Archives for posts with tag: recovery

When Treatment Isn’t Treatment

Oct 18, 2024 //
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I wrote something for the BC election, and had it published by a small independent online news outlet. You can read the published copy here:

Involuntary Treatment is a Cruel Betrayal

I’d also like to include the original article. A lot of the vitriol was removed from the piece, and I’d like to share my anger with my sweet Chumps. Cheers!

There appears to be a surreal and growing consensus between the two poles of British Columbian politics. Presumably as a preamble to fully dissolving the party and endorsing the Conservatives, the NDP has embraced a series of regressive policies that leaves one wondering if the party of the radical woke Marxists is truly living up to the moniker. This whiplash shift in the Overton Window began when the NDP caved to political pressure and ended their decriminalization pilot project halfway through its run time, then caved to pressure and abandoned the life-saving harm reduction vending machines providing discreet access to disease-free supplies, then caved to pressure and pledged to withdraw from the carbon tax at the earliest possible convenience, and then finally the latest surrender to conservative pressure has been the promise to, once again, force people who use drugs into treatment. If it is not consensus, it is – at the very least – brazen cowardice.

As mentioned, the latest endeavour of this Craven Coalition is to snatch all the people off the street who use drugs and jail them, allegedly for their own good. It’s “treatment,” after all! Of course, they can’t send anyone to actual drug and alcohol treatment centres because there aren’t even enough beds for the voluntary clients, nor can they place them in dedicated mental health facilities or hospitals because those are all spilling over too! I suppose jails were chosen through a process of elimination. The NDP will retort that it won’t be prison guards or wardens administering these units but licensed medical professionals – as if that somehow changes the facility this all takes place in or the dearth of licensed medical professionals in the hiring pool. It will be a locked unit with many security personnel, and it sure won’t be an ambulance bringing in the new inmates! Following the trend of recriminalization, the NDP is choosing to meet the Public Health Crisis that was declared in 2016 with the full force of the carceral system.

Perhaps I’m being unfair. This is a deadly serious problem, and there is a treatment for it! It’s literally in the name! If we can overcome the logistical impossibilities of this kind of program and force these recalcitrant sticks-in-the-mud to just get a little help, then so many lives will be saved, so many families will be happily reunited, and so many people will continue to vote for the incumbent government. Is that not something noble worth striving for?

I worry that when people hear the word “treatment” when it refers to addiction, they think it works like an antibiotic: you party too hard over the weekend, catch a smidge of an addiction, you take some penicillin as prescribed, and it clears right up! Forcing someone into treatment under those circumstances might make some sense; if someone stubbornly refuses their dialysis, they’re often assessed as incapable, forced into the medical procedure, then sent back into the world until their organs start failing again. The coercive dream seems to be a brief intervention that measurably prolongs a life through medically-sound practices.

This is not, however, what drug and alcohol addiction treatment looks like. I worked for a couple of years in a licensed treatment centre, and continue to work as a social worker with people who use drugs. In my experience with treatment centres, they typically have programs like art therapy, music therapy, trauma-informed yoga, group therapy, one-to-one counselling, Cognitive Behavioural Therapy to help establish healthier links between thoughts, feelings, and actions, Dialectical Behavioural Therapy to help regulate overwhelming emotions, and so on. A pattern is beginning to emerge here! Even 12 Step-based programs (like Alcoholics Anonymous and the facilities that embrace it) function along the lines of non-judgemental and accepting communities that provide a caring environment for residents who typically feel isolated and stigmatized out among the rest of society. I believe if John Rustad ever learns how much Social and Emotional Learning goes into addiction treatment, he would abandon the whole project.

Going into a bed-based treatment centre means going into a 90 day therapy session. The reason for this is that addiction arises from trauma. In fact, all the people who use drugs that I’ve worked with use them to cope with that trauma. Drugs are the treatment for trauma. I will say it again: drugs are the treatment that people with addiction use to help them live with their debilitating trauma. These facilities exist as 90 day therapy sessions to provide alternative coping skills to the numbing and euphoric effects of drugs – quite tempting when sobriety is a living hell. The reason these facilities aren’t always effective is because addiction manifests itself over years or potentially decades, accumulating compounding trauma throughout the process, and three months of therapy before returning to the same environment that spawned all that trauma and drug use in the first place is unfortunately not the “cure” that people want it to be. Remember, if they have them, people have to go home when they’re done. If people are being taken off the street, where does the NDP intend to send them once their “treatment” is complete?

If the NDP thinks forcing people who use drugs into therapy is a good idea, I would invite David Eby to tell his wife, “Just calm down!” the next time they’re having an argument and report back on how well it went. There is a reason that 99% of treatment facilities are unlocked: people need to want to be there. The idea is to regain control of your life, and taking away that control at the outset is so obviously counterintuitive to the therapeutic process that it makes me wonder if the NDP actually knows any more about addiction treatment than John Rustad. Abducting people off the street, forcing them into jails, telling them this is for their own good, all of this is going to add to their trauma, not reduce it. Calling this “treatment” in line with the other resources that are available is going to terrify people struggling with addiction away from getting any kind of legitimate help. Rather than force people into addiction recovery, the results from this would have the NDP forcing people away from it.

Who is this for? This anti-therapeutic model was clearly not designed with people who use drugs in mind, so what is the NDP’s goal here? The reason this disaster of a policy was introduced was because a 13 year old girl fled her foster care and overdosed in a homeless encampment. Why not promise improvements to the foster care system? Why not promise additional supports for families so that kids don’t end up in care? Why not promise additional funding to Child and Youth Mental Health services to cut down on wait times? Why resort to this asinine model? Unsurprisingly given the NDP’s sea-change from orange to yellow, we’re following the traditional conservative trope of being Tough On Crime: ignore all the complex reasons that the scary thing is happening and warehouse the scary people so that they’re out of sight and out of mind. If we can stoke people’s fears and promise simplistic solutions to resolve them, we’re sure to win!

This provincial election is an embarrassment. With Kevin Falcon having sabotaged his own party into oblivion, the two surviving contenders appear in lockstep to dehumanize and discard people who use drugs. I’m not so naive to think that the Conservatives will provide any kind of reasonable or humane drug policy, nor any kind of other policy, so as a progressive voter, I will likely swallow the caustic bile festering in the back of my throat and vote NDP – only because the Greens are not viable in my riding. We desperately need to do better. We desperately need to actually look at the evidence when trying to address addiction, and start addressing trauma. If there are any politicians remaining who are capable of feeling shame, I hope they’re crippled by it.

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Categories Politics

Why Bother With Drug Counselling?

Apr 11, 2019 //
1

I am a drug and alcohol counselor. I am at least okay at my job; clients will occasionally tell me they feel better after having spoken to me, which is as good a metric as any, and the odd client might even stop using drugs and/or alcohol if the stars are aligned just so. It’s a complicated career in which the measures of success are vague, yet regardless of whether or not I’m successful (whatever that means), a new client will always come in. This new client with their new idiosyncrasies are, more often than not, fundamentally similar to the old one. The tide comes in, the tide comes out, then, as per the pull of the moon, the tide comes back in again.

There will always be drug addicts, right? One must imagine Sisyphus happy in order to avoid the soul-crushing burnout of facing off against the boulder of the opioid crisis. And yet, even in the name, its immutability is questioned. It is called the opioid ‘crisis’, not the opioid ‘way of life’. A crisis is temporary. Solutions are possible. Causes can be identified.

Of course, a crisis can simply be an act of God or a natural disaster. There might be those who argue that nothing can be done about this crisis since its causes are out of our hands. Fentanyl is a thing now, so people will just die more because of it. There is some merit to this argument: Fentanyl is certainly deadly and more prevalent which is going to inevitably lead to more deaths. As any consumer advocate would tell you, the solution to a deadly product is of course a well-regulated market, but this ignores why people might seek out Fentanyl in the first place. Even if people take healthy doses of untainted heroin (or meth, or crack, or all the other drugs now laced with Fentanyl), this still doesn’t change the tide.

There are several theories about the causes of addiction. Trauma is a big one, and yet trauma is not preordained. The trauma of neglect is often predicated on poverty which can be alleviated through wealth redistribution (consider that there is more than enough housing for everyone, despite large numbers of homelessness. Similarly, we have enough food to feed the planet. Supply is not the issue, distribution is), livable minimum work standards (since many of those in poverty do indeed work), and so on. Trauma based on domestic abuse can also be curtailed if we shift masculine culture away from domination and violence.

There is also the lack of connection that drives addictive behaviour. This connection has been driven out of society by the cultural forces of individualism and competitiveness, and can just as easily be reduced by the imposition of their opposites. Solidarity with coworkers and neighbours, an emphasis on community values, respect for nature, and a reignition of hope; these too will reduce the need for the synthetic connections induced by narcotics.

Of course, there is also simple education. Not the education that tells us that drugs are bad. Drugs are actually amazing. Drugs offer solutions to problems when nothing else seems to have worked before. An individual, often having gone through trauma or who is suffering from mental illness, does not know how to cope with that trauma or illness. Along comes drugs, and all of a sudden the baggage associated with those things don’t seem so awful now! What needs to be taught are healthy coping skills as well as information on mental health that will help identify and then deal with these developmental dangers before addictive alternatives become the norm.

You may note that none of these things involve cognitive behavioural therapy, nor harm reduction, not even admitting you are powerless over your addiction and that your life has become unmanageable! The methods of dealing with those in addiction (with their varying degrees of effect) are only ever reactive, and ignore the systemic issues that produce drug addiction in the first place. Social fixes ought to attack the root of the problem rather than focus on managing its aftermath.

One of the stories I tell myself to endure the Sisyphean drudgery of endless addiction is the story of the curmudgeonly old man and the beach full of starfish:

Once upon a time, there was an old man who used to go to the ocean to do his writing. He had a habit of walking on the beach every morning before he began his work. Early one morning, he was walking along the shore after a big storm had passed and found the vast beach littered with starfish as far as the eye could see, stretching in both directions.

Off in the distance, the old man noticed a small boy approaching.  As the boy walked, he paused every so often and as he grew closer, the man could see that he was occasionally bending down to pick up an object and throw it into the sea.  The boy came closer still and the man called out, “Good morning!  May I ask what it is that you are doing?”

The young boy paused, looked up, and replied “Throwing starfish into the ocean. The tide has washed them up onto the beach and they can’t return to the sea by themselves,” the youth replied. “When the sun gets high, they will die, unless I throw them back into the water.”

The old man replied, “But there must be tens of thousands of starfish on this beach. I’m afraid you won’t really be able to make much of a difference.”

The boy bent down, picked up yet another starfish and threw it as far as he could into the ocean. Then he turned, smiled and said, “It made a difference to that one!”

This metaphor does help me feel better about the work I do, because ultimately helping one person live a better life is a worthwhile goal. It matters. However, the metaphor fails because a tide is by definition unstoppable, and drug addiction is not. The starfish have not been washed up onto the beach by some immutable fact of nature, they have been pushed by cultural ideologies, economic oppression, and brutish stigma.

Why bother with drug counselling? It does help, but it will never stop the tide.

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Categories Social Criticism

Addiction, Consumerism, and Human Connection

Jun 7, 2018 //
1

In my life I have worked with those who suffer from addiction, and I have also worked in retail. From these experiences, I have noticed something about the way these two demographics, addicts and customers, interact with those paid to deal with them. Anyone who has worked in retail can tell you that customers are the absolute worst, and addicts notoriously bear the not entirely unearned stigma of being untrustworthy and catastrophically self-centred. There are always outliers and exceptions, but working within the generalities for now will help identify the trend that I’m hoping to produce here, so bear with me.

Addicts lie. Not just to people who work with them, obviously, but to family members, friends, anyone. The fundamental motive behind these lies is shame. The addict is fully aware of their behaviour and lifestyle, and the guilt and shame is often overwhelming. They know stealing from their parents is wrong; they lie because they can’t bear being judged for it. They know that leaving a detox facility to go use defeats their deep, powerful desire for sobriety and normalcy, but they lie about their ultimate destination because they’re ashamed of their weakness. The reason that the Anonymous program demands honesty is so that the addict can uncover their shame, lay it bare, and witness a community that accepts them regardless. This is the process of recovery.

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Just say no

The addict lies because they fear the human capacity for judgement. Even the more malicious lies, such as the ones for personal gain, recognize the victim’s critical thinking skills that need to be overcome. Every lie, every betrayal, the mask of the addict, is made entirely in reaction to the human.

Contrast this behaviour to the untruths of the customer. The customer doesn’t necessarily lie, but the traditional pleasantries of, “I’m fine; how are you?” “Have a good day!” are the superficial banalities that reveal nothing of authentic value. Hence, an untruth. These untruths do not exist as a recognition of the human, but as an attempt to supersede it. They gloss over the human to expedite the exchange of the product. The honest addict reveals their shame; the honest customer makes curt demands and doesn’t bother to look you in the eye. The consumer’s untruths are made in reaction to the employee as only a facet of the product being sold.

Participation within capitalism, the act of consumerism, requires a dullness in our humanity unseen in any other form of addiction. The dealers and corporate pimps of the consumer marketplace have a greater understanding of predation than those in the Downtown Eastside. Addicts are looking to fill a void, and filling that void with honest, human recovery might alleviate the drive to consume. Customer service must therefore be performed with a plastic sincerity lest the consumer have a genuine interaction that makes them realize their purchase gives them nothing of real worth.

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It is not even the product that delivers the endorphins, but the act of purchasing itself. At that point we are still blind to its irrelevance to our lives

The customer, driven by advertising that manufactures an internal void and delivers only an empty promise to fill it back up again, has no time anyway for things beyond pleasantries. They must commute, work, consume, and then obliterate anything else that remains with distractions. Busyness is a virtue. Distractions are our culture. Humanity is evaporating from one blowout sale to the next, and there is no time to even notice. It’s myopic self-destruction on a global scale, and all that is left to do is wait anxiously for the overdose.

I guess that’s why I’m happier being lied to by drug addicts.

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Categories Social Criticism