Monthly Archives: February 2016

Resisting The Numb

heroin (1)

Last week one of the residents of the all-male sober residence where I work came into the main office, shut the door behind him and began to weep.  Still a few years from thirty, he grew up in one of the toughest, whitest projects in Boston, using drugs and committing crimes since the age of 14, so, seeing him in this vulnerable moment was a bit jarring.

At moments like these my coworkers and I are generally waiting for a confession of relapse.  Instead, he told us that he had just found out that his father, diagnosed with a very aggressive cancer, had three weeks to live.

This resident was not used to having these sorts of feelings.  His impulse, and the impulse of almost all of the men in the residence, was to inject, drink, snort, smoke and swallow their feelings away.  That lure is always there, everywhere.  The immediate goal for their lives, is to resist that desire to be numb.  They have to learn what it’s like to “sit with their feelings.”

The first thing we made sure was that he wouldn’t use.

“I can’t do that to my father.  He has watched me my whole life as an addict.  Out of respect for him, I won’t.”

His vulnerability was so innocent, so childlike in a way.  He is well-loved in the house but doesn’t want the other guys to know what’s going on.  I’ve urged him to talk to a select few, but he hasn’t.  We as staff, though, continue to check-in on him, see how he’s doing and know that the worst is yet to come.

The past few weeks have been heartbreaking at the house.  One of the young men I got very close to, relapsed a day after graduating the program, after 180 days clean.  Another, only weeks from graduating was found with a needle in his arm, fresh blood drops on the floor of the bathroom, so fucked up he couldn’t stand up straight.  And then, the worst of them all, one of the guys on my caseload who got discharged for using less than a month ago, was found dead at his girlfriend’s house.

Coming into work the day after this young man’s death I talked to a lot of the guys to see how they were processing the information.  Each one, many who had known him and liked him, said that they had gotten so used to this, yeah, it sucks, but it’s the nature of the beast.  One went through the contacts on his phone and ticked off at least 15 names of people he knew who had overdosed in the last six months.  Many said that their Facebook feeds has become their version of an obituary, being their source of information like this.  The overarching theme was “Better him than me.”

Death shouldn’t be the norm for twenty and 30 year-olds.  People in their seventies and eighties are the ones who should be scanning obituaries, sighing and feeling a pang of sadness when they learn that someone they know has died.

I knew this job would be tough, but I couldn’t have possibly imagined how tough.  Death and relapse will be a part of my life.  I look at the thirty names of the guys left in the house and wonder how many will make it the 180 days.  I fear for them, for those who can’t resist the numb, the ones who need to escape the pain of feelings, feelings that most of us know how to process, sober, or with one glass of wine, with people who will listen and help to take that pain away.

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“Why Do I Keep Doing This?”

pint-of-vodka

Yesterday at the men’s sober living program where I am a case manager, I witnessed the implosion of one of our residents.  To me, he was always the most intriguing and one who I knew the least.  He wasn’t on my caseload but I had read his file and learned about his ongoing struggles.  He is very tall, very handsome, very articulate, is (was) a lawyer.  He is also an alcoholic, one of the few in the program who isn’t a heroin addict.  When I would do rounds, part of the job to essentially make sure none of they guys has overdosed in their beds, I noticed that he was reading Philip Roth’s “American Pastoral,” a book that has been on my list for years.

The men in the program are required to find a job after 45 days of their admittance and he had taken a job at a Jiffy Lube, a far cry from practicing law.  Most of the men are just happy to actually FIND a job and are humbled, not necessarily bitter about their new reality.  On days off, they can do whatever they want–go to the beach, movies, whatever, as long as they’re back in the house at a certain time.  There are random urine checks and the knowledge that our eagle-eyed staff, all in recovery except for me, can pick out a relapse from a mile away.

Yesterday, at around 4 in the afternoon, this resident was a bit wobbly going up the stairs to the house.  He apparently reeked of alcohol and was immediately given a breathalyzer.  His levels were off the charts.  He LOOKED so different, his face sort of doughy, his eyes red.  He came into the office that I share with my two coworkers and sunk to his knees.  We gave him the obvious space he needed to process how his life had just changed dramatically, knowing that he would be discharged from the program immediately.  For the other guys in the house, seeing someone in that state could be a real trigger.

With his head in his hands he repeatedly shook his head, and asked to none of us in particular, “Why do I keep doing this?  What am I going to do NOW?” He had begun to sob.  It was excruciating and tragic for me to watch. His case manager, clean for 15 years from a raging heroin addiction, just let him ask the questions.  He suggested that he immediately go to a detox, which had become a never-ending cycle for him.  The resident chose not to do that, asked for his savings that all residents are required to pay, and said that it was inevitable that he would buy more vodka, and check into a downtown hostel for the night.  He’d make the bigger decisions the next day.  His case manager tried to talk him out of that, but there’s nothing we can do.  He couldn’t stay and as painful as it was for him, my coworker handed over his money.

After he was allowed to take a shower he came back down to the office and asked for another chance, fully knowing that that couldn’t happen.  He shook my hand last, a strong powerful shake, and said “I’m sorry you have to see me like this.”

I pray that he has made it through the night.  I pray that his helplessness hasn’t lead to something even more tragic.  I pray that he can eventually end this cycle of pain and walk past a liquor store like it was just another Subway or dry cleaners. This will not be the last time I witness this.  I know that the odds of most of these guys making it through this six month program are pretty low.  I look at my caseload and try to guess who will be next, who might be seen by another guy in a heroin haze.  I hope that I will never become inured to the horrors of addiction, that I will always pray for each and every one to stay clean who will never have to ask again, “WHY DO I KEEP DOING THIS?”

“Here Son, Try This”

cocaine

Part of my job as a case manager in a residential program for recovering addicts is conducting an intake within hours of them walking through the front door.  I always apologize for the litany of questions I’m required to go through because I know, as they’ve been shuffled from detox to other residential programs, they’ve been asked the same hundred or so questions upwards of ten, twenty times before.

The first page or two of the intake form consists of fairly standard demographic questions from “What ethnicity are you?,” to “What is your primary language?” to  “Do you have any sources of income?”  Without much of the equivalent of a “transitional” sentence, the questions abruptly move onto a checklist of substance of choice, everything from pot to alcohol, to opiates to crack to “club drugs.”  I record if they’ve ever tried a particular substance on the list, their age at first use, and the frequency of use.   I’ve become so used to hearing that these men have often begun their road to a serious opiate addiction at around the age of 14 or 15, that when they tell me that they first injected heroin at 19 I’m surprised at how late that seems.

Oftentimes the men will be eager to share their back story, the origins of their drug dependence.  Many are somewhat “standard—“ a prescription for pain meds due to a legitimate injury that snowballs into heroin addiction, raiding their parent’s liquor cabinet, flipping a dormant switch into full-on alcohol abuse.  Other stories go something like this:

“In 10th grade I was having a hard time staying awake studying for a history test.  My father came in, saw that I was struggling, left the room for a minute, and came back with a few lines of coke on a mirror and said, “Here son, try this.” He showed me what to do, and the rest is history.”

The first time I heard something equally as appalling was as a volunteer at a local women’s correctional facility.  A woman, clearly beaten down and defeated shared with the class I lead that her mother injected her with heroin when she was 10-years old.  At that time, my daughter was ten.  I felt heartsick for this woman and intense rage against her mother.

The majority of the men I counsel have been surrounded and immersed in a nuclear and extended family of addicts.  There have been their fathers who have murdered their mothers, drunk driving deaths and life sentences for one thing or another.  90% of the time their siblings and parents are all addicts, some with long-term sobriety under their belts, others enduring the same agonizing cycle of detox and relapse.

When I see or hear people who deride and judge those struggling with the enormous monster of addiction, I often feel the need to remind them that no one says, “I want to be a drug addict when I grow up.”  I am surrounded and reminded every day of the anguish and helplessness it creates.  It doesn’t come from nowhere.

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Don’t Dream It, Be It: Imposing My Own Dreams on Substance Abusers

 

dreamit

“I’m a substance abuse counselor.”

When I heard those words come out of my mouth when someone recently asked what I did for work, I said it assertively, as if I had been one for my entire career,  simultaneously thinking to myself, “Oh my God, I’m a SUBSTANCE ABUSE COUNSELOR.”  Those words had become my end-point, I was living my dream.

It wasn’t until about five years ago that this career was even on my radar.  For 20+ years I was a non-profit fundraiser, spending the majority of my time asking rich people for money.  I burned out, got lazy, and found that I really hated the lack of authenticity when I was in front of the wealthy, having to make small talk that had such transparency that they were just waiting for the ask.

When I found myself between jobs I fell into an opportunity to volunteer with newly incarcerated women.  Every Friday for two years I went “behind the wall”  and lead a group on goal-setting, instilling as much hope for women who had none.  About 80% of those women, and later, in a part-time job where I also worked with men newly released from prisons all over the country, were drug addicts or in prison for drug related crimes.  In addition, my best friend at the time was struggling with a 3-year crystal meth addiction, a drug so insidious that he became a completely different person.  It was in my orbit everywhere I looked and it was then that I knew that what I wanted to be was a substance abuse counselor.

I am not an addict but that didn’t stop my wonderful new boss from taking a chance on me, seeing my passion and understanding of the challenges that this population faces every day.  I now have a caseload of 15 men in a sober living residence, a place I look forward to going every day. The cycle of their lives are almost always identical–overdose, detox, halfway house, relapse, overdose, and on and on.  In the process, they’ve lost sight of whatever dreams they’ve had.  They’ve become too clouded, murky, shrouded in despair.

One of the most compelling men on my caseload, a 27-year old rough-around-the-edges but completely soft on the inside, had wonderful and candid conversations with me on Friday afternoons when he’d come home from work, covered in dirt with a single hammer hanging from his tool belt.  He was wise and without delusion about where his life was and where it was going.  He had been through our program before, had achieved almost 2 years of clean time before he was sucked back into the vortex of abuse.  In theory he knew what he had to do to avoid the suck of addiction, how he had to stay away from his ex-girlfriend.  He had helped raise her daughter, now 6 who he absolutely adored.  After 42 days out of the 180 days it would have taken to complete our program, and a day after one of these conversations, he left to go back to her.   Right before he went into detox his probation officer let him call me.  “This was the conversation I was dreading the most,” he said to me.  I’m so sorry.”

During several conversations I told him what I wanted for him.  I wanted him to have a wife, some children, a family to come home to and eat dinner with.  A wife to cuddle up next to on the couch when their children were finally settled.  My dream is to secretly walk by a cute little house with a big tree that I can duck behind in the yard, look in a big picture window, and see him hoisting his child over his head, making faces, and having this be his dream realized.

There Was An Old Woman Who Lived In a Shoe

 

 

old-woman-shoe-vintage-image-graphicsfairy004c (1)There was an old woman who lived in a shoe.
She had so many children, she didn’t know what to do;
She gave them some broth without any bread;
Then whipped them all soundly and put them to bed.*

–Mother Goose

*(I’m stating the obvious here but the aforementioned old woman not only seems to have made a bad real estate choice but she sounds like a real bitch, not to mention a child abuser.)

___________________________________

I have one child. Easy to count.  One.  She is my ONLY child.  She lives in my house.

At work, I have 30 “children.”  THIRTY.  They live in the sober living program where I work, 5 days a week.  They are men, average age of 30.  When they all start coming “home” at the end of the day, it is utter chaos.  It’s not bad chaos exactly.  In a bizarre way, it’s somewhat amusing.

When my daughter, my own flesh and blood comes home, I never know quite what I’m going to get.  She’s 14.  She either grunts at me or comes over, gives me a hug, and says “I love you mom.”  The men can’t really hug me and say that (although I certainly know the ones who would) and if they grunt they get called on it.

Other than this disparity, I’m living both lives in some bizarro parallel universe.  Here are the things I say in both places:

“Your room likes like a bomb exploded.”

“Are you REALLY going to leave your plate on the couch?”

“Put your phone away.”

“Get your wet towel off the floor.”

“Make your bed.”

At home, I usually get ignored and threaten some sort of consequence.  At work the guys can get written up and and if they keep doing it, we have a version of being grounded for a weekend day where they have to do pretty much what we tell them to do.  If it really gets out of hand they can be discharged from the program.  (This did happen with one of the guys when it became a big “fuck you” to staff.)  I can’t “discharge” my child from my house, as much as I’d like to sometimes.

The guys are great negotiators.  One night I was literally in the middle of a circle of 6 guys slowly crowding in on me with them begging to let one of them move into another’s room.  “Please Gayle…pretty please?”  At home, it’s “Please Mom, can you buy me Fruity Pebbles, just once?  Pretty please.”

Sometimes, when one of the guys misses some sort of deadline or another, usually to slip in a request for a late night or overnight, they might say “Gayle, can you just pretend I got it in on time?”  When my daughter does something like gets a bad grade, she might say, “Mom, can you please not tell Dad?”  Generally, unless it’s some major infraction, I cave in both places.  I am a total sucker.

The guys exhaust me but they make me laugh.  My daughter exhausts me and has been known to make me cry in utter frustration.

I recently discovered that there was a Christian version of the same rhyme,  a much softer version indeed:

There was an old woman
Who lived in a shoe,
She had so many children,
And loved them all, too.
She said, “Thank you Lord Jesus,
For sending them bread.”
Then kissed them all gladly
and sent them to bed.

Well, Jesus isn’t actually “sending” my daughter bread.  I drag my ass to the supermarket, fling a loaf in my cart, and wait in long lines to pay for it.  One of my coworkers shops for the guys, so Jesus has nothing to do with that either.  However, no matter how angry, I do kiss my daughter “gladly” while she’s already in bed sulking.  And when I leave work at the end of the day, I do a walk through the house and gladly say goodnight, to my other “children.”

“Gayle, What Have I Always Told You?”: Tough Love From a Heroin Addict

This past weekend I visited with two past residents of the all-male halfway house where I work.  Both of them had made it through the 6-month program in the past.  Both of them ended up relapsing.

They grew up in very rough and tumble neighborhoods in the Boston area and both were fiercely loyal to the city and their friends.  After both of them recently relapsed and detoxed in places they had been to before, the only open beds where they could start the process all over again was a two hour drive from their beloved city, way out in Western Mass.  Even though they would be a few miles apart they agreed to take the chance that being out there would get them out of their comfort zone and away from the distractions they faced every day.

One of them, “M,” has become like a son to me.  There was something there from the first time we met that silently conveyed “I will protect you,” and from him, “I’ll let you protect me.”

It was him who was the primary draw to take that long drive on a Sunday, but “D” was a wonderful added bonus.  I took them out for lunch in a mall where they were so happy to see a glimmer of civilization that they practically got down on their knees and kissed the ground.  They hadn’t seen each other in over a month so the love they had for each other oozed out of them.  Over lunch we laughed and laughed.  It was one of the best afternoons I have had in a long time.  That was a Sunday.  By Monday morning the news got out that “D” had overdosed and died, out there, in the middle of nowhere, where noone really knew how loved he was back home.

When I walked into the office and my co-worker said “D” died this morning,  I ran back out, sobbing, walking aimlessly around the neighborhood, the neighborhood where he grew up.  I covered my mouth and just sobbed and shook.  This visceral reaction was new to me.  I’ve always envied people who can cry instantly whereas I generally don’t cry, to this day never having sobbed at the loss of my mother almost 30  years ago.  He was in front of me, in a booth, in a mall restaurant, less than 48 hours before.

“D” was a permanent fixture, quite literally, in the house while he was there.  Weighing close to 400 pounds and on disability for other health reasons, he was always the first person the new guys would see on their first day.  He took care of them.  He made them laugh.  He made them feel welcome in his home.  He was enrolled in a culinary arts class and would come home, plop his backpack at my feet, and give me samples of what he had cooked that day, so proud of the results and what he was learning.

He observed how I got attached to the other 29 guys, how when they relapsed and were discharged from the program, I would mourn their absence in the house.

“Gayle, you can’t get too attached, ” is what he would say each time.  He knew this because his friends were dying left and right from overdoses.  He was trying to protect me from the pain.

He made it through the six months, had a wonderful graduation where the other guys in the house said beautiful and funny things about him.  He moved across the street to a sober living program that my agency oversees, and would come back every morning and cook breakfast for whoever was in the house.  When he stopped coming about a week later, it raised some suspicion in the guys who had known him for years.  One day I came in and one of the other guys told me that he had overdosed and his mother and brother were outside about to take him to yet another detox.

I ran outside and wrapped my arms as much of his body as I could fit into a hug.  He was absolutely smashed, eyes practically rolling in the back of his head.  I got very teary.

“Gayle, what have I always told you?”

As well-intentioned as it always was, it was futile advice.  I was with these guys every day.  One gets “attached.”  And I adored “D.”  Everyone did.  A service and funeral will be happening very soon.  There will be the guys who he has been through the struggle with for so many years, hugging each other.  Right now my biggest fear is that “M” will feel so helpless from being out there that he will flee his new program, come home, and stay home.  He’s gotten permission to come back for the service, but I will drag him, after he mourns with his friends, to the next bus back to Western Mass.  I will play that role as “protector” that he has invited me to be.

Band Of Brothers

bandofbrothers

When I began my job as a substance abuse counselor in an all-male residential program, the group of men were a pretty hardened bunch.  Their flesh peaked out from under tattooed murals on their arms, legs, chests and backs.  They were pumped up with six-pack abs and chiseled muscled arms that they teasingly showed off every once in a while, to each other and to staff.

The program is a revolving door of 30-men, some who make it through the 6-months and some who relapse within a week.  When I started here there were mini-reunions of friends who had shared needles on the streets and alleys, guys who had served time together, others who had detoxed and been in endless other amounts of programs together.  These are their trenches, drugs their landmines.

I love it when a guy comes through the door to discover old friends sitting in the kitchen or watching tv in the living room.  They greet each other in the way that men do, those quick hugs with double fist thumps on the back.  They begin to unravel their recent set-backs, catch up on mutual friends, and launch into the “did you hear about so-and-so?  He overdosed last week.”  Woven into these catch-ups are the “Fuck, I’m so pumped to see you, dude.”

My first few weeks in the house these seasoned bunch of guys were a bit skeptical of my presence.  They tested me in group, stopped talking when I was around and when I had to take three of their passes away for a particular incident, they ignored me for weeks.  Some other guys, the newer and still somewhat innocent ones told me that they were talking about me to the other guys.  Of those three, one is now dead and the other two have both relapsed and detoxed 5 times between them.

They have become numb to the frequent deaths of their friends and acquaintances.  Most of the time they learn about these deaths on Facebook, seeing in their feeds “RIP” with a familiar face and name.  They’ve told me endlessly that Facebook is their obituary.  They have also told me that they can tell when a friend is high by the times they are posting.  “What the fuck was he doing posting random shit at 3 in the morning?”

There are certain deaths that hit them harder than others.  You can tell by the length of their pauses, the moment of processing.  I attended my first funeral with a bunch of these core guys, the warriors on the front lines.  This one was a really hard death for them.  They hovered in the background vaping and smoking until the priest started speaking the generic, scripted words in front of him.  The guys inched forward, taking it all in, watching his mother and father weeping.  After this very brief, insultingly brief in my opinion, they shuffled back to the cars that they came in as they contemplated the dwindling of the friends that made up their shared history.

The stream of new guys coming into the house are often novices at this life.  They are younger and needier and look to me and to my other female co-worker as mother figures.  They aren’t tattooed or pumped up.  Their egos are more easily bruised when a girl isn’t interested in them.  Their focus tends to be spent on everything but their recovery.

One of the toughest of the original group lives in a sober house around the corner.  He comes around almost every day and the new guys follow him around, like the Pied Piper as he shows them how to get to certain places around the city.  He tells it like it is to them, never mincing words about how real the certainty of death is if they go out and inject the new poisonous strain of heroin.  They hang on his every word.

The numbers of the naive will continue to grow, while the tougher die off, one by one.  These newer guys may or not form a new core group, going through programs and jail together, maybe relapsing together.  Maybe they’ll get the joys of sobriety sooner, find the girls who won’t break their hearts and start living a “normal” life.  It’s a stretch but I’d love to believe that it’s possible for them and for those hardened ones who remain standing.