Tuesday, March 14, 2017

Selling Hope

When I started at The Recovery Center I didn’t know how to speak. Knowing nothing of either homelessness or addiction, I told stories instead. I brought other people’s words. I sifted through the history of drugs to find stores to elicit or inspire or ponder in my group sessions. One of these stories:  in Vancouver in the 1990s the addicts were dying. Overdose took several people a week, and serial killer was abducting and murdering sex workers while the city turned a blind eye. Theirs was the hell of the dispossessed. To the drug users of Vancouver, it was clear no one cared for them but themselves. So they rebelled. They organized patrols to bring medical attention before an overdose became fatal, and checked on the sex workers to make sure they were safe. They created public art to memorialize their dead. Stopped traffic. Carried empty coffins to city counsel meetings. They kept showing up. They demanded to be recognized until eventually the people who made decisions on their behalf had to see their humanity. The Mayor change his mind - began to call addiction a medical problem not a moral one. The city began to change. Vancouver is now the most progressive city in North America in terms of caring for their addicted.

Sam loved that story.

Sam is dead now.

And it is this story I choose to remember with him. A story of the downtrodden organizing and demanding change. A story of human agency, defiance and power in the face of death.

I know that he will become a statistic. A number people like me will tally and use to argue for better services, more services, a world less punishing of poverty and pain and the way this manifests. He is another casualty to our vengeance, ‘collateral damage’ in the absurd theatrics that is the war on drugs. In a way, I want him to be used this way. Want his death to mean something. To change things. But I also want to remember the complexity of his life -- the whole of it -- the stories he told about filling his pants with lipstick from pharmacies to resell, the near misses shoplifting, carrying grocery carts and strollers for ladies up subway steps fueled by opioid highs. I want to remember the gruff encouragement he offered the others at the clinic, the way he softened around our most helpless mentally ill clients. I want to remember the fragile hope he carried with him. The hope which flickered in and out of his words as he talked about relapse, about his friends and family dying around him, about how years ago he went to college and did well and one day maybe would go back - someday when he was ‘all good’, not just 80 or 90%. I want to remember Sam, volunteering to pack Narcan kits for the shelter - kits which will reverse overdose and save lives. I want to honor, in this moment, the complexity of him which will be washed out with the words ‘overdose death’.

I came to social work looking for formulas. I wanted The Secret to Healing the Broken, and I wanted in peer-reviewed articles with plenty of references for further reading. What I found is frustrating ambiguity. Healing a broken heart is not curing cancer or setting a bone -- it is far more complicated. There is no one prescription, no one method to make someone whole after trauma, after loss, while they live in a world which tells them again and again they are worthless. What we have found (and in fact, the peer-reviewed articles will back this up) is that what matters is most is love. Empathy is what makes a client come back, and it is empathy, not whatever theoretical orientation you follow or method you use, that best determines outcome in therapy. We take people who have been beaten: physically, emotionally, economically - in every way. We welcome them into our office and we delicately, carefully, we try to love them back together. We look for the best in them and hold up a mirror to it. As a professor of mine put it - our job is to sell hope. Love is our best and imperfect answer to a world full of horror - a world where poverty and pain are criminalized, and each infraction comes with a price tag in years of your life.

So this is what I have. My battle against hundreds of years of the systematic devaluing of human life is fought an hour at time - listening, caring, reminding my people of their goals and helping them to see the ways they can achieve them. I don’t know how much I believe in the efficacy of what I do - my hour against the world - but I believe in them. My clients. My people. My guys. And I love them dearly.

That love hurts today.

But it is that love which brought me back to work, after I spent the night before crying my eyes out for Sam. That love which makes me remember the hope he carried into our clinic, day after day. That love which keeps me believing.

It is an imperfect answer, but it is the best I have found.

(My client’s name was changed.)  

Tuesday, January 3, 2017

It's not about drugs

I don't write enough about my life in America. From looking at this blog you would think my life stops when I am not carrying a passport in my purse. But though this I do an injustice to the meaning I find in my own country, and especially the work I have done over the last several months. These days I joke my life is all about drugs. As part of my social work Masters degree program I work 3 days a week at an addition clinic set in a homeless shelter. I'm in a drug policy research group for class. I write this from a conference on opioid addiction, and I spend my down time reading about drugs and watching videos on YouTube and out drugs. But the more I learn about drugs the more I learn that it's not about drugs. The problems we ascribe to drugs stem from poverty.  From child abuse. From racism, and the systemic oppression which trails in its wake.

Did you know that 80-90% of drug users are not addicted?  Think about it. It makes sense. You know drug users -- maybe your college professor who slyly works LSD references into his lectures, or maybe your nephew who comes in from the backyard smelling a little odd. Maybe even your last three presidents are publicly known to have used drugs. We know that drugs, on their own, don't ruin people's lives and yet we treat them as if they had some inescapable gravity. Some malicious force of their own corrupting the good and the innocent, and catalyzing the bad and the lazy. Rather than the gravity of drugs leading to addiction I believe it is the gravity of pain which pulls people to use drugs destructively. One of my favorite quotes I have read on addiction comes from a Vancouver doctor who works with the homeless who writes “we should ask not why the addiction but why the pain?” I see this question etched into the lives of the men and women I work with,  who struggle with the pain of rejection, of loss, of abuse as children.  When we wage “war on drugs” we should be waging war on poverty,  on desperation,  on the forces and pressures which lead parents to beat or abandon their children. The good doctor says drugs are a replacement for the love his clients were never sure of as children -  as source of comfort they can be at last be sure will never abandon them.

Even in cases where drugs become destructive forces in people's lives I have come to see this damage stems as much from the way our society reviles drugs as from the drugs themselves. I wonder how many of my clients would still be pouring their pain into our cycle of plastic chairs if their lives hadn't been fragmented by a as series of imprisonments, if their chances for legal (much less meaningful) employment weren't destroyed by a criminal record or a urine test. Our society’s monolithic view of drugs fails to recognize gradients of use, and is only now beginning to recognize gradients of the drugs themselves. From the perspective of housing authorities, the homeless applicant who smokes Crack twice a month is just as ‘dirty’ as the one who shoots up twice a day. So I have the task of helping these men (primarily) wrestle with the impossible demands placed on them, as well as their own demons.

It is difficult to imagine a more difficult place to overcome addiction than a homeless shelter. Violence pools like a slick layer of oil on a dirty floor, tempers are sharp and minds and spirits are broken. The place mirrors prison life, and digs the trauma of it ever deeper.  And it is a place absolutely saturated with drugs. I cannot overstate how difficult and labyrinthine the systems which envelop the homeless are, how contradictory and obfuscated the demands are which are placed on the people least prepared to meet them.

But at the same time, I cannot overstate how much hope I’ve found in my clinic’s cinderblock walls. How much compassion and support the guys have for one another, and even for me, this clueless white intern young enough to be a daughter to most of them. What floors me is not the hardship or the failure or the relapses but the (many) times when one guy will tell another that they can do it. When someone reminds his friend of the things he has going for him, or of his qualities. When you see the other person believe it.

For as long as I have been able I have sought out the depths of suffering. But always, whether it is among the genocide survivors in Rwanda or in a refugee camp in Uganda, an orphanage in Cambodia or this shelter in New York City - what I have found is hope.