was supported by the Flexible Funding Brokerage program.

Each week, Sammy would share with her treatment team what she was learning and what her challenges were. Working together, she learned to use her writing as a coping strategy to manage her emotions.

Sammy continues to face all her life challenges with admirable strength and self-reflection, and no longer needs such intense support. She fills her days with art, gym and has recently taken on the responsibility of owning a puppy! Although we miss seeing Sammy (and her puppy) weekly, not needing us in the same way is indicative of all the hard work she has put in.

by Hayley Pedley Care Coordinator, Mental Health Services NPS Flexible Funding Brokerage

False Starts                            

For people accessing alcohol and drug treatment, it’s a big step.

It takes a lot of courage to admit that they are not managing well and to seek help, so we understand that when it comes time to turning up to the first appointment, there might be a false start.

We get it.

Participants might feel guilt or shame for missing that appointment, but the ResetLife team work hard to normalise this experience and let them know that it doesn’t mean they can’t come again. Our goal is to provide a positive experience so when they are ready to engage, whether with us or a different program, they are not scared off.

About 50% of participants have a false start – most of these people are new to treatment.

When it comes to ResetLife people don’t start straight into the program, there’s a bit of a run up. They meet the team, they visit the space, and they start to feel safe and comfortable and get a sense of hope before joining. It is also an opportunity for us to get to know them, to understand what their motivations are, what they want to achieve.

We connect with them through their feelings and their thoughts, we build trust, and that significantly increases the likelihood of them coming back. Like with any treatment model, it’s about the relationship between the client and the staff.

The ResetLife team knows that this is a tough process because our team have worked in this space for a long time. We understand.

When they join the program, participants are introduced to new theories, new languages, new behaviours and this can be very daunting. For some, it’s a bumpy landing and they might wonder if it’s really for them. Questioning if this is the right program is normal, but we have found that if a participant gets past the first month of treatment, then the likelihood of them staying engaged with the program increases significantly.

About 40% of people drop off and continue to self-manage. This does not exclude them from coming back when they are ready.

And when they are ready, we’ll be here.

by Benn Veenker Manager, ResetLife

Find out more about ResetLife:

The first time I drank to black out, I was 14. 

By then, I was already bulimic. 

As the only child of an emotionally distant single mother who failed to protect me from the men in her life, it was the only way I knew how to lock up the feelings and experiences that were happening to me. 

I could not wait to escape home at 18 but was not prepared for life on my own.  I found myself working night shifts in hospitality, using drugs to keep me awake, and drinking to black out. 

I had no idea who I was. Each crowd I fell in with, I moulded and adapted myself to them, searching for acceptance and love.  But inside, the anxiety would torment me, and I would muzzle it with alcohol and drugs.

Until I found out I was pregnant, and not long after, delivered my son at 26 weeks. This was a time of extreme stress and strain, but I managed myself without taking drugs or drinking, and I felt proud.

But it was not long until I relapsed.

In 2013, I met my husband.  This was the first healthy, functional relationship I had ever had.  I felt loved.  But I also felt that I did not deserve it.

At the age of 43, I unexpectedly fell pregnant with twins.  The pregnancy was complicated, and I delivered my girls at 29 weeks.  This time, I did not cope and began drinking regularly.

I felt isolated and alone. My children were quite boisterous and difficult to manage, so we rarely went out.   Every day was Groundhog Day and to escape this, my drinking escalated. I was self-medicating to cope.

Over the next two years, I accumulated a significant credit card debt which was primarily all spent on alcohol. Then the Department of Health stepped in, and I feared that I would lose my children.

I started to seek help – I went to AA meetings, spent 3.5 months in a rehabilitation facility and three stints in detox.  But each time I would relapse.  I couldn’t understand – I did everything they asked me to do.  What was wrong with me?  Why wasn’t it working?

Meanwhile, I was spiraling out of control.  My husband was supportive, but did not know how to help me, or protect himself and the children. On one occasion I was admitted to emergency because I was suicidal, on another, with alcohol blood levels so high I was at risk of going into a coma.

I didn’t know what to do, but I was sure I could not return to residential rehab.  I couldn’t quit my new job – it was stimulating me and allowing me to financially contribute to the family.  And I couldn’t bear to be without my children for another 3.5 months.  But I was putting them at risk, and I was going to lose my husband.

Then I found ResetLife at First Step. 

ResetLife is a day program that allowed me to continue working and being with my children.  It was the answer I was looking for.

Up until this point, I felt like I was carrying around an empty toolbox.  ResetLife filled it up with tools that I could use in daily life. And I learnt that alcoholism is a disease that does not make logical or rational decisions. 

If I had not learnt this, had not filled my toolbox, I would still be in the cycle of relapse.

Now when I am faced with challenges, I allow myself to feel emotions, to experience what is happening to me, with the knowledge that I know how to manage them, to move through them, and to implement practical steps. I use the tools that I learnt at ResetLife.

I want to be totally present and available for my children. To be the mother I wished I had.  I want them to grow into happy, healthy, secure adults who make wise decisions.  Who know that it’s never too late to change the direction their life is taking. 

ResetLife educated me. That was this missing piece.  It provided support to me and my husband and showed me that I can live a life of abstinence.  I was able to make meaningful connections in a safe space whilst staying at home with my children and in my job.  Now I have inner peace, gratitude and hope for the future.  Hope that I can break the generational cycle of addiction.  And hope that my family and I can lead full, happy and healthy lives.

This disease will not bring me down.

To protect my privacy, Emma is not my real name.  But this is a picture my 5 year old daughter drew of our family.

I joined the ResetLife programme straight out of yet another detox. 

To be completely honest, I didn't have much hope for the programme. I just thought it would give me a few weeks extra of being clean and being able to fix up the mess I had once again caused through my addictions.

That was generally the pattern and had been so for many years. I had lost everything, but most significantly I had lost hope and any belief that my life could ever be anything but a torment. I hated the world, the struggle, people and myself, and simply didn't care anymore. My existence was just that, I wasn't living - I simply didn't know how to.

I was sick of being told that this would help; or that "I should do this", or "you should just stop". I was different and, having struggled with this way of thinking all my life, thought I knew best about my life - whatever that was. I was convinced that no one could understand my problems as they simply hadn't experienced or suffered through what I had. I honestly was not looking forward to another "re-education" from know-it-all group facilitators and self-obsessed peers with their own tales of sorrow and relentless war-stories.

Thankfully, I was completely wrong. The programme has taught me so much from both a spiritual and scientific perspective. The facilitators understood where I was coming from and helped me to regain control of the negative thinking and behaviours that had dominated my life. I learnt so much, it is impossible to put into words. Certainly impossible in a short testimonial. 

The programme has reshaped absolutely every aspect of my life. It has given me structure, belief, new perspective and a humble confidence that I have never enjoyed. I am a new person. It has allowed me to take the time to find out who I am and what underlies my personality and thinking. Further to that it has given me the knowledge and the tools to fundamentally affect what I do with my life. My new thoughts and behaviours are not scary. My thinking isn't confusing. The future is not ominous and bleak. Thanks to all the facilitators, peers and the programme, I understand myself; what I need; what I want; and, most importantly, how to achieve it. I am no longer full of fear and anger. I have belief and confidence in myself. The programme has given me that.

I always related to the symbolism of the metamorphosis from caterpillar to butterfly and the potential for radical and extreme change within oneself – ResetLife Client

I first became aware of the Long-Acting Injectable Buprenorphine (LAIB) six years ago at The Australasian Professional Society on Alcohol and Other Drugs conference.

I clearly remember thinking, as Professor Nick Lintzeris spoke, what an incredible game changer this could be for the clients at First Step on the pharmacotherapy program, particularly those on stable suboxone (buprenorphine). I was then super disappointed to hear that it had not even begun a trial phase.

Fast forward a few years, and I heard murmurings that the LAIB had passed trials and was being rolled out into the community treatment space. Despite its availability, I, and several of my clients, felt hesitant about something that had only been proven ‘on paper’.

For many clients who had been on pharmacotherapy programs for a long time it presented an enormous decision.  On one hand, attending a pharmacy daily or weekly posed a significant risk – they might bump into someone they know, what if they missed a dose, what if they were judged by the pharmacist?  On the other hand, moving to a 28 day cycle was intimidating in itself – attending the pharmacy is an important link to their community, and sometimes, the pharmacist might be the most regular human contact some clients have.

We began small by providing it to people initiated elsewhere, or clients who specifically requested it. It was at this point that I met Stacey (not her real name), the patient whose story significantly shifted my opinion of this treatment option.

Stacey is a 59 year-old woman who started using opiates in her mid-teens and had been on the methadone program for more than 20 years. Throughout this time, she had continued to use heroin and it had continued to cause issues in her life.  In June 2020, Stacey admitted herself into a residential withdrawal unit to transfer from methadone to the LAIB program, and we picked up the management of this after she left. 

When I first met her, she was demanding, unreasonable and difficult to engage with because of her brittle manner.  Our time together over the first three months largely consisted of her telling me what was wrong, and what she wanted me to do to fix it.

Then something shifted. Slowly, and quite subtly, at first.

One of the things we speak about at First Step is the idea of ‘incremental whole –of-life improvements’, and this description perfectly described my interactions with Stacey.  On paper, she had only had a slight shift – she had remained on pharmacotherapy, albeit a different type and delivery system.  But the effect of this in her life was profound.

The first significant change we noticed was attitude. Stacey was more patient, understanding and could recognise situations around her that were affecting more than herself. She was more polite dealing with people, and the staff recognised this.

From there things just seemed to ‘incrementally improve’.  Stacey started to dress differently, as she described, “more appropriate for my age”.  And she began planning, weeks and months ahead for things, something she had previously been unable to do.

Over the next couple of months, Stacey would excitedly attend appointments, telling me with an enthusiasm I didn’t believe she had, that she was studying for her Learners, with the view of getting her license for the first time.

It is important to note, LAIB is not a ‘miracle cure’.  Stacey committed a tremendous amount of hard work to achieve everything that she did.  A clever psychiatrist once told me, ‘pills don’t teach skills, but they give the brain a chance to learn them’, and this was never clearer than with Stacey.

It was a humbling experience watching an adult woman’s life change slowly before my eyes, watching her discover new things she had not thought herself capable of previously.

Haydn Salomons, Clinical Care Coordinator

11 March 2022

During debate on Fiona Patten's proposed drug law reform bill, Bernie Finn MP proposed the death penalty for drug dealers ("drug lords"):

"I would be very happy to administer [the death penalty] myself in fact if it came to that, because quite frankly [drug lords] disgust me in a way that is hard to put into words: https://lnkd.in/gD97uTGV

At First Step we wonder if Mr Finn would consider killing the CEOs of big tobacco, big pharma and alcohol companies whose products are responsible for far more deaths than all illicit drugs and vastly more burden of disease: https://lnkd.in/gzbakVr7

Does Mr Finn perhaps even drink alcohol? Does he or has he ever smoked tobacco? Would he now consider, himself, finding those people that sold these drugs to him (alcohol and nicotine) and ending their lives?

The point here is not to score points or poke obvious holes in radical arguments, but rather to point out what is going on here.

It's called stigma.

There is a stigma around the use of illicit drugs. In Mr Finn's case it is directly at 'drug lords', but it certainly spills over to drug users, particularly people who inject drugs.

First Step recently met with the director of a secure facility for children (funded and run in one of the states of Australia), basically a temporary psych ward for kids at great risk. Practically all the kids in this facility have mental health treatment needs and addiction treatment needs and many are the victims of sexual exploitation. And guess what percentage of the kids are in child protection/out-of-home-care? 100% One hundred percent! These are literally the most vulnerable people in Australia, overly representing indigenous kids, near universal history of childhood abuse, including sexual abuse. A good many of these kids will go on to sell drugs at some point. What would Mr Finn like to do with them at that point, young people some of whom have never known a mother's or father's love. Many of these kids, if they had not found in illicit drugs a reliable source of dopamine stimulus (ie. temporary happiness) would have taken their own lives and might still.

We will invite Mr Finn to visit First Step, to see a little of the other side. You gotta try.

#mentalhealth #lifewithaddiction #firststep #healthnotharm

Patrick Lawrence Chief Executive Officer

22 February 2022

On Wednesday I had the great privilege of speaking at Fiona Patten's press conference at Victorian Parliament House in favour of her bill to decriminalise the possession of illicit drugs for personal use (small quantities). We have had great coverage of the event with Fiona's, Baden's (our former client and now amazing peer worker) and my won words repeated around the country and overseas. Here is a transcript of my address to the press for anyone interested. The bill will be debated and voted on in early March. Spread the word and make a noise (including by writing to your local member at www.decrim.com.au).

At First Step we work in a very challenging environment made infinitely harder by the world’s greatest public policy failure. The greatest impact of our current drug laws is felt not by the recreational drug user but people who have survived childhood poverty, sexual abuse, poverty, homelessness and the absence of love and bonding. In my 20 years working in the alcohol and other drug sector I’m yet to meet a single person dealing with significant drug use or addiction, who is not using those drugs to manage their pain and trauma. Most of us, if we had the tools, would move mountains to stop a child being harmed, we'd leap Paddy-Dangerfield-like into the surf. At what age does a human bein g become unworthy of empathy and protection?

Enable police to direct people to education, treatment and support, instead of arresting them. That’s actually all we’re asking for. Yes, it will need resourcing, but can you imagine the funds that would be freed up from the criminal justice system. If you create a society where the most vulnerable receive health not harm, well that benefits every single one of us. Everybody deserves every chance to turn their lives around, and this reform proposal aims to do just that.

The law didn’t break Baden’s cycle of addiction and trauma. Treatment did. Welcome, empathy and hope did. And of course Baden's own courage and resilience. The evidence tells us that Baden's example is typical, and that the proposed changes to the diversionary powers of the police will not result in an increase in drug use. Just an increase in treatment and new beginnings.
If we could design it again, we would never build a system like this. Thousands of people in prison and the courts, and recreational as well as heavy users receiving criminal sanctions. So it’s up to the people in this place of great power and privilege to listen to lived experience, study the evidence and talk with the experts. To say “It’s not a priority”. . . well, that’s not an answer.

Be tough of crime, but let’s redefine what a criminal is. Because currently it’s 40 per cent of the population and that’d be funny if it weren’t also tragic.

Here is the press conference in full:

#mentalhealth #lifewithaddiction #firststep #healthnotharm

Patrick Lawrence Chief Executive Officer

At this time of year, it would be remiss to not say something like, “Well, it’s been a very challenging year, but we’ve survived and learnt a great deal”, and then reflect on organisational achievements.
So, I’m going to be remiss!

Billed as a time for celebration, Christmas is also a time of societal pressures, social anxiety, revisiting old family wounds, sometimes fueled by alcohol. We would love for all gatherings of family and friends to make the words of Tim Minchin (‘White Wine in the Sun’) true for all:

Wherever you are and whatever you face
These are the people who'll make you feel safe.

But we know that this is not universal. Not by a long way. Poverty, dislocation, substance use and abandonment don’t make for a good start in life, and they don’t make for a good Christmas either.

As we say at First Step, ‘everybody deserves every chance to turn their lives around’, and this is just as true for every family, every friendship group and every support network.

It is our Christmas wish to all our clients, all our staff and all our supporters that you make of this summer break everything that you can. Be kind, listen, hug when the hugs are good, give, receive. During and after lockdowns we’ve all been re-evaluating life a little – let’s do that for Christmas too and make the most of every social connection we have.

And if you know someone who is going to be lonely at this time, please reach out to them.

Please enjoy our Christmas Newsletter.

Patrick Lawrence Chief Executive Officer

Relationship rebound - a ResetLife client story

I grew up in a typical Aussie home in the ’80s. Big sprawling house. All the neighbourhood kids hanging out together. My three sisters and twin brother playing at the pools in the summer. Family trips to Bright. I had a great family life and a fabulous childhood.

Until I was 7, when my mum left.

In my early-teens, some issues started to emerge for me – even though I looked masculine, that’s not what was inside me. I’ve always had a feminine side.

I was nervous about being around people and fitting in, so when I started going to parties, I found that alcohol could be the lubricant for confidence. But instead of fitting in, I would end up the joke of the party. Once, my brother shaved off my eyebrows when I was passed out!

My drinking accelerated after I finished school, and this was the start of 30 years of alcoholism.

There were a few years in my late 20’s when I felt I was getting my life together. I met a woman, and we had a child together. I went to University to study and was drinking only on the weekends.

But this didn’t last long and soon I was alone, lonely and miserable – and drinking every night. Twice, I lost my license and had to explain to my daughter what the ghastly interlock device on my car was. She was too young to understand, but I was so humiliated.

The first time I tried to take my life, I was admitted to a psychiatric unit and was diagnosed with Schizophrenia. Thirty years of alcohol abuse really pickled me. But I didn’t stop. Until one evening when providence intervened, and I thought: ‘Why am I drinking this? This is foul. What am I doing?’ And from that moment on, I never drank again.

Unfortunately, I replaced alcohol with drugs to fill the void, and that didn’t turn out so well for me. The drugs interfered with my Schizophrenia medication, so I decided to stop taking the meds. I began to hallucinate, I was paranoid, I wasn’t showering, I wasn’t eating, and my apartment had a cockroach infestation. I barricaded myself at home and thought there was a death squad out to kill me. I was frightened and couldn’t trust anyone.

I had hit rock bottom. My dad came, and so did the Crisis Assessment Team. Enough was enough.

Now, I am on the right medications every day, which means I can speak fluently without any voices in my head. I have the ResetLife Program at First Step, which helps me keep accountable to my own abstinence journey. And a long list of people to call for support.

ResetLife taught me about the physiological side of drug abuse. That my brain tried to keep me in addiction, but the longer I was into recovery, the more the logical brain took over and I could rationally consider, ‘Why would I want to take drugs when everything is working right now? Why would I want to take drugs when all of my relationships have recovered?’

All of my important relationships have rebounded.

I have reconnected with my mum. My sisters are more active in my life. My dad continues to be my rock. But most importantly, the relationship with my daughter has flourished. It’s incredible! She is the pride of my life. She accepts me for who I am, and we spend hours on long walks where she shares her stories with me. I feel so privileged that she trusts me! And so lucky to have great people in my life supporting and mentoring me.

I feel so good.

And now I want to get back into society – to work, study and volunteer. My graphic art has been a constant outlet over these years, but I really love writing so am looking at doing a writing and editing course in 2022. And I want to get involved within my local LBGT community so I can give back there too.

Everyone who sees me says, ‘You look so much better’. I have recovered.

Maddie ResetLife Client

Silver linings by Dr Basanth Kenchaiah

As I think about a COVID-19 normal world, I am planning to visit family in India, which has been long overdue.

The second wave in India was so intense, almost everyone in my family contracted the virus, many were hospitalised, and two passed away.

Throughout this period, the discussion between friends and family was consumed with concerns for our loved ones. Phones were constantly ringing. We were looking for medical supplies, beds and even cremation facilities as they were hard to find.

It was distressing to be so far away.

Things are looking much better in India, though there are concerns about a third wave with the new variant. I am really looking forward to going back to connect with loved ones.

While Melbourne has achieved the dubious distinction of the most locked down city in the world, and admittedly we have all struggled, I believe we are very lucky to live here. We have had relatively few deaths and our vaccination numbers are high. I find it hard when I come across people who dismiss the impact of the pandemic, even after I have shared my personal stories.

Generally, we would not disclose personal information during consultations, but COVID-19 has been one instance where patients have enquired about us, and our families, and the sharing of some stories have been a benefit to everyone, and a great equalizer.

One of the silver linings for the community has been the wide roll-out of telehealth which is now being made permanent. It has transformed healthcare in a significant way with numerous benefits.

There are limitations and our approach will have to adapt to them. For example, on occasion, all I see is a patient’s face, so it is difficult to ascertain what physical state they might be in. Do they have side effects such as tremors or weight gain from the medications? Where I would once observe the subtleties, I now have to use different skills. Some telehealth etiquettes need to be established so that the consultations don’t occur when people are driving around or sitting in a toilet!

The other silver lining, for me personally, was the birth of my son a couple of days before our first lockdown. At first, I was concerned about the impact of being born into lockdown, but soon realised what a remarkable bonding opportunity I had, thanks to the lockdowns!!!

As he starts exploring the new normal we live in, and we all start celebrating the Christmas spirit, welcoming a New Year, I hope you can reflect on this year, and also see the silver linings.a

Dr Basanth Kenchaiah Psychiatrist, First Step

A game changer for First Step

We are excited to announce our new partnership with 3 Phase Marketing (3PM), supported by RentBuyIt.com.au.

3PM are an award winning, boutique, digital marketing agency with a big heart and an amazing ability to quickly understand complex social issues.

They get us, they believe in our work, and they care about our clients.

3PM were introduced to us by RentBuyIt.com.au Director, Con Nakas, who saw the potential in this partnership to be a gamechanger for First Step. Con put philanthropy in action by connecting time, money and people for the greater good.

First Step receives no state government funding to deliver our health services. We rely on the generosity of our community to provide care to our unfunded clients, fill the funding gaps, and support innovation and growth.

Today, the sector is not able to meet demand, let alone what we anticipate it will need over the next 10 years.

This partnership aims to reach a wider audience than ever before, improve our financial sustainability, and grow our advocacy network. Our objective is to find people who believe what we believe, who admire the strength it takes to take the first step towards recovery, and are proud to assist people taking the second and third steps.

This will be a game changer for First Step.

Check out our first campaign together, the First Step Gift Shop.

In our Gift Shop, select a gift option to donate, instead of buying Christmas gifts, and we will then send you an eCard that you can print or email to your loved ones. Give a meaningful gift this Christmas.

We are very grateful to RentBuyIt.com.au and 3PM for their partnerships.

This is the kind of law I want to practice by Sasie Wijewardana

I wasn’t going to go into law. I was going to be a teacher. I come from a family of teachers – my brother is a teacher, my parents are teachers, their siblings are teachers. I wanted to do something that involved working and interacting with people.

My year 12 teacher suggested I apply for law, but I wasn’t too fussed, because in the back of my mind, I was going to be a teacher.

Needless to say, I’m not a teacher. And in fact, last week sat my final law exams!

About a year ago, I saw in a Facebook group a call out for First Step Legal volunteers. I researched the First Step model and what struck me was that people in Sri Lanka (which is where my family is from) with mental health issues don’t have access to appropriate resources and services, and I was in a position to positively impact this for people here in Melbourne.

I joined the team as a volunteer and quickly learnt that the theoretical knowledge taught at university is different from the practical application. Sometimes we deal with heavy subject matter that takes an emotional toll, but the lawyers are extremely approachable and prioritise supporting the volunteers, which is really comforting.

Spending time at First Step and seeing how closely we work with people with mental health and addiction issues, I thought, ‘yes, this is the kind of organisation I want to work with. This is the kind of law I want to practice.’

I get to work hands on with people, to speak to them and hear their stories. What I’ve seen time and again, is that their circumstances and experiences have led them down the path where they might offend. And I’ve also seen that the way we treat offenders is just not right. We disregard them, throw them in jail, don't care about them. And many people have already gone through such unfortunate circumstances in their lives.

I have now stepped up into the role of Legal Case Manager at First Step Legal, where I am responsible for managing client files, supporting the lawyers and overseeing the volunteers. I am grateful for the mentoring and guidance I have received from the team, and in my new role want to ensure that our volunteers have a positive, supported, experience.

Sasie Wijewardana Legal Case Manager First Step Legal