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‘Drugs’ to manage pain and more for PIP

Va1der
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Welfare Support Worker - Community Renewal Edinburgh

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Couldn’t find any previous threads on the forum for this topic.

Many of my clients have various addiction, drug and alcohol related issues, and I am curious about their impact on a PIP claim. I’m aware that dependency and its effects alone are not normally counted for PIP.
This is in relation to making claims and appeals at the moment, so would appreciate your input.

1) Non-prescription drugs, such as opiods and marijuana, to manage pain.
One of my clients is already on high level prescribed painkillers, but still finds the pain (and distraction it causes) unbearable without self-medicating on top of those. His issues are severe, but I’m not sure how they fit with descriptors, could I for instance argue that:
a) DWP/HMCTS should consider his ability to carry out activities as if he was not taking drugs, as they are not normally available, or
b) That he can’t carry out the relevant activity safely or to an acceptable standard, because it depends on taking drugs associated with negative health consequences.

In both scenarios I encounter issues, as I can’t present a ‘sober’ client - for obvious reasons I can’t ask a client to sober up for a tribunal. I have no doubt that an award would be made if the client was sober - I doubt he’d be able to even make it through the door.
He could theoretically be prescribed stronger medication - but the side-effects are significant.

2) Similarly - relying on drugs for social interactions - calming anxiety etc.

3) Can a methadone program be counted under 3(b)(ii) - supervision to manage medication, for:
a) A client who states liable to deliberately overdose if given enough
b) A client who would be perfectly safe with a month’s supply (dispensing would still be regulated - by law).

4) Alcohol dependency and budgeting - spends all money on drinks = can’t budget for essentials - 10(b)?

In some of these cases there would be supporting evidence that the clients have either sought treatment or are self-medicating and why. In others it’s not been something they’ve wanted to discuss with their health professionals.

Ruth Knox
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RAISE Benefits Advice Team, Liverpool

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I do think alcohol and drugs dependency can be taken into account in assessing PIP. They are medical conditions not a matter of choice. See SD v SSWP (PIP) [2017] UKUT 310 (AAC) - I will try to attach below.  There’s also an ESA on related to drug addiction - see JG v SSWP (ESA) [2013] UKUT 37 (AAC)  and a reported ESA decision [2016] AACR 35.

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Stainsby
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Welfare rights adviser - Plumstead Community Law Centre

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Loads of issues here, but I think that if the methadone has to be given under supervision then yes descriptor 3 will be met.  Similarly if the addiction is such that it impairs the ability to make budgeting decisions, the descriptor may be met

I seem to be making a bit of a habit of attaching submissions to my posts but here is another one where I address pain and a few other matters beside.  It does not deal with heroin addiction or a methadone programme but it does address substance dependency.

I think you could find it useful

[ Edited: 11 Jun 2020 at 06:04 pm by Stainsby ]

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Ruth Knox
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And Stainsby’s submission has reminded me of R(DLA) 6/06 which explores the questions of how alcohol consumption and its effects should be considered.

Mike Hughes
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I’ve a folder now called “The Stainsby Collection”.

Va1der
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Thank you both, that’s helpful - particularly some useful caselaw etc for alcohol dependency.

Incidentally, I got an MRN through from one of those clients yesterday, and 2 points had indeed been awarded for budgeting. First successful MR I’ve seen in ages.

However, on the topic of pain relief - the issue is less to do with dependency (and its side effects), but with the positive effects of some controlled substances. I don’t share the view of some that marijuana/cannabis is a wonder drug that fixes all problems, but there is undeniably (as your submission highlighted, Stainsby) evidence for some positive effects.
I’ll go with marijuana as the prime example - because it is used by very many people, and (reportedly) helps with both pain and anxiety/depression, and perhaps more importantly, there is less evidence for damaging effects.

In one particular case I won’t struggle to evidence the level of pain, but if he can manage his day to day activities to a reasonable standard with a combination of prescriptions and controlled substances - does that mean he scores 0 points?

Mike Hughes
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Marijuana very much depends on the health condition. Has been much touted for helping with some eye conditions. However, research suggests that the tobacco element is likely the beneficial element.

Stainsby
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Va1der - 12 June 2020 04:56 PM

Thank you both, that’s helpful - particularly some useful caselaw etc for alcohol dependency.

Incidentally, I got an MRN through from one of those clients yesterday, and 2 points had indeed been awarded for budgeting. First successful MR I’ve seen in ages.

However, on the topic of pain relief - the issue is less to do with dependency (and its side effects), but with the positive effects of some controlled substances. I don’t share the view of some that marijuana/cannabis is a wonder drug that fixes all problems, but there is undeniably (as your submission highlighted, Stainsby) evidence for some positive effects.
I’ll go with marijuana as the prime example - because it is used by very many people, and (reportedly) helps with both pain and anxiety/depression, and perhaps more importantly, there is less evidence for damaging effects.

In one particular case I won’t struggle to evidence the level of pain, but if he can manage his day to day activities to a reasonable standard with a combination of prescriptions and controlled substances - does that mean he scores 0 points?

It depends on what you mean by “reasonable standard”  As I say in that submission at [11] -[12] A descriptor is satisfied if the person cannot carry out the task for part of the day, providing the effects of the condition are more than trifling. 

The person must be able to carry out tasks as often as (s)he would reasonably wish to, and the yardstick of a more normal life established by Fairey applies to PIP just as much as it does to Attendance Allowance and DLA. 

I would say that you could put a strong argument that the person cannot carry out the tasks safely and/or to an acceptable standard if they have to resort to using illegal drugs or using legal drugs (which includes alcohol) in a manner that is potentially dangerous or has other consequences that are not acceptable

 

[ Edited: 12 Jun 2020 at 05:38 pm by Stainsby ]