Unconditional positive regard and harm reduction helped this drug addict overcome deep-seated shame and seek treatment.
In 2004, I relapsed after having a couple of years of sobriety. This time it was a bad relapse lasting two years and resulted in significant health consequences. I was emaciated, and I had a chronic respiratory infection. I had used up all the veins in my arms and legs to inject drugs and was getting staph infections on my arms and legs from trying to inject my drugs into damaged veins. I was truly wretched. There was a 24-hour grocery store I would go to at 3:00 a.m. to minimize the number of people who would see me. The grocery checker at this store would become very nervous and frightened when I would check out. I was miserable and wanted to get clean again, but I had little faith in my ability.
Eventually, my skin infection became severe enough that I needed to seek medical care. I went to a clinic I had been a patient when I was sober. The doctor there was openly hostile toward me. He grudgingly prescribed antibiotics and ordered labs but told me that he did not want to see me again if I was going to continue using drugs. He stated that he was unwilling to care for someone who would not care for themselves. I then went to the lab to get blood drawn, and they eventually gave up after poking me four times without getting any blood. They told me to drink some water and come back another day. The experience so mortified me that I never returned for the blood work. The antibiotics addressed the infection, but I had another one, much worse, a few months later.
I decided to try a different doctor. I would later learn that the doctor I had chosen was himself in recovery from methamphetamine addiction. My experience was completely different with him. He expressed genuine concern for my well-being. He empathized with my struggles. I told him about my experience with the blood draw, and he examined my veins and determined that he would need to draw blood himself from a deep vein in my leg instead of sending me to the phlebotomist. He did this very gently despite it being an uncomfortable procedure. At the end of the visit, he gave me a card and told me to call if I needed anything. His only agenda during the visit was to support me and care for me.
The effect this had on me was profound. As I was driving home, emotions overcame me. I had been emotionally numb for so long, and this man’s compassion opened a floodgate of pain, hope, and a sense that maybe I could try to get sober again. Within a few weeks, I entered a residential treatment program and began my first-lasting recovery. Humane treatment helps addicts like myself.
I eventually became an alcohol and drug counselor. I lived in San Diego, a conservative town with no harm-reduction services. Traditional drug and alcohol treatment requires the addict to “hit bottom” and be willing to go to any length to overcome addiction. This approach is often needed for lasting sobriety but is problematic because many addicts die before “hitting bottom.” Harm reduction enables us to support people who haven’t hit bottom yet. It allows us to work with and help people we would have traditionally deemed unready for change and turned away.
I had the good fortune of working with a mentor who was a fierce harm-reduction advocate. She helped find funding for a support group for active methamphetamine users. I would provide a delicious and nutritious lunch for this group. For many members, lunch was the only real meal they got all week, and many came just for food. These clients were in a similar state to the one I was in before getting sober. It was unorthodox to try to facilitate a support group for people who were actively using and often high on methamphetamine. Still, it was very successful precisely because it was so unorthodox. These clients had been denied services because of their inability or unwillingness to get sober to receive them. They had things to say. They wanted to be heard. They wanted to support each other. Several of these clients eventually get sober after engaging in this group. Many who didn’t get sober still had an improved quality of life.
After several years of working as a counselor, we lost our funding, and I got laid off. I returned to school and finished the biology degree I started 20 years ago. I then went to graduate school to become a physician assistant. Now I get to pay it forward with my patients, showing them unconditional positive regard and loving them until they can love themselves.
In 2001, Portugal became the first country to decriminalize drug use. They had a rampant heroin problem and were previously waging an ineffective war on drugs. The results of this policy change have been astonishing. The funding that once went into law enforcement supports treatment programs and harm reduction services. They have had a 60% increase in patients seeking addiction treatment. Drug-related crimes and deaths have plummeted. There are numerous volunteer outreach workers, and public perceptions have changed to view addiction as a treatable illness. (Ferreira 2017)
The ravages of addiction are profound, and we have compounded the problem by vilifying addicts. I invite you to join me in changing the perceptions and the status quo and finding room in our hearts for those who need reminding they are worthy of love.
References (section 4):
Ferreira, S. (2017). Portugal's Radical Drugs Policy is Working. Why Hasn't the World Copied It? The Guardian.
This story was originally published on September 23, 2021.
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Next week - Epilogue - More on Harm Reduction Methods and Getting Help
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