OSLO DISTRICT COURT (Dagbladet): – I went through my worst year ever. I didn’t get any help, says Hilde Bjerkeland to Dagbladet.
She describes what happened after the Norwegian Health Authority stripped Stig Asplin of his right to prescribe, i.e. the right to write prescriptions for addictive drugs, three years ago.
Asplin has sued the state to get this right back, and to change the system. His witness list includes Bjerkeland and three other of his former drug-addicted patients.
The Norwegian Health Authority believed that their treatment was unjustifiable and breached the guidelines in the Health Personnel Act.
The patients themselves believe that this treatment gave them stability and dignity in life.
– I had to go back to the streets to buy drugs, pills and heroin, because I could no longer get the medicines I needed. I had to resort to crime. It went straight to hell, to put it in a nice way, says Bjerkeland about the time after Asplin lost the right of prescription.
IN THE WITNESS BOX: Hilde Bjerkeland was asked several questions in court about the treatment she received from Stig Asplin when he was her GP. Photo: Oda Ording / Dagbladet
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– Don’t look down on us
From the witness box in the courtroom at the Oslo District Court, she was asked why she chose Stig Asplin as her GP:
– He didn’t look down on us drug addicts, he looked at us as normal people. It’s not often that I experience it.
Bjerkeland says that no other GP wanted to give her the same treatment as Asplin.
She describes it as life-saving that she finally got help through the Eika clinic, which was opened after the death of “the drug addicts’ doctor” Sverre Eika.
– I don’t know what would have happened if I hadn’t gotten help there.
FULL COURT: Aspl’s statement on the first day in court was met with both applause and tears from the audience. Photo: Nina Hansen
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Bjerkeland received the opioid methadone through Drug Assisted Rehabilitation (LAR). At the same time, she was prescribed benzodiazepines, i.e. sedatives and sleeping aids, by Asplin.
– The medication made her function better, seemed less lethargic and it reduced the likelihood of page abuse. If I didn’t give it to her she would have bought it elsewhere, it’s fireproof.
– Knew very well that I broke the law
However, the guidelines state that this combination should be avoided due to the high risk of overdose.
Asplin has spent a lot of time in court defending why, in the treatment of this group of patients, he has broken the guidelines:
– It was a conscious professionally justified choice. The principle of emergency law meant that we could not let them perish – we had to help.
– Someone will call you naive?
– I would rather say that I was a pragmatist. The times I was tricked I dealt with it forcefully, but I didn’t use more protection than I think they could handle. The most important thing was to motivate them to continue treatment.
CALLED AS A WITNESS: Former municipal superintendent Dagfinn Haarr in Kristiansand has for many years been involved in the debate surrounding the treatment of drug addicts. Photo: Tor Erik Schrøder / NTB
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Asplin was supported by Dagfinn Haarr, former municipal chief physician in Kristiansand, who spoke from the witness box about his experience of treating drug addicts:
– I knew very well that I was breaking the Health Personnel Act and the Medicines Act when I was doing this. I did it because I felt it was ethically and medically absolutely necessary, it was a matter of life and death.
“Enormous needs”: – Right on the brink
State’s witness: – Too high a risk
The state’s legal representative, Kristoffer Nerland at the Government Attorney, has along the way challenged several aspects of the proceedings which ended with Asplin being deprived of the right to prescription:
- Too generous pick-up arrangements, where the patients have been given a new prescription ahead of time
- The risk of these addictive drugs ending up on the streets and causing overdoses
- Lack of plans for tapering off this type of medicine
- Insufficient record keeping makes it difficult to get an overview of which assessments have been made
- Warnings from the Norwegian Health Authority to Asplin that came before they took away his right to prescribe
Fredrik Guttormsen Lærum Winsnes, senior physician at the clinic for drug and addiction medicine, was summoned as an expert witness for the state. He has gone through the documentation for the treatment of the six patients at Asplin.
– I have sympathy for the patient stories and feel that this is a GP who cares a lot about his patients. At the same time, I believe that the treatment is outside of what we believe is good practice. It involves too high a risk, he said, among other things, during his testimony in court.
Winsnes described it as demanding that it is presented as if the doctors associated with LAR want to punish the patients.
– We act with respect and dignity towards our patients, but we are clear about which disorder we treat, he concluded.
