It is with conflictual emotions that I begin this #thoughtfultuesday. Although these paradoxes are not out of the ordinary, today’s focus elicits discomfort and, at times, controversy. In reflection of the Holidays as they come to a close, I have much to be grateful for. It was a blessing to share cherished moments with loved ones. As I have likely stated before, the most precious commodity of our human existence is time; it can never be taken back. The loss of a cousin on Christmas Day was a candid reminder of time’s value. This cousin was thirty years young, which many would say is too early for a life to end. The news of his passing was received with tears and heavy hearts, but in the periphery there existed an underlying sense of peace. Life appeared to be rather unkind to this individual from a young age. As a child, there was evidence of challenge for him, but it was particularly difficult to untangle. Due to the diverse set of life circumstances that unfolded for each of us, we grew distant with age. The adversities I encountered, in some strange fashion, became the basis of my passion for service; I had the sense that via the authentic sharing of my pain, I could be of assistance to others. My cousin was not graced with the same stroke of luck. His path continued to lead him towards more suffering. He did not meet death in his darkest moments, but rather fell into its wrath when he was trying to make change.
This is the tragic and often misunderstood component of substance use. Despite the frequency of use during times of high dependence, the body’s natural protective factor is tolerance. Accordingly, individuals are at highest risk of fatal overdose after periods of abstinence or significant environmental changes. Please note this does not imply that fatal overdoses do not occur during times of frequent use. For street-involved substance users, fatal overdoses often follow periods of incarceration, detox and/or treatment, and after securing housing. The first two examples are indicative of reduced tolerance due to lack of exposure to and intake of substances. The most defining factor of using in an unfamiliar environment is that the body does not prime itself as it typically would for use. Thus, the body is not prepared for intake. Another component to consider is that in communal settings, use often occurs in the presence of others whereas upon being housed, use occurs in isolation. Regrettably, these facts are not widely discussed because there exists a moral panic around substance use, which lends itself to stigmatization and shame. In addition, abstinence is the most prominent paradigm. Although I disagree, it appears to disrupt the abstinence model to discuss substance use after times of abstinence as well as safer use practices.
My next rant targets the misguided beliefs that “addicts” are unwilling to help themselves. If you are of the belief that, “We should let all of the addicts die,” I have a sneaking suspicion that addiction has impacted you in such a profound way that you are wounded and have lost your sense of humanity or you have lived a life of such extreme privilege that you have lost sight of the reality of suffering. In any case, allow me to shed some light on the immense hurdles presented by the very system that is supposedly helping substance users. For the majority of centres, detox and treatment are separate facilities, often run by different agencies (government or non-profit). Treatment facilities require five to seven days of detox prior to attendance meaning there is an intricate dance that takes place to line up detox and treatment, especially if there exists a waiting list for treatment (which is frequently the case). There are medical and non-medical detox facilities. Non-medical detox does not occur in the presence of medical professionals. Accordingly, prescription medication related to mental health concerns cannot be taken as they will likely produce a failed drug test. Admission to treatment usually requires a physician assessment. If there are any evident mental health concerns present, addictions specific treatment centres are reluctant and suggest concurrent treatment, which limits options to two centres in the province. In my experience, the chances of reaching this stage are slim as they are narrowed by limiting factors early on. What if the individual asking for help doesn’t have any form of government issued identification? What if this individual has no support and has no means of transportation? What if this individual has no home address or way of being contacted? What if this individual does not have a physician and with all of the presenting obstacles above, how does he/she arrange an appointment? Lastly, how is this individual going to get the admission forms for a treatment centre? If the forms are provided, how will they be submitted? I have only listed a fraction of the hurdles I have encountered in serving these individuals. In reading this, you may feel a sense of gnawing hopelessness; an experience that is familiar to me and others who work in this field. On the regular, my persistence is derived from the fact that I experience a fraction of the frustration and hopelessness that substance users themselves do.
The next time you encounter someone belligerent, erratic, or visibly unhealthy please consider the multitude of demons that they are facing. It is not their intent to disrupt your day or inconvenience you. They were once innocent infants and are someone’s brother, sister, mother, father, cousin, or child. As I prepare to end this post, I return to honour my cousin. Given that I cannot converse with him in person, I hope that he can receive my vibrations on some energetic plane. D.D., may you know that you are and have always been loved immensely. It is my sincerest hope that leaving this world in a peaceful slumber is indicative of an end to your suffering. Embrace the adoration of those that have left this world before you.
Meet you on the other side,