2978 Design Direction 6
Australian Injecting and Illicit Drug Users League
South Western Sydney, Australia D. Zador, P. M. Lyons Wall, I. Webster1 High sugar intake in a group of women on methadone maintenance in FRCD(C). http://www.cda-adc.ca/jcda/vol-66/issue-11/600.html
Ph: 02 6279 1600
CARE SETTINGS
Chemaly, DMD, Annie Lefrançois DMD, Rénald Pérusse, DMD, MD, 5 4
http://www.hepccouncilsa.asn.au/index.html
Canberra ACT 2601
Oral and Maxillofacial Manifestations of Multiple Sclerosis. Daisy
www.aivl.org.au
Hepatitis C and Dental Health, Hepatitis Council of South Australia Aggleton2
and T.
Carson3
and non-drug users attending community pharmacies J. Sheridan,1 M. 3
Dental health and access to dental treatment: a comparison of drug users
IN ORAL HEALTH RESPONSIBILITIES
112–116 Alinga Street Level 2, Sydney Building
USERS RIGHTS AND
AIVL
CHARTER OF DRUG
Anti Discrimination Board of New South Wales, November 2001 2
C change, Report of the enquiry into hepatitis C related discrimination. Anti Discrimination Board of New South Wales, November 2001
1
C change, Report of the enquiry into hepatitis C related discrimination.
WA: WASUA – 08 9227 7866 VIC: VIVAIDS 03 9419 3633
References
Australia – no phone at this time USERS Association of South
fractured, loose, or missing teeth. chronic may lead to sensitive, worn-out, decayed,
SA:
SAVIVE – 08 8362 9299
cause bruxism (teeth clenching/grinding) which if QLD: DUNES – 07 5520 7900 TUF 08 8941 2308 NT: NAP 08 8942 0570 NSW:NUAA – 02 8354 7300 ACT: CAHMA - 02 6262 5299
Member Organisations Details •
Introduction
Some drug users are socially and economically is costly.
issue for many injecting/illicit drug users and their
disadvantaged and access to oral health treatment
Dental and oral health has and continues to be a major families who are simply unable to access oral health
•
The use of amphetamine type substances can Opiate use and particularly those opioids that are Studies have shown that users tend to regularly eat
Injecting/Illicit drug user specific oral health issues In addition to the barriers to oral health care
Inappropriate infection control systems and
appointments at the end of the day.
many other issues that illicit drug users face when
Hepatitis C positive. For example, being offered
accessing dental care. In response to this and the
when individuals have disclosed that they are
users face humiliation and discrimination when
poorly by oral health professionals particularly
for dental health services a problem, many illicit drug
prejudice can result in drug users being treated
services. Not only are waiting lists and lack of funding
treatment that illicit drug users experience, there are specific oral health issues that individuals experience: •
•
disease – for example the side effect
Drug users particularly those who are also homeless and /or on a low income tend not to
oral health care professionals about illicit drug
Methadone, other opioids and infections such as hepatitis C can contribute to oral health
accessing oral health care, AIVL has developed this charter to inform: •
xerostomia (the reduction in the production of
access services for fear of discrimination and poor
user’s issues, and •
•
health problems. longer acting such as methadone may mask oral •
dental decay(66). sweet and sugar based foods and this increases •
saliva) that increases dental decay (3).
treatment.
to inform drug users about their rights and
•
responsibilities when accessing oral health care.
Embarrassment about appearance and incidence
•
drug users are susceptible to both.
services. •
There is a link between poor dental health and bacterial infections of the heart and injecting
of pain can hinder illicit drug users access to
AIVL believes that this charter will begin to redress the imbalance in oral health care provision for drug users, will contribute to an improvement to illicit drug user’s
Not attending arranged appointments and/or
•
completing treatment can act as a barrier for the
oral health and will contribute to an improved
Treatments such as interferon for hepatitis C can increase the occurrence of mouth ulcers
individual who may embarrassed about
understanding for oral health practitioners of the
and oral thrush (4).
recontacting the service. This can also cause
needs of drug users.
frustration for the service provider. •
Barriers to oral healthcare treatment
•
interferon, steroids or immuno suppressors.
it is common for people with hepatitis C to be and surgery when they are known or assumed to
plucked up the courage to go, I was treated really
refused health services, particularly dental work
going to see a dentist is expensive and last time I
provide any pain relief
negative experiences when accessing oral health care
Inadequate pain management or actual refusal to
This comment is not unusual. Many drug users have
•
Dentists need to be particularly prudent in providing treatment to patients taking
As C Change the report of the enquiry into hepatitis C related discrimination shows (1), “…that
“I am embarrassed to smile. My teeth are terrible,
have hepatitis C.”
badly.”
intrusive oral health treatment.
and there are many contributing factors:
The dentist should prescribe a course of prophylactic antibiotics before performing surgery (5). •
Homelessness and low income contribute to the increase in likelihood of poor diet and this
(2) hinders users in obtaining
impacts on oral health.
3064 Oral Health broch revised 27/2/04 2:15 PM Page 1
3064 Oral Health broch revised 27/2/04 2:15 PM Page 2
CHARTER OF DRUG USERS
■
RIGHTS AND
You have the right to be able to make an
involved and any alternative treatments
appointment at a time that is suitable to
that are available to you
you and to take a friend, family member
RESPONSIBILITIES IN ORAL ■
HEALTH CARE SETTINGS RIGHTS
■
You have the right to be assessed,
written informed consent, nobody external
diagnosed and treated by a fully qualified
to your oral health care provider can have
dentist and dental staff. You may refuse to
information regarding your treatment
be treated by trainees and/or to be used for
either verbally or in writing
You have the right to be treated with
some government dental services that this
respect, dignity and consideration
may delay your access to treatment due to
You have the right not to be discriminated
the lack of fully trained staff
against regardless of your; race, gender,
■
religion, sexuality, source of payment, if
You have the right to access your notes/treatment records
■
You have the right to expect high quality care and treatment that is no different
You have the right to have your diagnosis in a language you can understand. You
have any other health issues
■
■
from other users of the service
and treatment plan fully explained to you
you are HIV and/or Hepatitis C positive or
■
You have the right to privacy and confidentiality. Unless you have provided
training purposes. However, you may find in ■
■
or peer advocate with you
■
You have the right to refuse treatment, to
have the right to fully participate in the
see another practitioner and if need be to
You have the right to be treated with
management of your oral health care. For
leave the practice
respect by all reception and
example by discussing treatment options
administration staff, for example being
and deciding on what treatment is best for
will implement appropriate infection
spoken to in a courteous manner
you
controls
You have the right to appropriate
■
You have the right to be told of any
treatment and pain relief medication
financial costs before treatment is started
applicable to the treatment received. Pain
and to access payment options that are
relief medication should be consistent
available to others
with that received by other patients for
■
similar procedures
RESPONSIBILITIES
■
■
■
You have the right to expect that all staff
You have the right to complain via the services providers’ complaints procedure about the service that you receive and to know that such a complaint will not in any
You have the right to be told of any risks
way effect your treatment or the manner
from your treatment or the procedures
in which you are dealt
To ensure that the
■
■
Being an active and accountable partner
people who
in your oral health treatment plan. For
attend your
example, adhering to the best of your
appointments
ability to any treatment regimes
with you behave in
Being on time for your appointments and
appropriate
letting the service know with plenty of
way towards
notice if you can’t make your
all staff and
appointment or if you are going to be late ■
■
Discussing with your treatment providers
other service users ■
notice and agreement that you are able to
progressing
peers
pay any fees for your treatment by agreed
Discussing with your providers any rules
times. If you are unable to pay, that you
your treatment then it is your
that need to be respected. Where you
inform the oral health practitioner as
responsibility to ask your dentist or other
disagree, you have the responsibility to
soon as possible and agree upon a pay
oral health care provider for further
raise this with your treatment provider
back plan. In addition, that you seek
and attempt to resolve them.
financial assistance/ advice from you
It is your responsibility to inform your
local drug service provider and/or drug
local drug user group of any unfair
user organisation
If you do not understand any element of
■
Making sure that your behaviour at your
■
treatment and seek additional support
either your own or your peers treatment ■
■
You are NOT responsible by law to tell any
You are responsible to the best of your
of your oral health care providers yours
ability to follow your treatment plan
or your family’s health status for example
You are responsible for providing
that you are hepatitis C positive. However,
feedback about the services that you
notification of your hepatitis C status may
Cooperating to the best of your ability
receive to your dentist or other oral
assist the provider in delivering a better
with your service providers requests
health care providers
treatment outcome for you.
programs Being courteous towards your treatment providers ■
Ensuring that where necessary and with
responsibilities of this charter with your
appointments does not compromise
■
■
how your treatment program is
information ■
Discussing and promoting the rights and
■