Streets Is Calling
Why people go back out after coming in from "The Streets"
This is a hard post to write, not because it's difficult to find the words, but because it's difficult to be a Sober Ally and know that many of your friends are making really bad choices-Leaving Detox early because they want to go home yet not having a plan, reacting to little setbacks by picking up drugs or the bottle again to numb their anger, getting upset with a PO or Case Manager and ignoring the rules only to get violated or arrested for vagrancy. The list could go on and on. Add onto this the cruel joke that is Sober Housing (usually a misnomer) with it's unqualified and callous “workers” who collect money for virtually nonexistent services, do drugs with their own residents, and throw people out who complain without due process., and it's easy to see why some people in recovery go back out to the streets.
When you talk to the people who come back after a relapse, you get a familiar pattern that I hear in story after story: Something really awful happened, I couldn't handle it, I just bought 1 Oxycodone to chill out. I got back to the sober house and some incident had happened, so they woke us up and made us take a UA. I popped up hot for opiates, so they told me to clear out. I called 211 but couldn't get a real person. I freaked out and went out and bought a few more pills. I woke up behind a dumpster. I guess the pill had fentanyl in it because I passed out and they had to give me Narcan. Now I'm here, I guess. Granted it isn't always pills, but you get the idea. The cycle creates a vicious circle: Crisis→Bad Decision→Consequences→Another Crisis. You ask yourself, when does Recovery take for these folks? The fact is, it starts when the cycle of crisis is broken.
This is where Emotional Self Regulation can come in handy. When you are able to work through a crisis by pausing, breathing, and thinking you stop the impulsive desire to just numb. You stop trying to triage on the fly with dysfunctional coping mechanisms like drugs or alcohol, you stop binges or purging, you stop harming yourself to escape. People who “relapse” (or in the language I prefer, have a Reoccurence) usually have poor coping skills and haven't learned to handle their emotions. It's not surprising that most people in recovery have what's known as a Co-Occuring Illness, usually mental health related, that goes hand in glove with their Substance Use Disorder. Many people have told me that when they ran out of their prescription for SSRI's or other mood stabilizers was when they panicked and bought pills off of a dealer. Our overburdened system means that keeping track of your meds when you are unhoused may be something that gets brushed aside by the pressing concerns of finding a safe place to bed down at night and getting food and clothing. We think that telling people to call their doc to reup the meds is an easy phone call, but when your doc handles 30 other unhoused people with their own issues, sometimes you will inevitably fall through the cracks of an overburdened healthcare system. To give you an example, on any given day in New Haven I could call 10 different detox units and be lucky to get a bed for someone at any of them. 10 places, no beds. Sometimes it's worse then that. Imagine calling to get a detox bed and waiting 3 hours for someone to come and get you, all while you are possibly in withdrawl and tired.
I wish I had a magic wand to wave to heal all the good, tender-hearted and tortured people I know who erase many of the gains they have made in their recovery by going back to the street life. As much as homelessness can be said to not always be someone's choice or fault, in some cases we need to be clear that some people WILL choose to be unhoused. They will choose it over shelters or even a friends house because it feels all too familiar and thus “safe” despite our pleas to the opposite. Sometimes you have to say what I have said to many family members who ask if we or they can “send” someone to rehab. While the answer to that is a resounding No, I tell them “He/She needs to make the choice themselves, or you will be doing this until you've run out of patience or time”. I am just the guy sitting behind the reception desk helping to make referrals or give info. I can't get your Mom to stop drinking. I cannot tell your sister she needs to stay in the program for the full 90 days. I cannot get your Suboxone refilled. What I can do is tell you that I believe in you, that you can get clean and sober, and that there are choices.
I was in denial about my own life issues until someone clicked handcuffs on my wrist. Luckily, I knew I needed to change my life or there would be no life left in me to change. I hit my rock bottom without losing absolutely everything in my life. I'm privileged, and more then a little lucky. That being said, it doesn't need to be Jail, Death, or Detox. Sometimes all that's really needed is saying “When you are ready, I will be here for you. You know my number”. Your phone may never ring, or when it rings it may be the police officer who found your loved one unresponsive. I pray against the latter scenario, but we know that addiction kills. We cannot force people to choose life and health, but we can offer it. Perhaps this is us doing our best..