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The Second Floor Bathroom

Drug Abuse

 

One week ago three hours after I left the all-male halfway house where I am a substance abuse counselor, one of my clients overdosed in the bathroom on the second floor of the house.  At 6’3″ his body twisted into a space the size of a small closet.  A really small closet.

Not being in recovery myself, I’m still learning how to spot the pinpoint pupils of a person high on heroin.  My co-workers, all recovering addicts themselves,  and the residents, the majority recovering  heroin addicts,  can spot this in a split-second.  I can easily tell when one of them is smashed from drinking (usually a lot of crying and staggering not to mention the reeking of booze that can be smelled from feet away) but someone on heroin, other opiates, and some of the newer synthetic marijuana, not so easy for me.  When I started all the guys who looked tired I generally thought were high.  I would ask my co-workers if so-and-so looked high to them, they would go and take a look, and come back with a definitive assessment of “No.  Not high.”

On my very first day of work, the house manager who has fifteen years clean, was staring at one of the guys who was picking over his food.

“He’s high,” he said.

I asked him how he could tell and he told me that he’s never seen him pick at his food before.  He was given a quick-cup (an on-the-spot urine sample) tested positive, and was discharged from the house.  I was amazed that that one subtle nuance tipped my co-worker off.  I had a lot to learn.

Since then, I’ve been taught to pay attention to broken patterns.  I had a client who came home from work every day at 2:00 on the dot.  Every day.  When one day he didn’t show up at this usual time, I called him in a slight panic.  “Gayle, I’m fine.  I had to go to the registry to renew my license.   It’s all good.”  Another day, when a guy didn’t show up for a mandatory house meeting the same co-worker said “He’s not coming back.”  And he was right.  He didn’t.

With the guy who overdosed, even I could tell he was high.  He was wearing glasses for the first time.  His speech was different.  My other co-worker had seen him first and made a beeline to the three staff in the office and said “________ is high.” Three hours later, he was minutes from death in the bathroom.

When I came into work the next morning I heard the details from the other guys:

  • A resident noticed that the water was running for a long time behind the locked bathroom door.
  • He went into his room and said to his roommate “Is someone dead in the bathroom?”
  • Roommate has a light bulb go off and runs to the door with a pen and tries to pick the lock.
  • Lock is picked but the aforementioned 6’3″ body is sprawled in a way that his legs are blocking the door making it impossible for anyone to get in.  A guy who had been there just one day turned into the Incredible Hulk and threw his body repeatedly against the door in an attempt to break it down.
  • Somehow, the door opens just enough to allow the lankiest guy in the house to get in, see that my client has banged his head on the toilet and that blood is everywhere.  He manages to lift the client just enough so that his legs are no longer blocking the door.
  • In the meantime the other residents are running around grabbing Narcan that hangs in bags on every floor of the house.  Lanky client doesn’t know how to use Narcan so another resident steps in and administers it, bringing the client out of his overdose.  Client is mortified and ashamed, sobbing and apologizing to the other 29 guys.
  • Ambulance arrives and the others walk him down with a leg and ankle injury sustained from the frantic pushing of the door.  The other guys stand on the sidewalk and watch him get whisked away.  From what I understand, this entire event unfolded in about three minutes.

The next morning I made sure to check-in with the men on my caseload and urged them to process what they were feeling.  The alcoholics who had never seen anything like this were the most rattled.  One said that it was the most terrifying thing he had ever seen.  The other heroin addicts were either triggered by the sight of the needle or were grateful that it wasn’t them.  The youngest on my caseload had an anxiety attack.

I called my client in the hospital the next day to see how he was doing.  The first thing he did was apologize and to say how embarrassed he was.  The next thing he said was that he had no idea where he was going to go next.  He doesn’t want to get into the never ending cycle of detox, program, relapse, detox, etc.  One of the other guys has said that he’s stopped texting and posting on Facebook.  That’s a pretty tell-tale sign that he’s on a run, perhaps using on the streets, where unfortunately, there won’t be 29 other guys around to save his life.

 

 

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Recognizing My Talents: How I Discovered What I Was Meant to Do

therapysession

When I began a new career as a substance abuse counselor in an all-male residential program, I had no idea what I was walking into (other than a really cool turn-of-the century former Governor’s mansion.)  I had absolutely zero experience but had clearly dazzled my now boss into taking a leap of faith when offering me the job.

For 20 years I was a pretty high-level non-profit fundraiser.  I worked as a sort of “matchmaker” between the very rich and the very poor.  The populations I raised money for consisted of homeless women and their children, children who nobody wanted and young people from the poorest cities in the state.   My passion for these people translated into substantial gifts from local philanthropists, but in the end, I became much more interested in the disenfranchised than in actually raising money.

While between jobs I networked my way into an opportunity to volunteer with incarcerated women in the local House of Corrections.  I threw together a creative writing curriculum and after observing just one group, found myself standing in front of 25 or so women in prison jumpsuits.  I fumbled my way through my first week and then for the next  2 ½ years, having gained enough confidence to make these women laugh, and often cry, I knew that there was no turning back in what eventually led me to where I am today.

The large majority of these women were in for drug-related crimes.  They were mostly addicts who would do absolutely whatever it took to support their raging drug habits. They dealt drugs, sold their bodies and stole from wherever there was money.  They never once denied their intense shame and the endless amount of pain they had caused others in the process.

I had addicts and alcoholics in my orbit.  My best friend had developed a fierce crystal meth habit that scrambled his brain, never to be repaired.

I successfully parlayed all of this into a pretty impressive resume and 9 months ago began what has become the most meaningful and unexpected journey into a world that many would be afraid to dip their toe into.

Most of the men I counsel are heroin addicts having run through the very common trajectory of childhood trauma to an addiction to opiates in the form of pills, and onto the cheaper and easier to find heroin.  Most tell me that never in a million years would they be sticking needles in their arms, sleeping on the streets, stealing from their parents and grandparents not only money but precious jewelry to pawn, breaking into houses and robbing people at gunpoint to get the money for their next fix.  When they talk about it they are disgusted and even though they say they never wanted or want to be that person again, they know that there is the looming risk (unfortunately often an inevitability) that they will be.

What I see every day is an intense loyalty that these men have towards each other.  Phone numbers get entered into smartphones right away, and even the most disparate of men will call each other if they sense that something is wrong.  Guys with barely anything will whip out a ten dollar bill when another resident is desperate for a pack of cigarettes.  If a guy who has come from a homeless shelter or jail comes in with nothing, a resident with a job will take them shopping.  They get it.  They’ve been there.

They cycle in and out of the 6-month program, sadly, much more due to relapse than to completion.  I have been with these men who make me laugh until I cry who are dead less than 24-hours later.  Unfortunately the surviving men have become inured to these deaths, having experience countless numbers of them, and after they get quiet for a few seconds, they quickly move on.  This is their lives.

I’m the only staff member who isn’t in recovery.  The only thing I’m even close to being “addicted” to is coffee.  They don’t judge me for this and never once has one of my clients doubted that I can help them.  They adore my quirkiness and my loyalty to them.  They sense my compassion and lack of judgement.   Even without training I have seen their vulnerability as they break into tears with me in front of them, peeling away at layers they’ve never known were there.

There is more laughter than tears but every day when I pull up to the house I brace myself for something horrible, a relapse or a death.  It’s the one occupational hazard of this career but as long as I keep on learning from these incredible men, I’m in it for the long haul.

 

“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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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.”